Mix

KODE_RS KELAS_RS KELAS_RAWAT KODE_TARIF PTD ADMISSION_DATE
DISCHARGE_DATE BIRTH_DATE BIRTH_WEIGHT SEX DISCHARGE_STATUS

DIAGLIST PROCLIST ADL1 ADL2 IN_SP IN_SR IN_SI IN_SD INACBG
SUBACUTE CHRONIC SP SR SI SD DESKRIPSI_INACBG TARIF_INACBG
TARIF_SUBACUTE TARIF_CHRONIC DESKRIPSI_SP TARIF_SP DESKRIPSI_SR
TARIF_SR DESKRIPSI_SI TARIF_SI DESKRIPSI_SD TARIF_SD
TOTAL_TARIF TARIF_RS TARIF_POLI_EKS LOS ICU_INDIKATOR ICU_LOS
VENT_HOUR NAMA_PASIEN MRN UMUR_TAHUN UMUR_HARI DPJP SEP NOKARTU
PAYOR_ID CODER_ID VERSI_INACBG VERSI_GROUPER C1 C2 C3
C4 PROSEDUR_NON_BEDAH PROSEDUR_BEDAH KONSULTASI TENAGA_AHLI
KEPERAWATAN PENUNJANG RADIOLOGI LABORATORIUM PELAYANAN_DARAH
REHABILITASI KAMAR_AKOMODASI RAWAT_INTENSIF OBAT ALKES BMHP
SEWA_ALAT
3201126 B 2 BS 1 27/12/2017 01/01/2018 11/02/2016 0 1
1 A41.9;J18.0 87.44;93.94 - - None None None None A-4-10-III
None None None None None None SEPTIKEMIA (BERAT) 7006300 0
0 - 0 - 0 - 0 - 0 7006300 6989359
0 6 0 0 0 FISYA NAZEERA RACHMAN D323525 1 685
DR HUDA, SPA 0138R01712170010942 0001971585606 3;JKN DR RIZKI;
5.2.0.201712280730 4 126348 1#0##0#0#0.0#2018-02-05
08:31:16#0#12:00:00#12:00:00#12:00:00 1 11a3c3197bc679731380cbeaa6946e3d
0 0 326744 0 0 3508867 0 0 0 0
3153748 0 0 0 0 0
3201126 B 3 BS 1 30/12/2017 01/01/2018 01/05/1996 0 2
1 O82.9;O63.1;Z37.0 74.0 - - None None None None O-6-10-I
None None None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN)
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8055851 0 3 0 0 0 SUMIYATI d386163
21 7913 DR ARI KUSUMA JANUARTO, DR. SPOG 0138R01712170012132
0000510026523 3;JKN DR RIZKI; 5.2.0.201712280730 4 127622
1#0##0#0#0.0#2018-02-05 08:45:54#0#12:00:00#12:00:00#12:00:00 2
96c04cae304ac4d597013188328d969c 0 3983304 365340 0 0
2120089 0 0 0 0 1399118 0 0 0 188000
0
3201126 B 1 BS 1 26/12/2017 01/01/2018 29/07/1973 0 2
1 I50.0;J18.0;J91;C50.9 89.52;87.44;93.94 - - None None None
None I-4-12-III None None None None None None KEGAGALAN JANTUNG
(BERAT) 6963100 0 0 - 0 - 0 - 0 - 0
6963100 7895595 0 7 0 0 0 SITI NURHASANAH
D329722 44 16221 DR BAMBANG DWIPUTRA SPJP 0138R01712170010456
0001172478093 3;JKN DR RIZKI; 5.2.0.201712280730 4 125919
1#0##0#0#0.0#2018-02-05 08:53:14#0#12:00:00#12:00:00#12:00:00 2
a40db61575dfa5ce98f822ec9724a2f6 0 0 609530 0 0
1885531 0 0 0 0 5400534 0 0 0 0 0
3201126 B 1 BS 1 30/12/2017 01/01/2018 01/10/2014 0 1
1 A49.9 - - - None None None None A-4-14-I None None
None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3477797 0 3 0 0 0 RAFA ASKA PUTRA
D386137 3 1186 DR RASTRA, SPA 0138R01712170012117
0001775721363 3;JKN DR RIZKI; 5.2.0.201712280730 4 127614
1#0##0#0#0.0#2018-02-06 09:49:36#0#12:00:00#12:00:00#12:00:00 2
5d9c18b5b918e23582889e6714aecbb2 0 0 338858 0 0
2223000 0 0 0 0 915939 0 0 0 0 0
3201126 B 3 BS 1 01/01/2018 01/01/2018 09/06/1956 0 2
1 I95.9;I25.0;D69.6 89.52 - - None None None None I-4-24-II
None None None None None None GANGGUAN SISTEM PEMBULUH DARAH LAIN-LAIN
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 2140836 0 1 0 0 0 LIE SIAN NIO
d386252 61 22486 DR MUHAMMAD RIZKI YUWANA 0138R01701180000284
0001323162718 3;JKN DR RIZKI; 5.2.0.201712280730 4 127720
1#0##0#0#0.0#2018-02-06 11:15:58#0#00:35:00#11:50:00#12:00:00 1
db9fe72b97936ceff2d5517cf50630f1 0 0 251631 0 0
1314150 0 0 0 0 575055 0 0 0 0 0
3201126 B 1 BS 1 31/12/2017 01/01/2018 12/12/1962 0 2
1 I67.9;I10 - - - None None None None G-4-26-I None
None None None None None GANGGUAN - PENYAKIT SISTEM SARAF LAIN-LAIN
(RINGAN) 5022200 0 0 - 0 - 0 - 0 - 0
5022200 3264255 0 2 0 0 0 RISMAWATI PANJAITAN
D101071 55 20108 DR MAYSAMIRAWATI SPS 0138R01712170012244
0000039858783 3;JKN DR RIZKI; 5.2.0.201712280730 4 127634
1#0##0#0#0.0#2018-02-06 11:23:42#0#12:00:00#12:00:00#00:00:00 2
56c59d9a9f61a245924e41562ed3ea85 0 0 478466 0 0
1064240 0 0 0 0 1721549 0 0 0 0 0
3201126 B 1 BS 1 30/12/2017 01/01/2018 24/11/2017 0 2
1 A09.9;E86 - - - None None None None K-4-17-I None
None None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 2303094 0 3 0 0 0 BAYI NY ERNI HAZAMI
D386206 0 36 DR AULIA TANGKARI, SPA 0138R01712170012198
0002314234315 3;JKN DR RIZKI; 5.2.0.201712280730 4 127630
1#0##0#0#0.0#2018-02-12 09:45:29#0#12:00:00#12:00:00#12:00:00 1
4ecef40954511646b3454ec5d289f67c 0 0 372374 0 0 272050
0 0 0 0 1658670 0 0 0 0 0
3201126 B 2 BS 1 30/12/2017 01/01/2018 13/12/2017 0 1
1 P59.9 99.82 - - None None None None B-4-13-I None None
None None None None GANGGUAN HATI LAIN-LAIN (RINGAN) 5045200 0
0 - 0 - 0 - 0 - 0 5045200 3257972
0 3 0 0 0 BAYI NY FETRI RATNA SARI D386186 0
17 DR AWIDIYA, SPA 0138R01712170012181 0002320531031 3;JKN DR
RIZKI; 5.2.0.201712280730 4 127626 1#0##0#0#0.0#2018-02-12
09:57:00#0#12:00:00#12:00:00#12:00:00 1 c0d53faa757da28758fd8059a245ecbf
0 0 507068 0 0 394266 0 0 0 0
1846638 0 0 0 510000 0
3201126 B 2 BS 1 29/12/2017 01/01/2018 20/07/2015 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3433987 0 4 0 0 0 MUHAMMAD AMMAR AKBAR
D305580 2 893 DR AWIDIYA, SPA 0138R01712170011967
0002286731316 3;JKN DR RIZKI; 5.2.0.201712280730 4 127366
1#0##0#0#0.0#2018-02-12 10:23:05#0#12:00:00#12:00:00#12:00:00 1
daa2d266626199950e2fa0a4d26a981d 0 0 298025 0 0 973309
0 0 0 0 2162653 0 0 0 0 0
3201126 B 2 BS 1 27/12/2017 01/01/2018 11/02/2016 0 1
1 A41.9;J18.0 - - - None None None None A-4-10-III None
None None None None None SEPTIKEMIA (BERAT) 7006300 0 0
- 0 - 0 - 0 - 0 7006300 6989359 0
6 0 0 0 FISYA NAZEERA RACHMAN D323525 1 685 DR
AULIA TANGKARI, SPA 0138R01712170012347 0001971585606 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 159326 1#0##0#0#0.0#2018-03-19
08:03:07#0#12:00:00#12:00:00#12:00:00 2 e2cc9ffaec901166620c199f5e4601de
0 0 326744 0 0 3508867 0 0 0 0
3153748 0 0 0 0 0
3201126 B 3 BS 1 30/12/2017 01/01/2018 07/12/1950 0 2
1 K92.1;I11.0 89.52 - - None None None None K-4-18-III None
None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (BERAT)
2941900 0 0 - 0 - 0 - 0 - 0
2941900 4705679 0 3 0 0 0 NAWANGSIH D340973
67 24495 DR AGOES KOOSHARTORO SPPD-KKV 0138R01712170012138
0001306656538 3;JKN DR RIZKI; 5.2.1.201804062320 4 127623
1#0##0#0#0.0#2018-05-07 11:59:56#0#12:00:00#12:00:00#00:00:00 3
b28eb6c532d11c035f41830a9290e89d 0 0 224603 0 0
1862256 0 0 0 0 2618820 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 02/01/2018 16/04/1978 0 2
1 Z51.1;C50.9 90.59;99.25 - - None None None None C-4-13-I
None None None None None None KEMOTERAPI (RINGAN) 2216400 0
0 - 0 - 0 - 0 - 0 2216400 5544117
0 1 0 0 0 ERWIN SUSANTI D343767 39 14506
RACHMAWATI DR,SPB(K)ONK 0138R01701180000303 0001648823321 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 127763 1#0##0#0#0.0#2018-
01-26 16:06:39#0#12:00:00#12:00:00#12:00:00 1
3374a4031bcaa0b755b7280f0d45e626 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 27/12/2017 02/01/2018 07/05/1953 0 1
1 N39.0;D29.1;N17.9;I48;R57.2 - - - None None None None
N-4-12-III None None None None None None INFEKSI GINJAL DAN SALURAN
URIN (BERAT) 7087700 0 0 - 0 - 0 - 0 -
0 7087700 14851846 0 7 1 2 0 MOH TOHIR,H,SKM
d381473 64 23610 DR SIDHI,SPU 0138R01712170010877
0000157502362 3;JKN DR RIZKI; 5.2.0.201712280730 4 126343
1#0##0#0#0.0#2018-02-01 14:16:50#0#12:00:00#12:00:00#12:00:00 1
81962c0da35e489a912e9ff23f813582 0 0 903524 0 0
7064706 0 0 0 0 6291616 0 0 0 0 592000
3201126 B 3 BS 1 28/12/2017 02/01/2018 26/10/1952 0 1
1 I67.9;G81.9;I10 93.19 - - None None None None G-4-26-II
None None None None None None GANGGUAN - PENYAKIT SISTEM SARAF LAIN-
LAIN (SEDANG) 4302200 0 0 - 0 - 0 - 0 -
0 4302200 3654071 0 6 0 0 0 MUSLIM
D385917 65 23804 DR AL RASYID SPS 0138R01712170011421
0001469861818 3;JKN DR RIZKI; 5.2.0.201712280730 4 126698
1#0##0#0#0.0#2018-02-05 10:54:26#0#16:25:27#16:25:27#12:00:00 1
4f93022b35ed1ebdf195689bd76c847c 0 0 743950 0 0
1157070 0 0 0 0 1753051 0 0 0 0 0
3201126 B 2 BS 1 30/12/2017 02/01/2018 01/01/2013 0 2
1 A90;A01.0 90.59 - - None None None None A-4-13-III None
None None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN (BERAT)
3841100 0 0 - 0 - 0 - 0 - 0
3841100 2728044 0 4 0 0 0 AISYAH QISTHIE TAQIYYA
D386209 4 1824 DR RASTRA, SPA 0138R01712170012212
0001743775806 3;JKN DR RIZKI; 5.2.0.201712280730 4 127631
1#0##0#0#0.0#2018-02-05 11:01:39#0#12:00:00#12:00:00#12:00:00 1
f895bc58f9931e794e81fe1f0689adcf 0 0 398699 0 0 690875
0 0 0 0 1638470 0 0 0 0 0
3201126 B 3 BS 1 30/12/2017 02/01/2018 05/09/1976 0 2
1 O05.4;O99.0 69.02;99.04 - - None None None None W-1-11-II
None None None None None None PROSEDUR DILATASI, KURET, INTRAUTERIN &
SERVIK (SEDANG) 2538700 0 0 - 0 - 0 - 0 -
0 2538700 8453383 0 4 0 0 0 SUYANTI
D386149 41 15091 DR ARI KUSUMA JANUARTO, DR. SPOG
0138R01712170012103 0002305124976 3;JKN DR RIZKI; 5.2.0.201712280730
4 127527 1#0##0#0#0.0#2018-02-05
12:34:17#0#12:00:00#12:00:00#12:00:00 1 208490b3dc37ade5f70039271f5f1ef8
0 2660168 116000 0 0 4049190 0 0 0 0
1361025 0 0 0 267000 0
3201126 B 3 BS 1 31/12/2017 02/01/2018 27/03/1946 0 1
1 I12.0;D63.8 39.27;99.04 - - None None None None N-1-12-II
None None None None None None MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN
ALAT DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0
- 0 8908800 12346520 0 3 0 0 0 SUBEKTI
D385042 71 26212 DR. ARU ARIADNO, SPPD 0138R01712170012290
0001431101081 3;JKN DR RIZKI; 5.2.0.201712280730 4 127648
1#0##0#0#0.0#2018-02-05 12:38:51#0#12:00:00#12:00:00#12:00:00 1
b377e5c08f6a4be3c6b0b31466afcd4b 0 7097552 53000 0 0
2618252 0 0 0 0 2508716 0 0 0 69000 0
3201126 B 3 BS 1 31/12/2017 02/01/2018 01/07/1950 0 1
- 0 8908800 10260630 0 3 0 0 0 ENDANG
KOSWARA D385091 67 24655 DR. ARU ARIADNO, SPPD 0138R01712170012269
0001274248304 3;JKN DR RIZKI; 5.2.0.201712280730 4 127637
1#0##0#0#0.0#2018-02-05 12:47:37#0#12:00:00#12:00:00#12:00:00 1
73012fca78e6674f895f6b9a8ef65f8d 0 4498260 854792 0 0
3638509 0 0 0 0 1243069 0 0 0 26000 0
3201126 B 3 BS 1 01/01/2018 02/01/2018 10/03/1992 0 2
1 O02.1 69.02 - - None None None None W-1-11-I None None
None None None None PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 4917497 0 2 0 0 0 DEWI MARLINA
D386285 25 9428 DR FERRI SABARUDDIN SPOG 0138R01701180000129
0001243732937 3;JKN DR RIZKI; 5.2.0.201712280730 4 127671
1#0##0#0#0.0#2018-02-05 12:52:51#0#12:00:00#12:00:00#12:00:00 1
b75c0aaccef6833d049f887774ad14bb 0 2660168 250000 0 0
1199124 0 0 0 0 739205 0 0 0 69000 0
3201126 B 3 BS 1 01/01/2018 02/01/2018 01/04/1998 0 2
1 I12.0 39.27 - - None None None None N-1-12-I None None
None None None None MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT DIALISIS
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 8391268 0 2 0 0 0 ELSA HEPRILIANI
0000511675863 3;JKN DR RIZKI; 5.2.0.201712280730 4 127665
1#0##0#0#0.0#2018-02-05 12:59:25#0#12:00:00#12:00:00#12:00:00 1
5ebda37cd3470e58f5f1ea689df07563 0 3960800 443745 0 0
2948762 0 0 0 0 968961 0 0 0 69000 0
3201126 B 3 BS 1 02/01/2018 02/01/2018 15/01/1951 0 1
1 A15.3;I48 89.52 - - None None None None J-4-15-II None
None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (SEDANG)
5180900 0 0 - 0 - 0 - 0 - 0
5180900 2377607 0 1 0 0 0 ILYASA d386291
66 24459 DR DICKI PRATAMA 0138R01701180000181 0000512616846 3;JKN
DR RIZKI; 5.2.0.201712280730 4 127758 1#0##0#0#0.0#2018-02-06
08:48:03#0#00:00:00#06:15:00#12:00:00 1 abc2a7aa4e64c6ad48c01ca2a95ec013
0 0 466281 0 0 1176782 0 0 0 0 444544
0 0 0 290000 0
3201126 B 1 BS 1 01/01/2018 02/01/2018 07/04/1952 0 2
1 N18.5;D63.8 99.04;39.27 - - None None None None N-1-12-II
- 0 12472300 14827212 0 2 0 0 0 ASUROH
0001259369954 3;JKN DR RIZKI; 5.2.0.201712280730 4 127661
1#0##0#0#0.0#2018-02-06 09:15:13#0#12:00:00#12:00:00#12:00:00 1
16e1ae828904a059114f16aa8a90e48f 0 3510660 1175507 0 0
3658526 0 0 0 0 6482519 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 02/01/2018 26/01/1958 0 1
4 A41.9;I67.9;I48 89.52 - - None None None None A-4-10-II
None None None None None None SEPTIKEMIA (SEDANG) 4330300 0
0 - 0 - 0 - 0 - 0 4330300 3500584
0 1 0 0 0 AZIAL AZIS CHANIAGO d386292 59 21891
DR DICKI PRATAMA 0138R01701180000308 0002255913123 3;JKN DR RIZKI;
5.2.0.201712280730 4 127735 1#0##0#0#0.0#2018-02-06
09:41:02#0#01:55:00#05:45:00#12:00:00 1 f4b3e39c498ad56b85a68008bbecc873
0 0 525474 0 0 1723100 0 0 0 0 536010
0 0 0 0 716000
3201126 B 1 BS 1 30/12/2017 02/01/2018 17/07/2017 0 1
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 3462243 0 4 0 0 0 KINAN NAORY SALADIN
PUTRA D386202 0 166 DR RASTRA, SPA 0138R01712170012188
0002250455635 3;JKN DR RIZKI; 5.2.0.201712280730 4 127629
1#0##0#0#0.0#2018-02-06 09:45:05#0#12:00:00#12:00:00#12:00:00 1
6ea659c80adceaeed6f9e5966d73a273 0 0 269459 0 0
2223000 0 0 0 0 969784 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 02/01/2018 07/03/1962 0 1
1 I20.0;A16.5 89.52 - - None None None None I-4-20-II None
None None None None None ANGINA PEKTORIS DAN NYERI DADA (SEDANG)
4854000 0 0 - 0 - 0 - 0 - 0
4854000 1282194 0 1 0 0 0 NURDIN D375846
DR RIZKI; 5.2.0.201712280730 4 127679 1#0##0#0#0.0#2018-02-06
10:07:47#0#00:00:00#07:00:00#12:00:00 1 f9e8217bb1e8a22d1cd9dd86d4ea668f
0 0 436860 0 0 182452 0 0 0 0 662882
0 0 0 0 0
3201126 B 1 BS 1 31/12/2017 02/01/2018 14/08/1949 0 1
- 0 12472300 14568154 0 3 0 0 0 I DEWA MADE
MARDIKA D380380 68 24976 DR SRI KUMARTINI 0138R01712170012293
0000040919905 3;JKN DR RIZKI; 5.2.0.201712280730 4 127643
1#0##0#0#0.0#2018-02-06 10:16:24#0#12:00:00#12:00:00#12:00:00 1
8664c87663075549b5d5e0ca3263e299 0 7008460 1175507 0 0
3362130 0 0 0 0 2953057 0 0 0 69000 0
3201126 B 3 BS 1 31/12/2017 02/01/2018 27/03/1946 0 1
- 0 8908800 12346520 0 3 0 0 0 SUBEKTI
0001431101081 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 127648
1#0##0#0#0.0#2018-03-19 08:00:19#0#12:00:00#12:00:00#12:00:00 3
b8289ad3aebbefdbd00a3b0ac87f982c 0 7097552 53000 0 0
2618252 0 0 0 0 2508716 0 0 0 69000 0
3201126 B 3 BS 1 26/12/2017 02/01/2018 20/11/2017 0 2
2 P23.9;Q24.9 96.04;96.72;87.44 - - None None None None J-1-
02-II None None None None None None VENTILASI MEKANIKAL LONG TERM TANPA
TRAKEOSTOMI (SEDANG) 40168300 0 0 - 0 - 0 - 0
- 0 40168300 31316785 0 8 0 0 0 BAYI NY
RISKA SUGESTIANA D385734 0 36 DR AULIA TANGKARI, SPA
0138R01712170011283 0002324318769 3;JKN DR RIZKI; 5.2.1.201804062320
4 126569 1#0##0#0#0.0#2018-05-17
14:31:15#0#12:00:00#12:00:00#12:00:00 3 0a54e4f16a4e3036316d204bbfbeb812
0 0 3467225 0 0 13221560 0 0 0 0
7964000 0 0 0 0 6664000
3201126 B 2 BS 1 23/12/2017 02/01/2018 01/05/2004 0 2
1 A15.3;E87.2;J18.9;A41.9 87.44;93.94 - - None None None None
J-4-15-III None None None None None None PERADANGAN DAN INFEKSI
PERNAFASAN (BERAT) 8364500 0 0 - 0 - 0 - 0
- 0 8364500 26392538 0 11 1 4 0 ANITA
CAROLINE W D385560 13 4984 DR NOVIK BUDIWARDHANA, SPA
0138R01712170009790 0001801189877 3;JKN DR RIZKI; 5.2.1.201804062320
4 125507 1#0##0#0#0.0#2018-05-17
14:32:30#0#12:00:00#12:00:00#12:00:00 2 74def2256e5670368c4ac80d08ae8af5
0 0 1301495 0 0 14353043 0 0 0 0
7704000 0 0 0 0 3034000
3201126 B 3 BS 1 02/01/2018 02/01/2018 31/12/1948 0 1
4 I64;I10 87.03;89.52 - - None None None None G-4-15-I
None None None None None None KECEDERAAN PEMBULUH DARAH OTAK NON
SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (RINGAN) 4096200 0 0
- 0 - 0 - 0 - 0 4096200 4020081 0
1 0 0 0 MUHAMMAD TABRONI D386288 69 25204 DR AL RASYID
SPS 0138R01701180000166 0001739674462 3;JKN DR RIZKI; 5.2.1.201804062320
4 127678 1#0##0#0#0.0#2018-05-17
14:34:19#0#12:00:00#12:00:00#12:00:00 2 45652969e8cd4b147badf9218487a83e
0 0 674855 0 0 2055230 0 0 0 0
1161996 0 0 0 0 128000
3201126 B 3 BS 1 02/01/2018 03/01/2018 01/09/1953 0 1
1 I25.0;I11.0;I08.9;N18.5 88.55;36.07 - - YY02 None None None
I-1-40-III None None YY-02-III None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (BERAT) 34354000 0 0 PCI 10725800 - 0 - 0
- 0 45079800 67784445 0 2 0 0 0 YADI SALEH
D347585 64 23499 DR AZRI NURIZAL SPPD KKV 0138R01701180000266
0000512763952 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 127685
1#0##0#0#0.0#2018-01-26 14:52:19#0#12:00:00#12:00:00#12:00:00 1
2e741db8f2186faca8efc5bdb9ba95fe 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 27/12/2017 03/01/2018 11/07/1944 0 2
1 S72.00;I11.0;D62 81.51;99.04 - - YY01 RR04 None None M-1-
04-III None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI
TUNGKAI BAWAH (BERAT) 25658500 0 0 HIP REPLACEMENT / KNEE REPLACEMENT
5782600 HIP IMPLANT/ KNEE IMPLANT 11565100 - 0 - 0
43006200 54455885 0 8 0 0 0 IA KURIATI D385838
73 26832 DR BENNY H T, SPOT 0138R01712170010984 0000062564567
3;JKN TANTIYO S;16137 5.1.1.201705010501 4 126353
1#0##0#0#0.0#2018-01-29 08:46:02#0#12:00:00#12:00:00#12:00:00 2
413bce8a8e4dc72f806640da2fe6c9e0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 03/01/2018 20/03/1963 0 1
1 R06.0 - - - None None None None J-4-21-I None None
None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM PERNAFASAN LAIN-
LAIN (RINGAN) 2798500 0 0 - 0 - 0 - 0 -
0 2798500 1120080 0 1 0 0 0 PARMAN. S
d372594 54 20013 DR MUHAMMAD RIZKI YUWANA 0138R01701180001003
0002263423239 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 128697
1#0##0#0#0.0#2018-01-30 16:52:07#0#12:00:00#12:00:00#12:00:00 1
1feeb55ac4e7b994b07cb523bf9d4b52 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 03/01/2018 14/04/2007 0 1
1 D56.1 99.04 - - None None None None D-4-13-I None None
None None None None GANGGUAN SEL DARAH MERAH SELAIN KRISIS ANEMIA SEL
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 2804918 0 1 0 0 0 ALIF REZA AR-
RASYID d136446 10 3917 DR VERA MUNA MANOE, SPA 0138R01701180000745
0001260919888 3;JKN DR RIZKI; 5.2.0.201712280730 4 129045
1#0##0#0#0.0#2018-02-01 12:04:05#0#12:00:00#12:00:00#12:00:00 1
78d085e91b9e93fe7bb065eadab84869 0 0 268830 0 0
2063589 0 0 0 0 472499 0 0 0 0 0
3201126 B 1 BS 1 31/12/2017 03/01/2018 03/07/2009 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4679662 0 4 0 0 0 AKHIL FEROZ SALIM
D196925 8 3103 DR RASTRA, SPA 0138R01712170012259
0001645279457 3;JKN DR RIZKI; 5.2.0.201712280730 4 127635
1#0##0#0#0.0#2018-02-01 14:26:16#0#12:00:00#12:00:00#12:00:00 1
3dbf16bfaefd048bc3d8beb0af778c34 0 0 338858 0 0
1037658 0 0 0 0 3303146 0 0 0 0 0
3201126 B 1 BS 1 29/12/2017 03/01/2018 05/10/1957 0 1
1 K29.7;N20.0 88.79 - - None None None None K-4-11-II None
None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG) 4615000
0 0 - 0 - 0 - 0 - 0 4615000
7488974 0 6 0 0 0 BAMBANG SUTOYO D386018 60
22000 DR ARU, SPPD 0138R01712170011919 0000038073363 3;JKN DR
RIZKI; 5.2.0.201712280730 4 127358 1#0##0#0#0.0#2018-02-02
09:03:38#0#12:00:00#12:00:00#12:00:00 1 0d12686d11dc9471ac2de4944a5427c6
0 0 345275 0 0 2510766 0 0 0 0
4632933 0 0 0 0 0
3201126 B 1 BS 1 02/01/2018 03/01/2018 07/07/1950 0 1
1 N17.9;N13.2 38.95;87.44 - - None None None None N-1-12-I
ALAT DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0
- 0 6076700 12793394 0 2 0 0 0 TUGIMAN
0000043161816 3;JKN DR RIZKI; 5.2.0.201712280730 4 128022
1#0##0#0#0.0#2018-02-02 10:39:42#0#12:00:00#12:00:00#12:00:00 1
4541e29367a62304c587a8b210ebc8e1 0 4059000 1815243 0 0
4102200 0 0 0 0 2816951 0 0 0 0 0
3201126 B 3 BS 1 01/01/2018 03/01/2018 10/07/1976 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 9464393 0 3 0 0 0 MARYATUN D386259
41 15150 DR. ARU ARIADNO, SPPD 0138R01701180000045 0002267696575
3;JKN DR RIZKI; 5.2.0.201712280730 4 127655 1#0##0#0#0.0#2018-
02-02 10:58:28#0#12:00:00#12:00:00#12:00:00 1
82e2cea51f622bfbcd7fad7d18ce12b5 0 2716000 1311745 0 0
2813432 0 0 0 0 2623216 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 03/01/2018 29/12/1949 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 9125606 0 2 0 0 0 ALWI d386293 68
24841 DR IRFIANSYAH LESMANA DR SPBTKV 0138R01701180000360
0001218281455 3;JKN DR RIZKI; 5.2.0.201712280730 4 127832
1#0##0#0#0.0#2018-02-02 15:02:19#0#12:00:00#12:00:00#12:00:00 1
5aa753e1d02a7069edde2073509c0d06 0 3609100 1563497 0 0
2401007 0 0 0 0 1552002 0 0 0 0 0
3201126 B 2 BS 1 01/01/2018 03/01/2018 21/12/1966 0 2
- 0 10690500 13478979 0 3 0 0 0 MARSIAH
0001275077733 3;JKN DR RIZKI; 5.2.0.201712280730 4 127663
1#0##0#0#0.0#2018-02-02 16:25:56#0#12:00:00#12:00:00#12:00:00 1
65f8556cbfb823835bdc1a7c302a5486 0 4081100 3153245 0 0
3992832 0 0 0 0 2182802 0 0 0 69000 0
3201126 B 3 BS 1 29/12/2017 03/01/2018 18/04/1949 0 1
1 I21.2;I50.9;J18.9 99.10;87.44;89.52 - - None None None None
I-4-10-III None None None None None None INFARK MYOKARD AKUT (BERAT)
10401900 0 0 - 0 - 0 - 0 - 0
10401900 11252286 0 6 1 3 0 H.BUCHORI D385960
68 25092 DR AZRI NURIZAL SPPD KKV 0138R01712170011595
0001739971956 3;JKN DR RIZKI; 5.2.0.201712280730 4 126909
1#0##0#0#0.0#2018-02-02 16:33:59#0#12:00:00#12:00:00#12:00:00 2
1f9f1c98fb9942ff5e12b4ee635f84b3 0 0 761191 0 0
5563464 0 0 0 0 3659631 0 0 1268000 0
0
3201126 B 2 BS 1 30/12/2017 03/01/2018 07/08/1977 0 2
1 K29.7 90.59;88.76;89.52 - - None None None None K-4-11-I
None None None None None None GASTRITIS & ULKUS PEPTIKUM (RINGAN)
2783600 0 0 - 0 - 0 - 0 - 0
2783600 5900154 0 5 0 0 0 NONA SAIDAH D386067
40 14755 DR ARU, SPPD 0138R01712170012007 0001270395966 3;JKN
DR RIZKI; 5.2.0.201712280730 4 127374 1#0##0#0#0.0#2018-02-02
16:40:24#0#12:00:00#12:00:00#12:00:00 1 a15a587d8212f38460311c89dd4d4172
0 0 409013 0 0 2671150 0 0 0 0
2819991 0 0 0 0 0
3201126 B 1 BS 1 30/12/2017 03/01/2018 08/11/1995 0 2
1 A01.0;K29.7 - - - None None None None A-4-14-I None
None None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5082677 0 5 0 0 0 NADHIRAH NOVITA PUTRI
0001454760966 3;JKN DR RIZKI; 5.2.0.201712280730 4 127627
1#0##0#0#0.0#2018-02-02 16:51:57#0#12:00:00#12:00:00#12:00:00 1
ab4c08fe4801ab5ff6a1430755ac3f92 0 0 551420 0 0 796745
0 0 0 0 3734512 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 03/01/2018 21/12/1944 0 1
1 K80.0;R17;A41.9;K29.7;N39.0;I10 88.76 - - None None None
None B-4-14-III None None None None None None GANGGUAN SALURAN EMPEDU
LAIN-LAIN (BERAT) 7875800 0 0 - 0 - 0 - 0 -
0 7875800 3756648 0 2 0 0 0 NATAK D355355
73 26675 DR BETTY DWI L, SPPD 0138R01701180000182 0000060717519
3;JKN DR RIZKI; 5.2.0.201712280730 4 127681 1#0##0#0#0.0#2018-
02-02 16:59:06#0#12:00:00#12:00:00#00:00:00 1
1bf71c1b54ebb14a8048804e421794e6 0 0 761822 0 0
1713064 0 0 0 0 1281762 0 0 0 0 0
3201126 B 1 BS 1 02/01/2018 03/01/2018 14/10/1956 0 1
1 S82.30 78.67 - - None None None None M-1-40-I None
None None None None None EKSISI LOKAL DAN PENGANGKATAN ALAT FIKSASI
INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 - 0 -
0 6041900 9944486 0 2 0 0 0 MISAN BIN MATARUM
D374509 61 22360 DR MOHAMMAD AULIA HERDIYANA,SPOT
0138R01701180000373 0001290299321 3;JKN DR RIZKI; 5.2.0.201712280730
4 127851 1#0##0#0#0.0#2018-02-02
17:02:53#0#12:00:00#12:00:00#12:00:00 1 9038df182f62c1c02339673bed95e37a
0 4059000 1754732 0 0 1629980 0 0 0 0
2500774 0 0 0 0 0
3201126 B 1 BS 1 31/12/2017 03/01/2018 15/04/1967 0 1
1 I63.9;I10 87.03;87.44 - - None None None None G-4-14-I
None None None None None None KECEDERAAN PEMBULUH DARAH OTAK DENGAN
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 7018969 0 4 0 0 0 APRIYANTO
0000037058321 3;JKN DR RIZKI; 5.2.0.201712280730 4 127651
1#0##0#0#0.0#2018-02-02 17:11:11#0#12:00:00#12:00:00#12:00:00 1
f35f0cbdfa61d6fe842eb21c1cfa95d6 0 0 1020330 0 0
2848454 0 0 0 0 3150185 0 0 0 0 0
3201126 B 3 BS 1 30/12/2017 03/01/2018 02/06/1984 0 2
1 K80.2;K29.7;K58.9 88.76 - - None None None None B-4-14-I
None None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN
(RINGAN) 4199800 0 0 - 0 - 0 - 0 - 0
4199800 3674748 0 5 0 0 0 SUNDARI D301792
3;JKN DR RIZKI; 5.2.0.201712280730 4 127619 1#0##0#0#0.0#2018-
02-02 17:15:30#0#12:00:00#12:00:00#12:00:00 1
65c1884235ad9309d4613a307f1be4d8 0 0 261764 0 0
1906580 0 0 0 0 1506404 0 0 0 0 0
3201126 B 3 BS 1 29/12/2017 03/01/2018 28/09/1975 0 1
1 G81.9;R13 87.03 - - None None None None G-4-26-II None
(SEDANG) 4302200 0 0 - 0 - 0 - 0 - 0
4302200 3600897 0 6 0 0 0 EDI M. MADJIAH
0002273450624 3;JKN DR RIZKI; 5.2.0.201712280730 4 127360
1#0##0#0#0.0#2018-02-02 17:31:04#0#12:00:00#12:00:00#12:00:00 1
01b28775d0773bfc9d214a89228916a5 0 0 743950 0 0
1189874 0 0 0 0 1667073 0 0 0 0 0
3201126 B 2 BS 1 29/12/2017 03/01/2018 28/08/1959 0 2
1 M54.22;K29.7 93.39;87.22 - - None None None None M-4-
17-I None None None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG BELAKANG
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 9529784 0 6 0 0 0 MALA RATINAH
d385955 58 21308 DR. ARU ARIADNO, SPPD 0138R01712170011494
0000043331523 3;JKN DR RIZKI; 5.2.0.201712280730 4 126828
1#0##0#0#0.0#2018-02-12 08:46:08#0#12:00:00#12:00:00#12:00:00 1
773845712b6b0f8fbd361e55d5b91044 0 0 786360 0 0
5225980 0 0 0 0 3517444 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 03/01/2018 18/08/1975 0 2
1 K29.6;K29.8 45.16 - - None None None None K-4-11-II None
0 0 - 0 - 0 - 0 - 0 3955700
5961870 0 2 0 0 0 HADIJAH D382435 42 15478
DR ZULFAN, SPPD 0138R01701180000631 0001266002684 3;JKN DR RIZKI;
5.2.0.201712280730 4 128241 1#0##0#0#0.0#2018-09-26
15:59:59#0#12:00:00#12:00:00#12:00:00 2 f0223b664faded939dc7e573c9936e0b
0 892500 1223596 0 0 900745 0 0 0 0
1345029 0 0 0 0 1600000
3201126 B 1 BS 1 03/01/2018 04/01/2018 24/04/1964 0 2
1 I25.0;I08.9;I11.0;E11.6 88.55;36.07 - - YY02 None None None
- 0 58821400 60435860 0 2 0 0 0 MARYAM
d372741 53 19612 DR AZRI SPJP 0138R01701180000672
0000037067984 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 128249
1#0##0#0#0.0#2018-01-29 08:40:19#0#12:00:00#12:00:00#12:00:00 1
2ee2e84ee5f0b4807dcb9fa58e9b4869 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 04/01/2018 03/07/1967 0 2
4 I63.9 87.44 - - None None None None G-4-14-I None None
None None None None KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK (RINGAN)
5013100 0 0 - 0 - 0 - 0 - 0
5013100 7242653 0 1 0 0 0 MARDIAH D386522
50 18448 DR ADITIA NATA KUSUMA 0138R01701180001205 0000511494344
3;JKN DR RIZKI; 5.1.1.201705010501 4 128888 1#0##0#0#0.0#2018-
01-30 16:49:52#0#12:00:00#12:00:00#12:00:00 1
c6a664ffd655e915550ae27f643aeaa3 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 04/01/2018 01/01/1958 0 2
1 K51.9;K80.8;Q44.6;I84.2 45.23 - - None None None None K-4-
13-I None None None None None None DIVERTIKULITIS, DIVERTIKULOSIS DAN
PENYAKIT PERADANGAN USUS BESAR (RINGAN) 3983300 0 0 - 0 -
0 - 0 - 0 3983300 6952552 0 3 0 0
0 MARYAM D355261 60 21916 DR BETTY DWI L, SPPD
0138R01701180000508 0001739669668 3;JKN DR RIZKI; 5.2.0.201712280730
4 128060 1#0##0#0#0.0#2018-02-01
11:41:18#0#12:00:00#12:00:00#12:00:00 1 c9f129c0c02376f2c18b6013e3f45f00
0 0 1231324 0 0 2053888 0 0 0 0
3522340 0 0 145000 0 0
3201126 B 1 BS 1 31/12/2017 04/01/2018 13/09/1981 0 1
1 I20.0;K30 89.52;88.72 - - None None None None I-4-20-I
None None None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN)
5883600 0 0 - 0 - 0 - 0 - 0
5883600 7423957 0 5 0 0 0 YUDI HELFI D378699
0000205121687 3;JKN DR RIZKI; 5.2.0.201712280730 4 127650
1#0##0#0#0.0#2018-02-01 11:48:22#0#12:00:00#12:00:00#12:00:00 1
fd16f3de4075c9f15c2c99462ee986ec 0 0 966724 0 0
2416554 0 0 0 0 4040679 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 04/01/2018 15/01/2007 0 2
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 4340442 0 3 0 0 0 RAHMA SEROJA
PUTRI.D d373343 10 4005 DR VERA MUNA MANOE, SPA 0138R01701180000617
0001261517049 3;JKN DR RIZKI; 5.2.0.201712280730 4 143154
1#0##0#0#0.0#2018-02-01 13:52:16#0#12:00:00#12:00:00#12:00:00 1
6f019f936ea30dcd1301589fb78fe020 0 0 268830 0 0
3059158 0 0 0 0 1012454 0 0 0 0 0
3201126 B 3 BS 1 31/12/2017 04/01/2018 10/02/1961 0 2
1 K29.7;C18.9;A09.9;E14.9 99.17 - - None None None None K-4-
11-I None None None None None None GASTRITIS & ULKUS PEPTIKUM (RINGAN)
2319600 0 0 - 0 - 0 - 0 - 0
2319600 4729009 0 5 0 0 0 MUKAROMAH D304898
56 20778 DR ARU, SPPD 0138R01712170012292 0001317277056 3;JKN
DR RIZKI; 5.2.0.201712280730 4 127644 1#0##0#0#0.0#2018-02-01
14:02:45#0#12:00:00#12:00:00#12:00:00 1 e4882403c01ecd7ed680a053ae97d9b7
0 0 688661 0 0 2449974 0 0 0 0
1590374 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 04/01/2018 02/03/1964 0 1
1 N18.5;D63.8;I10;K74.6 90.59;89.52;99.04 - - None None None
None N-4-10-II None None None None None None TUMOR GINJAL & SALURAN
URIN & GAGAL GINJAL (SEDANG) 4132100 0 0 - 0 - 0 -
0 - 0 4132100 4005624 0 2 0 0 0 ROMLI
D325831 53 19665 DR SRI KUNMARTINI, SPPD 0138R01701180001049
0001743644902 3;JKN DR RIZKI; 5.2.0.201712280730 4 129965
1#0##0#0#0.0#2018-02-01 15:26:55#0#12:00:00#12:00:00#00:00:00 1
85b425c8e6d35ce6d7ffa71104deff7e 0 0 424889 0 0
1406935 0 0 0 0 1883800 0 0 290000 0
0
3201126 B 3 BS 1 30/12/2017 04/01/2018 07/04/1951 0 1
1 I63.9;G81.9;E87.6;J22 87.03;93.19;93.96 - - None None None
None G-4-14-II None None None None None None KECEDERAAN PEMBULUH
DARAH OTAK DENGAN INFARK (SEDANG) 6909500 0 0 - 0 - 0
- 0 - 0 6909500 7148067 0 6 0 0 0
SANIAN D386172 66 24374 DR NURUL KOMARI SPS
0138R01712170012163 0001739686241 3;JKN DR RIZKI; 5.2.0.201712280730
4 127625 1#0##0#0#0.0#2018-02-01
15:37:58#0#12:00:00#12:00:00#12:00:00 1 4f5d2a53d4605da4dabce66cb2b6d5e2
0 0 1089423 0 0 3907013 0 0 0 0
1981631 0 0 0 170000 0
3201126 B 3 BS 1 01/01/2018 04/01/2018 21/12/2016 0 2
1 J22 93.94 - - None None None None J-4-21-I None None
LAIN (RINGAN) 2798500 0 0 - 0 - 0 - 0 -
0 2798500 3289389 0 4 0 0 0 NACHIRA MAHYA
MAULIDYA D386262 1 376 DR RASTRA, SPA 0138R01701180000058
0002201804875 3;JKN DR RIZKI; 5.2.0.201712280730 4 127666
1#0##0#0#0.0#2018-02-01 15:42:14#0#12:00:00#12:00:00#12:00:00 2
3db08937cfb439810488078b20d8c84f 0 0 378188 0 0
1618007 0 0 0 0 1293194 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 04/01/2018 06/10/2009 0 2
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 3412594 0 3 0 0 0 ADZKIA HUMAIRA
d373340 8 3010 DR VERA MUNA MANOE, SPA 0138R01701180000613
0001260998245 3;JKN DR RIZKI; 5.2.0.201712280730 4 129041
1#0##0#0#0.0#2018-02-01 16:06:40#0#12:00:00#12:00:00#12:00:00 1
49647a81210f79c9945423767bde6021 0 0 268830 0 0
2192010 0 0 0 0 951754 0 0 0 0 0
3201126 B 3 BS 1 31/12/2017 04/01/2018 18/07/2017 0 2
1 J18.0 87.44;93.94 - - None None None None J-4-16-I None
None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (RINGAN)
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4295376 0 5 0 0 0 BAYI NY ELRIN ARIES
JELLITA d386212 0 166 DR RASTRA, SPA 0138R01712170012338
0002262704578 3;JKN DR RIZKI; 5.2.0.201712280730 4 127935
1#0##0#0#0.0#2018-02-01 16:09:52#0#12:00:00#12:00:00#12:00:00 1
1d562e4bf795076e3cc1354d275e0c51 0 0 378188 0 0
2200182 0 0 0 0 1547006 0 0 0 170000
0
3201126 B 2 BS 1 01/01/2018 04/01/2018 02/04/1971 0 2
1 N85.1;D64.9 99.04;69.09 - - None None None None W-1-11-II
SERVIK (SEDANG) 3046400 0 0 - 0 - 0 - 0 -
0 3046400 10425340 0 4 0 0 0 NINA SUPRIYATINI
D384076 46 17076 DR ERDIYAN, SPOG 0138R01701180000069
0001848822118 3;JKN DR RIZKI; 5.2.0.201712280730 4 128999
1#0##0#0#0.0#2018-02-01 16:40:02#0#12:00:00#12:00:00#12:00:00 2
be9d4620725a439f290be0abc68f2f0e 0 0 968992 0 0
5370316 0 0 0 0 4017032 0 0 69000 0 0
3201126 B 2 BS 1 02/01/2018 04/01/2018 31/12/1945 0 1
1 N18.5;I50.0;R60.0;K29.6;R63.0 - - - None None None None
N-4-10-II None None None None None None TUMOR GINJAL & SALURAN URIN &
GAGAL GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0
- 0 4958500 4067415 0 3 0 0 0 MAR'IH
D355659 72 26300 DR SRI KUN, SPPD 0138R01701180000609
0001961373993 3;JKN DR RIZKI; 5.2.0.201712280730 4 128242
1#0##0#0#0.0#2018-02-02 08:38:31#0#12:00:00#12:00:00#00:00:00 1
03cb0b1670be8d29655bcd5e8933f5ce 0 0 499265 0 0
1968557 0 0 0 0 1599593 0 0 0 0 0
3201126 B 2 BS 1 01/01/2018 04/01/2018 10/05/1981 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2783976 0 4 0 0 0 RACHMAT HIDAYAT
D386284 36 13385 DR ARU, SPPD 0138R01701180000143
0001887452763 3;JKN DR RIZKI; 5.2.0.201712280730 4 127676
1#0##0#0#0.0#2018-02-02 09:08:46#0#12:00:00#12:00:00#12:00:00 2
d29965631455de38aa7ff47e06e0e319 0 0 266858 0 0 793989
0 0 0 0 1723129 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 04/01/2018 22/07/1954 0 1
- 0 8908800 9815614 0 2 0 0 0 MADRAIS
D328121 63 23176 DR SRI KUN, SPPD 0138R01701180000654
0001271539721 3;JKN DR RIZKI; 5.2.0.201712280730 4 128248
1#0##0#0#0.0#2018-02-02 10:33:29#0#12:00:00#12:00:00#12:00:00 1
88708e13b3a3b649d94f6500cecf9f53 0 2435000 2636552 0 0
3349419 0 0 0 0 1394643 0 0 0 0 0
3201126 B 1 BS 1 31/12/2017 04/01/2018 22/10/1950 0 1
1 I11.0;I20.0;I25.0 89.52 - - None None None None I-4-12-II
None None None None None None KEGAGALAN JANTUNG (SEDANG) 5802600
0 0 - 0 - 0 - 0 - 0 5802600
6494437 0 5 0 0 0 ACHMAD SAIDUN ALI, SH D286409
0000043180378 3;JKN DR RIZKI; 5.2.0.201712280730 4 127632
1#0##0#0#0.0#2018-02-02 10:42:53#0#12:00:00#12:00:00#00:00:00 1
4cc51de3cb2726eea40b4ba56dcaaca2 0 0 940040 0 0
1398527 0 0 0 0 4155870 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 04/01/2018 12/05/2011 0 2
1 A09.9 - - - None None None None K-4-17-I None None
None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN (RINGAN)
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2455806 0 3 0 0 0 NAOMI ANGELIQUE SILOOY
D336824 6 2427 DR OTTY MITHA S, SPA 0138R01701180000178
0001280148669 3;JKN DR RIZKI; 5.2.0.201712280730 4 127680
1#0##0#0#0.0#2018-02-02 10:45:00#0#12:00:00#12:00:00#00:00:00 1
a7dba0c4fc47981f5317cd1d41683f03 0 0 207620 0 0 762526
0 0 0 0 975660 0 0 0 0 510000
3201126 B 1 BS 1 01/01/2018 04/01/2018 17/12/1948 0 1
1 E14.2;D62 99.04;90.59 - - None None None None N-4-16-II
None None None None None None PENYAKIT GINJAL DAN SALURAN URIN LAIN-
LAIN (SEDANG) 7385300 0 0 - 0 - 0 - 0 -
0 7385300 8792667 0 4 0 0 0 PETRUS SUDIONO
D199951 69 25217 DR ARU, SPPD 0138R01701180000095
0000060695313 3;JKN DR RIZKI; 5.2.0.201712280730 4 127669
1#1#vvip#4#1407367#0.0#2018-02-02 10:51:16#0#12:00:00#12:00:00#12:00:00
1 b5d1679bcd1a0850877e8cb9e6836dbd 0 0 1345427 0 0
3045318 0 0 0 0 4401922 0 0 0 0 0
3201126 B 3 BS 1 01/01/2018 04/01/2018 13/10/1975 0 2
1 I83.1;I51.7 38.59;87.44 - - None None None None I-1-17-I
None None None None None None LIGASI DAN STRIPPING PEMBULUH DARAH VENA
(RINGAN) 13630500 0 0 - 0 - 0 - 0 - 0
13630500 11219822 0 4 0 0 0 SATIAH D385654
42 15421 DR IRFIANSYAH LESMANA DR SPBTKV 0138R01701180000139
0001258425009 3;JKN DR RIZKI; 5.2.0.201712280730 4 127674
1#0##0#0#0.0#2018-02-02 11:04:39#0#12:00:00#12:00:00#12:00:00 2
ec9dfffa6730e04546cf851eec1cd591 0 0 4498065 0 0
2263450 0 0 0 0 4458307 0 0 0 0 0
3201126 B 3 BS 1 01/01/2018 04/01/2018 27/11/1990 0 2
1 N39.0;K29.7 88.76 - - None None None None N-4-12-I None
None None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN)
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2794830 0 4 0 0 0 PUTRI NOVIYANTI
0002097361989 3;JKN DR RIZKI; 5.2.0.201712280730 4 127677
1#0##0#0#0.0#2018-02-02 11:19:42#0#12:00:00#12:00:00#12:00:00 1
79415fc1b5c663f91c716c4e9f6288d1 0 0 639089 0 0
1157902 0 0 0 0 997839 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 04/01/2018 23/02/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2437241 0 3 0 0 0 ARJUNA PRATAMA
0001960223128 3;JKN DR RIZKI; 5.2.0.201712280730 4 128122
1#0##0#0#0.0#2018-02-02 11:22:39#0#12:00:00#12:00:00#00:00:00 1
e5b2cc3cd4c33b6ab00201b4102dd397 0 0 238535 0 0 498260
0 0 0 0 1700446 0 0 0 0 0
3201126 B 2 BS 1 01/01/2018 04/01/2018 24/10/1983 0 1
1 I12.0;D63.8;A49.9 99.04;39.27 - - None None None None N-1-
12-II None None None None None None MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN
- 0 10690500 14330650 0 4 0 0 0 WINDU
S.ANUGRAH D331384 34 12488 DR SRI KUNMARTINI, SPPD 0138R01701180000134
0001638965226 3;JKN DR RIZKI; 5.2.0.201712280730 4 127673
1#0##0#0#0.0#2018-02-02 14:56:54#0#12:00:00#12:00:00#12:00:00 1
f5895ed436c4ad155602c66f3b19fd67 0 4149973 3153245 0 0
3425036 0 0 0 0 3602396 0 0 0 0 0
3201126 B 1 BS 1 01/01/2018 04/01/2018 15/04/1963 0 1
1 K74.6;A41.9;K29.7;K92.1;R77.0 88.76 - - None None None None
B-4-13-III None None None None None None GANGGUAN HATI LAIN-LAIN
(BERAT) 9446100 0 0 - 0 - 0 - 0 - 0
9446100 4276897 0 4 0 0 0 YOYO EFENDI D386278
54 19985 DR ARU, SPPD 0138R01701180000131 0001303697968 3;JKN
DR RIZKI; 5.2.0.201712280730 4 127672 1#0##0#0#0.0#2018-02-02
15:17:07#0#12:00:00#12:00:00#12:00:00 1 c44833f3aaae16a2838de2be53eb08fe
0 0 338858 0 0 2416500 0 0 0 0
1521539 0 0 0 0 0
3201126 B 2 BS 1 01/01/2018 04/01/2018 09/01/2017 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4402036 0 4 0 0 0 ABIZAR AL GHIFARI
D386273 0 357 DR RASTRA, SPA 0138R01701180000088
0002312037707 3;JKN DR RIZKI; 5.2.0.201712280730 4 127668
1#0##0#0#0.0#2018-02-02 15:27:13#0#12:00:00#12:00:00#12:00:00 1
cb9ec354524e0ae1e9af17d3565dd99a 0 0 443231 0 0
1624821 0 0 0 0 2333984 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 04/01/2018 15/01/1929 0 2
1 I67.9;G81.9;E78.5;I10 87.03 - - None None None None G-4-
26-II None None None None None None GANGGUAN - PENYAKIT SISTEM SARAF LAIN-
LAIN (SEDANG) 5162700 0 0 - 0 - 0 - 0 -
0 5162700 4040151 0 3 0 0 0 AMANAH
0000060999434 3;JKN DR RIZKI; 5.2.0.201712280730 4 127766
1#0##0#0#0.0#2018-02-02 15:33:00#0#12:00:00#12:00:00#12:00:00 3
36ea8152f306146c5c72151f01d458f4 0 0 882140 0 0
1352702 0 0 0 0 1805309 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 04/01/2018 15/11/1967 0 2
1 I13.1;A41.9;J40;N39.0;A01.0 87.44 - - None None None None
N-4-10-III None None None None None None TUMOR GINJAL & SALURAN URIN &
GAGAL GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0
- 0 7293200 3210934 0 3 0 0 0 WARKINAH
D386344 50 18311 DR BETTY DWI L, SPPD 0138R01701180000604
0001311658389 3;JKN DR RIZKI; 5.2.0.201712280730 4 128223
1#0##0#0#0.0#2018-02-02 15:36:27#0#12:00:00#12:00:00#12:00:00 1
8daf787df821e0503ff9fa35d169cb32 0 0 709388 0 0 957985
0 0 0 0 1543561 0 0 0 0 0
3201126 B 2 BS 1 30/12/2017 04/01/2018 12/05/1950 0 2
1 E87.5;D62;I85.0 99.04 - - None None None None E-4-11-III
None None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (BERAT)
7552000 0 0 - 0 - 0 - 0 - 0
7552000 13651780 0 6 0 0 0 SUMIYATI D383475
3;JKN DR RIZKI; 5.2.0.201712280730 4 127621 1#0##0#0#0.0#2018-
02-12 09:09:30#0#12:00:00#12:00:00#12:00:00 1
1306cba9d8a193574621339e4944684b 0 0 317771 0 0
7509902 0 0 0 0 4664107 0 0 0 1160000
0
3201126 B 1 BS 1 02/01/2018 04/01/2018 24/09/2001 0 1
1 A90 - - - None None None None A-4-13-I None None
None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN (RINGAN)
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3542111 0 3 0 0 0 DAFFA RAYHAN MULYADI
0002088864191 3;JKN DR RIZKI; 5.2.0.201712280730 4 127683
1#0##0#0#0.0#2018-02-12 10:51:26#0#12:00:00#12:00:00#00:00:00 1
42a19360362eff29766bfd7376b449ab 0 0 316331 0 0 625053
0 0 0 0 2600727 0 0 0 0 0
3201126 B 1 BS 1 02/01/2018 04/01/2018 23/09/1949 0 1
1 I21.9;R57.0;R40.2;K80.2;J80;A41.9 96.04;96.71 - - None None
None None J-1-20-III None None None None None None PROSEDUR SISTEM
PERNAFASAN NON-KOMPLEKS (BERAT) 40790100 0 0 - 0 - 0
- 0 - 0 40790100 26205322 0 3 1 3 48
SUHERNI D329476 68 24938 DR EVA INDAHWATI SPAN
0138R01701180000364 0001259168545 3;JKN DR RIZKI; 5.2.0.201712280730
4 129118 1#0##0#0#0.0#2018-02-12
10:57:34#0#12:00:00#12:00:00#12:00:00 1 339f7176f3f9d0170d6ef2b91225decd
0 0 4380010 0 0 14320312 0 0 0 0
4346000 0 0 0 0 3159000
3201126 B 2 BS 1 29/12/2017 04/01/2018 16/04/1988 0 1
1 I08.1;I50.0;I48 89.52;87.44 - - None None None None I-4-
18-II None None None None None None PENYAKIT JANTUNG KONGENITAL DAN KATUP
JANTUNG (SEDANG) 7642900 0 0 - 0 - 0 - 0 -
0 7642900 13696270 0 7 1 5 0 AHMAD AMRI
0001273472212 3;JKN DR RIZKI; 5.2.0.201712280730 4 126827
1#0##0#0#0.0#2018-02-12 11:56:15#0#12:00:00#12:00:00#12:00:00 1
f6072394628dd0f7f1aa1d020bb9fbdc 0 0 905868 0 0
3912384 0 0 0 0 5951018 0 0 0 0
2927000
3201126 B 3 BS 1 04/01/2018 04/01/2018 31/12/1946 0 2
1 I63.9 87.03;87.44 - - None None None None G-4-14-I None
None None None None None KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 3194535 0 1 0 0 0 KATINEM D386528
3;JKN DR RIZKI; 5.2.0.201712280730 4 128892 1#0##0#0#0.0#2018-
03-09 09:19:55#0#12:00:00#12:00:00#12:00:00 2
1da681df0e7730ec81d3818500a8942b 0 0 541422 0 0
2009125 0 0 0 0 515988 0 0 0 128000
0
3201126 B 1 BS 1 01/01/2018 04/01/2018 09/02/1941 0 1
1 K40.3;D29.1;E11.9 53.04;87.24;99.17 - - None None None None
K-1-14-I None None None None None None PROSEDUR HERNIA INGUINAL DAN
FEMORAL (RINGAN) 7684500 0 0 - 0 - 0 - 0 -
0 7684500 14848473 0 4 0 0 0 SUTEDJO
d381834 76 28085 DR HENDRIEK S, SPB 0138R01701180000140
0000060680283 3;JKN DR RIZKI; 5.2.0.201712280730 4 127675
1#0##0#0#0.0#2018-03-09 09:32:57#0#12:00:00#12:00:00#12:00:00 2
eacea552b8be016a4fc7add3b3b3ed94 0 5086200 2521708 0 0
3725670 0 0 0 0 3514895 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 04/01/2018 06/04/1975 0 2
SERVIK (SEDANG) 2538700 0 0 - 0 - 0 - 0 -
0 2538700 8202126 0 2 0 0 0 MAULINA HASANAH
D386459 42 15613 DR ARIS WAHJU, SPOG 0138R01701180001041
0001262532598 3;JKN DR RIZKI; 5.2.0.201712280730 4 128821
1#0##0#0#0.0#2018-03-09 14:53:03#0#12:00:00#12:00:00#12:00:00 3
355331174dc3446766f7e6638e205786 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 04/01/2018 14/08/1966 0 1
1 E11.2;D63.8;I10 38.95;99.04 - - None None None None N-1-
- 0 8908800 11666134 0 2 0 0 0 MUHAMAD
DAHLAN D386418 51 18770 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180000795 0001211811243 3;JKN DR RIZKI; 5.2.1.201804062320
4 128804 1#0##0#0#0.0#2018-05-17
14:31:44#0#12:00:00#12:00:00#12:00:00 2 8645b7199fe24977045fafbd9891452f
0 4498260 854792 0 0 4552082 0 0 0 0
1692000 0 0 0 69000 0
3201126 B 3 BS 1 04/01/2018 04/01/2018 01/07/1957 0 2
1 I64;R57.0 87.03 - - None None None None G-4-15-III None
None None None None None KECEDERAAN PEMBULUH DARAH OTAK NON SPESIFIK &
PENYUMBATAN PRE-CEREBRAL TANPA INFARK (BERAT) 6899800 0 0 - 0
- 0 - 0 - 0 6899800 3082972 0 1 0
0 0 SUMININGSIH d386519 60 22102 DR ADITIA NATA KUSUMA
0138R01701180001208 0001273607177 3;JKN DR RIZKI; 5.2.2.201806040537
4 148089 1#0##0#0#0.0#2018-08-13
10:32:24#0#12:00:00#12:00:00#12:00:00 3 043e365799fddced0d01f311af31d2c0
0 0 780498 0 0 0 0 0 1811784 0 490690
0 0 0 0 0
3201126 B 1 BS 1 31/12/2017 04/01/2018 09/03/1947 0 2
1 A91;R11;I10 - - - None None None None A-4-13-I None
None None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN (RINGAN)
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5690265 0 5 0 0 0 RISMA R SIMORANGKIR
D385791 70 25865 DR SOEGIONO, SPPD 0138R01712170012326
0000060944455 3;JKN DR RIZKI; 5.2.2.201806040537 4 127652
1#0##0#0#0.0#2018-08-14 12:18:49#0#12:00:00#12:00:00#12:00:00 3
4b616ae3c2161220d10c19b24c7ec176 0 0 551420 0 0
1598585 0 0 0 0 3540260 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 04/01/2018 11/07/1984 0 1
1 K20;K29.6 45.16 - - None None None None K-4-12-I None
None None None None None GANGGUAN ESOFAGUS (RINGAN) 2954900 0
0 - 0 - 0 - 0 - 0 2954900 6810234
0 2 0 0 0 AJAT SUDERAJAT D374948 33 12229 DR
ZULFAN, SPPD 0138R01701180001142 0001721308566 3;JKN DR RIZKI;
5.2.2.201806040537 4 128879 1#0##0#0#0.0#2018-09-06
08:58:25#0#12:00:00#12:00:00#12:00:00 2 a668b6a2e5fccd7844ea7fde40ec1ab8
0 2248820 658528 0 0 614857 0 0 0 0
1653529 0 0 0 34500 1600000
3201126 B 1 BS 1 04/01/2018 05/01/2018 30/05/1992 0 2
1 K29.7 - - - None None None None K-4-11-I None None
None None None None GASTRITIS & ULKUS PEPTIKUM (RINGAN) 3247500 0
0 - 0 - 0 - 0 - 0 3247500 2277222
0 2 0 0 0 ANGGYANI AYU RACHMAWATI D255761 25 9350
DR. ARU ARIADNO, SPPD 0138R01701180001771 0001467578171 3;JKN DR
RIZKI; 5.1.1.201705010501 4 129668 1#0##0#0#0.0#2018-01-17
08:48:04#0#12:00:00#12:00:00#00:00:00 1 2c55e90f9c506c7c2def495a3841821d
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 03/01/2018 05/01/2018 10/02/1987 0 2
1 D24 85.20 - - None None None None L-1-50-I None None
None None None None PROSEDUR PADA PAYUDARA (RINGAN) 9150100 0
0 - 0 - 0 - 0 - 0 9150100 11849780
0 3 0 0 0 HANIPAH D385944 30 11285 DR H TEDDY H
DJUNAEDI SPB 0138R01701180001174 0001078842778 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 128884 1#0##0#0#0.0#2018-01-26
15:02:44#0#12:00:00#12:00:00#12:00:00 1 a15e9b525e073152da1ce7c7480965f9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 03/01/2018 05/01/2018 03/01/2018 2794 1
1 P03.4 - - - None None None None P-8-17-I None None
None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR MAYOR (RINGAN)
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1391119 0 3 0 0 0 BY NY BETHA SUCI
OKTAVIANI D386497 0 0 DR RASTRA, SPA 0138R01701180002027
0002326433319 3;JKN DR RIZKI; 5.1.1.201705010501 4 130154
1#0##0#0#0.0#2018-01-30 16:19:00#0#12:00:00#12:00:00#12:00:00 1
05c71de73dcde70eac67cfe66dfcacc3 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 05/01/2018 15/09/1962 0 2
1 I12.0;J90;D63.8 38.95;90.59;89.52 - - None None None None
N-1-12-III None None None None None None MEMBUAT BARU, MEREVISI DAN
MEMINDAHKAN ALAT DIALISIS (BERAT) 27065300 0 0 - 0 - 0
- 0 - 0 27065300 22188963 0 2 0 0 0
ENI IRIANTININGSIH D386544 55 20200 DR SRI KUN, SPPD
0138R01701180001480 0000041748524 3;JKN DR RIZKI; 5.1.1.201705010501
4 129311 1#0##0#0#0.0#2018-01-30
16:37:32#0#12:00:00#12:00:00#12:00:00 1 6cdbc1bbc107da5af4a47b100562690b
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 04/01/2018 05/01/2018 29/07/1973 0 2
4 A41.9;R57.2;J81;C50.9 99.60 - - None None None None A-4-
10-III None None None None None None SEPTIKEMIA (BERAT) 5838600
0 0 - 0 - 0 - 0 - 0 5838600
2163528 0 2 0 0 0 SITI NURHASANAH D329722 44
16230 DR DICKI PRATAMA 0138R01701180001765 0001172478093 3;JKN DR
RIZKI; 5.1.1.201705010501 4 130599 1#0##0#0#0.0#2018-01-30
17:01:18#0#12:00:00#12:00:00#12:00:00 1 026a485eda91d5a3639c1facc30fafbd
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 03/01/2018 05/01/2018 08/10/1981 0 2
1 O82.9;Z37.0 74.0 - - None None None None O-6-10-I None
None None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN) 5984100
0 0 - 0 - 0 - 0 - 0 5984100
10638249 0 3 0 0 0 BETHA SUCI OKTAVIANI G007551
36 13236 DR ERDIYAN, SPOG 0138R01701180000889 0001830178495 3;JKN
DR RIZKI; 5.1.1.201705010501 4 128563 1#0##0#0#0.0#2018-01-30
17:21:49#0#12:00:00#12:00:00#12:00:00 1 0b8e04afc448c75d93a72fdcf9d1c150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 02/01/2018 05/01/2018 17/10/1989 0 2
1 A91;N39.9;K75.8 - - - None None None None A-4-13-II
None None None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN
(SEDANG) 3734400 0 0 - 0 - 0 - 0 - 0
3734400 5167406 0 4 0 0 0 ASRI RUMAISA
0001744154796 3;JKN DR RIZKI; 5.2.0.201712280730 4 128107
1#0##0#0#0.0#2018-02-01 14:23:56#0#12:00:00#12:00:00#12:00:00 1
77ba50a9998017dbb73dbfedc4b7a1d1 0 0 316331 0 0
1363020 0 0 0 0 3488055 0 0 0 0 0
3201126 B 1 BS 1 02/01/2018 05/01/2018 31/12/1969 0 2
1 A09.9;E87.6 90.59;89.52 - - None None None None K-4-17-II
None None None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 5447227 0 4 0 0 0 TUTI SUDIARTI, SH., M.H.
D293520 48 17534 DR ARU, SPPD 0138R01701180000622
0000042397479 3;JKN DR RIZKI; 5.2.0.201712280730 4 128238
1#0##0#0#0.0#2018-02-01 14:48:51#0#12:00:00#12:00:00#12:00:00 1
70cc0d822e4f31d6fb0dffdbd8f2cce1 0 0 845954 0 0
1440412 0 0 0 0 3160861 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 05/01/2018 04/09/2014 0 1
1 R33 88.76;57.94 - - None None None None N-4-15-I None
None None None None None GEJALA,TANDA GANGGUAN GINJAL DAN SALURAN URIN
(RINGAN) 3622000 0 0 - 0 - 0 - 0 - 0
3622000 2627948 0 2 0 0 0 ASHILLA NURUL KHUMAIROH
D386526 3 1218 DR AWIDIYA, SPA 0138R01701180001199
0002088491422 3;JKN DR RIZKI; 5.2.0.201712280730 4 129048
1#0##0#0#0.0#2018-02-01 15:04:25#0#12:00:00#12:00:00#12:00:00 1
67b8f79c1485ab212834a2b013fb2212 0 0 378980 0 0
1023046 0 0 0 0 1225922 0 0 0 0 0
3201126 B 1 BS 1 30/12/2017 05/01/2018 03/12/1941 0 1
1 I21.3;A16.1 90.59;87.49;89.52 - - None None None None I-4-
10-II None None None None None None INFARK MYOKARD AKUT (SEDANG) 10107000
0 0 - 0 - 0 - 0 - 0 10107000
9292570 0 7 0 0 0 PETRUS PANDI BENGKAL D383291
0001293050867 3;JKN DR RIZKI; 5.2.0.201712280730 4 127628
1#0##0#0#0.0#2018-02-01 15:10:50#0#12:00:00#12:00:00#12:00:00 1
978763c7bad2bb0d9c49c0bfbf86ab89 0 0 964029 0 0
2822616 0 0 0 0 5505925 0 0 0 0 0
3201126 B 3 BS 1 01/01/2018 05/01/2018 21/07/2016 0 2
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2400840 0 5 0 0 0 RORO JULIYA NEGARA
D386222 1 529 DR RASTRA, SPA 0138R01701180000052
0001774326925 3;JKN DR RIZKI; 5.2.0.201712280730 4 127660
1#0##0#0#0.0#2018-02-01 15:14:06#0#12:00:00#12:00:00#12:00:00 1
844524e7522ee2404192e9ae8fc9f921 0 0 207620 0 0 525156
0 0 0 0 1498064 0 0 0 0 170000
3201126 B 2 BS 1 03/01/2018 05/01/2018 02/02/1977 0 1
1 A49.9;A09.0 - - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2367151 0 3 0 0 0 SUMANTRI D350806
40 14945 DR SOEGIONO, SPPD 0138R01701180001168 0001621697477 3;JKN
DR RIZKI; 5.2.0.201712280730 4 128883 1#0##0#0#0.0#2018-02-01
15:17:13#0#12:00:00#12:00:00#00:00:00 1 7ed0a96aeb0fe2b7cad1252a7d7cc9a2
0 0 298025 0 0 587065 0 0 0 0
1482061 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 05/01/2018 13/10/1963 0 2
1 I13.1;D63.8 99.04 - - None None None None N-4-10-II None
None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2466012 0 2 0 0 0 SITI CHASIDAH
0000511209819 3;JKN DR RIZKI; 5.2.0.201712280730 4 129155
1#0##0#0#0.0#2018-02-01 15:31:35#0#12:00:00#12:00:00#00:00:00 1
6ec8da6c4422b5836f972afbb2774e31 0 0 424889 0 0
1309795 0 0 0 0 731328 0 0 0 0 0
3201126 B 1 BS 1 02/01/2018 05/01/2018 01/11/2010 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4514601 0 4 0 0 0 MUHAMMAD ARFA BASTARI
d386355 7 2619 DR OTTY MITHA S, SPA 0138R01701180000570
0002260219364 3;JKN DR RIZKI; 5.2.0.201712280730 4 128138
1#0##0#0#0.0#2018-02-01 16:15:32#0#12:00:00#12:00:00#12:00:00 1
8894b913d9b20fb587ab4356f4c5ca4c 0 0 316331 0 0 752922
0 0 0 0 3445348 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 05/01/2018 17/12/1958 0 1
1 D29.1;I11.0 60.29 - - None None None None V-1-14-III None
None None None None None PENGANGKATAN PROSTAT MELALUI URETRA (BERAT)
16034600 0 0 - 0 - 0 - 0 - 0
16034600 22351354 0 4 0 0 0 TUKIMAN D379015
59 21566 DR HERY TIERA, SPU 0138R01701180000202 0001457671465
3;JKN DR RIZKI; 5.2.0.201712280730 4 127682 1#0##0#0#0.0#2018-
02-12 09:19:04#0#12:00:00#12:00:00#12:00:00 1
1e3fae8179d45374cd83f5e121f88d03 0 0 9025034 0 0
5806020 0 0 0 0 6693298 0 0 0 0 827000
3201126 B 3 BS 1 15/12/2017 05/01/2018 07/10/1992 0 2
1 A17.0;A17.8;A19.9;G61.8 90.59;87.49;87.03;03.31 - - None None
None None G-4-18-III None None None None None None INFEKSI BAKTERI
SISTEM SARAF (BERAT) 6624900 0 0 - 0 - 0 - 0
- 0 6624900 27118250 0 22 1 4 0 HERNIATI
CANIAGO D384788 25 9200 DR NURUL KOMARI SPS 0138R01712170006573
0001771604908 3;JKN DR RIZKI; 5.2.0.201712280730 4 123249
1#0##0#0#0.0#2018-02-12 09:24:20#0#12:00:00#12:00:00#12:00:00 1
0641437962fd7c28d570ad6b2b291fc6 0 0 1201739 0 0
12139011 0 0 0 0 10889500 0 0 0 0
2888000
3201126 B 1 BS 1 04/01/2018 05/01/2018 29/12/2017 2600 1
0 - 0 - 0 - 0 - 0 5886000 3638286
0 2 0 0 0 BAYI NY DELSY NIKE D385965 0 6
DR SRI SAPARNI, SPA 0138R01701180001557 0002324925123 3;JKN DR
RIZKI; 5.2.0.201712280730 4 129413 1#0##0#0#0.0#2018-02-12
09:59:16#0#12:00:00#12:00:00#12:00:00 1 2928d83a6431160be306baf313a313eb
0 0 529740 0 0 186266 0 0 0 0
1614280 0 0 0 0 1308000
3201126 B 2 BS 1 04/01/2018 05/01/2018 15/05/1951 0 2
1 E16.2;E11.9 90.59;89.52 - - None None None None E-4-10-I
None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
NUTRISI/ METABOLIK (RINGAN) 4203300 0 0 - 0 - 0 -
0 - 0 4203300 1730495 0 2 0 0 0
SUNARSIH D374420 66 24341 DR SOEGIONO, SPPD 0138R01701180001699
0001717927187 3;JKN DR RIZKI; 5.2.0.201712280730 4 129607
1#0##0#0#0.0#2018-03-29 10:16:57#0#12:00:00#12:00:00#12:00:00 2
2017b789809d8845bac23785d603941f 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 05/01/2018 12/08/1970 0 2
1 K21.9;J45.9;A09.9 - - - None None None None K-4-12-I
None None None None None None GANGGUAN ESOFAGUS (RINGAN) 2954900
0 0 - 0 - 0 - 0 - 0 2954900
1345387 0 1 0 0 0 ROSMAWATI D143279 47 17313
DR TANTIYO SETIYOWATI 0138R01701180002291 0001101106247 3;JKN DR
RIZKI; 5.2.1.201804062320 4 130501 1#0##0#0#0.0#2018-05-17
14:33:18#0#14:07:00#20:10:00#12:00:00 2 6b45f8f3d964196646679920a1b8e4ef
0 0 265941 0 0 702430 0 0 0 0 377016
0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 05/01/2018 27/08/1950 0 2
None None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 7003960 0 2 0 0 0 EMMA SUHEMAH SANTOSO,
NY. D005345 67 24602 DR ZULFAN, SPPD 0138R01701180001454
0001341261257 3;JKN DR RIZKI; 5.2.2.201806040537 4 129282
1#0##0#0#0.0#2018-09-06 09:00:16#0#12:00:00#12:00:00#12:00:00 2
1e901db9a2bca995358f96b4a2146453 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 05/01/2018 11/06/1979 0 1
None None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5416160 0 2 0 0 0 SUPRIADI TN
0000211433501 3;JKN DR RIZKI; 5.2.2.201806040537 4 129658
1#0##0#0#0.0#2018-09-07 16:07:26#0#12:00:00#12:00:00#00:00:00 2
1d50698d70fd8cb0ce02c0e4294d058c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 05/01/2018 12/08/1970 0 2
1 K21.9;J45.9;A09.9 - - - None None None None K-4-12-I
0 0 - 0 - 0 - 0 - 0 2954900
1345387 0 1 0 0 0 ROSMAWATI D143279 47 17313
DR BETTY DWI L, SPPD 0138R0170118V000018 0001101106247 3;JKN DR
RIZKI; 5.2.2.201806040537 4 228587 1#0##0#0#0.0#2018-09-29
15:35:03#0#00:00:00#00:00:00#12:00:00 1 93d78c5aeeb0f6578c2c030531a40536
0 0 0 0 0 0 0 0 0 0 1345387 0
0 0 0 0
3201126 B 2 BS 1 05/01/2018 06/01/2018 31/05/1982 0 1
1 K51.9;K58.0;I84.2 90.59;45.23 - - None None None None K-4-
0 - 0 - 0 4780000 6850264 0 2 0 0
0 ROLAND FRANK D015733 35 13003 DR ARU, SPPD
0138R01701180001985 0001287055978 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130095 1#0##0#0#0.0#2018-01-29
16:28:13#0#12:00:00#12:00:00#12:00:00 1 44a5f651c4a0319da2499e688119e83e
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 03/01/2018 06/01/2018 08/09/2017 0 1
1 J18.0;Q24.9 87.44;93.94 - - None None None None J-4-16-II
None None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH
(SEDANG) 7108500 0 0 - 0 - 0 - 0 - 0
7108500 7068659 0 4 0 0 0 BAYI NY ISMIYAH
0002284792571 3;JKN DR RIZKI; 5.1.1.201705010501 4 128247
1#0##0#0#0.0#2018-01-30 15:14:26#0#12:00:00#12:00:00#12:00:00 1
22daba15e5191e2380395a48934d521a 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 06/01/2018 01/06/1987 0 2
0 0 - 0 - 0 - 0 - 0 5984100
9985481 0 3 0 0 0 INTAN YUNITA d216079 30
11175 DR RM DHENI DANARDHONO SPOG 0138R01701180001658 0001873767701
3;JKN DR RIZKI; 5.1.1.201705010501 4 129571 1#0##0#0#0.0#2018-
01-30 15:22:45#0#12:00:00#12:00:00#12:00:00 1
34a195e9075ad3836eabddbddbf47e7c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 06/01/2018 16/02/1945 0 2
1 D64.9;A09.9 99.04 - - None None None None D-4-13-I None
None None None None None GANGGUAN SEL DARAH MERAH SELAIN KRISIS ANEMIA
SEL SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0
- 0 3584400 5240701 0 3 0 0 0 ASENIH
0001462352782 3;JKN DR RIZKI; 5.1.1.201705010501 4 129555
1#0##0#0#0.0#2018-01-30 15:24:37#0#12:00:00#12:00:00#12:00:00 1
a691a518e7a57cfe95da94805cc6f21b 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 06/01/2018 25/08/2015 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3461342 0 3 0 0 0 IMANUEL D308526
2 863 DR HUDA HILMAN 0138R01701180001368 0002041762127 3;JKN
DR RIZKI; 5.1.1.201705010501 4 129070 1#0##0#0#0.0#2018-01-30
15:26:15#0#12:00:00#12:00:00#12:00:00 1 ee4695f0aa606a6ed2874063598a90f9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 03/01/2018 06/01/2018 06/07/1957 0 2
1 E11.9;K29.7 87.44;88.76 - - None None None None E-4-10-I
0 - 0 4903800 6664615 0 4 0 0 0
ASNALINA SIALLAGAN D308634 60 22096 DR. ARU ARIADNO, SPPD
0138R01701180000919 0000061066427 3;JKN DR RIZKI; 5.1.1.201705010501
4 128599 1#0##0#0#0.0#2018-01-30
15:57:19#0#12:00:00#12:00:00#12:00:00 1 bcab1179782ab6a81537b72c102c7f92
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 04/01/2018 06/01/2018 03/01/1963 0 2
1 I64;E14.9;M54.22 87.03;87.44 - - None None None None G-4-
15-I None None None None None None KECEDERAAN PEMBULUH DARAH OTAK NON
- 0 - 0 - 0 - 0 5734600 5902794 0
3 0 0 0 YULIANTI D229609 55 20090 DR NURUL KOMARI
SPS 0138R01701180001218 0002070119529 3;JKN DR RIZKI; 5.1.1.201705010501
4 128891 1#0##0#0#0.0#2018-01-30
16:00:12#0#12:00:00#12:00:00#00:00:00 1 7d6138e24e60788c91588abf54ef354a
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 06/01/2018 06/01/2018 01/03/2012 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 2569961 0 1 0 0 0 AQMARUL IKHSAN
D236635 5 2137 DR VERA MUNA MANOE, SPA 0138R01701180002466
0001274835126 3;JKN DR RIZKI; 5.1.1.201705010501 4 130608
1#0##0#0#0.0#2018-01-30 16:02:21#0#12:00:00#12:00:00#00:00:00 1
aee99747d2e9f4116e4128c3faf78400 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 01/01/2018 06/01/2018 01/06/1944 0 1
1 I21.2;I50.9 89.52;87.44;88.19 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 7219300
11855870 0 6 1 3 0 ONIM D386251 73 26877 DR
AZRI NURIZAL SPPD KKV 0138R01701180000038 0001455726104 3;JKN DR RIZKI;
5.1.1.201705010501 4 127653 1#0##0#0#0.0#2018-01-30
16:22:09#0#12:00:00#12:00:00#12:00:00 1 9e2bc300e0526f7139f9e330fedbaa6f
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 04/01/2018 06/01/2018 08/05/2013 0 2
1 A01.0;J02.9 93.94 - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3984310 0 3 0 0 0 KAREEN MEIRA AHMAD
D386524 4 1702 DR AWIDIYA, SPA 0138R01701180001200
0001650347572 3;JKN DR RIZKI; 5.1.1.201705010501 4 128886
1#0##0#0#0.0#2018-01-30 16:40:40#0#12:00:00#12:00:00#12:00:00 1
8e1d0adbab94fdf0a85e64ce0d36d052 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 06/01/2018 22/05/1948 0 2
1 I49.5;E87.5 89.52 - - None None None None I-4-19-II None
None None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG (SEDANG)
6111300 0 0 - 0 - 0 - 0 - 0
6111300 2956786 0 2 0 0 0 MEI ERNI SITOHANG
D184610 69 25430 DR RICO ADITYA 0138R01701180002386
0000013266055 3;JKN DR RIZKI; 5.1.1.201705010501 4 130549
1#0##0#0#0.0#2018-01-30 16:43:38#0#12:00:00#12:00:00#00:00:00 2
da6f50a1bd86e60597c1762697159d6f 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 03/01/2018 06/01/2018 28/01/1965 0 2
1 J18.0;E11.9 87.44 - - None None None None J-4-16-I None
5058500 0 0 - 0 - 0 - 0 - 0
5058500 5063176 0 4 0 0 0 NY.IKA YANIARTI
0001209105898 3;JKN DR RIZKI; 5.1.1.201705010501 4 128881
1#0##0#0#0.0#2018-01-30 16:52:24#0#12:00:00#12:00:00#12:00:00 2
6739b0897887958d86d05cd2badd5811 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 06/01/2018 24/10/1967 0 2
1 A09.9;K29.7 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2250760 0 3 0 0 0 NURJANAH D386535
DR RIZKI; 5.1.1.201705010501 4 129273 1#0##0#0#0.0#2018-01-30
16:55:38#0#12:00:00#12:00:00#12:00:00 1 ccd384b6527fec2281a64043f8d96c67
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 05/01/2018 06/01/2018 11/05/1962 0 1
1 E14.2;K29.7;I25.0 - - - None None None None N-4-16-I
LAIN (RINGAN) 3695900 0 0 - 0 - 0 - 0 -
0 3695900 1527939 0 2 0 0 0 TN. NISIN
D366080 55 20328 DR SRI KUMARTINI 0138R01701180002048
0000509944162 3;JKN DR RIZKI; 5.1.1.201705010501 4 130216
1#0##0#0#0.0#2018-01-30 17:03:19#0#12:00:00#12:00:00#00:00:00 1
31ab498fd4c695fe747ace4eaf61db59 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 03/01/2018 06/01/2018 13/05/1938 0 1
1 I11.0;K29.7;I64 87.44 - - None None None None I-4-12-III
None None None None None None KEGAGALAN JANTUNG (BERAT) 4973600
0 0 - 0 - 0 - 0 - 0 4973600
3495594 0 4 0 0 0 SOEDADI MARIYONO D131075 79
29090 DR. ARU ARIADNO, SPPD 0138R01701180000932 0001261427703 3;JKN
DR RIZKI; 5.1.1.201705010501 4 128601 1#0##0#0#0.0#2018-01-30
17:05:40#0#12:00:00#12:00:00#12:00:00 1 f2a6d29520abb694f6cae1ca0a626b67
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 04/01/2018 06/01/2018 28/05/1951 0 2
1 A09.9;I25.0;K30 89.52 - - None None None None K-4-17-I
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 3229731 0 3 0 0 0 HJ.EUIS SUHAENI
0000060708745 3;JKN DR RIZKI; 5.1.1.201705010501 4 129662
1#0##0#0#0.0#2018-01-30 17:13:25#0#12:00:00#12:00:00#12:00:00 2
277eff882b269f142a7924acdf912dfc 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 05/01/2018 06/01/2018 16/08/1984 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 3810694 0 2 0 0 0 SANI WALIULU
0001627459874 3;JKN DR RIZKI; 5.1.1.201705010501 4 130157
1#0##0#0#0.0#2018-01-30 17:19:42#0#12:00:00#12:00:00#00:00:00 1
6c36d9411d584c61d044304431b82068 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 06/01/2018 06/01/2018 17/11/1964 0 2
1 D06.9 67.19 - - None None None None W-1-30-I None None
None None None None PROSEDUR PADA VAGINA, SERVIK & VULVA (RINGAN)
6531400 0 0 - 0 - 0 - 0 - 0
6531400 3192354 0 1 0 0 0 NIKEN DHARMAYANTI,NY
d386698 53 19408 DR ERDIYAN, SPOG 0138R01701180002455
0000043450514 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130595
1#0##0#0#0.0#2018-01-30 17:25:34#0#12:00:00#20:00:00#12:00:00 1
c6dac0855b73ba5cbddb658df9b66aca 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 03/01/2018 06/01/2018 07/06/1984 0 2
0 0 - 0 - 0 - 0 - 0 5984100
11125366 0 4 0 0 0 MAIMUNAH D386500 33 12263
DR ATJANG S, SPOG 0138R01701180001130 0001742207163 3;JKN TANTIYO
S;16137 5.1.1.201705010501 4 128878 1#0##0#0#0.0#2018-01-30
17:43:25#0#12:00:00#12:00:00#12:00:00 1 34b71dbf0aadecaee9db2f8b399da081
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 05/01/2018 06/01/2018 11/03/1956 0 2
2319600 0 0 - 0 - 0 - 0 - 0
2319600 1469512 0 2 0 0 0 HJ. APSAH d377964
61 22580 DR ARU, SPPD 0138R01701180001774 0001339972391 3;JKN
DR RIZKI; 5.2.0.201712280730 4 129669 1#0##0#0#0.0#2018-02-01
15:07:43#0#12:00:00#12:00:00#12:00:00 2 57cdec1551dec40e411f9143722a48b9
0 0 261764 0 0 822612 0 0 0 0 385136
0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 06/01/2018 25/08/1944 0 1
1 C22.0;E14.9 - - - None None None None B-4-11-I None
None None None None None TUMOR SISTEM HEPATOBILLIARI DAN PANCREAS
(RINGAN) 4874900 0 0 - 0 - 0 - 0 - 0
4874900 2882410 0 2 0 0 0 WARDJIJANA D310247
73 26796 DR RICO ADITYA 0138R01701180002400 0000060732922 3;JKN
DR RIZKI; 5.2.0.201712280730 4 130583 1#0##0#0#0.0#2018-02-12
09:30:26#0#12:00:00#12:00:00#12:00:00 1 3feb13ee012e85a5c80abbedaf1eeea4
0 0 614241 0 0 1201600 0 0 0 0 495569
0 0 0 0 571000
3201126 B 1 BS 1 01/01/2018 06/01/2018 22/07/1967 0 2
1 E11.9;I64;I10 87.03;87.44 - - None None None None E-4-
10-III None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
NUTRISI/ METABOLIK (BERAT) 8768000 0 0 - 0 - 0 -
0 - 0 8768000 20809283 0 6 1 3 0 SILVIA
CHRISTINA.S D299605 50 18426 DR. ARU ARIADNO, SPPD 0138R01701180000002
0001303511049 3;JKN DR RIZKI; 5.2.0.201712280730 4 127656
1#0##0#0#0.0#2018-02-12 12:01:26#0#12:00:00#12:00:00#00:00:00 1
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10830703 0 0 0 0 6206000 0 0 0 0
2580000
3201126 B 3 BS 1 04/01/2018 06/01/2018 20/09/1966 0 2
1 D48.6;D63.0 85.12;99.04 - - None None None None L-1-50-II
None None None None None None PROSEDUR PADA PAYUDARA (SEDANG)
10518600 0 0 - 0 - 0 - 0 - 0
10518600 3674915 0 3 0 0 0 HINDUN IDA D382429
51 18734 RACHMAWATI DR,SPB(K)ONK 0138R01701180001761 0002264371907
3;JKN DR RIZKI; 5.2.0.201712280730 4 129661 1#0##0#0#0.0#2018-
03-09 14:08:00#0#12:00:00#12:00:00#12:00:00 2
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3201126 B 1 BS 1 04/01/2018 06/01/2018 16/02/1979 0 1
1 I12.0;E87.5;D63.8 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 4381645 0 3 0 0 0 ANDRI ARRASYID
d342890 38 14202 DR SRI KUNMARTINI, SPPD 0138R01701180001638
0001260055192 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 129554
1#0##0#0#0.0#2018-03-19 13:05:44#0#12:00:00#12:00:00#00:00:00 3
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1497854 0 0 0 0 2310150 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 06/01/2018 01/06/1945 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1131845 0 2 0 0 0 NANI D386666 72
26516 DR SOEGIONO, SPPD 0138R01701180002155 0000511733586 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 130342 1#0##0#0#0.0#2018-
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3201126 B 3 BS 1 05/01/2018 06/01/2018 28/02/1980 0 1
1 E13.2;D63.8;T82.4 99.04;39.27;90.59 - - None None None None
- 0 - 0 19332400 14295827 0 2 0 0 0
ADE DANIAL BOKULO D386575 37 13826 DR SRI KUN, SPPD
0138R01701180002133 0001960637264 3;JKN DR RIZKI; 5.2.2.201806040537
4 130412 1#0##0#0#0.0#2018-08-13
10:30:55#0#12:00:00#12:00:00#12:00:00 3 3ddffbf87013962381696514e3679ef4
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3201126 B 2 BS 1 02/01/2018 06/01/2018 13/04/1987 0 1
4 I25.0;I50.1 88.55 - - None None None None I-1-15-II None
None None None None None KATETERISASI JANTUNG (SEDANG) 7609600 0
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0 5 1 3 0 CITA ANDRAINI O006395 30 11222 DR
SOEGIONO, SPPD 0138R01701180000551 0001454289715 3;JKN DR RIZKI;
5.2.2.201806040537 4 128127 1#0##0#0#0.0#2018-08-13
10:40:33#0#12:00:00#12:00:00#12:00:00 3 937d31ba067eb4b4d61c540d298c4fd2
0 5655600 1371770 0 0 13052395 0 0 0 0
4723000 0 0 0 0 4292000
3201126 B 2 BS 1 05/01/2018 07/01/2018 06/01/2011 0 2
1 B34.9;G40.9 - - - None None None None A-4-13-II None
None None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN (SEDANG)
3200900 0 0 - 0 - 0 - 0 - 0
3200900 2480623 0 3 0 0 0 ANINDYA SAFIRA PUTRI
D201073 6 2556 DR KRISTON SILITONGA, SPA 0138R01701180002235
0001898263427 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130410
1#0##0#0#0.0#2018-01-26 14:41:44#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 07/01/2018 16/12/2016 0 1
1 A15.3 93.94 - - None None None None J-4-15-I None None
None None None None PERADANGAN DAN INFEKSI PERNAFASAN (RINGAN)
5203800 0 0 - 0 - 0 - 0 - 0
5203800 4485617 0 4 0 0 0 LAIS ANGGA KURNIAWAN
0002208901961 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 129634
1#0##0#0#0.0#2018-01-26 15:00:27#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 31/12/2017 07/01/2018 28/12/1959 0 1
1 E10.1;E87.1;N18.3;E87.5;A41.9 88.76 - - None None None None
E-4-10-III None None None None None None PENYAKIT KENCING MANIS &
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YOHANES MARYONO D386220 58 21188 DR. ARU ARIADNO, SPPD
0138R01712170012285 0001377205975 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 127642 1#0##0#0#0.0#2018-01-26
15:11:30#0#12:00:00#12:00:00#12:00:00 1 34229b68d6dc5874a5de416104057223
0 0 0 0 0 0 0 0 0 0 0 0 0
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3201126 B 3 BS 1 05/01/2018 07/01/2018 12/05/2017 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2043554 0 3 0 0 0 BAYI NY VIRA JUNITA
0002239702097 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130083
1#0##0#0#0.0#2018-01-26 15:19:22#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 05/01/2018 07/01/2018 24/08/2008 0 2
1 A49.9;J45.9 - - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2891063 0 3 0 0 0 LATISSHA ALIN
0001287425621 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130543
1#0##0#0#0.0#2018-01-26 15:26:42#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 04/01/2018 07/01/2018 03/04/1985 0 2
1 E04.9;R25.1 06.52;90.59 - - None None None None E-1-20-II
None None None None None None PROSEDUR PADA TIROID, PARATIROID DAN
SALURAN TIROGLOSAL (SEDANG) 12140300 0 0 - 0 - 0 -
0 - 0 12140300 20460036 0 4 0 0 0 SITI
ROMDIYAH D356014 32 11964 RACHMAWATI DR,SPB(K)ONK 0138R01701180001756
0001469807144 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 129660
1#0##0#0#0.0#2018-01-30 17:31:28#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 05/01/2018 07/01/2018 01/10/1953 0 2
1 D62;I11.0;I25.1;E13.2 90.59 - - None None None None D-4-
13-III None None None None None None GANGGUAN SEL DARAH MERAH SELAIN
KRISIS ANEMIA SEL SICKLE (BERAT) 5407200 0 0 - 0 - 0
- 0 - 0 5407200 2753354 0 3 0 0 0
SURYATI D329400 64 23472 DR AZRI NURIZAL SPPD KKV
0138R01701180002275 0001014230452 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130542 1#0##0#0#0.0#2018-01-30
17:39:42#0#12:00:00#12:00:00#00:00:00 1 60e6d5df2ef53b17888b72faa4f38e2c
0 0 0 0 0 0 0 0 0 0 0 0 0
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3201126 B 1 BS 1 30/12/2017 07/01/2018 06/11/1955 0 1
1 E13.5;I50.0;A41.9;J18.0 93.94;88.77 - - None None None None
I-4-15-III None None None None None None PENYAKIT PEMBULUH DARAH
PERIFER DAN LAIN-LAIN (BERAT) 10244500 0 0 - 0 - 0 -
0 - 0 10244500 14189945 0 9 0 0 0
TENNY .N. WILLEM MANUHUTU D062289 62 22700 DR PRIYO SUNARTO , SPJP
0138R01712170012038 0001861984258 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 127376 1#0##0#0#0.0#2018-01-30
17:56:42#0#12:00:00#12:00:00#12:00:00 1 b62467ca35b05c0c6eb8c13efef5d8f1
0 0 0 0 0 0 0 0 0 0 0 0 0
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3201126 B 1 BS 1 06/01/2018 07/01/2018 14/11/1949 0 2
1 E11.2;I13.1;D63.8 39.27;99.04;90.59 - - None None None None
N-1-12-II None None None None None None MEMBUAT BARU, MEREVISI DAN
MEMINDAHKAN ALAT DIALISIS (SEDANG) 12472300 0 0 - 0 - 0
- 0 - 0 12472300 14206644 0 2 0 0 0
SRI SUMIYATI D376753 68 24890 DR SRI KUN, SPPD
0138R01701180002554 0001459706714 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130775 1#0##0#0#0.0#2018-01-30
18:08:17#0#12:00:00#12:00:00#12:00:00 1 e4d16f1a69a5a8d1733ad041b93bf6d9
0 0 0 0 0 0 0 0 0 0 0 0 0
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3201126 B 1 BS 1 05/01/2018 07/01/2018 05/01/2018 3631 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040510 0 3 0 0 0 BAYI NY DIANA JONATHANS
D386641 0 0 DR GUNAWAN S, SPA 0138R01701180002306
0002326873476 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130510
1#0##0#0#0.0#2018-01-30 18:20:17#0#12:00:00#12:00:00#12:00:00 1
4d2960ad632dca31a9a421334ac41f0c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 03/01/2018 07/01/2018 27/04/1947 0 1
1 E16.2;E87.6 - - - None None None None E-4-10-II None
None None None None None PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/
METABOLIK (SEDANG) 6852200 0 0 - 0 - 0 - 0
- 0 6852200 8719552 0 5 1 2 0 RAHMAN
SETIAWAN D355415 70 25819 DR ZULFAN, SPPD 0138R01701180001118
0001119689919 3;JKN DR RIZKI; 5.1.1.201705010501 4 128882
1#0##0#0#0.0#2018-01-30 18:27:51#0#12:00:00#12:00:00#00:00:00 1
e156efb0ba112dca5abe09a204b75ab7 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 05/01/2018 07/01/2018 18/05/2012 0 1
1 A49.9 88.76 - - None None None None A-4-14-I None None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4653536 0 3 0 0 0 MUHAMMAD KANZIE ADIB AL
FATIH D386626 5 2058 DR OTTY MITHA S, SPA 0138R01701180001790
0001086031517 3;JKN DR RIZKI; 5.1.1.201705010501 4 129670
1#0##0#0#0.0#2018-01-30 19:09:52#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 03/01/2018 07/01/2018 01/08/1946 0 1
1 E14.5;I64;J06.9 87.44;88.77 - - None None None None I-4-
15-I None None None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN LAIN-
LAIN (RINGAN) 6275300 0 0 - 0 - 0 - 0 -
0 6275300 9500085 0 5 0 0 0 DJOHAR ARIFIN,DRS.
0000061007051 3;JKN DR RIZKI; 5.1.1.201705010501 4 128600
1#0##0#0#0.0#2018-01-30 19:14:15#0#12:00:00#12:00:00#00:00:00 1
13e0309e2f627e2d5962b19d3c9b8c6f 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 06/01/2018 07/01/2018 20/11/1965 0 1
1 N18.5;D63.8;I25.0 90.59;89.52;87.44 - - None None None None
- 0 5784900 3019285 0 2 0 0 0 TIMOTIUS
HIDAYAT D381586 52 19040 DR SRI KUN, SPPD 0138R01701180002557
0001738407846 3;JKN DR RIZKI; 5.1.1.201705010501 4 130778
1#0##0#0#0.0#2018-01-30 19:23:28#0#12:00:00#12:00:00#12:00:00 1
d1fc90130452aca0747371ebe67c3317 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 05/01/2018 07/01/2018 15/03/1964 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5566400 0 3 0 0 0 ISMAJAYA
0000059574148 3;JKN DR RIZKI; 5.1.1.201705010501 4 130969
1#0##0#0#0.0#2018-01-30 19:27:47#0#12:00:00#12:00:00#12:00:00 1
5e5fff59564b806992574448c3550784 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 07/01/2018 18/09/1981 0 1
1 K80.8;K29.7 90.59 - - None None None None B-4-14-I None
None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (RINGAN)
5879800 0 0 - 0 - 0 - 0 - 0
5879800 4163223 0 4 0 0 0 ALEXANDER JECK LUMINTANG
0001627300247 3;JKN DR RIZKI; 5.1.1.201705010501 4 129617
1#0##0#0#0.0#2018-01-30 19:31:31#0#12:00:00#12:00:00#12:00:00 1
4f8f9d9b318ba124bc954a1fc49a71cf 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 07/01/2018 19/03/1977 0 1
1 I11.0 - - - None None None None I-4-12-I None None
None None None None KEGAGALAN JANTUNG (RINGAN) 3575600 0 0
- 0 - 0 - 0 - 0 3575600 2445178 0
4 0 0 0 MARULI SUKARNO D386501 40 14901 DR AZRI
NURIZAL SPPD KKV 0138R01701180001216 0001731212436 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 128890 1#0##0#0#0.0#2018-01-30
20:05:08#0#12:00:00#12:00:00#12:00:00 1 1ad976eced61e0fada9aae401e87382d
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 07/01/2018 07/01/2018 05/07/1956 0 2
1 G00.9;A41.9 - - - None None None None G-4-18-III None
None None None None None INFEKSI BAKTERI SISTEM SARAF (BERAT)
6624900 0 0 - 0 - 0 - 0 - 0
6624900 2306643 0 1 0 0 0 SAANAH d386829
61 22466 DR RENDRA RAMADYA 0138R01701180003172 0001338928637 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 132108 1#0##0#0#0.0#2018-
02-01 13:41:39#0#12:00:00#12:00:00#12:00:00 1
d2991bf099e6a635ccbfa380e2aba6af 0 0 596241 0 0 536500
0 0 0 0 457903 0 0 0 715999 0
3201126 B 1 BS 1 05/01/2018 07/01/2018 29/02/2012 0 1
1 J35.3 28.3 - - None None None None U-1-15-I None None
None None None None PROSEDUR TONSIL & ADENOID (RINGAN) 5461000 0
0 - 0 - 0 - 0 - 0 5461000 11132142
0 3 0 0 0 NOAH RIZQULLAH PRIONO D363974 5 2137
DR ASNOMINANDA, SPHT 0138R01701180002362 0001369126552 3;JKN DR
RIZKI; 5.2.0.201712280730 4 143555 1#0##0#0#0.0#2018-02-02
09:16:08#1#12:00:00#12:00:00#00:00:00 1 8b6893b17cfbb8ae04223a858c7cb6a3
0 0 4020840 0 0 1479871 0 0 0 0
5486431 0 0 0 145000 0
3201126 B 1 BS 1 05/01/2018 07/01/2018 17/05/1958 0 2
1 N18.5;G72.9;D64.9 99.04;89.52;90.59;39.95 - - None None None
0 - 0 5784900 5258505 0 3 0 0 0
ROSMIYATI D382439 59 21783 DR SRI KUNMARTINI, SPPD
0138R01701180002253 0001447717882 3;JKN DR RIZKI; 5.2.0.201712280730
4 130464 1#0##0#0#0.0#2018-02-12
09:54:46#0#12:00:00#12:00:00#12:00:00 1 1f678d64d21283b204fb245896e666ab
0 0 520641 0 0 1214100 0 0 0 0
3523764 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 07/01/2018 08/02/1983 0 2
0 0 - 0 - 0 - 0 - 0 6981500
12967067 0 4 0 0 0 DIANA JONATHANS D211712 34
12749 DR FX BHIMANTORO, SPOG 0138R01701180001764 0001456176879 3;JKN
DR RIZKI; 5.2.0.201712280730 4 129664 1#0##0#0#0.0#2018-02-12
11:20:59#0#12:00:00#12:00:00#12:00:00 1 40caa483fdab3e255df9f89a97155ab0
0 6962720 418890 0 0 2595144 0 0 0 0
2990313 0 0 0 0 0
3201126 B 1 BS 1 05/01/2018 07/01/2018 26/11/2014 0 1
1 A09.9;B37.9 - - - None None None None K-4-17-II None
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 3232219 0 3 0 0 0 NOVAN GIFARI YUSUF
0001856065871 3;JKN DR RIZKI; 5.2.0.201712280730 4 130546
1#0##0#0#0.0#2018-03-09 09:37:08#0#12:00:00#12:00:00#12:00:00 2
2d675a34167afd51a6e0b4520fc2c596 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 07/01/2018 27/03/1969 0 2
1 N85.1;D63.0 99.04 - - None None None None W-4-12-II None
None None None None None GANGGUAN MENSTRUASI & SISTEM REPRODUKSI WANITA
LAIN-LAIN (SEDANG) 3857000 0 0 - 0 - 0 - 0
- 0 3857000 5801634 0 4 0 0 0 SITI
AKBARINURULAFIAH A034462 48 17815 DR DENNY DHANARDONO, SPOG
0138R01701180001768 0002037583438 3;JKN DR RIZKI; 5.2.0.201712280730
4 129667 1#0##0#0#0.0#2018-03-09
14:22:32#0#12:00:00#12:00:00#12:00:00 4 8ccec07ebeba828edfbb70094a1e3490
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 06/01/2018 07/01/2018 25/01/1964 0 1
1 D59.3;I64 - - - None None None None D-4-13-III None
SEL SICKLE (BERAT) 5407200 0 0 - 0 - 0 - 0
- 0 5407200 5792154 0 2 0 0 0 EDDY
KASWANTO D370891 53 19705 DR RENDRA RAMADYA 0138R01701180002641
0001723998183 3;JKN DR RIZKI; 5.2.0.201712280730 4 130922
1#0##0#0#0.0#2018-03-09 14:49:37#0#12:00:00#12:00:00#00:00:00 2
df27c81ce0aea83f4f742a80f8a7dbcc 0 0 439974 0 0
3151254 0 0 0 0 685926 0 0 1515000 0
0
3201126 B 2 BS 1 05/01/2018 07/01/2018 27/08/1964 0 2
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4647790 0 3 0 0 0 HETI SETIAWATI
d377284 53 19489 DR SRI KUN, SPPD 0138R01701180002258
0001261150222 3;JKN DR RIZKI; 5.2.1.201804062320 4 130966
1#0##0#0#0.0#2018-05-17 14:30:39#0#12:00:00#12:00:00#12:00:00 4
d41db8ad650be35b628fe985f81b9da3 0 0 446265 0 0
1407714 0 0 0 0 2793811 0 0 0 0 0
3201126 B 1 BS 1 05/01/2018 07/01/2018 31/12/1944 0 1
1 E87.5;A09.9 90.59 - - None None None None E-4-11-I None
None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (RINGAN)
4136800 0 0 - 0 - 0 - 0 - 0
4136800 3755447 0 3 0 0 0 ABDUL ROJAK D356272
TANTIYO S;16137 5.2.1.201804062320 4 130402 1#0##0#0#0.0#2018-
05-17 15:58:42#0#12:00:00#12:00:00#00:00:00 2
a31aa071cf95695d506642561c6eb6cc 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 06/01/2018 07/01/2018 05/11/1957 0 1
- 0 10690500 13867539 0 2 0 0 0 DRS. UTUH
SANTOSO D386748 60 21977 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180002492 0001227548428 3;JKN DR RIZKI; 5.1.1.201705010501
4 130657 1#0##0#0#0.0#2018-09-05
16:49:46#0#12:00:00#12:00:00#12:00:00 2 f8ca90a9aee32e7035dc08d7848ec57d
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 05/01/2018 08/01/2018 17/06/2016 0 2
1 J18.0 93.94 - - None None None None J-4-16-I None None
None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (RINGAN)
3613200 0 0 - 0 - 0 - 0 - 0
3613200 2840677 0 4 0 0 0 KEISAH ANNISAH RAMADHANI
D386710 1 567 DR RASTRA, SPA 0138R01701180003177
0002066396049 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 131389
1#0##0#0#0.0#2018-01-30 15:58:59#0#12:00:00#12:00:00#12:00:00 2
9e59725cb6c3ce4ae5332eb0026dae1d 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 03/01/2018 08/01/2018 23/04/1983 0 1
1 J18.0;I10 - - - None None None None J-4-16-I None
5058500 0 0 - 0 - 0 - 0 - 0
5058500 8708464 0 6 0 0 0 SANTONI SULAIMAN
0001337905359 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 128851
1#0##0#0#0.0#2018-01-30 16:02:05#0#12:00:00#12:00:00#12:00:00 1
699110d7934de7f90c30effc8edab70b 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 05/01/2018 08/01/2018 17/08/1987 0 2
0 0 - 0 - 0 - 0 - 0 5984100
19081185 0 4 0 0 0 ARNELIA PUTRI D380997 30
11099 DR MUTIA P, SPOG 0138R01701180002375 0002229281076 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 130547
1#1#vvip#4#13097085#0.0#2018-01-30 16:22:29#0#12:00:00#12:00:00#12:00:00
1 eca709bfbd91454a4ba94eabd9edd394 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 06/01/2018 08/01/2018 04/03/1967 0 1
1 N18.5;D63.8 99.04;90.59;89.52;39.42 - - None None None None
- 0 - 0 12472300 13953934 0 3 0 0 0
ADI PURWANTO D210287 50 18571 DR SRI KUN, SPPD
0138R01701180002585 0001370717076 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130780 1#0##0#0#0.0#2018-01-30
16:26:27#0#12:00:00#12:00:00#12:00:00 1 0249de989bd089f96eb1000c899bfc15
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 06/01/2018 08/01/2018 15/08/1965 0 1
1 E11.9;I10;A91 90.59 - - None None None None E-4-10-III
0 - 0 8768000 6274357 0 3 0 0 0 SHRI
MULYANTO D386728 52 19137 DR SOEGIONO, SPPD 0138R01701180002406
0000037772684 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130553
1#0##0#0#0.0#2018-01-30 16:29:40#0#12:00:00#12:00:00#12:00:00 1
44bb195d02c759a7268136f265c97b0f 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 08/01/2018 01/10/2009 0 1
1 B34.9;R63.8 - - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1992229 0 5 0 0 0 MUHAMMAD RASYID RAMADHAN
D386521 8 3017 DR AWIDIYA, SPA 0138R01701180001209
0000510578651 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 128889
1#0##0#0#0.0#2018-01-30 16:44:38#0#12:00:00#12:00:00#12:00:00 1
3ac775d91759d386264bbaa8a22c6aee 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 08/01/2018 12/04/1958 0 2
16-II None None None None None None PENYAKIT GINJAL DAN SALURAN URIN LAIN-
LAIN (SEDANG) 5275200 0 0 - 0 - 0 - 0 -
0 5275200 3855723 0 4 0 0 0 TURYATI
0001435178845 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130390
1#0##0#0#0.0#2018-01-30 17:03:07#0#12:00:00#12:00:00#12:00:00 1
9566d82df4938b7f5e1f2490cc870f5a 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 07/01/2018 08/01/2018 09/09/2017 0 2
1 J45.0;J06.9 93.94 - - None None None None J-4-18-I None
None None None None None ASTHMA & BRONKIOLITIS (RINGAN) 2225900
0 0 - 0 - 0 - 0 - 0 2225900
1647465 0 2 0 0 0 MISYKA NOURA CITRA RAMADHAN
0002268859983 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130803
1#0##0#0#0.0#2018-01-30 17:08:19#0#12:00:00#12:00:00#12:00:00 1
92e0093cbed8a0be8cb4cf03805b95e7 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 06/01/2018 08/01/2018 02/11/2016 0 1
1 A49.9;R56.0 - - - None None None None A-4-14-II None
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 2178327 0 3 0 0 0 PRAISYA ANGGUNG DAVIDA
0002198238636 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130786
1#0##0#0#0.0#2018-01-30 17:23:44#0#12:00:00#12:00:00#12:00:00 1
57c096ce6b049f94c21a0a232bcc1095 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 08/01/2018 22/08/2017 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 6079747 0 5 0 0 0 FATHAN NAUFAL ALFARABI
AN. D374328 0 135 DR OTTY MITHA S, SPA 0138R01701180001384
0002278513034 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 129114
1#0##0#0#0.0#2018-01-30 17:41:47#0#12:00:00#12:00:00#12:00:00 1
a043e9441e9989216f4c98a31b9b5ce3 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 08/01/2018 10/05/1983 0 1
1 A91;K29.6 90.59;89.52 - - None None None None A-4-13-I
(RINGAN) 2090000 0 0 - 0 - 0 - 0 - 0
2090000 2596516 0 5 0 0 0 DHARU SUKMAJATI
0001796651302 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130084
1#0##0#0#0.0#2018-01-30 17:44:58#0#12:00:00#12:00:00#12:00:00 1
40cd8e3211077e97ae52e56dacf41f41 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 04/01/2018 08/01/2018 11/04/1966 0 2
1 I63.9;G81.9;I11.9 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 5323296 0 5 0 0 0 NURLAELA
D386594 51 18896 DR NURUL KOMARI SPS 0138R01701180001667
0002280451454 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 129659
1#0##0#0#0.0#2018-01-30 17:46:14#0#12:00:00#12:00:00#12:00:00 1
3a3980a85cb370ecd5b53e2870ba5d77 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 07/01/2018 08/01/2018 15/11/1967 0 2
- 0 10690500 11806061 0 2 0 0 0 WARKINAH
0001311658389 3;JKN DR RIZKI; 5.1.1.201705010501 4 130804
1#0##0#0#0.0#2018-01-30 18:08:48#0#12:00:00#12:00:00#12:00:00 1
5f8af81b9a12257deef753a61516f4a4 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 06/01/2018 08/01/2018 28/08/1950 0 1
1 I20.9;I25.0;I11.0;I08.9 88.55;36.07;90.59;89.52 - - YY02 None
None None I-1-40-III None None YY-02-III None None None PROSEDUR
KARDIOVASKULAR PERKUTAN (BERAT) 41224800 0 0 PCI 10725800 -
0 - 0 - 0 51950600 59457585 0 3 0 0
0 IDRIS D386684 67 24603 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180002423 0000197980828 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130555 1#0##0#0#0.0#2018-01-30
19:07:19#0#12:00:00#12:00:00#12:00:00 1 a6f374e5bab1ac46b135fdf5123181bc
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 06/01/2018 08/01/2018 11/04/1993 0 2
1 A16.1;M54.57 87.44;87.24 - - None None None None J-4-
15-I None None None None None None PERADANGAN DAN INFEKSI PERNAFASAN
(RINGAN) 5203800 0 0 - 0 - 0 - 0 - 0
5203800 4039749 0 3 0 0 0 APRILIA PUTRI
D386468 24 9036 DR HARDI PRANATA SPS 0138R01701180002506
0001636349499 3;JKN DR RIZKI; 5.1.1.201705010501 4 130697
1#0##0#0#0.0#2018-01-30 19:07:54#0#12:01:02#12:01:02#12:00:00 1
1935ccdc7469cc54a9a42a5c0c577305 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 06/01/2018 08/01/2018 06/01/2018 2992 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437343 0 3 0 0 0 BAYI NY MAIMUNAH
0002327131855 3;JKN DR RIZKI; 5.1.1.201705010501 4 131097
1#0##0#0#0.0#2018-01-30 19:17:17#0#12:00:00#12:00:00#12:00:00 1
67f47175878cd245093308567cc7a9d0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 07/01/2018 08/01/2018 15/09/2013 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1813176 0 2 0 0 0 ALZENA KHALIQA WIBOWO
0002249741744 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130793
1#0##0#0#0.0#2018-01-30 20:02:17#0#12:00:00#12:00:00#12:00:00 1
5dd23ce7758f05ea479ffe5b6c9d1c7e 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 07/01/2018 08/01/2018 24/10/2014 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1552584 0 2 0 0 0 ABDILLAH BARQY ABASSY
D285478 3 1171 DR RASTRA, SPA 0138R01701180002645
0002083818677 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130789
1#0##0#0#0.0#2018-01-30 20:03:43#0#12:00:00#12:00:00#12:00:00 1
27bfe8633467b75ca0bc6b1f103b3b79 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 06/01/2018 08/01/2018 22/04/1985 0 1
1 S65.0;I77.2;S66.2 39.59;38.33;82.99 - - None None None None
I-1-20-II None None None None None None PROSEDUR SISTIM PEREDARAN
DARAH LAIN-LAIN (SEDANG) 19193800 0 0 - 0 - 0 -
0 - 0 19193800 25800759 0 3 0 0 0 OKY
ENDITO HARDONINGTIAS D386813 32 11947 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180002600 0001445667917 3;JKN DR RIZKI; 5.2.0.201712280730
4 130782 1#0##0#0#0.0#2018-02-01
08:35:29#0#12:00:00#12:00:00#12:00:00 1 a5e23b45262ede9eb031bc334d4407f3
0 0 9649900 0 0 7284959 0 0 0 0
8865900 0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 08/01/2018 25/07/1958 0 1
1 N18.5;D63.8 39.95 - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3165851 0 1 0 0 0 ROKIB D348894 59
21717 DR YOHANNES DWINANDA 0138R01701180002844 0001125532642 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 130818 1#0##0#0#0.0#2018-
02-01 15:32:55#0#12:00:00#12:00:00#00:00:00 1
67410310f36690f9cb14266e2cabacbe 0 0 371889 0 0
1141600 0 0 0 0 470112 0 0 0 1182250
0
3201126 B 3 BS 1 08/01/2018 08/01/2018 22/04/1966 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2081299 0 1 0 0 0 JOHN TUA MP SIMARMATA,
SE D148895 51 18889 DR YOHANES DWINANDA R P 0138R01701180002845
0001423898605 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131695
1#0##0#0#0.0#2018-02-01 15:35:21#0#12:00:00#12:00:00#00:00:00 1
1a968025011246aab3e898a8271fb264 0 0 371889 0 0 128000
0 0 0 0 399160 0 0 0 1182250 0
3201126 B 1 BS 1 07/01/2018 08/01/2018 13/06/1971 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 4958458 0 2 0 0 0 ARIS MUNENDAR TN
0000045100124 3;JKN DR RIZKI; 5.2.0.201712280730 4 130812
1#0##0#0#0.0#2018-02-12 09:38:36#0#12:00:00#12:00:00#00:00:00 1
2359cb99a9e1eb5277abefce83659c1d 0 0 573641 0 0
1661682 0 0 0 0 2723135 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 08/01/2018 29/04/2017 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1859058 0 4 0 0 0 MUHAMMAD SULTAN
FIERLIANSYAH D386724 0 251 DR RASTRA, SPA 0138R01701180002394
0002249068386 3;JKN DR RIZKI; 5.2.0.201712280730 4 130551
1#0##0#0#0.0#2018-02-12 09:48:54#0#12:00:00#12:00:00#12:00:00 1
884db3744a40e1ff18f6098c5a1ef282 0 0 207620 0 0 714817
0 0 0 0 936621 0 0 0 0 0
3201126 B 3 BS 1 04/01/2018 08/01/2018 28/11/1951 0 2
1 I21.3;I25.0;I11.9;I08.9 88.55;36.07;90.59;89.52 - - YY02 None
None None I-1-40-II None None YY-02-III None None None PROSEDUR
KARDIOVASKULAR PERKUTAN (SEDANG) 25720600 0 0 PCI 10725800 -
0 - 0 - 0 36446400 73087104 0 5 0 0
0 THAI DJI KHIUN D386590 66 24144 DR AZRI NURIZAL SPPD KKV
0138R01701180001692 0001388641331 3;JKN DR RIZKI; 5.2.0.201712280730
4 129589 1#0##0#0#0.0#2018-03-09
13:33:40#0#12:00:00#12:00:00#12:00:00 2 f0884024e1e4801e8a5c0b17f867515a
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 07/01/2018 08/01/2018 15/05/1954 0 1
1 I12.0;D63.8;A49.9;I25.0 99.04;39.42 - - None None None None
- 0 - 0 8908800 10582347 0 2 0 0 0
S. DARNO D384005 63 23248 DR SRI KUN, SPPD 0138R01701180002751
0001259236067 3;JKN DR RIZKI; 5.2.0.201712280730 4 130805
1#0##0#0#0.0#2018-03-10 09:11:10#0#12:00:00#12:00:00#12:00:00 2
b1c229951844f5b09c3b2c9e6576d5af 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 07/01/2018 08/01/2018 18/06/1940 0 1
1 H81.3;R11 - - - None None None None U-4-11-I None
None None None None None DYSEQUILIBRIUM (RINGAN) 2124500 0 0
- 0 - 0 - 0 - 0 2124500 2602273 0
2 0 0 0 MANGATAS A.P. SILITONGA D306843 77 28327 DR
5.2.1.201804062320 4 130791 1#0##0#0#0.0#2018-05-07
14:34:06#0#12:00:00#12:00:00#00:00:00 4 403c616d0789e41ca3f235275de47bf7
0 0 344459 0 0 499572 0 0 0 0
1758242 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 08/01/2018 01/01/1968 0 2
1 R11;R42 88.76;89.52 - - None None None None K-4-17-I
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 3414629 0 4 0 0 0 HARIYANI D090434
50 18267 DR NURUL KOMARI SPS 0138R01701180002084 0002208982184
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 130232
1#0##0#0#0.0#2018-05-17 16:03:38#0#12:00:00#12:00:00#00:00:00 2
68d8f8f8e0b188499956272c31263e3b 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 08/01/2018 01/12/1959 0 2
1 K21.9;R07.4 89.52 - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 2954900 2173131
0 1 0 0 0 RAHMAWATI D386978 58 21223 DR ELISABETH
DYAH NOVIANI 0138R01701180003398 0000511806069 3;JKN DR RIZKI;
5.2.0.201712280730 4 131644 1#0##0#0#0.0#2018-08-13
10:34:03#0#17:23:00#23:43:00#12:00:00 3 4c6ca1fe11f4d7c4ca9088403bed7525
0 0 378234 0 0 927730 0 0 0 0 449167
0 0 0 418000 0
3201126 B 2 BS 1 05/01/2018 08/01/2018 05/01/2017 0 1
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 2851737 0 4 0 0 0 MIKHAYLA HANUM PUTRI
KARTA D386721 0 365 DR OTTY MITHA S, SPA 0138R01701180002438
0002213748022 3;JKN DR RIZKI; 5.2.2.201806040537 4 130559
1#0##0#0#0.0#2018-08-13 10:43:16#0#12:00:00#12:00:00#12:00:00 2
c3be4929e1a0282fec76ac31d9d01452 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 09/01/2018 09/01/2018 3435 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3154201 0 1 0 0 0 AIRA AZKADINA NAMORA
PULUNGAN D387051 0 0 DR SRI SAPARNI, SPA 0138R01701180004377
0002327832549 3;JKN DR RIZKI; 5.1.1.201705010501 4 132927
1#0##0#0#0.0#2018-01-30 11:10:20#0#12:00:00#12:00:00#12:00:00 1
a27eb08c25f2787484a95ad41df1632c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 07/01/2018 09/01/2018 19/11/1962 0 1
1 I20.0;I25.0;I05.9;I11.0 88.55;36.07 - - YY02 None None None
- 0 58821400 62108756 0 3 0 0 0 ONTO PRABOWO
0000037205379 3;JKN DR RIZKI; 5.1.1.201705010501 4 130794
1#0##0#0#0.0#2018-01-30 11:46:04#0#12:00:00#12:00:00#12:00:00 1
b60a2e42e99dfc64eb9099816d432301 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 05/01/2018 09/01/2018 27/11/2015 0 1
1 R56.0 - - - None None None None G-4-22-I None None
None None None None SERANGAN KEJANG (RINGAN) 3718200 0 0
- 0 - 0 - 0 - 0 3718200 5673090 0
5 0 0 0 MUHAMMAD AUFAR D386686 2 770 DR RASTRA,
SPA 0138R01701180002229 0001710876295 3;JKN DR RIZKI; 5.1.1.201705010501
4 130413 1#0##0#0#0.0#2018-01-30
17:36:55#0#12:00:00#12:00:00#12:00:00 1 b2f10cd29a5b74d81ff3260f6a1b4053
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 07/01/2018 09/01/2018 02/07/1966 0 2
- 0 10690500 12328826 0 3 0 0 0 HJ. MARYATI
0001259148328 3;JKN DR RIZKI; 5.1.1.201705010501 4 130802
1#0##0#0#0.0#2018-01-30 17:42:54#0#12:00:00#12:00:00#12:00:00 1
7112d32710e0eb0eee1329f8516a6e36 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 07/01/2018 09/01/2018 18/12/1955 0 1
- 0 8908800 10736653 0 3 0 0 0 MUHAMAD NUR
D384762 62 22666 DR SRI KUN, SPPD 0138R01701180002754
0001469578083 3;JKN DR RIZKI; 5.1.1.201705010501 4 130806
1#0##0#0#0.0#2018-01-30 18:01:22#0#12:00:00#12:00:00#12:00:00 1
a1bef311ac13690c59d6afd7fbe6b118 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 07/01/2018 09/01/2018 05/04/1976 0 1
1 E14.2;D63.8;A49.9;I10 99.04;39.27 - - None None None None
- 0 - 0 10690500 16873101 0 3 0 0 0
SUPRIYANTO D386865 41 15252 DR SRI KUN, SPPD 0138R01701180002705
0001153205223 3;JKN DR RIZKI; 5.1.1.201705010501 4 130796
1#0##0#0#0.0#2018-01-30 18:05:41#0#12:00:00#12:00:00#12:00:00 1
5c00305739869536ebda72e234ed7c8c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 06/01/2018 09/01/2018 12/11/1968 0 2
0 0 - 0 - 0 - 0 - 0 4973600
4394811 0 4 0 0 0 SUMINI D386820 49 17952
DR AZRI NURIZAL SPPD KKV 0138R01701180003187 0001283774264 3;JKN
DR RIZKI; 5.1.1.201705010501 4 131394 1#0##0#0#0.0#2018-01-30
18:11:15#0#12:00:00#12:00:00#12:00:00 1 9ca75d776354d56300bf5aa7cacbcddb
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 07/01/2018 09/01/2018 16/04/1965 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 3620299 0 3 0 0 0 YAHYA D363282 52
19259 DR SRI KUNMARTINI, SPPD 0138R01701180002787 0001155907473 3;JKN
DR RIZKI; 5.1.1.201705010501 4 130808 1#0##0#0#0.0#2018-01-30
18:13:59#0#12:00:00#12:00:00#00:00:00 1 0e69cb32fdabe7356adffe9aff04a7bc
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 07/01/2018 09/01/2018 08/12/1950 0 2
1 E04.0;L04.0 06.11 - - None None None None E-4-13-I None
None None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN (RINGAN)
5176000 0 0 - 0 - 0 - 0 - 0
5176000 4142922 0 3 0 0 0 ZURNA ALI D384995
3;JKN DR RIZKI; 5.1.1.201705010501 4 130811 1#0##0#0#0.0#2018-
01-30 18:18:29#0#12:00:00#12:00:00#12:00:00 1
5ecfd38716ea1c0e426d0ee8d61be2af 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 07/01/2018 09/01/2018 13/08/2006 0 1
1 N30.9 99.21;88.75 - - None None None None N-4-12-I None
2871200 0 0 - 0 - 0 - 0 - 0
2871200 3336158 0 3 0 0 0 SHAFA MAHDIYAH UTAMI
0001297375942 3;JKN DR RIZKI; 5.1.1.201705010501 4 130792
1#0##0#0#0.0#2018-01-30 18:20:05#0#12:00:00#12:00:00#12:00:00 1
f48b857636f45093ee21f4bd1ca5f559 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 07/01/2018 09/01/2018 01/08/1963 0 2
1 N18.5;D63.8;R63.0 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 4315689 0 3 0 0 0 MULYATI
0000512880366 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130799
1#0##0#0#0.0#2018-01-30 18:21:53#0#12:00:00#12:00:00#12:00:00 1
048eed1148b012e62ee77f06cd8c93a6 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 07/01/2018 09/01/2018 21/02/1959 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5326455 0 3 0 0 0 ROSIYATI D384812
58 21505 DR SRI KUNMARTINI, SPPD 0138R01701180002792 0000044937145
3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130809
1#0##0#0#0.0#2018-01-30 18:23:30#0#12:00:00#12:00:00#12:00:00 1
01301ae5ebe3fec00ad34f1c756e2c85 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 30/12/2017 09/01/2018 10/10/1953 0 2
1 J18.9;I11.0;E11.6;I51.7;J45.9 - - - None None None None
J-4-16-III None None None None None None SIMPLE PNEUMONIA & WHOOPING
COUGH (BERAT) 8987600 0 0 - 0 - 0 - 0 -
0 8987600 15933770 0 11 0 0 0 EUIS NANI NURJANI
D106422 64 23457 DR BOBBY SP.P 0138R01712170012035
0001267825792 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 127416
1#0##0#0#0.0#2018-01-30 18:34:22#0#12:00:00#12:00:00#00:00:00 1
9e4c335e216d04d1e0794a271b5c83d3 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 08/01/2018 09/01/2018 22/12/1989 0 2
1 O62.4 - - - None None None None W-4-16-I None None
None None None None GANGGUAN ANTEPARTUM (RINGAN) 2601900 0 0
- 0 - 0 - 0 - 0 2601900 2193843 0
2 0 0 0 EKA TATIEK ULANSARI D214736 28 10244 DR
ERDIYAN, SPOG 0138R01701180003051 0001627459997 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 131794 1#0##0#0#0.0#2018-01-30
19:09:17#0#12:00:00#12:00:00#00:00:00 1 303a0bcac0a63489fdc0a9bd8e901834
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 06/01/2018 09/01/2018 01/10/1945 0 1
1 K29.7;A09.9 - - - None None None None K-4-11-I None
None None None None None GASTRITIS & ULKUS PEPTIKUM (RINGAN) 2319600
0 0 - 0 - 0 - 0 - 0 2319600
2958781 0 4 0 0 0 SAYUM D386790 72 26395 DR
ARU, SPPD 0138R01701180002537 0000509711242 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 131039 1#0##0#0#0.0#2018-01-30
19:11:24#0#12:00:00#12:00:00#12:00:00 1 6df3e268599b277cc261eb1cd2a33173
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 06/01/2018 09/01/2018 21/10/1998 0 2
1 K35.2 54.11 - - None None None None K-1-40-I None None
None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
9351000 0 0 - 0 - 0 - 0 - 0
9351000 13965069 0 4 0 0 0 CINDY PERMATA SARI
D386726 19 7017 DR HENDRIEK S, SPB 0138R01701180002399
0001477930037 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130552
1#0##0#0#0.0#2018-01-30 19:15:57#0#12:00:00#12:00:00#12:00:00 1
a9573bbe4bfa76358244656c26e61d12 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 06/01/2018 09/01/2018 18/04/1960 0 2
1 E10.6;K29.7;H81.4 87.03 - - None None None None E-4-10-I
0 - 0 4903800 8146884 0 4 0 0 0 ELLY
DWI SARWANTI,DRA,MM D221141 57 21082 DR ARU, SPPD
0138R01701180002407 0000038269067 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130554 1#0##0#0#0.0#2018-01-30
19:21:21#0#12:00:00#12:00:00#12:00:00 1 4bc9f890f1ef7c93395131aebae04c2c
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 06/01/2018 09/01/2018 27/04/1994 0 2
1 D39.1;E87.1;R63.0 - - - None None None None W-4-12-II
None None None None None None GANGGUAN MENSTRUASI & SISTEM REPRODUKSI
WANITA LAIN-LAIN (SEDANG) 5399900 0 0 - 0 - 0 -
0 - 0 5399900 6388551 0 4 0 0 0 ERVA
KARIMATUNISA D384685 23 8655 DR. ARU ARIADNO, SPPD
0138R01701180002529 0000061164101 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130736 1#0##0#0#0.0#2018-01-30
19:24:56#0#12:00:00#12:00:00#12:00:00 1 131e2377a0f21320acd50d9ef6f994ce
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 08/01/2018 09/01/2018 07/08/1981 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2062548 0 2 0 0 0 LIAWATI D208755
36 13303 DR ARU, SPPD 0138R01701180003426 0001463521465 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 131650 1#0##0#0#0.0#2018-
01-30 19:27:10#0#12:00:00#12:00:00#00:00:00 1
129a5506de04e4dcdb848796d909ac9b 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 05/01/2018 09/01/2018 01/09/1948 0 1
1 I50.0;J44.9 - - - None None None None I-4-12-II None
None None None None None KEGAGALAN JANTUNG (SEDANG) 4973600 0
0 - 0 - 0 - 0 - 0 4973600 4943775
0 5 0 0 0 H A CHALIK W D346526 69 25328 DR
SUPONO 0138R01701180002344 0001167252219 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130545 1#0##0#0#0.0#2018-01-30
19:30:40#0#12:00:00#12:00:00#00:00:00 1 f160f939e7cbeab7e947af2c2b4bc71e
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 07/01/2018 09/01/2018 11/10/1959 0 1
- 0 8908800 11250436 0 3 0 0 0 CECEP
D374795 58 21273 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180002737 0001841397794 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130801 1#0##0#0#0.0#2018-01-30
19:39:37#0#12:00:00#12:00:00#12:00:00 1 e481fdd9b8df2ff8ce4735a120bbd768
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 07/01/2018 09/01/2018 12/04/1971 0 1
1 I12.0;D63.8;A49.9;K21.9;L02.1 99.04 - - None None None None
- 0 4132100 2475615 0 3 0 0 0 PRIJO
DJATMIKO HADISAPUTRO D329418 46 17072 DR SRI KUNMARTINI, SPPD
0138R01701180002701 0001272243453 3;JKN DR RIZKI; 5.1.1.201705010501
4 130798 1#0##0#0#0.0#2018-01-30
19:43:03#0#12:00:00#12:00:00#00:00:00 1 66a021481a859489e6d157a0874e967c
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 07/01/2018 09/01/2018 24/04/1975 0 2
1 I13.1;A41.9;D64.9;N39.0 99.04 - - None None None None N-4-
10-III None None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL
GINJAL (BERAT) 8508800 0 0 - 0 - 0 - 0 -
0 8508800 5462774 0 3 0 0 0 IRMA PRIHANTI SARI
0001459879334 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130810
1#0##0#0#0.0#2018-01-30 19:53:58#0#12:00:00#12:00:00#00:00:00 1
8b8d40cdc8e06a88e34cc6e66c843cd2 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 01/01/2018 09/01/2018 21/10/1956 0 1
1 I63.9;E11.6;J18.0;I11.0;D64.9;G81.9 99.04;87.03;93.94 - - None
None None None G-4-14-III None None None None None None KECEDERAAN
PEMBULUH DARAH OTAK DENGAN INFARK (BERAT) 10406600 0 0 - 0 -
0 - 0 - 0 10406600 28234995 0 9 0 0
0 SJAENAN D386255 61 22352 DR. ARU ARIADNO, SPPD
0138R01701180000055 0000060550323 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 127658 1#0##0#0#0.0#2018-01-30
19:58:53#0#12:00:00#12:00:00#12:00:00 1 175442a87e1e2143561e69a925728a28
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 07/01/2018 09/01/2018 02/03/1984 0 1
1 A01.0;K29.7 99.21 - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2385424 0 3 0 0 0 ROHMAT KARTOLO
0001632561895 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 130815
1#0##0#0#0.0#2018-01-30 20:00:37#0#12:00:00#12:00:00#12:00:00 1
0f246a029d8ade19254f7f09c56876e2 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 09/01/2018 22/08/1981 0 2
0 0 - 0 - 0 - 0 - 0 3296400
5451668 0 1 0 0 0 MAMNUN KHUNAFAH D311678 36
13289 DR ZULFAN, SPPD 0138R01701180003461 0001315749137 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 131660 1#0##0#0#0.0#2018-
01-31 15:34:12#0#12:00:00#12:00:00#12:00:00 1
e66ff5dadb0f9c797b542a18ef5cf1b2 0 0 975992 0 0 925525
0 0 0 0 1801151 0 0 0 0 1749000
3201126 B 3 BS 1 07/01/2018 09/01/2018 08/11/1970 0 1
1 K51.9;K59.0 45.23;90.59 - - None None None None K-4-13-I
None None None None None None DIVERTIKULITIS, DIVERTIKULOSIS DAN
0 - 0 - 0 3983300 5928676 0 3 0 0
0 ENTJIK MOHAMMAD RAMADHANI N. D386301 47 17227 DR ZULFAN, SPPD
0138R01701180002836 0001733093469 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 130817 1#0##0#0#0.0#2018-01-31
15:48:19#0#12:00:00#12:00:00#12:00:00 1 235befad1e467cccbfbae07d445e16c4
0 0 597040 0 0 1900279 0 0 0 0
1682357 0 0 0 0 1749000
3201126 B 1 BS 1 09/01/2018 09/01/2018 01/01/1944 0 1
1 D29.1;D63.0;I11.0 99.04 - - None None None None V-4-11-III
None None None None None None PENYAKIT SISTEM REPRODUKSI LAKI-LAKI
SELAIN TUMOR (BERAT) 9579300 0 0 - 0 - 0 - 0
- 0 9579300 2859499 0 1 0 0 0 A DACHLAN R
D321636 74 27037 DR R SIDDI 0138R01701180003674 0000060742359
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131982
1#0##0#0#0.0#2018-02-01 09:14:00#0#12:00:00#12:00:00#00:00:00 1
7e526d29b0992b6f31e40c11d0c37cba 0 0 1113579 0 0 751850
0 0 0 0 994070 0 0 0 0 0
3201126 B 2 BS 1 08/01/2018 09/01/2018 16/01/2015 0 1
None None None None PROSEDUR HERNIA INGUINAL DAN FEMORAL (RINGAN)
6586700 0 0 - 0 - 0 - 0 - 0
6586700 8380648 0 2 0 0 0 SATRIO ADI WIDODO
D385237 2 1088 DR CATUR SUZANTARA 0138R01701180003066
0001876875221 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131115
1#0##0#0#0.0#2018-02-01 15:53:51#0#10:39:48#10:39:48#12:00:00 1
dbc16f29fee219e53cdab72eb1702f27 0 4433500 1907276 0 0
1270605 0 0 0 0 624267 0 0 0 145000
0
3201126 B 1 BS 1 08/01/2018 09/01/2018 28/05/2015 0 1
None None None None PROSEDUR HERNIA TIDAK TERMASUK INGUINAL & FEMORAL
(RINGAN) 4809500 0 0 - 0 - 0 - 0 - 0
4809500 10027657 0 2 0 0 0 ABYAZ EL FATHARIZZ
ARDIVA D368425 2 956 DR CATUR SUZANTARA 0138R01701180003044
0001899883157 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131066
1#0##0#0#0.0#2018-02-01 15:58:06#0#12:00:00#12:00:00#12:00:00 1
6f12af26ae5f9cd1b548ea2ef5582834 0 6558200 1346660 0 0
1245782 0 0 0 0 732015 0 0 0 145000
0
3201126 B 3 BS 1 08/01/2018 09/01/2018 23/03/2017 0 1
1 N48.1 64.0 - - None None None None V-1-15-I None None
None None None None SIRKUMSISI DENGAN KONDISI TERTENTU (RINGAN)
1467400 0 0 - 0 - 0 - 0 - 0
1467400 3999595 0 2 0 0 0 BAYI NY HAIRINNISAH
0002260578745 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131155
1#0##0#0#0.0#2018-02-01 16:06:51#0#12:00:00#12:00:00#12:00:00 1
dc9d7dc3c71833fdc3adbdb71ec96107 0 2380000 410872 0 0
746067 0 0 0 0 317656 0 0 0 145000
0
3201126 B 3 BS 1 09/01/2018 09/01/2018 17/07/1949 0 1
2 I21.3;A49.9;R57.0 - - - None None None None I-4-10-III
None None None None None None INFARK MYOKARD AKUT (BERAT) 10401900
0 0 - 0 - 0 - 0 - 0 10401900
4046538 0 1 0 0 0 MUCHTAR d387039 68 25013
DR ANGGA TOMALA PUTRA 0138R01701180003729 0001722559353 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 133593 1#0##0#0#0.0#2018-
02-01 16:38:57#0#12:00:00#12:00:00#12:00:00 1
e601c8a4282457486985d0acf79ee393 0 0 936171 0 0
2556640 0 0 0 0 553727 0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 09/01/2018 01/07/1979 0 1
1 E87.6;K29.7;B23 - - - None None None None E-4-11-I
None None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (RINGAN)
2954900 0 0 - 0 - 0 - 0 - 0
2954900 2184587 0 2 0 0 0 THEODORE CORNELIUS. W
d386947 38 14071 DR RENDRA RAMADYA 0138R01701180003368
0002223041602 3;JKN DR RIZKI; 5.2.0.201712280730 4 131638
1#0##0#0#0.0#2018-02-08 11:35:12#0#12:00:00#12:00:00#12:00:00 1
6bfd0d71b80aac524cf6c9ab9f23615c 0 0 265941 0 0 0
0 1426200 0 0 327846 0 164600 0 0 0
3201126 B 3 BS 1 08/01/2018 09/01/2018 21/01/1976 0 2
1 A17.0;A41.9;E87.8;E16.2;R57.9 89.52 - - None None None None
G-4-18-III None None None None None None INFEKSI BAKTERI SISTEM SARAF
(BERAT) 6624900 0 0 - 0 - 0 - 0 - 0
6624900 6544658 0 2 0 0 0 TASNIM D386028
41 15328 DR LIDYA SANTALIA 0138R01701180003397 0001771734082 3;JKN
DR RIZKI; 5.2.0.201712280730 4 131646 1#0##0#0#0.0#2018-02-08
17:14:23#0#12:00:00#12:00:00#12:00:00 1 714446bf26d5ffa21d172ca4bd2f0ad6
0 0 596241 0 0 4021262 0 0 0 0 735155
0 0 0 290000 902000
3201126 B 3 BS 1 09/01/2018 09/01/2018 06/10/2017 0 1
1 J22;A49.9 - - - None None None None J-4-21-I None
None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM PERNAFASAN
LAIN-LAIN (RINGAN) 2798500 0 0 - 0 - 0 - 0
- 0 2798500 3117984 0 1 0 0 0 BY NY YUNI
TIKA RATU JAYA D378253 0 95 DR ANGGA TOMALA PUTRA
0138R01701180003690 0002294373958 3;JKN DR RIZKI; 5.2.0.201712280730
4 132082 1#0##0#0#0.0#2018-02-08
17:18:19#0#09:10:00#15:00:00#00:00:00 1 78f53b09f902ccb129e937bb9a140ff0
0 0 325188 0 0 2299816 0 0 0 0 492980
0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 09/01/2018 12/12/2017 0 2
1 A09.9;B37.8;A41.9 - - - None None None None K-4-17-III
(BERAT) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 963312 0 2 0 0 0 BAYI NY DEWI NURYANTI
D384476 0 27 DR ELISABETH DYAH NOVIANI 0138R01701180003427
0002319544539 3;JKN DR RIZKI; 5.2.0.201712280730 4 131652
1#0##0#0#0.0#2018-02-09 08:33:46#0#19:00:00#02:45:00#12:00:00 1
121581fb38332176abc17d8fc710b9c4 0 0 228492 0 0 382800
0 0 0 0 352020 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 09/01/2018 01/11/2004 0 2
1 Q21.3;Q21.0;R23.0 87.44 - - None None None None I-4-18-I
None None None None None None PENYAKIT JANTUNG KONGENITAL DAN KATUP
JANTUNG (RINGAN) 4057700 0 0 - 0 - 0 - 0 -
0 4057700 1889639 0 1 0 0 0 MARISKA. R
D386569 13 4817 DR ANGGA TOMALA PUTRA 0138R01701180003789
0000511498236 3;JKN DR RIZKI; 5.2.0.201712280730 4 147791
1#0##0#0#0.0#2018-02-10 11:47:45#0#10:40:00#19:45:00#12:00:00 1
8cd0a41306b462e4d1e5e16d41c0fa06 0 0 352341 0 0
1124677 0 0 0 0 412621 0 0 0 0 0
3201126 B 2 BS 1 06/01/2018 09/01/2018 17/02/1982 0 2
1 N85.3;D62;R57.1 99.04;69.09 - - None None None None W-1-
11-III None None None None None None PROSEDUR DILATASI, KURET,
INTRAUTERIN & SERVIK (BERAT) 3370000 0 0 - 0 - 0 -
0 - 0 3370000 14576117 0 4 1 2 0 INDAH
DWI PURWATI D366605 35 13107 DR AFRA FONDA SPOG 0138R01701180003168
0002256188591 3;JKN DR RIZKI; 5.2.2.201806040537 4 131340
1#0##0#0#0.0#2018-08-13 12:30:24#0#12:00:00#12:00:00#12:00:00 2
69dbbf8ce22865cdb1fecb09f79307cc 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 10/01/2018 15/08/1962 0 1
1 K30;R07.4 - - - None None None None K-4-18-I None
None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1744325 0 2 0 0 0 ARKIYANTO D384905
55 20236 DR ERTY MASIHAT 0138R01701180004047 0001469267561 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 132435 1#0##0#0#0.0#2018-
01-25 14:03:06#0#12:00:00#12:00:00#12:00:00 1
acf7491dbfed009b77b62358dc7b9f45 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 08/01/2018 10/01/2018 31/12/1954 0 1
1 I25.0;I08.9;I13.2 36.07 - - YY02 None None None I-1-40-III
None None YY-02-III None None None PROSEDUR KARDIOVASKULAR PERKUTAN
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 77542871 0 3 0 0 0 AGUS SALIM TN
0000060983357 3;JKN DR RIZKI; 5.1.1.201705010501 4 130819
1#0##0#0#0.0#2018-01-30 12:26:11#0#12:00:00#12:00:00#00:00:00 1
ee0bab53aa9905bdc6b741226b9fa004 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 02/01/2018 10/01/2018 05/12/1972 0 1
1 E87.6;I25.0;I13.2;R57.0 - - - None None None None E-4-
11-III None None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT
(BERAT) 6293300 0 0 - 0 - 0 - 0 - 0
6293300 12677085 0 9 0 0 0 ASWAN D386370 45
16464 DR AZRI NURIZAL SPPD KKV 0138R01701180000897 0002247683815
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 128551
1#0##0#0#0.0#2018-01-31 08:56:56#0#12:00:00#12:00:00#12:00:00 1
8f983b3bdd8e37b7f41e6b1c18944fba 0 0 0 1010730 855342
5532013 0 0 0 0 3934000 0 0 1345000 0
0
3201126 B 1 BS 1 07/01/2018 10/01/2018 12/08/1970 0 2
1 K76.0;A01.4;K29.6;J45.9 90.59;89.52;88.01 - - None None None
None B-4-13-III None None None None None None GANGGUAN HATI LAIN-LAIN
(BERAT) 9446100 0 0 - 0 - 0 - 0 - 0
9446100 6749014 0 4 0 0 0 ROSMAWATI D143279
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 130814
1#1#vvip#4#0#0.0#2018-01-31 15:12:24#0#12:00:00#12:00:00#12:00:00 1
a1b03a95fa159b7d6a451c829b70f054 0 0 1540761 0 0 915729
0 0 0 0 4292524 0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 10/01/2018 21/12/1964 0 2
1 E87.6;K29.7;A01.0;R11 90.59;89.52 - - None None None None
E-4-11-III None None None None None None HIPOVOLEMIA & GANGGUAN
ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 - 0 -
0 6293300 2799339 0 3 0 0 0 NANY D386930
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131205
1#0##0#0#0.0#2018-01-31 15:19:08#0#12:00:00#12:00:00#12:00:00 1
598e00d5f6b7455dda201c132a596d4c 0 0 619397 0 0
1181808 0 0 0 0 998134 0 0 0 0 0
3201126 B 2 BS 1 08/01/2018 10/01/2018 25/09/1987 0 2
- 0 - 0 - 0 - 0 2601900 2360420 0
3 0 0 0 YERIMIA ARITONANG D387006 30 11063 DR ERDIYAN,
SPOG 0138R01701180003421 0001636942072 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 131651 1#0##0#0#0.0#2018-01-31
15:36:44#0#12:00:00#12:00:00#12:00:00 1 84c264a912a55ade525a603a046d04f7
0 0 537171 0 0 614829 0 0 0 0
1208420 0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 10/01/2018 01/08/1953 0 2
1 I47.1;E11.5 90.59;89.52 - - None None None None I-4-19-II
None None None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 5784012 0 3 0 0 0 SUNANI d386941
0000512669024 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131440
1#0##0#0#0.0#2018-02-01 08:15:30#0#12:00:00#12:00:00#12:00:00 1
5c94aa1b5d8aecce27eafe2bab640fd6 0 0 603017 0 0
1625602 0 0 0 0 2413393 0 0 0 0
1142000
3201126 B 3 BS 1 07/01/2018 10/01/2018 10/11/1991 0 2
0 0 - 0 - 0 - 0 - 0 4986800
7845510 0 4 0 0 0 HANNA GRACIA SRI ANGELINA
D386901 26 9555 DR MAMAN H, SPOG 0138R01701180002834
0001302764861 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 130816
1#0##0#0#0.0#2018-02-01 08:29:26#0#12:00:00#12:00:00#12:00:00 1
5baf67bfafb2289193160e953ca33b3d 0 0 1761644 0 0
1738108 0 0 0 0 4148758 0 0 0 197000
0
3201126 B 3 BS 1 09/01/2018 10/01/2018 07/08/1974 0 1
1 I12.0;D63.8 90.59;89.52;39.27;99.04 - - None None None None
- 0 - 0 8908800 10103308 0 2 0 0 0
ZAENAL ABIDIN D387106 43 15861 DR SRI KUN, SPPD
0138R01701180004044 0001740260913 3;JKN DR RIZKI; 5.2.0.201712280730
4 132432 1#0##0#0#0.0#2018-02-01
09:00:13#0#12:00:00#12:00:00#12:00:00 1 faee29e18ca8e91e534dc91c65c1f672
0 0 2636552 0 0 3328492 0 0 0 0
4138264 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 10/01/2018 01/08/1937 0 2
1 I63.9;I25.0;I48;G81.9;M84.91 87.03;81.92 - - None None None
- 0 - 0 9673300 11944409 0 7 0 0 0
DJUSMAR,HJ. D205491 80 29376 DR NURUL KOMARI SPS
0138R01701180001605 0000042815777 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 129547 1#0##0#0#0.0#2018-02-01
09:02:29#0#12:00:00#12:00:00#00:00:00 1 e34df8ea4814551d7e8e41538d37ed7d
0 0 923597 0 0 4746402 0 0 0 0
6274410 0 0 0 0 0
3201126 B 1 BS 1 08/01/2018 10/01/2018 21/12/2007 0 1
1 D56.1 99.04;90.59 - - None None None None D-4-13-I None
- 0 4181800 5562845 0 3 0 0 0 IQBAL
MARLOPO PURNAMASIDI C240998 10 3671 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180003367 0001335363658 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 131639 1#0##0#0#0.0#2018-02-01
09:06:38#0#12:00:00#12:00:00#12:00:00 2 3d26868904c02f09663baa25853e1b59
0 0 376362 0 0 2799059 0 0 0 0
2387424 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 10/01/2018 15/06/1960 0 2
1 I12.0;D63.8;A49.9;E16.2 99.21;99.04;39.27 - - None None None
None N-1-12-II None None None None None None MEMBUAT BARU, MEREVISI
DAN MEMINDAHKAN ALAT DIALISIS (SEDANG) 10690500 0 0 - 0 -
0 - 0 - 0 10690500 15534097 0 2 0 0
0 SUNDARI HARTATI D068054 57 21027 DR SRI KUN, SPPD
0138R01701180003680 0000042653237 3;JKN DR RIZKI; 5.2.0.201712280730
4 132009 1#0##0#0#0.0#2018-02-01
09:07:44#0#12:00:00#12:00:00#00:00:00 2 1f5176ac7a842b55cd00146823190e38
0 0 6780681 0 0 3173067 0 0 0 0
5580349 0 0 0 0 0
3201126 B 3 BS 1 05/01/2018 10/01/2018 18/10/1984 0 2
1 K81.9;K29.1;N39.0 90.59;89.52;88.76 - - None None None None
B-4-14-II None None None None None None GANGGUAN SALURAN EMPEDU LAIN-
LAIN (SEDANG) 4899600 0 0 - 0 - 0 - 0 -
0 4899600 4244211 0 6 0 0 0 RINNY PFAFF
D381768 33 12132 DR ARU, SPPD 0138R01701180002358
0000511519678 3;JKN DR RIZKI; 5.2.0.201712280730 4 130550
1#0##0#0#0.0#2018-02-01 09:11:46#0#12:00:00#12:00:00#12:00:00 1
e5fe6fff70768e9c95a96fb2626c9079 0 0 493964 0 0
2311588 0 0 0 0 1438659 0 0 0 0 0
3201126 B 1 BS 1 07/01/2018 10/01/2018 10/04/1935 0 1
1 I63.9;G81.9;I48;I49.3 87.03;87.44 - - None None None None
G-4-14-III None None None None None None KECEDERAAN PEMBULUH DARAH
OTAK DENGAN INFARK (BERAT) 12141100 0 0 - 0 - 0 -
0 - 0 12141100 7335327 0 4 0 0 0 PAIMAN
TAMBI SYAMSYUDDIN D385512 82 30223 DR NURUL KOMARI SPS
0138R01701180002729 0001732948424 3;JKN DR RIZKI; 5.2.0.201712280730
4 130800 1#0##0#0#0.0#2018-02-01
10:17:08#0#12:00:00#12:00:00#12:00:00 1 32dfc6977821ef368cdf5d8b435a7d10
0 0 719644 0 0 2985802 0 0 0 0
3629881 0 0 0 0 0
3201126 B 2 BS 1 08/01/2018 10/01/2018 04/06/1958 0 2
1 C18.9;D64.8;E10.6 90.59;89.52 - - None None None None K-4-
10-II None None None None None None TUMOR PENCERNAAN (SEDANG) 8475400
0 0 - 0 - 0 - 0 - 0 8475400
4888494 0 3 0 0 0 ELISABETH ELLEN.T. LH D363093
59 21768 DR ARU, SPPD 0138R01701180003382 0001268332479 3;JKN
DR RIZKI; 5.2.0.201712280730 4 131643 1#0##0#0#0.0#2018-02-01
11:09:17#0#12:00:00#12:00:00#00:00:00 1 eb4b3c22af5ead5d99b912259e0bcdab
0 0 815786 0 0 2401400 0 0 0 0
1671308 0 0 0 0 0
3201126 B 1 BS 1 08/01/2018 10/01/2018 14/06/1957 0 1
1 E16.0;N18.5 90.59;38.95;39.95 - - None None None None N-1-
12-I None None None None None None MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN
- 0 6076700 14411157 0 3 0 0 0 DANIEL
NGADIMIN D365425 60 22123 DR SOEGIONO, SPPD 0138R01701180003260
0001261234462 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131637
1#0##0#0#0.0#2018-02-01 14:06:31#0#12:00:00#12:00:00#00:00:00 1
edc924ace37a7079238b2e9cdea1a655 0 1182250 2056523 0 0
3070398 0 0 0 0 8101986 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 10/01/2018 04/05/2002 0 2
1 M79.98 83.39 - - None None None None M-1-50-I None
None None None None None PROSEDUR JARINGAN LUNAK (RINGAN) 6397900
0 0 - 0 - 0 - 0 - 0 6397900
8708532 0 2 0 0 0 AULIA PUTRI D386296 15 5729
DR HENDRIEK S, SPB 0138R01701180003610 0001733118928 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 131766 1#0##0#0#0.0#2018-
02-01 15:14:37#0#12:00:00#12:00:00#12:00:00 1
73dd1d22417bfa274234e3d04800f40d 0 4457100 1791412 0 0
1765303 0 0 0 0 625717 0 0 0 69000 0
3201126 B 2 BS 1 07/01/2018 10/01/2018 05/07/1975 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 25428884 0 4 0 0 0 ENDANG TARUNINGRUM
d325616 42 15527 DR NOVI RESISTANTIE, SPOG 0138R01701180002824
0002069174125 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133264
1#1#vvip#4#19444784#0.0#2018-02-01 15:43:03#0#12:00:00#12:00:00#12:00:00
1 8456ac4cd081cf992efc44eb046e6f82 0 8784200 9524000 0
0 5607684 0 0 0 0 1316000 0 0 0 197000
0
3201126 B 2 BS 1 08/01/2018 10/01/2018 08/01/2018 3717 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2936175 0 3 0 0 0 FATIH MAULANA YUSUF
0002327789812 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 132428
1#0##0#0#0.0#2018-02-01 16:18:03#0#12:00:00#12:00:00#12:00:00 2
501d8858c8d201e09cbff43afaa8d2a4 0 0 310000 0 0 110589
0 0 0 0 2442086 0 0 0 73500 0
3201126 B 1 BS 1 05/01/2018 10/01/2018 15/12/1939 0 1
1 I21.1;I11.0 - - - None None None None I-4-10-III None
None None None None None INFARK MYOKARD AKUT (BERAT) 14562700 0
0 - 0 - 0 - 0 - 0 14562700 15825991
0 6 0 0 0 AZWAR. H D125853 78 28511 DR AZRI
5.2.0.201712280730 4 130476 1#0##0#0#0.0#2018-02-12
09:36:28#0#12:00:00#12:00:00#12:00:00 1 f71e5b7d5780d8beb6a5830087b388d0
0 4674000 1363643 0 0 0 0 0 0 0
1061345 0 0 6939003 1788000 0
3201126 B 3 BS 1 08/01/2018 10/01/2018 10/04/1996 0 2
0 - 0 - 0 - 0 - 0 6535800 7661932
0 3 0 0 0 DINA USTRIAH H.S D227325 21 7943 DR
HENDRIEK SP B 0138R01701180003416 0001740413417 3;JKN DR RIZKI;
5.2.0.201712280730 4 131647 1#0##0#0#0.0#2018-02-12
09:52:27#0#12:00:00#12:00:00#12:00:00 1 cc6eaa9604e96b04256c5c1079367410
0 4546524 0 0 0 2067160 0 0 0 0 903248
0 0 0 145000 0
3201126 B 3 BS 1 08/01/2018 10/01/2018 08/01/2018 2737 2
3655700 0 0 - 0 - 0 - 0 - 0
3655700 980711 0 3 0 0 0 BAYI NY HANNA GRACIA SRI
ANGELINA D386902 0 0 DR RASTRA, SPA 0138R01701180002999
0002308659232 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 130877
1#0##0#0#0.0#2018-02-12 10:04:36#0#12:00:00#12:00:00#12:00:00 1
0411366e348e549719d9694e485ebe7b 0 0 398013 0 0 79039
0 0 0 0 430159 0 0 0 73500 0
3201126 B 2 BS 1 08/01/2018 10/01/2018 17/12/2017 0 1
0 - 0 - 0 - 0 - 0 5045200 2992933
0 3 0 0 0 BAYI NY YOHANITA EFFENDI D387013 0
22 DR OTTY MITHA S, SPA 0138R01701180003447 0002321142388 3;JKN
DR RIZKI; 5.2.0.201712280730 4 131656 1#0##0#0#0.0#2018-02-12
11:02:13#0#12:00:00#12:00:00#12:00:00 1 6b2257c0af81cdcfe0e515e97e155693
0 0 507068 0 0 570066 0 0 0 0
1575799 0 0 0 340000 0
3201126 B 1 BS 1 09/01/2018 10/01/2018 08/09/1957 0 1
None None None None None PROSEDUR PADA URETRA DAN TRANSURETRA (RINGAN)
11257400 0 0 - 0 - 0 - 0 - 0
11257400 17370073 0 2 0 0 0 SUPARDIYONO D384163
60 22038 DR SIDHI,SPU 0138R01701180003538 0000038661941 3;JKN
DR RIZKI; 5.2.0.201712280730 4 131667 1#0##0#0#0.0#2018-03-09
09:47:56#0#12:00:00#12:00:00#12:00:00 2 a264a74e32223f5f1b18f32a4e46953f
0 6468200 7928824 0 0 1711689 0 0 0 0
1192360 0 0 0 69000 0
3201126 B 3 BS 1 06/01/2018 10/01/2018 11/03/2017 0 2
1 A37.0;J17.0 93.94 - - None None None None J-4-16-III None
None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (BERAT)
6419700 0 0 - 0 - 0 - 0 - 0
6419700 4498350 0 5 0 0 0 NAZWA PUTRI KAMILA
0002273981894 3;JKN DR RIZKI; 5.2.0.201712280730 4 130783
1#0##0#0#0.0#2018-03-09 13:39:40#0#12:00:00#12:00:00#12:00:00 2
dcdc21b0d3ea10964a80492531378b46 0 0 378188 0 0
2571377 0 0 0 0 1548785 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 10/01/2018 21/04/1985 0 2
LAIN-LAIN (RINGAN) 3358200 0 0 - 0 - 0 - 0
- 0 3358200 2136510 0 2 0 0 0 ELLYA SHINTA
d387050 32 11951 DR AZRI NURIZAL SPPD KKV 0138R01701180003824
0001335677984 3;JKN DR RIZKI; 5.2.0.201712280730 4 132390
1#0##0#0#0.0#2018-03-10 09:10:11#0#12:00:00#12:00:00#12:00:00 2
94247e4ae2db6f5cd132052f726f5e92 0 0 355238 0 0 587500
0 0 0 0 1193772 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 10/01/2018 13/06/1963 0 1
1 I20.9;E11.9;I11.0;I25.0;K30 - - - None None None None
I-4-20-III None None None None None None ANGINA PEKTORIS DAN NYERI
DADA (BERAT) 9856000 0 0 - 0 - 0 - 0 -
0 9856000 7722360 0 7 0 0 0 WIBOWO HADI
0001337348981 3;JKN DR RIZKI; 5.2.0.201712280730 4 129663
1#0##0#0#0.0#2018-03-10 09:12:20#0#12:00:00#12:00:00#00:00:00 2
2e7221ed224f17db42d358f559b43592 0 0 579536 0 0
1925623 0 0 0 0 5217201 0 0 0 0 0
3201126 B 3 BS 1 07/01/2018 10/01/2018 11/03/1956 0 2
1 A91 90.59;89.52 - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2339708 0 4 0 0 0 HJ. APSAH d377964
61 22582 DR ARU, SPPD 0138R01701180002719 0001339972391 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 130807 1#0##0#0#0.0#2018-
05-17 16:01:15#0#12:00:00#12:00:00#12:00:00 2
420cf761a87581314bcb2174051ab0a9 0 0 409013 0 0 786130
0 0 0 0 1144565 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 10/01/2018 20/09/1936 0 2
1 R07.4 90.59;89.52;88.76 - - None None None None I-4-20-I
5043100 0 0 - 0 - 0 - 0 - 0
5043100 3451200 0 2 0 0 0 NASIAH JD SUHAEMI
D335117 81 29696 DR ARU, SPPD 0138R01701180003454
0000060838391 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 131658
1#0##0#0#0.0#2018-05-17 16:08:47#0#12:00:00#12:00:00#00:00:00 2
7d4ee8b4bfa0344ece826f1061a3e0f8 0 0 303524 0 0
1885897 0 0 0 0 1261779 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 10/01/2018 12/09/1944 0 2
4 A41.9;E87.6;K56.7;E63.1;S72.40 - - - None None None
None A-4-10-III None None None None None None SEPTIKEMIA (BERAT)
5838600 0 0 - 0 - 0 - 0 - 0
5838600 3815925 0 2 0 0 0 MURSINAH D387092
73 26782 DR ERTY MASIHAT 0138R01701180004035 0001461049885 3;JKN
DR RIZKI; 5.2.2.201806040537 4 132431 1#0##0#0#0.0#2018-09-06
17:23:48#0#12:00:00#12:00:00#12:00:00 2 2afebc4fe3c62c6cc90dbcaee69fe81f
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 10/01/2018 11/01/2018 25/12/1959 0 2
1 I25.0;I08.9;E11.9 88.55;36.07 - - YY02 None None None I-1-
40-II None None YY-02-III None None None PROSEDUR KARDIOVASKULAR PERKUTAN
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 65397547 0 2 0 0 0 IRMINA SRI
REJEKI,NY D383397 58 21201 DR AZRI NURIZAL SPPD KKV
0138R01701180004180 0000061174225 3;JKN DR RIZKI; 5.1.1.201705010501
4 132531 1#0##0#0#0.0#2018-01-30
12:33:44#0#12:00:00#12:00:00#12:00:00 2 e2e1e6b57966a126dd0ec0877a326e49
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 08/01/2018 11/01/2018 30/03/1988 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 20818430 0 4 0 0 0 AMRI PANGESTUTININGRUM
D367917 29 10876 DR KARTIKA MAYA, SPOG 0138R01701180003093
0001852860137 3;JKN DR RIZKI; 5.1.1.201705010501 4 131806
1#1#vvip#4#14834330#0.0#2018-01-30 14:50:26#0#12:00:00#12:00:00#12:00:00
2 67632f756c2915b3751af06ae55c3eb5 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 08/01/2018 11/01/2018 08/01/2018 2615 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3620602 0 4 0 0 0 BAYI NY. AMRI
PANGESTUTININGRUM d386993 0 0 DR AULIA TANGKARI, SPA
0138R01701180004486 0002328246494 3;JKN DR RIZKI; 5.1.1.201705010501
4 133017 1#0##0#0#0.0#2018-01-30
14:52:54#0#12:00:00#12:00:00#12:00:00 3 a53d17ee89581d8bf8d3a910d9e627c0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 10/01/2018 11/01/2018 15/06/1977 0 2
1 K80.1 - - - None None None None B-4-14-I None None
None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (RINGAN)
4199800 0 0 - 0 - 0 - 0 - 0
4199800 1791556 0 2 0 0 0 NINIK ISMOYOWATI
D373117 40 14819 DR E SURYA POHAN DR SPB KBD 0138R01701180004076
0002271832547 3;JKN DR RIZKI; 5.2.0.201712280730 4 132440
1#0##0#0#0.0#2018-01-31 15:48:41#0#12:00:00#12:00:00#12:00:00 2
b5d4f98b4e75fcd08bcd1a335586d773 0 0 430982 0 0 691369
0 0 0 0 669205 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 11/01/2018 16/04/1968 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3506894 0 3 0 0 0 EDRUS D327346* 49
DR RIZKI; 5.2.0.201712280730 4 132438 1#0##0#0#0.0#2018-01-31
16:22:05#0#12:00:00#12:00:00#12:00:00 1 837fc437afb0fe94c33110ab42ede101
0 0 424889 0 0 1144332 0 0 0 0
1937673 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 11/01/2018 10/02/2017 0 2
- 0 - 0 - 0 - 0 3187000 3332218 0
3 0 0 0 CLAIRINE NATHANIA SASIWA D387026 0 333
DR RASTRA, SPA 0138R01701180003604 0002223834276 3;JKN DR RIZKI;
5.2.0.201712280730 4 131759 1#0##0#0#0.0#2018-01-31
16:25:39#0#12:00:00#12:00:00#12:00:00 1 80e6e0393aed2eb31f9695dded3286d9
0 0 341081 0 0 1232141 0 0 0 0
1758996 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 11/01/2018 23/04/1952 0 2
1 E14.2;I11.9;D63.8;J90;A41.9 99.04 - - None None None None
N-4-16-III None None None None None None PENYAKIT GINJAL DAN SALURAN
URIN LAIN-LAIN (BERAT) 8686600 0 0 - 0 - 0 - 0
- 0 8686600 4531460 0 3 0 0 0 KUSMIYATI
d382844 65 24002 DR BETTY DWI L, SPPD 0138R01701180003989
0001423720596 3;JKN DR RIZKI; 5.2.0.201712280730 4 132427
1#0##0#0#0.0#2018-02-01 08:28:23#0#12:00:00#12:00:00#12:00:00 1
de27d2dd8486254b46c049506bcc3988 0 0 709388 0 0
2192121 0 0 0 0 1629951 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 11/01/2018 09/10/1982 0 1
None None None None HIPERTENSI (RINGAN) 2288000 0 0 -
0 - 0 - 0 - 0 2288000 6012277 0 3
0 0 0 TONI SETIJAWAN D387019 35 12876 DR AZRI NURIZAL
SPPD KKV 0138R01701180003472 0000209216349 3;JKN DR RIZKI;
5.2.0.201712280730 4 131663 1#0##0#0#0.0#2018-02-01
08:53:48#0#12:00:00#12:00:00#12:00:00 1 dd46d39402c9cbca4189a573351bc541
0 0 324000 0 0 1029950 0 0 0 0
4658327 0 0 0 0 0
3201126 B 1 BS 1 09/01/2018 11/01/2018 30/07/1990 0 2
1 A01.4;O23.4 88.78 - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4458861 0 3 0 0 0 RINI KHOIRATUL MAR'I
0002070041398 3;JKN DR RIZKI; 5.2.0.201712280730 4 131662
1#0##0#0#0.0#2018-02-01 09:20:32#0#12:00:00#12:00:00#12:00:00 1
df6075509e2346dacba73ed5e9ea656c 0 0 851153 0 0 947007
0 0 0 0 2660701 0 0 0 0 0
3201126 B 1 BS 1 06/01/2018 11/01/2018 07/04/2016 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 9951899 0 6 0 0 0 BAYI NY YUDAMAI ASTUTI
D329717 1 639 DR KHARNINA, SPA 0138R01701180002584
0002049919514 3;JKN DR RIZKI; 5.2.0.201712280730 4 130781
1#0##0#0#0.0#2018-02-01 09:41:18#0#12:00:00#12:00:00#12:00:00 1
10f289fb65cde2e1fe16fd6704b5d07d 0 0 508264 0 0
4256076 0 0 0 0 5187559 0 0 0 0 0
3201126 B 1 BS 1 08/01/2018 11/01/2018 15/10/1970 0 1
1 S42.00;I10 79.30 - - None None None None M-1-60-I None
None None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN
PENGHUBUNG LAIN-LAIN (RINGAN) 11182000 0 0 - 0 - 0 -
0 - 0 11182000 20086883 0 4 0 0 0
MUTAQIN D336248 47 17252 DR RAY HENDRY, SPOT
0138R01701180003184 0000036104319 3;JKN DR RIZKI; 5.2.0.201712280730
4 131376 1#0##0#0#0.0#2018-02-01
09:56:50#0#12:00:00#12:00:00#12:00:00 1 821cd1007ec06113b1766d3a007c35b1
0 0 6195240 0 0 4237043 0 0 0 0
9654600 0 0 0 0 0
3201126 B 3 BS 1 10/01/2018 11/01/2018 31/12/1942 0 1
1 N18.5;I51.7;I45.1 39.42;38.95 - - None None None None N-1-
- 0 4340500 10035680 0 2 0 0 0 ROSID
0001482063478 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 132647
1#0##0#0#0.0#2018-02-01 14:39:10#0#12:00:00#12:00:00#12:00:00 1
f54b39a79aa12d36eb475c8f0c8deb13 0 0 921100 0 0
4894240 0 0 0 0 4151340 0 0 0 69000 0
3201126 B 2 BS 1 09/01/2018 11/01/2018 13/01/2017 0 2
1 B34.9;D50.9 - - - None None None None A-4-13-II None
3200900 0 0 - 0 - 0 - 0 - 0
3200900 3532593 0 3 0 0 0 VARISHA ALMEIRA NASYA
0002215971167 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133283
1#0##0#0#0.0#2018-02-01 16:15:51#0#12:00:00#12:00:00#12:00:00 1
b50962c511d34890bccd84d20db1a8b7 0 0 341081 0 0
1419408 0 0 0 0 1772104 0 0 0 0 0
3201126 B 3 BS 1 11/01/2018 11/01/2018 05/06/1949 0 1
1 I21.9;I50.0;K30 89.52 - - None None None None I-4-10-II
None None None None None None INFARK MYOKARD AKUT (SEDANG) 7219300
0 0 - 0 - 0 - 0 - 0 7219300
3306123 0 1 0 0 0 UDJANG SUTISNA D360508 68
25057 DR DICKY KARUNDENG 0138R01701180004708 0000043211755 3;JKN
DR RIZKI; 5.2.0.201712280730 4 133153 1#0##0#0#0.0#2018-02-08
16:18:13#0#00:00:00#14:00:00#00:00:00 1 c7cb2a0dc3bd6ae4d98752a4af19da55
0 0 936171 0 0 1864664 0 0 0 0 505288
0 0 0 0 0
3201126 B 3 BS 1 11/01/2018 11/01/2018 25/12/1955 0 2
1 E14.9;K29.7 - - - None None None None E-4-10-I None
METABOLIK (RINGAN) 3502700 0 0 - 0 - 0 - 0
- 0 3502700 2050779 0 1 0 0 0 LIES
NATALISA D029029 62 22663 DR RENDRA RAMADYA 0138R01701180004932
0001458434709 3;JKN DR RIZKI; 5.2.0.201712280730 4 133397
1#0##0#0#0.0#2018-02-09 08:57:39#0#10:30:00#19:10:00#12:00:00 1
fbfabbf87674232046ffa0ee682288bf 0 0 265941 0 0
1343675 0 0 0 0 441163 0 0 0 0 0
3201126 B 2 BS 1 02/01/2018 11/01/2018 11/02/2016 0 1
1 A49.9;R56.8;A09.9 - - - None None None None A-4-14-II
None None None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT
LAIN-LAIN (SEDANG) 3304700 0 0 - 0 - 0 - 0
- 0 3304700 12142856 0 10 1 2 0 FISYA
NAZEERA RACHMAN D323525 1 691 DR AULIA TANGKARI, SPA
0138R01701180000187 0001971585606 3;JKN DR RIZKI; 5.2.0.201712280730
4 127684 1#0##0#0#0.0#2018-02-12
10:05:24#0#12:00:00#12:00:00#12:00:00 2 d195e1cd80fac81853b04ae48481c411
0 0 517643 0 0 3379821 0 0 0 0
6423392 0 0 0 0 1822000
3201126 B 1 BS 1 03/01/2018 11/01/2018 14/10/1965 0 1
1 E14.4;I64 87.44;87.03 - - None None None None G-4-17-III
None None None None None None GANGUAN SARAF KRANIAL DAN PERIFER (BERAT)
10695200 0 0 - 0 - 0 - 0 - 0
10695200 28159596 0 9 0 0 0 ARIS KRIDO HALIM
D277121 52 19074 DR ARU, SPPD 0138R01701180001006
0000037521347 3;JKN DR RIZKI; 5.2.0.201712280730 4 128723
1#1#vvip#9#17464396#0.0#2018-02-12 10:31:36#0#12:00:00#12:00:00#12:00:00
2 45568e3d7d9a2f8d58a6bf5b01b15b23 0 0 3847000 0 0
10349596 0 0 0 0 13963000 0 0 0 0 0
3201126 B 2 BS 1 10/01/2018 11/01/2018 06/01/2018 3000 2
1 P59.9 99.82 - - None None None None P-8-17-I None None
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2246619 0 2 0 0 0 BAYI NY MAIMUNAH
0002327131855 3;JKN DR RIZKI; 5.2.0.201712280730 4 133020
1#0##0#0#0.0#2018-02-12 11:04:27#0#12:00:00#12:00:00#12:00:00 1
1d562309f7d965f93cccee03e9f2010f 0 0 394812 0 0 278327
0 0 0 0 1233475 0 0 0 340000 0
3201126 B 3 BS 1 08/01/2018 11/01/2018 13/11/2008 0 1
1 L50.9 - - - None None None None L-4-14-I None None
None None None None GANGGUAN PADA KULIT & PAYUDARA LAIN-LAIN (RINGAN)
2944000 0 0 - 0 - 0 - 0 - 0
2944000 1756494 0 4 0 0 0 FATTAN NAUFAL ABID
0002221803303 3;JKN DR RIZKI; 5.2.0.201712280730 4 131655
1#0##0#0#0.0#2018-03-09 14:54:22#0#12:00:00#12:00:00#12:00:00 2
1ef76a5d5c643d0d3631d7ddf0b5963d 0 0 317960 0 0 508623
0 0 0 0 929911 0 0 0 0 0
3201126 B 3 BS 1 08/01/2018 11/01/2018 07/05/1967 0 1
1 E11.9;K29.7;I64 87.44;87.03 - - None None None None E-4-
0 - 0 6262900 3594585 0 4 0 0 0 ABDUL
KODIR D351442 50 18509 DR YUNITA ARLINY SPP 0138R01701180003634
0001722132448 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131857
1#0##0#0#0.0#2018-03-19 10:57:54#0#12:00:00#12:00:00#00:00:00 3
19dc2c7e3c839149d2ace7c2c0748ed8 0 0 368243 0 0
2176182 0 0 0 0 1050160 0 0 0 0 0
3201126 B 3 BS 1 11/01/2018 11/01/2018 12/05/1981 0 2
1 R94.6 06.11 - - None None None None E-4-13-I None None
None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN (RINGAN)
3697100 0 0 - 0 - 0 - 0 - 0
3697100 2087003 0 1 0 0 0 RETNOWATI d386001
3;JKN DR RIZKI; 5.2.1.201804062320 4 133884 1#0##0#0#0.0#2018-
05-17 15:51:59#0#12:00:00#12:00:00#12:00:00 2
f578c269ba893bee3cda62257ff01e05 0 2087003 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 11/01/2018 30/09/1956 0 1
1 R63.0;R42 - - - None None None None E-4-10-I None
- 0 4203300 3053073 0 3 0 0 0 DEDE
SUHERMAN D307355 61 22381 DR NURUL KOMARI SPS 0138R01701180003962
0000060706056 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 132426
1#0##0#0#0.0#2018-05-17 16:10:33#0#12:00:00#12:00:00#12:00:00 2
79e801324030789f4e0cc27ecdfbba4f 0 0 216890 0 0
1302949 0 0 0 0 1533234 0 0 0 0 0
3201126 B 1 BS 1 04/01/2018 12/01/2018 15/05/1990 0 2
1 K35.2 47.09;54.19 - - None None None None K-1-40-I None
None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
10909500 0 0 - 0 - 0 - 0 - 0
10909500 23635893 0 9 0 0 0 JOSEPHIN P SIREGAR
0001256936398 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 129637
1#0##0#0#0.0#2018-01-25 13:07:30#0#12:00:00#12:00:00#12:00:00 1
6367f906a5ee12a7be46d30a215d7e78 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 10/01/2018 12/01/2018 23/10/1986 0 2
1 N60.0 85.20;85.12 - - None None None None L-1-50-I None
None None None None None PROSEDUR PADA PAYUDARA (RINGAN) 6535800
0 0 - 0 - 0 - 0 - 0 6535800
10424908 0 3 0 0 0 IKE TRI LESTARI D386245 31
11402 RACHMAWATI DR,SPB(K)ONK 0138R01701180004653 0001835508194 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 133027 1#0##0#0#0.0#2018-
01-25 13:21:53#0#12:00:00#12:00:00#12:00:00 1
9e37d4bf2787894a0d407c134a0013b8 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 10/01/2018 12/01/2018 10/02/1986 0 2
1 I50.0;J44.9;I08.9 90.59;89.52 - - None None None None I-4-
12-II None None None None None None KEGAGALAN JANTUNG (SEDANG) 4144700
0 0 - 0 - 0 - 0 - 0 4144700
1896726 0 3 0 0 0 EKA PRUWANTI D387187 31
11657 DR BAMBANG DWIPUTRA SPJP 0138R01701180004695 0001739618695
3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133035
1#0##0#0#0.0#2018-01-25 15:08:44#0#12:00:00#12:00:00#12:00:00 1
90a909c8fb1356069dce21d403dd0338 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 11/01/2018 12/01/2018 20/09/1992 0 1
1 N18.5;D63.8;J06.9 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 2979485 0 2 0 0 0 YUDI SETIAWAN
d374450 25 9244 DR SRI KUN, SPPD 0138R01701180004906
0001868283246 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133345
1#0##0#0#0.0#2018-01-25 15:15:47#0#12:00:00#12:00:00#12:00:00 1
840e142d5c1149c08accf52bf17d62f8 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 12/01/2018 11/12/1948 0 1
1 N18.5;M54.57;M81.55;D63.8 99.04 - - None None None None
- 0 4958500 5978332 0 4 0 0 0 IR PAUL
RAUBUN, M.S.E D361946 69 25231 DR SRI KUNMARTINI, SPPD
0138R01701180004045 0001222739706 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 132433 1#0##0#0#0.0#2018-01-25
15:26:39#0#12:00:00#12:00:00#00:00:00 1 7ce8d46bef099a07b48581ddaf5ece91
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 09/01/2018 12/01/2018 01/07/2003 0 2
1 A09.9;N39.0 88.75 - - None None None None K-4-17-II None
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 4562666 0 4 0 0 0 SARAH AMIRA YAHYA
0001878547421 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 132860
1#0##0#0#0.0#2018-01-25 15:38:32#0#12:00:00#12:00:00#12:00:00 1
5f77e636a73360160e628f7305a06fc9 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 12/01/2018 23/12/1994 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 4640315 0 4 0 0 0 DENI HARYANTO
d387069 23 8418 DR SRI KUN, SPPD 0138R01701180003890
0001800177039 3;JKN DR RIZKI; 5.1.1.201705010501 4 132425
1#0##0#0#0.0#2018-01-30 12:57:52#0#12:00:00#12:00:00#12:00:00 1
e01896413e3c1dfe31a48cb3301e8d8a 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 10/01/2018 12/01/2018 06/11/1963 0 1
1 E11.2;D63.8;I10 39.49;38.95;99.04;99.21 - - None None None
0 - 0 - 0 8908800 11074806 0 3 0 0
0 K A S D I D377733 54 19789 DR SRI KUN, SPPD
0138R01701180004667 0001439445194 3;JKN DR RIZKI; 5.1.1.201705010501
4 133030 1#0##0#0#0.0#2018-01-30
15:07:36#0#12:00:00#12:00:00#12:00:00 1 aec6f63d51bd072e6cb5396059e1f4fc
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 10/01/2018 12/01/2018 14/09/1988 0 2
1 O62.4;D64.9 99.04 - - None None None None W-4-16-II None
None None None None None GANGGUAN ANTEPARTUM (SEDANG) 2899500 0
0 - 0 - 0 - 0 - 0 2899500 3471383
0 3 0 0 0 MARIA AGUSTINA KUSUMA D387177 29 10710
DR ERDIYAN, SPOG 0138R01701180004578 0000511007466 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 133037 1#0##0#0#0.0#2018-02-01
13:45:47#0#12:00:00#12:00:00#12:00:00 1 465407bb3e6216fbaecff2a21a61aebb
0 0 366955 0 0 2130828 0 0 0 0 973600
0 0 0 0 0
3201126 B 1 BS 1 11/01/2018 12/01/2018 16/02/2010 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 10073635 0 2 0 0 0 FARIS RAHMAN AL KAUTSAR
0001483002887 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133599
1#0##0#0#0.0#2018-02-01 14:19:08#0#12:00:00#12:00:00#12:00:00 2
738ee31dcb7f515ba6cfee057c60b2e9 0 6496200 1346660 0 0
1370752 0 0 0 0 715023 0 0 0 145000
0
3201126 B 2 BS 1 11/01/2018 12/01/2018 08/09/2016 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 7743329 0 2 0 0 0 HERJUNO ZAFRAN
0002252129995 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133575
1#0##0#0#0.0#2018-02-01 14:22:52#0#12:00:00#12:00:00#12:00:00 1
8a3b985a7199e97a104fae99d51e45ac 0 4933300 1217272 0 0
941184 0 0 0 0 582573 0 0 0 69000 0
3201126 B 1 BS 1 09/01/2018 12/01/2018 31/12/2016 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 9582046 0 4 0 0 0 BAYI NY ROSMAWATI LAOLI
0002212809175 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 132391
1#1#vip#4#3793875#75.0#2018-02-01 14:27:43#0#12:00:00#12:00:00#00:00:00
1 f57915987972e5e9c38d7771bbdcd276 0 0 849714 0 0
2689469 0 0 0 0 5752863 0 0 0 290000
0
3201126 B 1 BS 1 09/01/2018 12/01/2018 03/08/1985 0 2
1 O82.0 74.0 - - None None None None O-6-10-I None None
None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN) 6981500 0
0 - 0 - 0 - 0 - 0 6981500 20362196
0 4 0 0 0 YENNY KRISTINA,SE D368117 32 11847 ENDANG
TRI KURNIADEWI DR SPOG 0138R01701180003873 0001626602038 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 132424 1#1#vvip#4#13380696#0.0#2018-
02-01 14:30:55#0#12:00:00#12:00:00#12:00:00 1
91983caa036330f3bebfe02712e35c05 0 8680900 6551000 0 0
3223296 0 0 0 0 1316000 0 0 0 591000
0
3201126 B 2 BS 1 10/01/2018 12/01/2018 12/03/1994 0 2
1 O60.1;O80.9 72.71 - - None None None None O-6-12-I None
None None None None None PERSALINAN VAGINAL DENGAN PROSEDUR SELAIN
STERILISASI &/ DILATASI &KURET (RINGAN) 3011100 0 0 - 0 -
0 - 0 - 0 3011100 4262118 0 3 0 0
0 AIDA NURUL ULFA D387212 23 8705 DR ERDIYAN, SPOG
0138R01701180004696 0001622512719 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 133039 1#0##0#0#0.0#2018-02-01
15:06:03#0#12:00:00#12:00:00#12:00:00 1 a9560f4e7170ab5f773fb4258e2bbc8a
0 0 636360 0 0 1348328 0 0 0 0
2208430 0 0 0 69000 0
3201126 B 3 BS 1 10/01/2018 12/01/2018 04/11/1979 0 1
1 I25.0;I11.0;I08.9 88.55;36.07 - - YY02 None None None I-1-
40-III None None YY-02-III None None None PROSEDUR KARDIOVASKULAR
- 0 45079800 66861649 0 3 0 0 0 MOCH. AZIZ
0002223818223 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 132636
1#0##0#0#0.0#2018-02-01 15:28:41#0#12:00:00#12:00:00#12:00:00 1
4f948161fb0987bbd618294c752da666 0 44723529 5144120 0 0
0 0 0 0 0 9425000 0 0 7569000 0 0
3201126 B 2 BS 1 06/01/2018 12/01/2018 04/06/2017 0 1
1 J18.0;A49.9 93.94 - - None None None None J-4-16-I None
4335900 0 0 - 0 - 0 - 0 - 0
4335900 8977156 0 7 0 0 0 AZKA RASYID MOONTI
D368915 0 216 DR HUDA, SPA 0138R01701180002552
0002255182874 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 130779
1#0##0#0#0.0#2018-02-01 15:38:52#0#12:00:00#12:00:00#12:00:00 1
fb3c83e4a4b6cb2129926fab10fadd88 0 0 443231 0 0
4385634 0 0 0 0 4148291 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 12/01/2018 03/08/1957 0 2
1 E86;E11.6;A49.9;E87.6;I10;K30 90.59;88.76 - - None None None
None E-4-11-II None None None None None None HIPOVOLEMIA & GANGGUAN
ELEKROLIT (SEDANG) 4504900 0 0 - 0 - 0 - 0
- 0 4504900 4139548 0 4 0 0 0 LILY
MURNIATI D387021 60 22074 DR SRI KUN, SPPD 0138R01701180003537
0001963127766 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131669
1#0##0#0#0.0#2018-02-01 16:32:17#0#12:00:00#12:00:00#12:00:00 1
fc86ccaa9a9b78f7ab31eeefa313e0bb 0 0 300851 0 0
2489885 0 0 0 0 1348812 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 12/01/2018 14/02/1973 0 2
1 K29.6;D64.9 99.04;90.59;89.52 - - None None None None K-4-
11-II None None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG)
3296400 0 0 - 0 - 0 - 0 - 0
3296400 4839868 0 4 0 0 0 LUSIANA D358147
44 16400 DR SRI KUN, SPPD 0138R01701180003546 0001720428952 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 131668 1#0##0#0#0.0#2018-
02-01 16:43:15#0#12:00:00#12:00:00#00:00:00 1
2afb11f894f801f9f018100973b9ff14 0 0 349676 0 0
3077565 0 0 0 0 1412627 0 0 0 0 0
3201126 B 2 BS 1 03/01/2018 12/01/2018 14/05/1957 0 2
1 I95.9;A41.9;J18.0;R65.1;N17.9 90.59;89.52 - - None None None
None I-4-24-III None None None None None None GANGGUAN SISTEM PEMBULUH
DARAH LAIN-LAIN (BERAT) 9767800 0 0 - 0 - 0 - 0
- 0 9767800 23791690 0 10 1 7 0 HARTINI
D270216 60 22149 DR ARU, SPPD 0138R01701180001152
0001792840656 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 128880
1#0##0#0#0.0#2018-02-02 08:35:04#0#12:00:00#12:00:00#12:00:00 1
ba2bd106b76d750dbf6c8af5e72a11fc 0 0 683567 0 0
8132123 0 0 0 0 8840000 0 0 0 6136000
0
3201126 B 3 BS 1 11/01/2018 12/01/2018 01/01/1969 0 2
1 I20.9;K30;M51.8 90.59;89.52 - - None None None None I-4-
20-I None None None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN)
4202600 0 0 - 0 - 0 - 0 - 0
4202600 2688837 0 2 0 0 0 MUHAYANAH D387202
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1#0##0#0#0.0#2018-02-02 08:43:45#0#12:00:00#12:00:00#12:00:00 1
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1 I63.9;I11.9;I45.1;G81.9 - - - None None None None G-4-
14-II None None None None None None KECEDERAAN PEMBULUH DARAH OTAK DENGAN
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1#0##0#0#0.0#2018-02-02 08:50:37#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 10/01/2018 12/01/2018 15/12/2009 0 1
1 G40.9;A49.9 - - - None None None None G-4-22-I None
None None None None None SERANGAN KEJANG (RINGAN) 3187000 0
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DR KRISTON SILITONGA, SPA 0138R01701180004488 0001745516373 3;JKN
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3201126 B 3 BS 1 08/01/2018 12/01/2018 05/06/1958 0 1
1 E14.1;A41.9;J18.9;I11.9 - - - None None None None E-4-
0 - 0 6262900 5348089 0 5 0 0 0
HASANUDDIN D386972 59 21767 DR AZRI NURIZAL SPPD KKV
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1427875 0 0 0 0 0
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1 I84.1 49.46 - - None None None None K-1-50-I None None
None None None None PROSEDUR ANAL (RINGAN) 8335900 0 0 -
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0138R01701180004023 0001078400259 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 132430 1#0##0#0#0.0#2018-02-02
09:12:18#0#12:00:00#12:00:00#12:00:00 1 edca9d136e7a77c4f23861883fd6950d
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7736603 0 0 0 125000 0
3201126 B 2 BS 1 08/01/2018 12/01/2018 21/08/1980 0 2
1 J18.0;G70.0 93.94 - - None None None None J-4-16-II None
None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (SEDANG)
6093000 0 0 - 0 - 0 - 0 - 0
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0001627459479 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 131424
1#0##0#0#0.0#2018-02-02 09:16:55#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 12/01/2018 12/01/2018 01/01/2018 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 1923366 0 1 0 0 0 BAYI NY ISMIYATI
d387339 0 11 DR. SUKMARINI 0138R01701180005749
0002320492162 3;JKN DR RIZKI; 5.2.0.201712280730 4 134563
1#0##0#0#0.0#2018-02-08 16:57:37#0#10:10:00#20:30:00#12:00:00 1
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1183350 0 0 0 0 414828 0 0 0 0 0
3201126 B 2 BS 1 10/01/2018 12/01/2018 25/04/1979 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3285388 0 3 0 0 0 FELIX RIVELDAM MAMAHIT
0001644068182 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 132439
1#0##0#0#0.0#2018-02-12 09:33:22#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 07/01/2018 12/01/2018 03/12/2010 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2765781 0 6 0 0 0 REVANIEYA GERALDIN
LOEN D207570 7 2592 DR AULIA TANGKARI, SPA 0138R01701180002814
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1#0##0#0#0.0#2018-02-12 09:47:15#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 08/01/2018 12/01/2018 07/08/2013 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3955753 0 5 0 0 0 HAMDALLAH BILQIS GUNJANI
D314113 4 1615 DR RASTRA, SPA 0138R01701180003290
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1#0##0#0#0.0#2018-02-12 10:53:14#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 11/01/2018 12/01/2018 07/01/2018 3000 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2857518 0 2 0 0 0 BAYI NY SITI ROHMAH
0002328118907 3;JKN DR RIZKI; 5.2.0.201712280730 4 133853
1#0##0#0#0.0#2018-02-12 11:09:05#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 12/01/2018 12/01/2018 01/03/1958 0 1
1 J90;K65.8 - - - None None None None J-4-20-II None
None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (SEDANG)
6429900 0 0 - 0 - 0 - 0 - 0
6429900 1297309 0 1 0 0 0 SAIFUL D387312
59 21867 DR YOHANES DWINANDA R P 0138R01701180005318 0001014240396
3;JKN DR RIZKI; 5.2.0.201712280730 4 133888 1#0##0#0#0.0#2018-
03-09 14:03:11#0#00:00:00#03:30:00#12:00:00 2
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3201126 B 2 BS 1 09/01/2018 12/01/2018 11/12/1948 0 1
1 N18.5;M54.57;M81.55;D63.8 99.04 - - None None None None
- 0 4958500 5978332 0 4 0 0 0 IR PAUL
RAUBUN, M.S.E D361946 69 25231 SRI KUNMARTINI.DR,SPPD
0138R01701180014798 0001222739706 3;JKN DR RIZKI; 5.2.0.201712280730
4 159334 1#0##0#0#0.0#2018-03-09
15:11:47#0#12:00:00#12:00:00#00:00:00 1 ee144e29ed94c9431e4a41a18469ac6f
0 0 610046 0 0 1982430 0 0 0 0
3385856 0 0 0 0 0
3201126 B 3 BS 1 10/01/2018 12/01/2018 08/08/1957 0 2
1 I49.3;E11.9;K92.1;I10;A09.0 - - - None None None None
I-4-19-I None None None None None None GANGGUAN KONDUKSI & ARITMIA
JANTUNG (RINGAN) 3914900 0 0 - 0 - 0 - 0 -
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3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133024
1#0##0#0#0.0#2018-03-28 12:17:48#0#12:00:00#12:00:00#12:00:00 2
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3201126 B 3 BS 1 10/01/2018 12/01/2018 26/11/1997 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2219635 0 3 0 0 0 TASYA NADELA
d387124 20 7350 DR SRI KUN, SPPD 0138R01701180004185
0001739963428 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 132644
1#0##0#0#0.0#2018-03-28 12:58:05#0#12:00:00#12:00:00#12:00:00 2
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3201126 B 2 BS 1 09/01/2018 12/01/2018 09/02/2016 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3474900 0 4 0 0 0 MUHAMMAD GALIH ALFARO
0002035053808 3;JKN DR RIZKI; 5.2.0.201712280730 4 131666
1#0##0#0#0.0#2018-03-29 10:13:02#0#12:00:00#12:00:00#12:00:00 2
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3201126 B 2 BS 1 08/01/2018 12/01/2018 19/04/2002 0 2
1 K35.8;J06.9 47.09 - - None None None None K-1-13-I None
None None None None None PROSEDUR APPENDIK (RINGAN) 4649300 0
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DR CATUR S, SPB 0138R01701180003400 0002077870037 3;JKN DR RIZKI;
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17:15:00#0#12:00:00#12:00:00#12:00:00 2 34df1d630cc2be805d7638dcf28029e7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 09/01/2018 13/01/2018 21/08/1969 0 1
1 I21.9;I45.1;I13.2;I63.9;A49.9 87.03 - - None None None None
12482300 0 0 - 0 - 0 - 0 - 0
12482300 8024189 0 5 0 0 0 HERY AGUS SETIYONO
0001096019627 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 132429
1#0##0#0#0.0#2018-01-25 11:20:26#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 11/01/2018 13/01/2018 04/07/2016 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2727479 0 3 0 0 0 CALON BAYI NYONYA ELSA
SUSELY PUTRI D338266 1 556 DR AWIDIYA, SPA 0138R01701180005259
0002069191168 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133882
1#0##0#0#0.0#2018-01-25 11:25:27#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 10/01/2018 13/01/2018 18/06/1984 0 2
1 M32.9;D69.3 99.23 - - None None None None M-4-16-II None
None None None None None GANGGUAN JARINGAN KONEKTIF (SEDANG) 5629200
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5241941 0 4 0 0 0 YANITA A200025 33 12259
DR SRI KUN, SPPD 0138R01701180004072 0002104105757 3;JKN TANTIYO
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11:32:29#0#12:00:00#12:00:00#12:00:00 1 58f2b3590ee50dab226da6a409221de9
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3201126 B 2 BS 1 11/01/2018 13/01/2018 22/12/1989 0 2
1 K29.7;A09.9 90.59 - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 2783600
2963465 0 3 0 0 0 EKA TATIEK ULANSARI D214736
TANTIYO S;16137 5.1.1.201705010501 4 133399 1#0##0#0#0.0#2018-
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3201126 B 1 BS 1 11/01/2018 13/01/2018 05/03/1963 0 1
1 I13.1;D63.8 38.95;99.04;39.95 - - None None None None N-1-
- 0 12472300 13732687 0 3 0 0 0 YASIR
D387102 54 20036 DR DEDY PRATAMA SPBV 0138R01701180004879
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1#0##0#0#0.0#2018-01-25 13:11:25#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 11/01/2018 13/01/2018 07/12/1962 0 1
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- 0 4132100 5050714 0 3 0 0 0 KASONO
0002223029204 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133886
1#0##0#0#0.0#2018-01-25 13:24:57#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 10/01/2018 13/01/2018 05/11/1955 0 1
1 I20.0;K29.7;I10 - - - None None None None I-4-20-I
5043100 0 0 - 0 - 0 - 0 - 0
5043100 2694122 0 4 0 0 0 NAFRIAL NAWI, SE
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0001810310837 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133040
1#0##0#0#0.0#2018-01-25 13:28:04#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 11/01/2018 13/01/2018 26/08/1960 0 1
1 I12.0;A49.9;D63.8 99.04;99.21;39.42 - - None None None None
- 0 - 0 10690500 17445591 0 3 0 0 0
ASMAWI D385415 57 20957 DR. ARU ARIADNO, SPPD
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5.1.1.201705010501 4 133844 1#0##0#0#0.0#2018-01-25
14:07:22#0#12:00:00#12:00:00#12:00:00 1 a5ce8b70b8c54e0dd4a38cd3062a7863
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3201126 B 3 BS 1 11/01/2018 13/01/2018 18/02/1958 0 1
1 K40.3;I69.4 53.05 - - None None None None K-1-14-I None
None None None None None PROSEDUR HERNIA INGUINAL DAN FEMORAL (RINGAN)
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6498455 0 3 0 0 0 MUHAMMAD YUSUF
0002292516055 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133046
1#0##0#0#0.0#2018-01-25 14:11:58#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 09/01/2018 13/01/2018 12/10/1987 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4087733 0 5 0 0 0 RYO EKA PRIHATNA
0001609339061 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 132153
1#0##0#0#0.0#2018-01-25 14:52:04#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 10/01/2018 13/01/2018 28/10/1991 0 1
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LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-01-25 14:54:39#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 06/01/2018 13/01/2018 21/06/1957 0 2
1 E13.2;J81;I25.0;D63.8 38.95;93.94;99.04 - - None None None
None N-1-12-III None None None None None None MEMBUAT BARU, MEREVISI
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0 SUTARNI D366344 60 22114 DR AZRI NURIZAL SPPD KKV
0138R01701180002555 0001727956214 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130777 1#0##0#0#0.0#2018-01-25
15:04:09#0#12:00:00#12:00:00#00:00:00 1 95a33c170d262f099fba2735979fbffe
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1 M47.87;I11.0;J44.0;I25.0 - - - None None None None
M-4-17-III None None None None None None MASALAH BAGIAN
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SAUT M.P PANJAITAN D368534 79 28895 DR AL RASYID SPS
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5.1.1.201705010501 4 131659 1#0##0#0#0.0#2018-01-25
15:33:54#0#12:00:00#12:00:00#00:00:00 1 3fe57c124f19fea9897cba3efeab1cd8
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3201126 B 1 BS 1 11/01/2018 13/01/2018 11/01/2018 3514 1
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0002328675546 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133841
1#0##0#0#0.0#2018-01-25 15:56:51#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 13/01/2018 13/01/2018 15/04/1963 0 1
1 K29.7;D72.9 45.16 - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 3247500
5517412 0 1 0 0 0 YOYO EFENDI D386278 54 19997
DR. ARU ARIADNO, SPPD 0138R01701180005931 0001303697968 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 134582 1#0##0#0#0.0#2018-
01-26 08:49:25#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 12/01/2018 13/01/2018 28/05/2008 0 1
1 T78.2 - - - None None None None S-4-11-I None None
None None None None ALERGI DAN SYOK ANAFILAKTIK (RINGAN) 1970100
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1655197 0 2 0 0 0 ALZUFARY DENIAS AFANDI d289539
9 3516 DR OTTY MITHA S, SPA 0138R01701180005697 0001108534432
3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134556
1#0##0#0#0.0#2018-01-26 08:57:14#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 13/01/2018 13/01/2018 23/05/1995 0 2
1 O80.9;O60.1;Z37.0 73.59 - - None None None None O-6-13-II
None None None None None None PERSALINAN VAGINAL (SEDANG) 2379000
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8271 DR ATJANG 0138R01701180006609 0002102635168 3;JKN TANTIYO
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09:06:31#0#12:00:00#12:00:00#12:00:00 1 d326145fd82f721e9dbb9d16b971c681
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3201126 B 2 BS 1 08/01/2018 13/01/2018 22/09/2016 0 1
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 4386253 0 6 0 0 0 YEHUDA NAPITUPULU
d366856 1 473 DR KRISTON SILITONGA, SPA 0138R01701180003420
0002089282825 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 131649
1#0##0#0#0.0#2018-01-26 11:40:28#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 11/01/2018 13/01/2018 07/12/1954 0 2
1 K29.7;I25.0 - - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 2783600
2633450 0 3 0 0 0 HAYATI D387225 63 23046
DR SRI KUN, SPPD 0138R01701180004726 0000060584499 3;JKN DR RIZKI;
5.1.1.201705010501 4 133044 1#0##0#0#0.0#2018-01-30
10:59:52#0#12:00:00#12:00:00#12:00:00 1 9f46e98548d7cfe1fefb21cb035fed99
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 10/01/2018 13/01/2018 12/01/2013 0 2
1 N39.0;A49.9 - - - None None None None N-4-12-I None
2871200 0 0 - 0 - 0 - 0 - 0
2871200 4789345 0 4 0 0 0 LAKEISHA AMEHKO RIODANO
0001627458491 3;JKN DR RIZKI; 5.1.1.201705010501 4 132744
1#0##0#0#0.0#2018-01-30 11:08:08#0#12:00:00#12:00:00#00:00:00 1
dd7f57a5cd6e290dd4f0fdca3830aac9 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 13/01/2018 09/01/1966 0 1
1 I21.2;I08.9;I50.0 88.55;36.07;93.94 - - YY02 None None None
I-1-40-II None None YY-02-III None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0
- 0 36446400 75758535 0 5 1 4 0 JANUARIUS
TARIGAN D387062 52 18993 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180003837 0002058843071 3;JKN DR RIZKI; 5.1.1.201705010501
4 132399 1#0##0#0#0.0#2018-01-30
12:30:09#0#12:00:00#12:00:00#12:00:00 1 2d2627cb6f6924b51db015c9df7e4ab4
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 11/01/2018 13/01/2018 22/10/1950 0 1
1 I20.0;I25.0;I50.0;I08.9;E11.9 88.55;36.07 - - YY02 None None
None I-1-40-II None None YY-02-III None None None PROSEDUR
0 - 0 - 0 46734600 57060320 0 3 0 0
0 ACHMAD SAIDUN ALI, SH D286409 67 24553 DR AGOES KOOSHARTORO
SPPD-KKV 0138R01701180004838 0000043180378 3;JKN DR RIZKI;
5.1.1.201705010501 4 133115 1#0##0#0#0.0#2018-01-30
12:40:19#0#12:00:00#12:00:00#00:00:00 1 98c4937037b616ba3fb1ae25a11eac06
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 11/01/2018 13/01/2018 04/01/1971 0 2
1 K29.7;I10;A01.0 90.59;89.52 - - None None None None K-4-
11-III None None None None None None GASTRITIS & ULKUS PEPTIKUM (BERAT)
4746800 0 0 - 0 - 0 - 0 - 0
4746800 3328828 0 3 0 0 0 IMAS SUCIATI CHANDRA
0001309198869 3;JKN DR RIZKI; 5.1.1.201705010501 4 133724
1#0##0#0#0.0#2018-01-30 14:55:08#0#12:00:00#12:00:00#12:00:00 1
7e28e4b01036539c99716e846f42a692 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 09/01/2018 13/01/2018 13/01/1990 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 25123941 0 5 0 0 0 RIZKA AMELIA
d266938 27 10223 DR ARJU A, SPOG 0138R01701180003477
0001483123779 3;JKN DR RIZKI; 5.2.0.201712280730 4 131665
1#1#vvip#5#19139841#0.0#2018-01-31 16:30:28#0#12:00:00#12:00:00#12:00:00
1 23fb35cb3dd4df50f297f49d5c3d95b0 0 0 8750000 0 0
6091741 0 0 0 0 10282200 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 13/01/2018 14/12/1935 0 2
1 I64;R13 - - - None None None None G-4-15-II None
PENYUMBATAN PRE-CEREBRAL TANPA INFARK (SEDANG) 4888600 0 0 - 0
- 0 - 0 - 0 4888600 2271007 0 1 0
0 0 ATIKAH HJ D387380 82 29981 DR ADRIAN HANDARU
0138R01701180005932 0000061017952 3;JKN DR RIZKI; 5.2.0.201712280730
4 135656 1#0##0#0#0.0#2018-02-08
15:33:03#0#00:00:00#02:30:00#12:00:00 1 36deea91057f3dde0efc9194c2d4751a
0 0 451179 0 0 648257 0 0 0 0 455571
0 0 0 0 716000
3201126 B 3 BS 1 13/01/2018 13/01/2018 25/08/1937 0 1
1 I20.0;I50.0;R07.4 89.52 - - None None None None I-4-20-II
None None None None None None ANGINA PEKTORIS DAN NYERI DADA (SEDANG)
4854000 0 0 - 0 - 0 - 0 - 0
4854000 2346645 0 1 0 0 0 RM SIMAMORA D351802
80 29361 DR ANGGA TOMALA PUTRA 0138R01701180006001 0001318197306
3;JKN DR RIZKI; 5.2.0.201712280730 4 134651 1#0##0#0#0.0#2018-
02-08 15:37:31#0#07:20:00#15:00:00#12:00:00 1
0f409b5a70daf91632fcea1529d2e9ed 0 0 378234 0 0
1030892 0 0 0 0 442519 0 0 0 0 495000
3201126 B 1 BS 1 10/01/2018 13/01/2018 06/03/1969 0 2
1 N93.9 69.09 - - None None None None W-1-11-I None None
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 14796300 0 4 0 0 0 TOYIBAH D326805
TANTIYO S;16137 5.2.0.201712280730 4 133029
1#1#vvip#4#11575500#0.0#2018-02-08 16:53:07#0#12:00:00#12:00:00#12:00:00
1 40cb40693bae09ec668db2174d97f4c9 0 6128500 1997284 0
0 5501534 0 0 0 0 1168982 0 0 0 0
0
3201126 B 3 BS 1 13/01/2018 13/01/2018 11/10/1963 0 1
1 I50.0;I21.9;J44.9;K29.7 89.52 - - None None None None I-4-
12-III None None None None None None KEGAGALAN JANTUNG (BERAT)
4973600 0 0 - 0 - 0 - 0 - 0
4973600 2316255 0 1 0 0 0 AHMAD KAHFI D359276
DR RIZKI; 5.2.0.201712280730 4 134591 1#0##0#0#0.0#2018-02-09
08:40:04#0#00:00:00#09:00:00#00:00:00 1 bf4e2c4be7eed8c7020f9d126e3f429d
0 0 447624 0 0 1428100 0 0 0 0 440531
0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 13/01/2018 28/07/1945 0 1
1 I20.0;R07.4 89.52 - - None None None None I-4-20-I None
None None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN)
4202600 0 0 - 0 - 0 - 0 - 0
4202600 713940 0 1 0 0 0 H AMDALI D383782
DR RIZKI; 5.2.0.201712280730 4 134585 1#0##0#0#0.0#2018-02-09
09:05:56#0#00:00:00#05:30:00#12:00:00 1 abf20fcce863044ebb93ac32fcabd943
0 0 378234 0 0 0 0 0 0 0 335706
0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 13/01/2018 03/03/1948 0 2
1 I20.0;R07.4;K29.7;L50.9 89.52 - - None None None None I-4-
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1974109 0 1 0 0 0 CASMINAH d323663
DR RIZKI; 5.2.0.201712280730 4 134586 1#0##0#0#0.0#2018-02-09
10:41:31#0#00:00:00#08:30:00#00:00:00 1 930c6c0fa5e409815c96246568b9c703
0 0 378234 0 0 1031728 0 0 0 0 436147
0 0 0 128000 0
3201126 B 3 BS 1 12/01/2018 13/01/2018 22/06/1984 0 2
1 G41.9;R57.1 38.93 - - None None None None G-4-22-III None
None None None None None SERANGAN KEJANG (BERAT) 3965000 0 0
- 0 - 0 - 0 - 0 3965000 11052556 0
2 0 0 0 RIZKI ROMADONA D116119 33 12257 DR.
SUKMARINI 0138R01701180005803 0001281519202 3;JKN DR RIZKI;
5.2.0.201712280730 4 135678 1#0##0#0#0.0#2018-02-09
11:28:45#0#08:10:00#12:00:00#00:00:00 1 d3a9ab3668f247ee2b235d0fe5a87561
0 0 1304850 0 0 8309642 0 0 0 0
1012064 0 0 0 426000 0
3201126 B 1 BS 1 12/01/2018 13/01/2018 13/03/1953 0 1
- 0 58821400 72599080 0 2 0 0 0 RAMLI
0000061034589 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133891
1#0##0#0#0.0#2018-02-09 19:37:47#0#12:00:00#12:00:00#00:00:00 1
7bf7153657cfec0de84659ee2f41a9f0 0 10062000 9619120 0 0
0 0 0 0 0 1256000 0 0 44092960 7569000
0
3201126 B 3 BS 1 12/01/2018 13/01/2018 20/11/1971 0 1
1 D17.5 88.76 - - None None None None K-4-18-I None None
None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1952215 0 2 0 0 0 JOHAN D387367 46
16855 DR TANTIYO SETIYOWATI 0138R01701180005926 0002069572724 3;JKN
DR RIZKI; 5.2.0.201712280730 4 134580 1#0##0#0#0.0#2018-02-10
09:54:22#0#12:00:00#12:00:00#12:00:00 1 0c39e36fded44777d517139178161f93
0 0 442395 0 0 1093105 0 0 0 0 416715
0 0 0 0 0
3201126 B 2 BS 1 12/01/2018 13/01/2018 25/05/2016 0 1
4 A41.9;G04.2;D64.9;Q31.5;J96.0 96.04;96.71;38.93 - - None None
- 0 - 0 34963000 20162593 0 2 1 2 24
FEREL FATIR AN. D364104 1 597 DR NOVIK BUDIWARDHANA, SPA
0138R01701180005507 0002061609142 3;JKN DR RIZKI; 5.2.0.201712280730
4 134299 1#0##0#0#0.0#2018-02-12
11:26:53#0#12:00:00#12:00:00#00:00:00 1 fa14e03ee95c9cd56ef0abd0c3daf462
0 0 4177670 0 0 9262923 0 0 0 0
4328000 0 0 0 0 2394000
3201126 B 3 BS 1 10/01/2018 13/01/2018 31/12/1960 0 1
- 0 36446400 61924004 0 4 0 0 0 SOFYAN
0000511578033 3;JKN DR RIZKI; 5.2.0.201712280730 4 132436
1#0##0#0#0.0#2018-03-09 13:52:38#0#12:00:00#12:00:00#12:00:00 3
0f5ae7c535677c9ec71a5802e50e19e1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 13/01/2018 11/10/1963 0 1
1 I50.0;I21.9;J44.9;K29.7 89.52 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 2316255 0 1 0 0 0 AHMAD KAHFI D359276
TANTIYO S;16137 5.2.0.201712280730 4 134591 1#0##0#0#0.0#2018-
03-19 08:05:34#0#00:00:00#09:00:00#00:00:00 2
e86180300cb74db893644f6c97e667a7 0 0 447624 0 0
1428100 0 0 0 0 440531 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 13/01/2018 26/02/1966 0 2
1 I12.0 - - - None None None None N-4-10-I None None
None None None None TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL (RINGAN)
3313800 0 0 - 0 - 0 - 0 - 0
3313800 2490108 0 1 0 0 0 EKA SUHANINGSIH
D351328 51 18949 DR LIDYA SANTALIA 0138R01701180005933
0002205688072 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134584
1#0##0#0#0.0#2018-03-19 11:12:23#0#00:00:00#05:00:00#00:00:00 2
254625ed86d65f1792a8b47476369cb6 0 0 251865 0 0
1768339 0 0 0 0 469904 0 0 0 0 0
3201126 B 1 BS 1 11/01/2018 13/01/2018 17/06/1979 0 2
1 O82.0;Z37.0 74.0;65.61 - - None None None None W-1-20-I
None None None None None None PROSEDUR PADA RAHIM & ADNEKSA (RINGAN)
11569900 0 0 - 0 - 0 - 0 - 0
11569900 28806390 0 3 0 0 0 HENNI WIJAYANI
A158637 38 14088 DR KARTIKA MAYA, SPOG 0138R01701180004747
0001378391196 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133045
1#1#vvip#3#17236490#0.0#2018-03-19 15:32:09#0#12:00:00#12:00:00#12:00:00
3 a2cc08f846636f632f1c9cded8df4fbf 0 10077700 11358012 0
0 5998678 0 0 0 0 1372000 0 0 0 0
0
3201126 B 3 BS 1 31/12/2017 13/01/2018 10/05/1962 0 1
1 I63.9;G81.9;A49.9;N18.5;J18.9 87.03;39.95;38.95 - - None None
None None N-1-12-III None None None None None None MEMBUAT BARU,
MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (BERAT) 19332400 0 0 - 0
- 0 - 0 - 0 19332400 46233984 0 14 0
0 0 SUGANDI D374149 55 20324 DR MAYSAMIRAWATI SPS
0138R01712170012260 0001014301361 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 127636 1#0##0#0#0.0#2018-03-29
16:03:47#0#12:00:00#12:00:00#12:00:00 3 d9dea54d7fd54298a1776bc787025d32
0 46233984 0 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 11/01/2018 13/01/2018 14/10/1987 0 2
1 R63.0 88.76;87.24 - - None None None None E-4-10-I None
- 0 4903800 4548233 0 3 0 0 0 DIYAN ATIKA
0001139398187 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 133678
1#0##0#0#0.0#2018-05-17 15:54:53#0#12:00:00#12:00:00#12:00:00 2
6d5023163dd82e4aef833e420ed3ba01 0 0 517661 0 0
1364024 0 0 0 0 2666548 0 0 0 0 0
3201126 B 1 BS 1 13/01/2018 14/01/2018 01/06/1951 0 1
1 I12.0;E10.2;D63.8 38.95;99.04;99.17 - - None None None None
- 0 - 0 12472300 12782264 0 2 0 0 0
SOBARI H, SE D387233 66 24333 DR SRI KUMARTINI
0138R01701180006105 0000061012427 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 134865 1#0##0#0#0.0#2018-01-25
15:43:21#0#12:00:00#12:00:00#12:00:00 1 30690a098041b8a5c500bc75a5c143e2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 12/01/2018 14/01/2018 02/10/1967 0 1
1 J35.0;G47.3 28.2 - - None None None None U-1-15-I None
None None None None None PROSEDUR TONSIL & ADENOID (RINGAN) 5461000
0 0 - 0 - 0 - 0 - 0 5461000
9707386 0 3 0 0 0 SUPROBO D225161 50 18365
DR ASNOMINANDA, SPHT 0138R01701180005902 0001259310835 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 134573 1#0##0#0#0.0#2018-
01-25 15:55:32#0#12:00:00#12:00:00#12:00:00 1
2b5dbb5dddee86687019153ee60b72b2 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 12/01/2018 14/01/2018 14/03/1989 0 2
1 O41.0;O14.0;O82.0 74.0 - - None None None None O-6-10-I
5984100 0 0 - 0 - 0 - 0 - 0
5984100 20910977 0 3 0 0 0 CITRA AMANDA YANSA PUTRI
D368251 28 10531 DR NINING H, SPOG 0138R01701180005313
0002095072209 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133887
1#1#vip#3#6233525#75.0#2018-01-25 16:36:13#0#12:00:00#12:00:00#12:00:00
1 ef6e41613169c82bff1550cb75e88fb3 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 12/01/2018 14/01/2018 19/03/2015 0 1
1467400 0 0 - 0 - 0 - 0 - 0
1467400 3899456 0 3 0 0 0 AHMAD MAULANA ALFIANSYAH
D381397 2 1030 DR CATUR S, SPB 0138R01701180005896
0002297426319 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134574
1#0##0#0#0.0#2018-01-26 08:59:44#0#12:00:00#12:00:00#12:00:00 2
786c427f6e0c86fe7eeb0fe72b678a5a 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 12/01/2018 14/01/2018 16/10/1970 0 2
1 I20.9;L94.0;I10 90.59;89.52;87.24 - - None None None None
I-4-20-I None None None None None None ANGINA PEKTORIS DAN NYERI
DADA (RINGAN) 4202600 0 0 - 0 - 0 - 0 -
0 4202600 2626683 0 3 0 0 0 UMAYA D316237
3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134565
1#0##0#0#0.0#2018-01-26 14:38:26#0#12:00:00#12:00:00#00:00:00 1
f1dd548d317b5b497808c37637508773 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 10/01/2018 14/01/2018 15/07/1963 0 2
1 I50.0;I08.9;I25.0 87.44;89.52 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4973600
4564966 0 5 0 0 0 SARI MAAT D360799 54 19903
DR AGOES KOOSHARTORO SPPD-KKV 0138R01701180004684 0001810155341 3;JKN
DR RIZKI; 5.1.1.201705010501 4 133033 1#0##0#0#0.0#2018-01-30
10:58:03#0#12:00:00#12:00:00#00:00:00 1 111be5c485f181f589ed82558289f765
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 12/01/2018 14/01/2018 10/05/1975 0 2
12-I None None None None None None KEGAGALAN JANTUNG (RINGAN) 3575600
0 0 - 0 - 0 - 0 - 0 3575600
2362504 0 3 0 0 0 LILIS SURYANI D339258 42
15588 DR AGOES KOOSHARTORO SPPD-KKV 0138R01701180005584 0001305707128
3;JKN DR RIZKI; 5.1.1.201705010501 4 134394 1#0##0#0#0.0#2018-
01-30 11:02:09#0#12:00:00#12:00:00#00:00:00 1
fa8b346a446449ee772d376721b351f6 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 06/01/2018 14/01/2018 22/05/1952 0 2
1 S82.50;I11.0 79.19 - - None None None None M-1-60-III
None None None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN
PENGHUBUNG LAIN-LAIN (BERAT) 21893600 0 0 - 0 - 0 -
0 - 0 21893600 22784861 0 9 0 0 0
MAGDALENA HALIM D386851 65 23970 DR BENNY H T, SPOT
0138R01701180002624 0001469925191 3;JKN DR RIZKI; 5.1.1.201705010501
4 130785 1#0##0#0#0.0#2018-01-30
12:20:04#0#12:00:00#12:00:00#12:00:00 1 8f47584770a00ae1ef7c32eec1c6b83d
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 12/01/2018 14/01/2018 10/03/1963 0 2
1 J01.8;K29.7 87.44 - - None None None None U-4-13-I None
None None None None None PERADANGAN EPIGLOTIS, TELINGA TENGAH, ISPA DAN
LARINGOTRAKEITIS (RINGAN) 2772200 0 0 - 0 - 0 -
0 - 0 2772200 6098395 0 3 0 0 0
SULISTI D237001 54 20032 DR ARU, SPPD 0138R01701180005590
0000040974625 3;JKN DR RIZKI; 5.1.1.201705010501 4 134890
1#1#vvip#3#3326195#0.0#2018-01-30 12:43:34#0#12:00:00#12:00:00#12:00:00
1 700fa6b4e8b56f920242a5f3ef93ccd8 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 12/01/2018 14/01/2018 14/11/1993 0 2
0 - 0 - 0 - 0 - 0 3900700 6985164
0 3 0 0 0 SUSI SILVIA D384121 24 8825 DR. INDAH
TRISNAWATY SP.THT 0138R01701180005888 0001465547747 3;JKN DR RIZKI;
5.1.1.201705010501 4 134569 1#0##0#0#0.0#2018-01-30
12:45:42#0#12:00:00#12:00:00#12:00:00 1 f972efc95f260a70485f0b766ae83f96
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 2 BS 1 13/01/2018 14/01/2018 25/04/1952 0 1
1 E14.2;D63.8 99.04 - - None None None None N-4-16-II None
None None None None None PENYAKIT GINJAL DAN SALURAN URIN LAIN-LAIN
(SEDANG) 6330300 0 0 - 0 - 0 - 0 - 0
6330300 3442369 0 2 0 0 0 DIDI SUHENDRI
D321683 65 24004 DR MOHAMAD NIZAM ERHAMZA SPP 0138R01701180006115
0001459026955 3;JKN DR RIZKI; 5.1.1.201705010501 4 134867
1#0##0#0#0.0#2018-01-30 12:51:04#0#12:00:00#12:00:00#00:00:00 1
390350ea299c6144488ce8fd0951b487 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 10/01/2018 14/01/2018 15/06/2016 0 1
1 J06.9;R56.0 - - - None None None None U-4-13-II None
LARINGOTRAKEITIS (SEDANG) 3268200 0 0 - 0 - 0 -
0 - 0 3268200 4687163 0 5 0 0 0 ARSYAD
ABINAYA FAEYZA IRZALDI D336281 1 574 DR KRISTON SILITONGA, SPA
0138R01701180004703 0002065531195 3;JKN DR RIZKI; 5.1.1.201705010501
4 133038 1#0##0#0#0.0#2018-01-30
13:00:17#0#12:00:00#12:00:00#12:00:00 1 8f3f72ccce42bd6f9d03e3586578cd94
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 1 BS 1 11/01/2018 14/01/2018 02/10/1991 0 1
10909500 0 0 - 0 - 0 - 0 - 0
10909500 13801319 0 4 0 0 0 GIBSON WINNER SIMATUPANG
0001464612636 3;JKN DR RIZKI; 5.1.1.201705010501 4 133042
1#0##0#0#0.0#2018-01-30 13:03:46#0#12:00:00#12:00:00#12:00:00 1
2625e50f627d0e27aeec95da129b9e7e 0 0 0 0 0 0 0
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3201126 B 1 BS 1 12/01/2018 14/01/2018 24/09/1960 0 1
1 K74.6;I98.3 42.33 - - None None None None B-4-13-I None
None None None None None GANGGUAN HATI LAIN-LAIN (RINGAN) 5886000
0 0 - 0 - 0 - 0 - 0 5886000
12610444 0 3 0 0 0 BABAN BASTARI D381150 57
DR RIZKI; 5.1.1.201705010501 4 134577 1#0##0#0#0.0#2018-01-30
13:12:13#0#12:00:00#12:00:00#12:00:00 1 6b0e982ade241db070e3a0fc5d9edd3f
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0138R01701180005886 0001309015315 3;JKN DR RIZKI; 5.1.1.201705010501
4 134570 1#0##0#0#0.0#2018-01-30
14:41:59#0#12:00:00#12:00:00#12:00:00 1 5fa38d33b24ce0c71627215b35078994
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3201126 B 1 BS 1 12/01/2018 14/01/2018 08/03/1967 0 1
1 I20.9;I11.9 88.55 - - None None None None I-1-15-I None
None None None None None KATETERISASI JANTUNG (RINGAN) 6357300 0
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BAMBANG DWIPUTRA SPJP 0138R01701180005891 0000060734417 3;JKN DR RIZKI;
5.1.1.201705010501 4 134571 1#0##0#0#0.0#2018-01-30
14:45:01#0#12:00:00#12:00:00#12:00:00 1 af879a035a74622d52bf1a6f4830be94
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3201126 B 2 BS 1 13/01/2018 14/01/2018 15/06/1955 0 1
1 I25.0;I13.2;I08.9 88.55 - - None None None None I-1-15-III
None None None None None None KATETERISASI JANTUNG (BERAT) 14653000
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13567234 0 2 0 0 0 UMAR BIN HASAN D340995 62
22858 DR AGOES KOOSHARTORO SPPD 0138R01701180005954 0001897133422
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1#0##0#0#0.0#2018-02-03 11:36:22#0#12:00:00#12:00:00#00:00:00 1
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4099058 0 0 0 0 4468576 0 0 0 2069000
0
3201126 B 2 BS 1 12/01/2018 14/01/2018 20/01/1942 0 1
1 I20.9;I11.0 36.07;88.55 - - YY02 None None None I-1-40-III
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
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0000060720186 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134567
1#0##0#0#0.0#2018-02-05 07:11:38#0#12:00:00#12:00:00#00:00:00 1
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0
3201126 B 2 BS 1 12/01/2018 14/01/2018 26/06/1953 0 2
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11151989 0 3 0 0 0 ENNY DJUHAENI D372132 64
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135234
1#0##0#0#0.0#2018-02-05 14:58:14#0#12:00:00#12:00:00#12:00:00 1
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3475100 0 0 0 0 755569 0 0 0 2069000
0
3201126 B 2 BS 1 11/01/2018 14/01/2018 20/11/2017 0 1
4335900 0 0 - 0 - 0 - 0 - 0
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HANIFAH D387269 0 52 DR OTTY MITHA S, SPA 0138R01701180005239
0002311575693 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133828
1#0##0#0#0.0#2018-02-05 17:05:44#0#12:00:00#12:00:00#12:00:00 1
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2385830 0 0 0 0 2387254 0 0 0 0 0
3201126 B 2 BS 1 12/01/2018 14/01/2018 12/01/2018 2240 2
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(RINGAN) 6580300 0 0 - 0 - 0 - 0 - 0
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1#1#vip#3#1096700#0.0#2018-02-05 17:39:45#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 12/01/2018 14/01/2018 12/03/1957 0 1
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SUMIRAT D385692 60 22221 DR BAMBANG DWIPUTRA SPJP
0138R01701180005903 0000042712547 3;JKN TANTIYO S;16137
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15:50:36#0#12:00:00#12:00:00#12:00:00 1 11229ef91d29aa5252bfc81ec4da1fe8
0 10062000 9346920 0 0 0 0 0 0 0
1226000 0 0 38574190 7569000 0
3201126 B 3 BS 1 14/01/2018 14/01/2018 27/07/1953 0 2
4 I21.2;J96.0;I50.0;E14.9 99.60 - - None None None None I-4-
10-III None None None None None None INFARK MYOKARD AKUT (BERAT)
10401900 0 0 - 0 - 0 - 0 - 0
10401900 6052954 0 1 0 0 0 PAULINA SOEKARNI
D387533 64 23547 DR MUHAMMAD RIZKI YUWANA 0138R01701180006191
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1#0##0#0#0.0#2018-02-08 08:51:58#0#05:00:00#07:47:00#12:00:00 2
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2309744 0 0 0 0 702988 0 0 0 418000
0
3201126 B 1 BS 1 12/01/2018 14/01/2018 26/07/1977 0 1
1 I25.0;I11.0 88.55 - - None None None None I-1-15-III None
None None None None None KATETERISASI JANTUNG (BERAT) 17095200 0
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DWIPUTRA SPJP 0138R01701180005875 0000042054862 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 134566 1#0##0#0#0.0#2018-02-09
10:47:08#0#12:00:00#12:00:00#00:00:00 1 91a4917732b396c7774b5fa6c62bcca2
0 4777000 3419040 0 0 0 0 0 0 0
1033858 0 0 4106935 2069000 0
3201126 B 1 BS 1 12/01/2018 14/01/2018 06/11/1970 0 2
- 0 58821400 53953215 0 3 0 0 0 PRITA
NOVIANTI D277925 47 17234 DR BAMBANG DWIPUTRA SPJP
0138R01701180005893 0001650441104 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 134572 1#0##0#0#0.0#2018-02-09
10:50:39#0#12:00:00#12:00:00#12:00:00 2 afb80abbaa4ed917474c0e36fac36168
0 10062000 7201760 0 0 0 0 0 0 0
1226000 0 0 27894455 7569000 0
3201126 B 3 BS 1 14/01/2018 14/01/2018 29/06/1969 0 1
1 E14.4;J18.0;J96.0;I11.9;R57.1;K92.1 99.60;57.94 - - None None
None None G-4-17-III None None None None None None GANGUAN SARAF
KRANIAL DAN PERIFER (BERAT) 7639400 0 0 - 0 - 0 -
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ROSYAD SYIHAB D387527 48 17731 DR MUHAMMAD RIZKI YUWANA
0138R01701180006203 0000060792276 3;JKN DR RIZKI; 5.2.0.201712280730
4 134882 1#0##0#0#0.0#2018-02-10
09:46:46#0#12:00:00#12:00:00#12:00:00 1 28acbb767d23042fc4e3f2b3141e8ee2
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0 0 0 128000 0
3201126 B 1 BS 1 10/01/2018 14/01/2018 28/06/2006 0 1
1 I47.1 89.52 - - None None None None I-4-19-I None None
None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG (RINGAN)
5480800 0 0 - 0 - 0 - 0 - 0
5480800 6976720 0 5 1 3 0 MUHAMMAD FAEYZA DEVAN
ISYRAQYUDA D236476 11 4214 DR VINSENSIA NOVI KARTIKA
0138R01701180004508 0001737572747 3;JKN DR RIZKI; 5.2.0.201712280730
4 133019 1#0##0#0#0.0#2018-02-12
11:06:58#0#12:00:00#12:00:00#12:00:00 1 d91bca5668990897ece76955f5a43e7f
0 0 546272 0 0 695027 0 0 0 0
3905421 0 0 0 0 1830000
3201126 B 1 BS 1 07/01/2018 14/01/2018 01/08/1953 0 2
1 I21.9;R57.2;E87.2;J15.9;E10.4;I13.2;N18.5;R57.0;I48
96.05;38.95;39.95;96.71 - - None None None None J-1-20-III None
None None None None None PROSEDUR SISTEM PERNAFASAN NON-KOMPLEKS (BERAT)
40790100 0 0 - 0 - 0 - 0 - 0
40790100 55758983 0 8 1 3 96 AUGUSTIEN A. SUNDALANGI
D319145 64 23535 DR EVA INDAHWATI SPAN 0138R01701180002644
0001472918488 3;JKN DR RIZKI; 5.2.0.201712280730 4 130788
1#0##0#0#0.0#2018-03-09 09:43:38#0#12:00:00#12:00:00#00:00:00 3
34bb7f751cbd11e8b44541de0e6e2ff9 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 10/01/2018 14/01/2018 16/06/1985 0 2
1 I13.2;D69.6;N05.9;D63.8 99.04 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4973600
11886263 0 5 0 0 0 MAYA SAFITRI D387141 32
TANTIYO S;16137 5.2.0.201712280730 4 132920 1#0##0#0#0.0#2018-
03-28 13:22:42#0#12:00:00#12:00:00#12:00:00 2
d9cfe77c15f58257902cf4b16b968d0c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 12/01/2018 14/01/2018 05/10/1958 0 1
1 I50.0;I25.0;I05.9;I48;I34.0;K30 - - - None None None
None I-4-12-II None None None None None None KEGAGALAN JANTUNG
(SEDANG) 5802600 0 0 - 0 - 0 - 0 - 0
5802600 7954155 0 3 0 0 0 DRS.H. JAJAT JATMIKA
0001454760562 3;JKN DR RIZKI; 5.2.1.201804062320 4 133889
1#0##0#0#0.0#2018-05-17 15:01:36#0#12:00:00#12:00:00#00:00:00 2
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1770998 0 0 0 0 2889365 0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 14/01/2018 07/12/1954 0 2
2 I95.9;R57.1;K92.2;D64.9 99.04 - - None None None None I-4-
24-III None None None None None None GANGGUAN SISTEM PEMBULUH DARAH
LAIN-LAIN (BERAT) 8139800 0 0 - 0 - 0 - 0 -
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0000060584499 3;JKN DR RIZKI; 5.2.2.201806040537 4 135665
1#0##0#0#0.0#2018-08-13 12:34:32#0#00:00:00#14:00:00#12:00:00 2
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3201126 B 1 BS 1 12/01/2018 15/01/2018 20/09/1957 0 2
1 S93.0;D64.9;E13.8 79.87;99.04 - - None None None None M-1-
70-II None None None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN
KAKI (SEDANG) 23493100 0 0 - 0 - 0 - 0 -
0 23493100 29749904 0 4 0 0 0 ERNIWATI
D291114 60 22029 DR BENNY H T, SPOT 0138R01701180005319
0001382190592 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133890
1#0##0#0#0.0#2018-01-25 15:52:10#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 12/01/2018 15/01/2018 07/08/1987 0 2
None None None None None None PROSEDUR PADA RAHIM & ADNEKSA (SEDANG)
12391500 0 0 - 0 - 0 - 0 - 0
12391500 13478710 0 4 0 0 0 RINI MULYA SARI
d370739 30 11116 DR ERDIYAN, SPOG 0138R01701180006521
0001339228552 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134963
1#0##0#0#0.0#2018-01-25 16:32:27#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 07/01/2018 15/01/2018 21/12/1965 0 1
1 E10.5;L03.9;I50.0 86.28;89.52;87.49;88.77 - - None None None
None I-4-15-II None None None None None None PENYAKIT PEMBULUH DARAH
PERIFER DAN LAIN-LAIN (SEDANG) 8537100 0 0 - 0 - 0
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HENJANG NURCAHYA BAYU EDI D288905 52 19010 DR ARU, SPPD
0138R01701180002650 0000036731428 3;JKN TANTIYO S;16137
5.1.1.201705010501 4 130790 1#0##0#0#0.0#2018-01-25
16:46:36#0#12:00:00#12:00:00#12:00:00 1 6baebd76451d4764269676f20ec6cbbd
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 11/01/2018 15/01/2018 17/07/1971 0 2
W-1-20-II None None None None None None PROSEDUR PADA RAHIM & ADNEKSA
(SEDANG) 10326200 0 0 - 0 - 0 - 0 - 0
10326200 12171678 0 5 0 0 0 ENDANG DWI WACHYUNI
0001739946745 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133883
1#0##0#0#0.0#2018-01-25 16:53:41#0#12:00:00#12:00:00#12:00:00 1
a0c1cf0bde0295abd2f4507fca3fdfca 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 15/01/2018 03/10/1976 0 1
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0002249447962 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134899
1#0##0#0#0.0#2018-01-26 08:51:50#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 14/01/2018 15/01/2018 16/12/1965 0 2
1 N18.5;D63.8;I10 99.04;89.52;39.95 - - None None None None
- 0 4958500 4651627 0 2 0 0 0 RUMONDANG
NABABAN D326745 52 19022 DR SRI KUNMARTINI, SPPD 0138R01701180006332
0001436760786 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134910
1#0##0#0#0.0#2018-01-26 08:53:52#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 1 BS 1 14/01/2018 15/01/2018 01/10/2016 0 1
1 A49.9;R56.0 99.21 - - None None None None A-4-14-II None
(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 3168127 0 2 0 0 0 AIZAR RASYIQUL AL AUF
D345986 1 470 DR AA 0138R01701180006311 0002217344804 3;JKN
TANTIYO S;16137 5.1.1.201705010501 4 134901 1#0##0#0#0.0#2018-
01-26 08:55:42#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 11/01/2018 15/01/2018 09/09/2011 0 2
2507900 0 0 - 0 - 0 - 0 - 0
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0002248869137 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133457
1#0##0#0#0.0#2018-01-26 10:17:59#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 13/01/2018 15/01/2018 03/03/1947 0 1
1 E10.2;I25.1;J18.0 39.27;99.17 - - None None None None N-1-
12-III None None None None None None MEMBUAT BARU, MEREVISI DAN
- 0 - 0 27065300 13946790 0 3 0 0 0
SUKIMIN D387487 70 25884 DR SRI KUN, SPPD 0138R01701180006084
0000042653316 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134863
1#0##0#0#0.0#2018-01-26 10:24:30#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 11/01/2018 15/01/2018 22/08/1988 0 2
4665300 0 0 - 0 - 0 - 0 - 0
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29 10734 DR HENDRIEK S, SPB 0138R01701180005265 0002096714092
3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133881
1#0##0#0#0.0#2018-01-26 10:29:09#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 12/01/2018 15/01/2018 01/07/2011 0 1
1 N39.0;A09.9;A49.9 99.21 - - None None None None N-4-12-I
None None None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN)
2871200 0 0 - 0 - 0 - 0 - 0
2871200 5768432 0 4 0 0 0 ADITYA RACHMAN ANANTO
0001735912934 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134885
1#1#vip#4#2990950#75.0#2018-01-26 13:36:53#0#12:00:00#12:00:00#00:00:00
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3201126 B 2 BS 1 10/01/2018 15/01/2018 13/11/2009 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
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D178443 8 2980 DR TRI LESTARI, SPA 0138R01701180004419
0002050252198 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 133010
1#1#vvip#6#10873005#0.0#2018-01-26 13:44:59#0#12:00:00#12:00:00#12:00:00
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3201126 B 2 BS 1 13/01/2018 15/01/2018 21/03/1981 0 2
1 I69.4;R56.8 88.41 - - None None None None G-1-12-II None
None None None None None PROSEDUR PEMBULUH DARAH EXTRA KRANIAL (SEDANG)
11443900 0 0 - 0 - 0 - 0 - 0
11443900 11948666 0 3 0 0 0 ANILY WARNY, SE, AS
D321984 36 13447 DR. RAKHMAD HIDAYAT, SP.S (K) 0138R01701180006122
0001656268378 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134868
1#0##0#0#0.0#2018-01-26 14:12:54#0#12:00:00#12:00:00#00:00:00 1
18932dcf64021ea9ae7bb94af96583b6 0 0 0 0 0 0 0
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3201126 B 3 BS 1 12/01/2018 15/01/2018 21/12/1964 0 2
1 N39.0;E87.6;K29.7;N17.9;E87.1 - - - None None None None
URIN (BERAT) 5062600 0 0 - 0 - 0 - 0 -
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3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134578
1#0##0#0#0.0#2018-01-26 14:20:52#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 12/01/2018 15/01/2018 08/09/1976 0 2
1 N93.9;D62;D26.1 99.04;90.59 - - None None None None W-4-
12-II None None None None None None GANGGUAN MENSTRUASI & SISTEM REPRODUKSI
0 - 0 4628500 6581620 0 4 0 0 0 ANITA
RATNA DEWI,SE d221826 41 15101 DR ARU, SPPD 0138R01701180005806
0001625703491 3;JKN TANTIYO S;16137 5.1.1.201705010501 4 134564
1#0##0#0#0.0#2018-01-26 14:32:05#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 12/01/2018 15/01/2018 20/11/2016 0 1
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
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0002204246608 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134568
1#0##0#0#0.0#2018-02-03 12:19:33#0#12:00:00#12:00:00#12:00:00 1
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1030664 0 0 0 0 1812500 0 0 0 243539
0
3201126 B 2 BS 1 14/01/2018 15/01/2018 07/04/1976 0 1
None None None None None PROSEDUR ANGGOTA TUBUH ATAS (RINGAN)
10406400 0 0 - 0 - 0 - 0 - 0
10406400 16777001 0 2 0 0 0 ASMADI D387542
41 15257 DR BENNY H T, SPOT 0138R01701180006318 0001608801783
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134905
1#0##0#0#0.0#2018-02-03 12:28:00#0#12:00:00#12:00:00#12:00:00 1
78de1122a5f4d1fa4ed4774e7cf4fe50 0 5930500 6820856 0 0
2707084 0 0 0 0 1173561 0 0 0 145000
0
3201126 B 2 BS 1 13/01/2018 15/01/2018 24/05/2017 0 1
1 A09.9;J15.9 93.94 - - None None None None K-4-17-III None
(BERAT) 3046500 0 0 - 0 - 0 - 0 - 0
3046500 2355445 0 3 0 0 0 AL FATTAH SULAEMAN
ISKANDAR D387514 0 234 DR AWIDIYA, SPA 0138R01701180006137
0002238650954 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134872
1#0##0#0#0.0#2018-02-03 12:53:38#0#12:00:00#12:00:00#12:00:00 2
3d21f4dba27da4e82aa954f74ab7add0 0 0 238535 0 0 926815
0 0 0 0 1190095 0 0 0 0 0
3201126 B 1 BS 1 13/01/2018 15/01/2018 04/04/1955 0 2
0 0 - 0 - 0 - 0 - 0 17095200
17062325 0 3 0 0 0 ERLY JONATHANS D036792 62
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134590
1#0##0#0#0.0#2018-02-07 19:31:23#0#12:00:00#12:00:00#00:00:00 1
92a50609f0aeb445fc496349383826c0 0 5486000 3419040 0 0
4946058 0 0 0 0 1142227 0 0 0 2069000
0
3201126 B 3 BS 1 14/01/2018 15/01/2018 02/03/1964 0 1
1 I12.0;D63.8;B17.1 99.04;89.52;90.59;39.95 - - None None None
0 - 0 4132100 4662678 0 2 0 0 0 ROMLI
D325831 53 19676 DR SRI KUN, SPPD 0138R01701180006258
0001743644902 3;JKN DR RIZKI; 5.2.0.201712280730 4 134894
1#0##0#0#0.0#2018-02-09 11:04:23#0#12:00:00#12:00:00#00:00:00 1
b8c6bdc09fa4eb274b246c469431781e 0 0 599993 0 0
2049400 0 0 0 0 2013285 0 0 0 0 0
3201126 B 1 BS 1 14/01/2018 15/01/2018 10/10/1953 0 2
1 J45.9;E14.9;I11.0 - - - None None None None J-4-18-III
None None None None None None ASTHMA & BRONKIOLITIS (BERAT) 4376300
0 0 - 0 - 0 - 0 - 0 4376300
4433431 0 2 0 0 0 EUIS NANI NURJANI D106422 64
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134879
1#0##0#0#0.0#2018-02-09 19:33:59#0#12:00:00#12:00:00#00:00:00 1
9a129e262312724a6d75dd2c48c73b23 0 0 333467 0 0
2221926 0 0 0 0 1878038 0 0 0 0 0
3201126 B 1 BS 1 11/01/2018 15/01/2018 02/04/1967 0 2
1 I12.0;A49.9;D63.8;I25.0 99.04 - - None None None None N-4-
10-II None None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 8512260 0 5 0 0 0 MARIA CHRISTINA
ATJE NY D078740 50 18547 DR SRI KUNMARTINI, SPPD 0138R01701180005195
0001320360423 3;JKN DR RIZKI; 5.2.0.201712280730 4 133763
1#0##0#0#0.0#2018-03-09 09:41:26#0#12:00:00#12:00:00#00:00:00 2
81abf7f72337f6358eafd29da51bf05c 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 12/01/2018 15/01/2018 12/09/1960 0 2
1 I45.1;D33.2;H81.1;I11.0 90.59;89.52;87.49;87.03 - - None None
None None I-4-19-III None None None None None None GANGGUAN KONDUKSI
& ARITMIA JANTUNG (BERAT) 10214100 0 0 - 0 - 0 -
0 - 0 10214100 7829281 0 4 0 0 0 PAINEM
0001790671318 3;JKN DR RIZKI; 5.2.0.201712280730 4 134293
1#0##0#0#0.0#2018-03-10 13:40:10#0#12:00:00#12:00:00#12:00:00 3
acd9687ffa5878929e3550389f3724d7 0 0 928675 0 0
3328410 0 0 0 0 3572196 0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 15/01/2018 03/10/1976 0 1
- 0 8908800 9933820 0 2 0 0 0 TAUPIK
D385740 41 15078 SRI KUNMARTINI.DR,SPPD 0138R01701180006293
0002249447962 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 165850
1#0##0#0#0.0#2018-03-28 13:11:09#0#12:00:00#12:00:00#12:00:00 1
07820d69d82d4605c26016c9c68cd742 0 0 2636552 0 0
3558892 0 0 0 0 649876 0 0 0 3088500
0
3201126 B 3 BS 1 14/01/2018 15/01/2018 15/07/1963 0 1
2 I63.9;A17.0;R56.8;A41.9 96.71 - - None None None None J-1-
20-III None None None None None None PROSEDUR SISTEM PERNAFASAN NON-
KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0 -
0 29135800 22668658 0 2 0 0 0 SUTARJO
D369590 54 19907 DR DICKI PRATAMA 0138R01701180006356
0001110193828 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 134914
1#0##0#0#0.0#2018-05-18 08:19:59#0#12:00:00#12:00:00#00:00:00 2
2db236b3ac3ca9695acc1647ab963823 0 0 596241 0 0
10087813 0 0 0 0 1469604 0 0 0 6015000
4500000
3201126 B 3 BS 1 15/01/2018 15/01/2018 01/05/1957 0 2
1 K21.9;R07.4;I21.9 89.52 - - None None None None K-4-12-III
None None None None None None GANGGUAN ESOFAGUS (BERAT) 6781600
0 0 - 0 - 0 - 0 - 0 6781600
2006622 0 1 0 0 0 AMINAH D372721 60 22174
DR DICKI PRATAMA 0138R01701180006360 0000512274521 3;JKN DR RIZKI;
5.2.0.201712280730 4 134918 1#0##0#0#0.0#2018-08-13
10:35:13#0#00:00:00#06:00:00#12:00:00 4 75eff3020ea46337078ef88506b16822
0 0 610344 0 0 540004 0 0 0 0 438274
0 0 0 0 418000
3201126 B 2 BS 1 14/01/2018 15/01/2018 07/05/1974 0 2
1 S52.6;S09.9 79.32 - - None None None None M-1-80-II None
None None None None None PROSEDUR ANGGOTA TUBUH ATAS (SEDANG)
12358500 0 0 - 0 - 0 - 0 - 0
12358500 21288895 0 2 0 0 0 SYARIFAH D387543
43 15958 DR BENNY H T, SPOT 0138R01701180006319 0001608801794
3;JKN irene; 5.2.0.201712280730 4 134906 1#0##0#0#0.0#2018-
09-10 15:16:08#0#12:00:00#12:00:00#12:00:00 3
1778ffc9c6a7d23e6f055aa4a16e7a26 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 15/01/2018 15/07/1963 0 1
2 I63.9;A17.0;R56.8;A41.9 87.03 - - None None None None G-4-
14-III None None None None None None KECEDERAAN PEMBULUH DARAH OTAK
DENGAN INFARK (BERAT) 8672200 0 0 - 0 - 0 - 0
- 0 8672200 18168658 0 2 0 0 0 SUTARJO
D369590 54 19907 DR DICKI PRATAMA 0138R0170118V000017
0001110193828 3;JKN DR RIZKI; 5.2.2.201806040537 4 228588
1#0##0#0#0.0#2018-09-29 15:39:35#0#00:00:00#00:00:00#00:00:00 1
53b9140ecad11cfae21851ac3fe39044 0 18168658 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 15/01/2018 16/01/2018 16/03/1981 0 1
1 N39.0;R10.3 88.76 - - None None None None N-4-12-I None
2871200 0 0 - 0 - 0 - 0 - 0
2871200 2517200 0 2 0 0 0 DWI KUKUH HERWANTO
D302675 36 13454 DR ARU, SPPD 0138R01701180006375
0001622622791 3;JKN DR RIZKI; 5.2.0.201712280730 4 134920
1#0##0#0#0.0#2018-02-02 09:27:22#1#12:00:00#12:00:00#12:00:00 2
d0dbc88cf0a8d50e7de479161bb28748 0 0 286280 0 0
1222143 0 0 0 0 1008775 0 0 0 0 0
3201126 B 2 BS 1 14/01/2018 16/01/2018 05/01/1952 0 1
(SEDANG) 6330300 0 0 - 0 - 0 - 0 - 0
6330300 5236609 0 3 0 0 0 A. SOPIANSYAH
0001480417492 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134900
1#0##0#0#0.0#2018-02-03 12:01:47#0#12:00:00#12:00:00#00:00:00 1
7235413852dfd361937a835c24621051 0 0 499265 0 0
2853762 0 0 0 0 1883582 0 0 0 0 0
3201126 B 2 BS 1 12/01/2018 16/01/2018 12/12/1986 0 1
1 A91 90.59 - - None None None None A-4-13-I None None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4526990 0 5 0 0 0 ERIK HENDRO SUTOPO
D387334 31 11354 DR ARU, SPPD 0138R01701180005552
0001150390449 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134390
1#0##0#0#0.0#2018-02-03 12:06:07#0#12:00:00#12:00:00#12:00:00 1
0abbc0b207af41e7e58c4ba43e74eb12 0 0 278711 0 0
1401121 0 0 0 0 2847158 0 0 0 0 0
3201126 B 2 BS 1 14/01/2018 16/01/2018 10/12/1968 0 1
1 S93.3;E14.8 79.38 - - None None None None M-1-30-II None
None None None None None PROSEDUR KAKI (SEDANG) 16995200 0 0
- 0 - 0 - 0 - 0 16995200 19304778 0
3 0 0 0 TAUFIK NASIR D387554 49 17932 DR BENNY H
TUMBELAKA 0138R01701180006330 0001156622286 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 134908 1#0##0#0#0.0#2018-02-03
12:11:50#0#12:00:00#12:00:00#12:00:00 1 ba713424883e3a8e264b0c9be74ddf2e
0 7972500 7533116 0 0 2454162 0 0 0 0
1276000 0 0 0 69000 0
3201126 B 2 BS 1 15/01/2018 16/01/2018 23/03/1955 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 5666779 0 2 0 0 0 ASTUTI D365706
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135536
1#0##0#0#0.0#2018-02-03 12:24:44#0#12:00:00#12:00:00#00:00:00 1
95fe39a907bd1630e82814ebb1d6e00b 0 0 446265 0 0
2865040 0 0 0 0 802500 0 0 0 1552974
0
3201126 B 2 BS 1 13/01/2018 16/01/2018 13/05/1977 0 2
1 O82.9;D64.9;Z30.2 74.0;66.31;99.04 - - None None None None
O-6-10-II None None None None None None OPERASI PEMBEDAHAN CAESAR
(SEDANG) 6486300 0 0 - 0 - 0 - 0 - 0
6486300 25836859 0 4 0 0 0 ELI ASNANI D264454
40 14855 ENDANG TRI KURNIADEWI DR SPOG 0138R01701180005944
0001624631793 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134587
1#1#vip#4#6756475#75.0#2018-02-03 12:35:38#0#12:00:00#12:00:00#12:00:00
1 8d0c82bc2d8208278466b92290ee1a40 0 10479900 8723837 0
0 4574122 0 0 0 0 1251000 0 0 0 808000
0
3201126 B 2 BS 1 15/01/2018 16/01/2018 14/11/2010 0 2
None None None None None FRAKTUR/DISLOKASI SELAIN FEMUR DAN PELVIS
(RINGAN) 3536800 0 0 - 0 - 0 - 0 - 0
3536800 8991655 0 2 0 0 0 ALYSHA FARAH PRADITIYA
0001742896416 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135506
1#0##0#0#0.0#2018-02-03 12:40:35#0#12:00:00#12:00:00#12:00:00 1
86a638b3a31c93732f97f36d0f6b9696 0 4300200 1106304 0 0
2703412 0 0 0 0 588239 0 0 0 293500
0
3201126 B 2 BS 1 14/01/2018 16/01/2018 20/03/1950 0 2
- 0 10690500 12977431 0 3 0 0 0
TRIMININGSIH,NY D387024 67 24772 DR SRI KUNMARTINI, SPPD
0138R01701180006282 0000060903268 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 134896 1#0##0#0#0.0#2018-02-03
12:48:23#0#12:00:00#12:00:00#12:00:00 1 cb90055ae263d5f119b8bc0ed6b0366a
0 5326100 3153245 0 0 3524095 0 0 0 0
904991 0 0 0 69000 0
3201126 B 2 BS 1 13/01/2018 16/01/2018 20/01/1966 0 2
1 M89.45 - - - None None None None M-4-18-I None
None None None None None PENYAKIT TULANG DAN SENDI LAIN-LAIN (RINGAN)
3344900 0 0 - 0 - 0 - 0 - 0
3344900 4279857 0 4 0 0 0 ROSMAWATI d376434
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134725
1#0##0#0#0.0#2018-02-03 12:57:12#0#12:00:00#12:00:00#12:00:00 1
f2bfe2036736292a9c64507004ace752 0 0 460041 0 0
1493825 0 0 0 0 2325991 0 0 0 0 0
3201126 B 2 BS 1 13/01/2018 16/01/2018 13/01/2018 3306 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3209272 0 4 0 0 0 BAYI NY ELI ASNANI
d387428 0 0 DR AWIDIYA, SPA 0138R01701180006601
0002419658278 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135114
1#1#vip#4#731200#0.0#2018-02-03 13:34:12#0#12:00:00#12:00:00#12:00:00 1
e5627b3f5fb0269cfbbdf8adacd341ca 0 0 721921 0 0 88899
0 0 0 0 2115000 0 0 0 283452 0
3201126 B 1 BS 1 14/01/2018 16/01/2018 26/03/1939 0 1
4 I21.9;I48;R57.0;J18.0 99.60 - - None None None None I-4-
14562700 0 0 - 0 - 0 - 0 - 0
14562700 6659848 0 3 0 0 0 HARJONO BSC D387575
0000045463724 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134916
1#0##0#0#0.0#2018-02-06 15:07:01#0#12:00:00#12:00:00#12:00:00 1
41105a6f65a22f4d7c0be53fe4a109cc 0 0 562418 0 0
3591739 0 0 0 0 2207691 0 0 0 298000
0
3201126 B 3 BS 1 16/01/2018 16/01/2018 28/02/1935 0 2
1 E87.8 - - - None None None None E-4-11-I None None
None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (RINGAN) 2954900
0 0 - 0 - 0 - 0 - 0 2954900
1275363 0 1 0 0 0 MARGOTJE KAENG D179609 82
30273 DR ADITIA NATA KUSUMA 0138R01701180006965 0001317815919 3;JKN
DR RIZKI; 5.2.0.201712280730 4 135541 1#0##0#0#0.0#2018-02-08
15:11:16#0#00:00:00#21:05:00#12:00:00 1 1625fe9a1c25c89c9c5e344ebeb485e2
0 0 265941 0 0 490987 0 0 0 0 390435
0 0 0 128000 0
3201126 B 3 BS 1 16/01/2018 16/01/2018 07/12/1962 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2605881 0 1 0 0 0 KASONO
D357931 55 20129 DR ADITIA NATA KUSUMA 0138R01701180006963
0002223029204 3;JKN DR RIZKI; 5.2.0.201712280730 4 135542
1#0##0#0#0.0#2018-02-08 15:16:03#0#00:00:00#15:00:00#00:00:00 1
5958ee2ec436b1edd3cc6c63d4573cf3 0 0 371889 0 0
1330514 0 0 0 0 477478 0 0 0 0 426000
3201126 B 3 BS 1 16/01/2018 16/01/2018 04/05/1976 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2521010 0 1 0 0 0 IRWANSYAH
0001727179053 3;JKN DR RIZKI; 5.2.0.201712280730 4 135544
1#0##0#0#0.0#2018-02-08 15:23:36#0#01:13:00#19:40:00#00:00:00 2
d7fdb71e550a35ea0c73264d6447ce27 0 0 371889 0 0
1386525 0 0 0 0 580346 0 0 0 26000 156250
3201126 B 3 BS 1 16/01/2018 16/01/2018 26/10/1983 0 1
1 I10 - - - None None None None I-4-17-I None None
0 - 0 - 0 - 0 1906700 2139386 0 1
0 0 0 ANDREW SURYA HARTANTO D295014 34 12501 DR ADITIA
NATA KUSUMA 0138R01701180006968 0000060531535 3;JKN DR RIZKI;
5.2.0.201712280730 4 135545 1#0##0#0#0.0#2018-02-08
15:27:53#0#00:00:00#05:30:00#12:00:00 1 cd85564be12d06e17c02d5417a7e17b0
0 0 171603 0 0 804823 0 0 0 0 446960
0 0 0 0 716000
3201126 B 3 BS 1 15/01/2018 16/01/2018 01/10/1953 0 2
1 I25.0;I11.0;E10.2;I08.9 36.07;89.52;87.49 - - YY02 None None
None I-1-40-III None None YY-02-III None None None PROSEDUR
0 - 0 - 0 45079800 62536152 0 2 0 0
0 SURYATI D329400 64 23482 DR AZRI NURIZAL SPPD KKV
0138R01701180006453 0001014230452 3;JKN DR RIZKI; 5.2.0.201712280730
4 134922 1#0##0#0#0.0#2018-02-08
16:36:46#0#12:00:00#12:00:00#00:00:00 1 99e4dc5c1acfad7a8610dcfe40d2412c
0 7650000 6870800 0 0 38844352 0 0 0 0
1602000 0 0 0 69000 7500000
3201126 B 3 BS 1 14/01/2018 16/01/2018 05/03/1976 0 2
1 I13.1 39.27;87.44 - - None None None None N-1-12-I None
None None None None None MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 6114594 0 3 0 0 0 MINTARSIH
0001403692694 3;JKN DR RIZKI; 5.2.0.201712280730 4 134893
1#0##0#0#0.0#2018-02-09 10:31:22#0#12:00:00#12:00:00#12:00:00 1
97405273b258cf5b2e698a62f6a63b7e 0 0 1311745 0 0
1141329 0 0 0 0 3661520 0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 16/01/2018 11/10/1953 0 1
- 0 8908800 9295744 0 3 0 0 0 H ISMET
RACHMANTO D373124 64 23471 DR SRI KUN, SPPD 0138R01701180006315
0001425176886 3;JKN DR RIZKI; 5.2.0.201712280730 4 134903
1#0##0#0#0.0#2018-02-09 10:53:16#0#12:00:00#12:00:00#12:00:00 1
65549f9331db11c91f2500a93fad9be4 0 4498260 854792 0 0
2485045 0 0 0 0 1457647 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 16/01/2018 25/05/1973 0 1
1 A91;K29.7 - - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2432497 0 4 0 0 0 AMAD MUHAMAD
d387442 44 16304 DR SOEGIONO, SPPD 0138R01701180006051
0002231721797 3;JKN DR RIZKI; 5.2.0.201712280730 4 134815
1#0##0#0#0.0#2018-02-09 10:55:35#0#12:00:00#12:00:00#12:00:00 1
099ca0ab4527efbce29fe1a0bd61b412 0 0 350422 0 0 844940
0 0 0 0 1237135 0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 16/01/2018 23/06/2016 0 1
1 G00.8;R50.9;D64.9 - - - None None None None G-4-18-II
None None None None None None INFEKSI BAKTERI SISTEM SARAF (SEDANG)
5920800 0 0 - 0 - 0 - 0 - 0
5920800 2381959 0 3 0 0 0 MUHAMMAD HASYIM ASHARI
D347177 1 570 DR NOVIK BUDIWARDHANA, SPA 0138R01701180006249
0002058130427 3;JKN DR RIZKI; 5.2.0.201712280730 4 134891
1#0##0#0#0.0#2018-02-09 10:58:11#0#12:00:00#12:00:00#00:00:00 1
b4749c118ca7f80fcf0ea99eef1baa17 0 0 585872 0 0 485258
0 0 0 0 970829 0 0 0 0 340000
3201126 B 1 BS 1 15/01/2018 16/01/2018 24/02/1967 0 1
1 D21.6 83.39 - - None None None None M-1-50-I None None
None None None None PROSEDUR JARINGAN LUNAK (RINGAN) 7464200 0
0 - 0 - 0 - 0 - 0 7464200 11045668
0 2 0 0 0 HERI DWINANTO D386943 50 18588 DR
HENDRIEK S, SPB 0138R01701180006473 0000058906293 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 134924 1#0##0#0#0.0#2018-02-09
18:42:35#0#12:00:00#12:00:00#12:00:00 1 0fc67d3b2c55074c3ac4ef46e9b9d3b1
0 5896000 2152976 0 0 200000 0 0 0 0
722679 0 0 0 2074013 0
3201126 B 1 BS 1 14/01/2018 16/01/2018 04/02/1984 0 1
- 0 12472300 15293429 0 3 0 0 0 GUNTORO
D378591 33 12398 DR SRI KUN, SPPD 0138R01701180006294
0001630790223 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134898
1#0##0#0#0.0#2018-02-09 19:18:18#0#12:00:00#12:00:00#12:00:00 1
dba5fc089701e8ccf12eb37affbb36fe 0 7159200 3669967 0 0
0 0 0 0 0 1125505 0 0 0 3338757 0
3201126 B 1 BS 1 15/01/2018 16/01/2018 04/12/1964 0 2
1 M65.3 82.01 - - None None None None M-1-80-I None None
None None None None PROSEDUR ANGGOTA TUBUH ATAS (RINGAN) 12140800
0 0 - 0 - 0 - 0 - 0 12140800
16649194 0 2 0 0 0 SITI MASITOH D107483 53
19400 DR BENNY H TUMBELAKA 0138R01701180006573 0000041364742 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 135048 1#0##0#0#0.0#2018-
02-09 19:21:26#0#12:00:00#12:00:00#00:00:00 1
7c5d9bf4e509511c7cf6336991a20d51 0 9763300 3520832 0 0
0 0 0 0 0 1290200 0 0 0 2074862 0
3201126 B 1 BS 1 14/01/2018 16/01/2018 20/10/1962 0 2
1 E11.2;D63.8 39.27;99.04;89.52 - - None None None None N-1-
- 0 12472300 14172821 0 3 0 0 0 YUSRINA ENNI
D387555 55 20175 DR SRI KUN, SPPD 0138R01701180006281
0001482866976 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134897
1#0##0#0#0.0#2018-02-09 19:23:35#0#12:00:00#12:00:00#12:00:00 1
47caea629cebabcb86dd67d60fdc466d 0 7159200 3669967 0 0
0 0 0 0 0 1052194 0 0 0 2291460 0
3201126 B 3 BS 1 15/01/2018 16/01/2018 12/11/1968 0 1
1 J81;J44.1;I95.9;R00.0 90.59;89.52 - - None None None None
J-4-21-II None None None None None None GEJALA, TANDA DAN DIAGNOSIS
SISTEM PERNAFASAN LAIN-LAIN (SEDANG) 4508300 0 0 - 0 -
0 - 0 - 0 4508300 2254588 0 2 0 0
0 BAMBANG SURYANTO d356251 49 17961 DR AHMAD HIBBAN A WRIYA
0138R01701180006935 0000038139129 3;JKN DR RIZKI; 5.2.0.201712280730
4 135659 1#0##0#0#0.0#2018-02-10
09:32:35#0#12:00:00#12:00:00#00:00:00 1 2e294c8ab1cc8896bab24374042cd886
0 0 405747 0 0 1412345 0 0 0 0 436496
0 0 0 0 0
3201126 B 1 BS 1 15/01/2018 16/01/2018 19/02/1964 0 1
- 0 58821400 58207227 0 2 0 0 0 SUPRIYANTO
0001095080646 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135302
1#0##0#0#0.0#2018-02-12 08:21:33#0#12:00:00#12:00:00#12:00:00 1
f293e94bd928a7fde4a4b6b38623919b 0 10062000 9619120 0 0
0 0 0 0 0 1256000 0 0 29701107 7569000
0
3201126 B 1 BS 1 14/01/2018 16/01/2018 16/10/1978 0 2
3349800 0 0 - 0 - 0 - 0 - 0
3349800 6992097 0 3 0 0 0 LENI HARLINA
G210593 39 14335 DR. ARU ARIADNO, SPPD 0138R01701180006576
0001862818918 3;JKN DR RIZKI; 5.2.0.201712280730 4 135046
1#1#vvip#3#3642297#0.0#2018-03-15 10:12:36#0#12:00:00#12:00:00#12:00:00
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1403670 0 0 0 0 4722427 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 16/01/2018 01/06/1997 0 2
1 R11;R42 87.44 - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2783960 0 4 0 0 0 SRI MARYATI D387510
3;JKN DR RIZKI; 5.2.1.201804062320 4 134869 1#0##0#0#0.0#2018-
05-07 14:27:56#0#12:00:00#12:00:00#12:00:00 2
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1445751 0 0 0 0 997128 0 0 0 0 0
3201126 B 3 BS 1 11/01/2018 16/01/2018 19/06/2015 0 2
1 A91;R57.1;A09.9 - - - None None None None A-4-13-III
(BERAT) 3200900 0 0 - 0 - 0 - 0 - 0
3200900 13123644 0 6 1 4 0 PUTRI ZAHRA ALMAYRA
RAHMA D387257 2 937 DR NOVIK BUDIWARDHANA, SPA 0138R01701180005904
0002419322196 3;JKN DR RIZKI; 5.2.1.201804062320 4 134576
1#0##0#0#0.0#2018-05-17 15:04:05#0#12:00:00#12:00:00#12:00:00 2
4ef0967f1c98e4c5db98c1d5af5ed725 0 0 241100 0 0
6678987 0 0 1 0 5097556 0 0 0 0
1106000
3201126 B 3 BS 1 13/01/2018 16/01/2018 02/06/1984 0 2
1 K80.2;R11 - - - None None None None B-4-14-I None
4199800 0 0 - 0 - 0 - 0 - 0
4199800 2826518 0 4 0 0 0 SUNDARI D301792
3;JKN DR RIZKI; 5.2.1.201804062320 4 134874 1#0##0#0#0.0#2018-
08-14 12:16:20#0#12:00:00#12:00:00#12:00:00 3
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1642854 0 0 0 0 999912 0 0 0 0 0
3201126 B 2 BS 1 15/01/2018 17/01/2018 04/04/1993 0 2
- 0 - 0 - 0 - 0 2601900 3006229 0
3 0 0 0 SELLY NURLIYANI D319965 24 9052 DR ATJANG S,
5.2.0.201712280730 4 135394 1#0##0#0#0.0#2018-02-05
15:39:40#0#12:00:00#12:00:00#00:00:00 1 bd93313af0ca1113ee2755312728cb1d
0 0 537171 0 0 713389 0 0 0 0
1755669 0 0 0 0 0
3201126 B 2 BS 1 15/01/2018 17/01/2018 17/12/2015 0 2
SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0 -
0 3584400 5099460 0 3 0 0 0 ADEEVA AFSHEEN
MYESHA D339916 2 760 DR VERA MUNA MANOE, SPA 0138R01701180006898
0001898497269 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135531
1#0##0#0#0.0#2018-02-05 15:46:56#0#12:00:00#12:00:00#00:00:00 1
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3109754 0 0 0 0 1667110 0 0 0 0 0
3201126 B 2 BS 1 16/01/2018 17/01/2018 07/03/1973 0 2
1 N13.2;I11.9;E13.9 59.8;56.0 - - None None None None N-1-
40-I None None None None None None PROSEDUR PADA URETRA DAN TRANSURETRA
(RINGAN) 9649200 0 0 - 0 - 0 - 0 - 0
9649200 15882710 0 2 0 0 0 A YATI D376241
44 16386 DR SIDDHI ANDIKA, SPU 0138R01701180007176 0001730325914
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135751
1#0##0#0#0.0#2018-02-05 15:53:17#0#12:00:00#12:00:00#12:00:00 1
89b0c0d95f3a88e00ab5dca6068c2eb2 0 4911100 8668952 0 0
1153102 0 0 0 0 1149556 0 0 0 0 0
3201126 B 2 BS 1 14/01/2018 17/01/2018 25/02/2014 0 2
1 B34.9 - - - None None None None A-4-13-I None None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3140139 0 4 0 0 0 ALMAIRA KHASIEFA AZZAHRA
D387531 3 1419 DR RASTRA, SPA 0138R01701180006175
0002079502042 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134880
1#0##0#0#0.0#2018-02-05 16:07:05#0#12:00:00#12:00:00#12:00:00 1
029557b0edcc2d1d5d681c978d6ae18e 0 0 278710 0 0 609999
0 0 0 0 2251430 0 0 0 0 0
3201126 B 2 BS 1 15/01/2018 17/01/2018 11/12/2016 0 1
1 A49.9;R56.0;J06.9;J45.9 - - - None None None None A-4-
14-II None None None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT
LAIN-LAIN (SEDANG) 3304700 0 0 - 0 - 0 - 0
- 0 3304700 3430836 0 3 0 0 0 MUHAMAD BOY
ADNAN SYARIF D387581 1 400 DR RIANITA SYAMSU, SPA
0138R01701180006462 0002236354479 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 134923 1#0##0#0#0.0#2018-02-05
16:09:21#0#12:00:00#12:00:00#12:00:00 1 e7a20fe1aad8b964a90a2343362e0d84
0 0 339830 0 0 1325559 0 0 0 0
1765447 0 0 0 0 0
3201126 B 2 BS 1 16/01/2018 17/01/2018 19/09/1987 0 1
9649200 0 0 - 0 - 0 - 0 - 0
9649200 16781613 0 2 0 0 0 MARINGAN PASARIBU
D387261 30 11077 DR HERY TIERA, SPU 0138R01701180007392
0002282891657 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136173
1#0##0#0#0.0#2018-02-05 16:24:59#0#12:00:00#12:00:00#12:00:00 1
eb0b3359a11261f7c9009013d0bf3696 0 7031500 7322760 0 0
0 0 0 0 0 2427353 0 0 0 0 0
3201126 B 1 BS 1 15/01/2018 17/01/2018 11/01/2018 2600 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3921856 0 3 0 0 0 BAYI NY RARAS PUTRI
D387611 0 4 DR KHARINA CHATAR SPA 0138R01701180006638
0002318221506 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135215
1#0##0#0#0.0#2018-02-06 15:09:29#0#12:00:00#12:00:00#12:00:00 1
295216d53f62325ee24f735fbfe59629 0 0 513620 0 0 270666
0 0 0 0 2313570 0 0 0 824000 0
3201126 B 3 BS 1 11/01/2018 17/01/2018 19/03/1960 0 1
0 - 0 - 0 45079800 76397429 0 7 1 1
0 ADI RISDIYANTO D387262 57 21117 DR AZRI NURIZAL SPPD KKV
0138R01701180005207 0001221503409 3;JKN DR RIZKI; 5.2.0.201712280730
4 133769 1#0##0#0#0.0#2018-02-08
12:37:20#0#12:00:00#12:00:00#12:00:00 1 2a7ca5216c704922ea2383cce69a0982
0 14520800 53000 0 0 49308629 0 0 0 0
3261000 0 0 0 0 9254000
3201126 B 3 BS 1 16/01/2018 17/01/2018 30/01/1987 0 1
1 I11.0;K30 89.52 - - None None None None I-4-12-I None
None None None None None KEGAGALAN JANTUNG (RINGAN) 3575600 0
0 - 0 - 0 - 0 - 0 3575600 3491121
0 2 0 0 0 FRANSISCUS PRAYUDHANTO D333257 30 11309
DR NIKEN PRABHA DUHITA 0138R01701180007563 0001907215446 3;JKN DR
RIZKI; 5.2.0.201712280730 4 136204 1#0##0#0#0.0#2018-02-08
16:54:34#0#12:00:00#12:00:00#12:00:00 1 4eb5711df26a43dffeb4da786421facd
0 0 496845 0 0 2458885 0 0 0 0 535391
0 0 0 0 0
3201126 B 3 BS 1 14/01/2018 17/01/2018 03/07/1948 0 1
1 D64.9;K29.7 99.04 - - None None None None D-4-13-I None
- 0 2987000 5089409 0 4 0 0 0 M. H.
SIMATUPANG D339112 69 25397 DR. ARU ARIADNO, SPPD 0138R01701180006302
0001089737469 3;JKN DR RIZKI; 5.2.0.201712280730 4 134902
1#0##0#0#0.0#2018-02-09 10:48:43#0#12:00:00#12:00:00#00:00:00 1
71b9149f76cb565b7ae3f7448ac63c10 0 0 349676 0 0
3328781 0 0 0 0 1410952 0 0 0 0 0
3201126 B 3 BS 1 15/01/2018 17/01/2018 29/05/2017 0 1
1 G40.9 - - - None None None None G-4-22-I None None
- 0 - 0 - 0 - 0 2655900 2925150 0
3 0 0 0 ABRISAM RAFIF ALTHAF D387616 0 231 DR
OTTY MITHA S, SPA 0138R01701180006915 0002248536521 3;JKN DR RIZKI;
5.2.0.201712280730 4 135533 1#0##0#0#0.0#2018-02-09
11:07:18#0#12:00:00#12:00:00#12:00:00 1 b27eb4737a66f51ff339fb981b5d1378
0 0 292030 0 0 995255 0 0 0 0 937865
0 0 0 0 700000
3201126 B 3 BS 1 16/01/2018 17/01/2018 21/06/1957 0 2
1 I12.0;A49.9;D63.8 39.42;99.04 - - None None None None N-1-
- 0 8908800 11604476 0 2 0 0 0 SUTARNI
0001727956214 3;JKN DR RIZKI; 5.2.0.201712280730 4 135694
1#0##0#0#0.0#2018-02-09 11:12:09#0#12:00:00#12:00:00#00:00:00 1
5c260a56eb8e6c808fbd4e07c739eb4c 0 4498260 854792 0 0
5085753 0 0 0 0 1131171 0 0 0 34500 0
3201126 B 3 BS 1 14/01/2018 17/01/2018 02/01/1963 0 1
1 J18.9;R04.2 87.44 - - None None None None J-4-16-I None
3613200 0 0 - 0 - 0 - 0 - 0
3613200 5524010 0 4 0 0 0 AGUS D356127 55
20101 DR MOHAMAD NIZAM ERHAMZA SPP 0138R01701180006169 0001865020961
3;JKN DR RIZKI; 5.2.0.201712280730 4 134877 1#0##0#0#0.0#2018-
02-09 11:14:27#0#12:00:00#12:00:00#00:00:00 1
090cda3a2bd3713d47d4ad3d3b085b63 0 0 443285 0 0
1477341 0 0 0 0 3603384 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 17/01/2018 02/03/1953 0 1
1 I63.9;E14.9;G81.9 90.59;89.52;87.03 - - None None None None
G-4-14-II None None None None None None KECEDERAAN PEMBULUH DARAH
OTAK DENGAN INFARK (SEDANG) 6909500 0 0 - 0 - 0 -
0 - 0 6909500 6151839 0 5 0 0 0 ACHMAD
HAMBALI D387465 64 23693 DR MAYSAM I., SPS 0138R01701180006090
0001740080439 3;JKN DR RIZKI; 5.2.0.201712280730 4 134864
1#0##0#0#0.0#2018-02-09 11:20:39#0#12:00:00#12:00:00#12:00:00 1
192dc56b640a24347762ff15fdac0e96 0 0 594860 0 0
3813522 0 0 0 0 1743457 0 0 0 0 0
3201126 B 1 BS 1 15/01/2018 17/01/2018 15/01/2018 2669 1
1 P03.4;L30.9 - - - None None None None P-8-17-I None
None None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR MAYOR
(RINGAN) 5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040510 0 3 0 0 0 BY NY VEREN AZRINA PUTRI
D387653 0 0 DR RIANITA SYAMSU, SPA 0138R01701180007865
0002318846826 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136670
1#0##0#0#0.0#2018-02-09 18:56:27#0#12:00:00#12:00:00#12:00:00 1
9d4b51c350b9d2ed90d432f73dc8cdb2 0 0 499620 0 0 88899
0 0 0 0 1378491 0 0 0 73500 0
3201126 B 1 BS 1 14/01/2018 17/01/2018 21/03/1997 0 2
None None None None None None OPERASI PEMBEDAHAN CAESAR (SEDANG)
7567300 0 0 - 0 - 0 - 0 - 0
7567300 13314512 0 4 0 0 0 VEREN AZRINA PUTRI
D378352 20 7604 DR MAMAN H, SPOG 0138R01701180006354
0002318845792 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134913
1#0##0#0#0.0#2018-02-09 19:06:03#0#12:00:00#12:00:00#12:00:00 2
11fa1516b9e370394fe3c3809e9268b4 0 7098900 2791170 0 0
0 0 0 0 0 1282043 0 0 0 2142399 0
3201126 B 1 BS 1 16/01/2018 17/01/2018 29/01/1944 0 1
- 0 58821400 52404020 0 2 0 0 0 SOEWARSO
0000060978508 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135550
1#0##0#0#0.0#2018-02-09 20:14:45#0#12:00:00#12:00:00#12:00:00 1
d52a58eda9aa02459f89ea3b9b9e2cb1 0 10062000 3419040 0 0
0 0 0 0 0 1256000 0 0 30097980 7569000
0
3201126 B 1 BS 1 08/01/2018 17/01/2018 07/07/1935 0 2
1 S72.00;M81.99;I50.0 81.51;87.44;88.37;88.72 - - YY01 RR04
None None M-1-04-II None None YY-01-II RR-04-III None None
PROSEDUR PADA SENDI TUNGKAI BAWAH (SEDANG) 20800900 0 0 HIP
REPLACEMENT / KNEE REPLACEMENT 5782600 HIP IMPLANT/ KNEE IMPLANT
11565100 - 0 - 0 38148600 60300541 0 10 1
3 0 SUPINAH D386949 82 30136 DR BENNY H T, SPOT
0138R01701180003428 0001341322154 3;JKN DR RIZKI; 5.2.0.201712280730
4 131653 1#0##0#0#0.0#2018-02-10
08:55:31#0#12:00:00#12:00:00#12:00:00 1 1fbf015f1d1ff0522aca5f07608e53e1
0 14328852 1353936 0 0 22089253 0 0 0 0
7975500 0 0 12500000 510000 1543000
3201126 B 1 BS 1 16/01/2018 17/01/2018 15/06/1968 0 1
1 K21.0;K29.6 45.16;89.52;90.59 - - None None None None K-4-
12-I None None None None None None GANGGUAN ESOFAGUS (RINGAN) 4136800
0 0 - 0 - 0 - 0 - 0 4136800
6178757 0 2 0 0 0 FAIRDI JAYA D367731 49 18112
DR ZULFAN, SPPD 0138R01701180007498 0000041430442 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 136201 1#0##0#0#0.0#2018-02-12
08:33:05#0#12:00:00#12:00:00#00:00:00 1 93149cd30d5edeecfb73aebd11d1ce75
0 1929000 1211304 0 0 893735 0 0 0 0
430218 0 0 0 1714500 0
3201126 B 1 BS 1 15/01/2018 17/01/2018 10/04/1964 0 2
1 K80.0;A41.9;A01.0 90.59;88.76 - - None None None None B-4-
14-III None None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN
(BERAT) 9188400 0 0 - 0 - 0 - 0 - 0
9188400 5840409 0 3 0 0 0 ROSLIA FANE D387589
53 19638 DR ZULFAN, SPPD 0138R01701180006674 0001272144982 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 135297 1#0##0#0#0.0#2018-
02-12 08:42:39#0#12:00:00#12:00:00#12:00:00 1
505e57d97565568d2ff1ead388c4a384 0 2343000 879956 0 0
2209370 0 0 0 0 408083 0 0 0 0 0
3201126 B 1 BS 1 13/01/2018 17/01/2018 07/05/1953 0 1
1 N39.0;I48;D29.1;A41.9 - - - None None None None N-4-
12-III None None None None None None INFEKSI GINJAL DAN SALURAN URIN
(BERAT) 7087700 0 0 - 0 - 0 - 0 - 0
7087700 6708095 0 5 0 0 0 MOH TOHIR,H,SKM
0000157502362 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134871
1#0##0#0#0.0#2018-02-12 08:45:53#0#12:00:00#12:00:00#12:00:00 1
385b8b95ab9a292d8121b87c585480b4 0 3124000 1074410 0 0
2044838 0 0 0 0 464847 0 0 0 0 0
3201126 B 2 BS 1 10/01/2018 17/01/2018 23/06/2017 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 8246185 0 8 0 0 0 BAYI NY SITI
SUBHIYANTRIANA D369297 0 201 DR RASTRA, SPA 0138R01701180004580
0002235364187 3;JKN DR RIZKI; 5.2.0.201712280730 4 133022
1#0##0#0#0.0#2018-03-10 09:13:57#0#12:00:00#12:00:00#00:00:00 2
df935287cf60b40b5df34c5d08e5036e 0 0 443230 0 0
2857485 0 0 0 0 4579470 0 0 0 366000
0
3201126 B 1 BS 1 16/01/2018 17/01/2018 24/08/1987 0 1
1 D33.4;G82.2 - - - None None None None G-4-26-II None
(SEDANG) 6023100 0 0 - 0 - 0 - 0 - 0
6023100 4621530 0 2 0 0 0 ADE PUTRA D387679
3;JKN DR RIZKI; 5.2.0.201712280730 4 135539 1#0##0#0#0.0#2018-
03-10 11:48:03#0#12:00:00#12:00:00#12:00:00 2
69a77ad997f719d618476c172ac2acbe 0 0 504998 0 0
2226189 0 0 0 0 1890343 0 0 0 0 0
3201126 B 1 BS 1 15/01/2018 17/01/2018 20/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 7464200
11564371 0 3 0 0 0 SU'AD D111227 63 23037 DR
HENDRIEK S, SPB 0138R01701180006432 0001283083277 3;JKN DR RIZKI;
5.2.0.201712280730 4 134921 1#0##0#0#0.0#2018-03-13
16:30:58#0#12:00:00#12:00:00#00:00:00 2 5e9ba6e27da4f11a5ab0c50ce0c6ee50
0 6587000 2014572 0 0 0 0 0 0 0 881548
0 0 0 2081251 0
3201126 B 3 BS 1 17/01/2018 17/01/2018 01/11/1950 0 1
1 E16.2;A41.9;I63.9;K92.0 - - - None None None None E-4-
0 - 0 6262900 3173334 0 1 0 0 0
H.SYAHRONI D382455 67 24549 DR DINI DANIATY 0138R01701180007924
0001476473861 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136795
1#0##0#0#0.0#2018-03-19 14:34:00#0#09:05:00#16:00:00#12:00:00 2
53f6fea15ae216c9ddbad22273bb5140 0 0 789120 0 0
1153613 0 0 0 0 514601 0 0 0 0 716000
3201126 B 2 BS 1 14/01/2018 17/01/2018 06/09/1992 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10484095 0 4 0 0 0 DEWI RATIH
KUSUMAWARDHANI D387545 25 9261 DR MAMAN HILMAN 0138R01701180006239
0001267311216 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134888
1#0##0#0#0.0#2018-03-28 12:07:24#0#12:00:00#12:00:00#12:00:00 2
67f56d2ab51315cc9e666de9c28c6f54 0 5666900 2256479 0 0
1704841 0 0 0 0 685875 0 0 0 170000
0
3201126 B 2 BS 1 16/01/2018 17/01/2018 07/01/1979 0 2
1 K80.2;K29.7 - - - None None None None B-4-14-I None
5039800 0 0 - 0 - 0 - 0 - 0
5039800 5167180 0 2 0 0 0 INDAH SASMITO WIDIYOWATI
0001639137273 3;JKN DR RIZKI; 5.2.0.201712280730 4 135979
1#1#vip#2#1721970#15.0#2018-03-29 10:23:40#0#12:00:00#12:00:00#00:00:00
2 d0d4363b606d5d104abc9b94983c9e5f 0 0 979068 0 0
1274072 0 0 0 0 2914040 0 0 0 0 0
3201126 B 3 BS 1 16/01/2018 17/01/2018 01/06/1982 0 2
1 A09.9;R10.1 - - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 1318536 0 2 0 0 0 SITI MARIA ULFA
0002041994889 3;JKN DR RIZKI; 5.2.1.201804062320 4 135547
1#0##0#0#0.0#2018-05-07 11:57:58#0#12:00:00#12:00:00#12:00:00 2
877669865db993a54bbc5c69ec368dea 0 0 183752 0 0 496525
0 0 0 0 638259 0 0 0 0 0
3201126 B 1 BS 1 16/01/2018 17/01/2018 27/03/1946 0 1
1 N18.5;I21.9 89.52 - - None None None None N-4-10-III None
(BERAT) 8508800 0 0 - 0 - 0 - 0 - 0
8508800 3081676 0 2 0 0 0 SUBEKTI D385042
71 26228 DR ARU, SPPD 0138R01701180007189 0001431101081 3;JKN
DR RIZKI; 5.2.2.201806040537 4 135785 1#0##0#0#0.0#2018-09-05
15:40:33#0#12:00:00#12:00:00#12:00:00 2 5f541aede073d10b0b11588807073cf7
0 0 962630 0 0 329441 0 0 0 0
1789605 0 0 0 0 0
3201126 B 1 BS 1 16/01/2018 17/01/2018 05/04/1953 0 2
3247500 0 0 - 0 - 0 - 0 - 0
3247500 6244468 0 2 0 0 0 WANTI D007884 / D347181
DR RIZKI; 5.2.2.201806040537 4 136200 1#0##0#0#0.0#2018-09-06
09:05:47#0#12:00:00#12:00:00#00:00:00 2 f5ee1d86fb152167d020aac74ee8d3f9
0 1929000 962300 0 0 1204151 0 0 0 0
434517 0 0 0 1714500 0
3201126 B 3 BS 1 14/01/2018 17/01/2018 01/08/2001 0 1
1 S82.11;L98.8 79.06;86.22 - - None None None None M-4-
12-I None None None None None None FRAKTUR/DISLOKASI SELAIN FEMUR DAN PELVIS
(RINGAN) 2947400 0 0 - 0 - 0 - 0 - 0
2947400 13291264 0 4 0 0 0 REZKY HAMZAH F
0000510684074 3;JKN irene; 5.2.1.201804062320 4 134912
1#0##0#0#0.0#2018-09-10 15:20:26#0#12:00:00#12:00:00#12:00:00 4
c317d592e88487188e49b37688c47ffe 0 0 3057295 0 0
3306449 0 0 0 0 6782520 0 0 0 0 145000
3201126 B 1 BS 1 16/01/2018 17/01/2018 03/03/2002 0 1
None None None None None GANGGUAN JARINGAN KONEKTIF (RINGAN) 3978000
0 0 - 0 - 0 - 0 - 0 3978000
17479715 0 2 0 0 0 DIMAS HAKIM MAULANA D359775
15 5798 DR NIA KURNIATI, SPA 0138R01701180007399 0001620848485
3;JKN DR RIZKI; 5.2.2.201806040537 4 136168 1#0##0#0#0.0#2018-
09-26 16:01:27#0#12:00:00#12:00:00#12:00:00 2
f613782442d7bd2bb209b73cef6c4329 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 14/01/2018 18/01/2018 23/05/1948 0 2
1 A91;I10;J90 - - - None None None None A-4-13-III None
3841100 0 0 - 0 - 0 - 0 - 0
3841100 8882800 0 5 0 0 0 LEMERIA AMBARITA
0001471772621 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134904
1#1#vvip#5#5041700#0.0#2018-02-03 11:27:00#0#12:00:00#12:00:00#12:00:00
1 ddefc2ed1c92eb9bae6103402c77c6cc 0 0 866000 0 581118
1592032 0 0 0 0 5843650 0 0 0 0 0
3201126 B 2 BS 1 17/01/2018 18/01/2018 24/06/1972 0 2
1 N92.1;I10 69.09 - - None None None None W-1-11-I None
None None None None None PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 6233227 0 2 0 0 0 NUR SYAMSIAH
0000038338492 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137086
1#0##0#0#0.0#2018-02-03 11:39:45#0#12:00:00#12:00:00#12:00:00 1
49972793e94b36ea2fefbc831308bf73 0 0 1293896 0 0
1513550 0 0 0 0 2864000 0 0 0 561781
0
3201126 B 2 BS 1 17/01/2018 18/01/2018 12/03/1962 0 1
- 0 51950600 62274268 0 2 0 0 0 AGUS WITARNO
D383483 55 20400 DR AGOES KOOSHARTORO SPPD-KKV 0138R01701180007702
0001819788412 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136283
1#0##0#0#0.0#2018-02-05 08:52:10#0#12:00:00#12:00:00#12:00:00 1
b559e3fd57ffb8fbc850998738da88a5 0 0 8244960 0 0 0
0 0 0 0 10186000 0 0 36218308 7625000 0
3201126 B 2 BS 1 17/01/2018 18/01/2018 15/06/1960 0 2
- 0 10690500 11559146 0 2 0 0 0 SUNDARI
HARTATI D068054 57 21035 DR SRI KUN, SPPD 0138R01701180007991
0000042653237 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136972
1#0##0#0#0.0#2018-02-05 15:05:00#0#12:00:00#12:00:00#00:00:00 1
7f459e3755208603aa7adc278179ce01 0 4231600 1015145 0 0
4274945 0 0 0 0 825206 0 0 0 1212250
0
3201126 B 2 BS 1 17/01/2018 18/01/2018 12/05/1959 0 2
1 E11.2;D63.8 99.04;38.95 - - None None None None N-1-12-II
- 0 10690500 12615776 0 2 0 0 0 KUSMIATI
LESTARI D379536 58 21435 DR SRI KUNMARTINI, SPPD 0138R01701180007771
0001289034044 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136482
1#0##0#0#0.0#2018-02-05 15:30:08#0#12:00:00#12:00:00#12:00:00 1
f864efce3df711441602c00f0263202b 0 4439100 3153245 0 0
4073100 0 0 0 0 950331 0 0 0 0 0
3201126 B 2 BS 1 16/01/2018 18/01/2018 14/12/2016 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 1700005 0 3 0 0 0 ZAHRA AFINA MOCHAMAD
D377424 1 398 DR HUDA, SPA 0138R01701180007552
0002208026395 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136203
1#0##0#0#0.0#2018-02-05 15:37:32#0#12:00:00#12:00:00#12:00:00 1
0325ba8e3b20380b8427500a37a0beaa 0 0 278711 0 0 274079
0 0 0 0 1147215 0 0 0 0 0
3201126 B 2 BS 1 15/01/2018 18/01/2018 10/10/2005 0 2
1 A49.9;K29.7;G44.2 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 3475892 0 4 0 0 0 NAZWA PUTRI
DEWI D387608 12 4480 DR RIANITA SYAMSU, SPA 0138R01701180006730
0002033733363 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135588
1#0##0#0#0.0#2018-02-05 15:42:21#0#12:00:00#12:00:00#12:00:00 1
d71015eda80df0ec7d95e3356a3637c3 0 0 298025 0 0 904472
0 0 0 0 2273395 0 0 0 0 0
3201126 B 1 BS 1 17/01/2018 18/01/2018 19/02/1944 0 2
- 0 58821400 66395572 0 2 0 0 0 SUSZANA
MARIA SUKARTINI SOETADI D387359 73 26996 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180007903 0000043741405 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 136793 1#0##0#0#0.0#2018-02-06
13:42:33#0#12:00:00#12:00:00#12:00:00 1 a69db074f1b0981855bd702047d49c14
0 10062000 9619120 0 0 37869452 0 0 0 0
1276000 0 0 0 7569000 0
3201126 B 3 BS 1 17/01/2018 18/01/2018 21/03/1982 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2879842 0 2 0 0 0 MARIDAH D383877
DR RIZKI; 5.2.0.201712280730 4 137090 1#0##0#0#0.0#2018-02-06
15:43:31#0#12:00:00#12:00:00#12:00:00 1 8f5cdc382509aefcf8a3fa0c4fe37c89
0 0 284903 0 0 1941038 0 0 0 0 653901
0 0 0 0 0
3201126 B 3 BS 1 16/01/2018 18/01/2018 15/12/1956 0 1
1 I80.9;M62.26;I25.0 88.77 - - None None None None I-4-
15-II None None None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN LAIN-
LAIN (SEDANG) 6097900 0 0 - 0 - 0 - 0 -
0 6097900 5429326 0 3 0 0 0 HAMZAH SIMIN
D378274 61 22312 DEDY PRATAMA,SPBV 0138R01701180007564
0001772148969 3;JKN DR RIZKI; 5.2.0.201712280730 4 136205
1#0##0#0#0.0#2018-02-08 13:42:33#0#12:00:00#12:00:00#12:00:00 1
9401626a14a98e67aac89dba8d1f3fdd 0 0 674811 0 0
3847325 0 0 0 0 907190 0 0 0 0 0
3201126 B 3 BS 1 17/01/2018 18/01/2018 05/03/1976 0 2
1 N18.5;K29.7;J22 38.95;90.59;89.52 - - None None None None
N-1-12-I None None None None None None MEMBUAT BARU, MEREVISI DAN
MEMINDAHKAN ALAT DIALISIS (RINGAN) 4340500 0 0 - 0 - 0
- 0 - 0 4340500 10417914 0 2 0 0 0
MINTARSIH D387544 41 15293 DR SRI KUNMARTINI, SPPD
0138R01701180008109 0001403692694 3;JKN DR RIZKI; 5.2.0.201712280730
4 137092 1#0##0#0#0.0#2018-02-08
16:28:56#0#12:00:00#12:00:00#12:00:00 1 5c20d00f311a0f083eae4bec879ccf30
0 4623820 911294 0 0 3816754 0 0 0 0
997046 0 0 0 69000 0
3201126 B 1 BS 1 15/01/2018 18/01/2018 09/05/2003 0 1
1 A91;K29.7;J06.9 - - - None None None None A-4-13-I
(RINGAN) 2925900 0 0 - 0 - 0 - 0 - 0
2925900 4793606 0 4 0 0 0 NABILA NUR SAIDAH
0000149173942 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135222
1#0##0#0#0.0#2018-02-08 22:11:46#0#12:00:00#12:00:00#12:00:00 1
f1278393db58d6ef49c1c8507336ef8b 0 0 316331 0 0
1013675 0 0 0 0 3124000 0 0 0 339600
0
3201126 B 3 BS 1 15/01/2018 18/01/2018 17/07/1970 0 2
1 N39.0;A01.0;N20.0;D64.9 90.59;99.04;89.52 - - None None None
None N-4-12-III None None None None None None INFEKSI GINJAL DAN
SALURAN URIN (BERAT) 5062600 0 0 - 0 - 0 - 0
- 0 5062600 3674712 0 4 0 0 0 SITI AISYAH
0000510298773 3;JKN DR RIZKI; 5.2.0.201712280730 4 136549
1#0##0#0#0.0#2018-02-09 10:25:20#0#12:00:00#12:00:00#12:00:00 1
6b742e240fe12c41458abc7bef3a5882 0 0 508634 0 0
2110676 0 0 0 0 1055402 0 0 0 0 0
3201126 B 3 BS 1 17/01/2018 18/01/2018 01/05/1977 0 2
1 D10.6;D23.4 22.12 - - None None None None U-1-12-I None
None None None None None PROSEDUR MASTOID DAN SINUS (RINGAN) 6576600
0 0 - 0 - 0 - 0 - 0 6576600
7904257 0 2 0 0 0 SULISTININGSIH D386425 40
14871 DR BENHARD B J PANJAITAN SPTHT 0138R01701180007616
0000512014792 3;JKN DR RIZKI; 5.2.0.201712280730 4 136211
1#0##0#0#0.0#2018-02-09 10:29:16#0#12:00:00#12:00:00#12:00:00 1
497789b54cd46defa0184ecef590423c 0 4916348 0 0 0
1903808 0 0 0 0 939101 0 0 0 145000
0
3201126 B 3 BS 1 15/01/2018 18/01/2018 20/10/1982 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8414061 0 4 0 0 0 RUMIYATI D387344
35 12871 DR AFRA FONDA SPOG 0138R01701180006893 0001462029028
3;JKN DR RIZKI; 5.2.0.201712280730 4 135529 1#0##0#0#0.0#2018-
02-09 11:17:48#0#12:00:00#12:00:00#12:00:00 1
0eabf947fb90d056fc94d88339a68c3a 0 4393804 302340 0 0
2383964 0 0 0 0 1264953 0 0 0 69000 0
3201126 B 1 BS 1 17/01/2018 18/01/2018 09/01/1991 0 2
None None None None None PERSALINAN VAGINAL (RINGAN) 2344900 0
0 - 0 - 0 - 0 - 0 2344900 6078230
0 2 0 0 0 ROSMA SARI D387764 27 9870 DR ARIS
WAHJU, SPOG 0138R01701180007574 0001630438806 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 136207 1#0##0#0#0.0#2018-02-09
11:43:07#0#12:00:00#12:00:00#12:00:00 1 122e06e1c8049111d310f7db1d7f215b
0 3471700 521980 0 0 1255909 0 0 0 0
562641 0 0 0 266000 0
3201126 B 1 BS 1 14/01/2018 18/01/2018 13/10/1975 0 2
1 G44.2;K30 - - - None None None None G-4-23-I None
None None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN)
3710200 0 0 - 0 - 0 - 0 - 0
3710200 7302873 0 5 0 0 0 ENI NURAINI D042135
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134884
1#0##0#0#0.0#2018-02-09 18:47:13#0#12:00:00#12:00:00#12:00:00 1
9c6f57dfcfea46ad558f0396be8b0e73 0 0 386918 0 0
2507197 0 0 0 0 4408758 0 0 0 0 0
3201126 B 1 BS 1 14/01/2018 18/01/2018 06/12/2012 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4679822 0 5 0 0 0 AINA RADHYA WININGRUM
D352426 5 1865 DR AWIDIYA, SPA 0138R01701180006339
0001078397548 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134911
1#0##0#0#0.0#2018-02-09 18:49:57#0#12:00:00#12:00:00#00:00:00 1
92b4b0540ad08e14d9b6cbae3df9c900 0 0 338858 0 0 449307
0 0 0 0 3891657 0 0 0 0 0
3201126 B 1 BS 1 16/01/2018 18/01/2018 16/01/2018 2849 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040510 0 3 0 0 0 BAYI NY YULISTIA
MEILANIE PUTRI D387741 0 0 DR TRI LESTARI, SPA
0138R01701180007848 0002322669126 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 136607 1#0##0#0#0.0#2018-02-09
19:08:14#0#12:00:00#12:00:00#12:00:00 1 b15e206fcb7a8883a92de0a5ba8e0998
0 0 499620 0 0 88899 0 0 0 0 1451991
0 0 0 0 0
3201126 B 1 BS 1 15/01/2018 18/01/2018 31/12/1952 0 2
1 N18.5;J18.0;I50.1 90.59;89.52;87.49;39.95 - - None None None
None N-4-10-III None None None None None None TUMOR GINJAL & SALURAN
URIN & GAGAL GINJAL (BERAT) 8508800 0 0 - 0 - 0 -
0 - 0 8508800 7171172 0 4 0 0 0
SUTIYEM D324160 65 23756 DR SRI KUMARTINI 0138R01701180006955
0000060714033 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135538
1#0##0#0#0.0#2018-02-09 19:58:29#0#12:00:00#12:00:00#00:00:00 1
aafba2e75fe498d55a55eb984ea08795 0 0 818792 0 0
2357988 0 0 0 0 2812142 0 0 0 1182250
0
3201126 B 3 BS 1 15/01/2018 18/01/2018 29/01/1979 0 1
8672000 0 0 - 0 - 0 - 0 - 0
8672000 14930617 0 4 0 0 0 YUNUS MANAFE
0001726483149 3;JKN DR RIZKI; 5.2.0.201712280730 4 135535
1#0##0#0#0.0#2018-02-10 09:01:20#0#12:00:00#12:00:00#12:00:00 1
62d8f19b82e86ffd56342323c1be03f1 0 5848760 226440 0 0
3503148 0 0 0 0 1312269 0 0 3750000 290000
0
3201126 B 3 BS 1 17/01/2018 18/01/2018 15/01/1991 0 1
1 I63.9;A16.1;J96.0 87.44;87.03 - - None None None None G-4-
- 0 8672200 6839697 0 2 0 0 0 YUSUP
PURWANTO D387318 27 9864 DR MUHAMMAD RIZKI YUWANA
0138R01701180008123 0001983021996 3;JKN DR RIZKI; 5.2.0.201712280730
4 137091 1#0##0#0#0.0#2018-02-10
11:55:41#0#00:30:00#16:00:00#12:00:00 1 a70109fcb37668a3479d7e7174d873ef
0 0 532872 0 0 5570368 0 0 0 0 736457
0 0 0 0 0
3201126 B 3 BS 1 17/01/2018 18/01/2018 27/11/2017 0 1
2 A41.9;K56.7;E16.2;Q24.9 - - - None None None None A-4-
10-II None None None None None None SEPTIKEMIA (SEDANG) 4330300 0
0 - 0 - 0 - 0 - 0 4330300 4063208
0 2 0 0 0 BAYI NY. MULYATI D383916 0 51 DR
MUHAMMAD RIZKI YUWANA 0138R01701180008141 0002314084241 3;JKN DR RIZKI;
5.2.0.201712280730 4 137301 1#0##0#0#0.0#2018-02-10
12:50:25#0#12:00:00#12:00:00#12:00:00 2 9796824bbf97799f28db21251722c0f0
0 0 282514 0 0 2637877 0 0 0 0 554817
0 0 0 0 588000
3201126 B 3 BS 1 18/01/2018 18/01/2018 26/09/1946 0 2
1 K30 - - - None None None None K-4-18-I None None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 810878 0 1 0 0 0 NURHAYATI NAFIAH
D159587 71 26047 DR RICO ADITYA 0138R01701180008575
0000002528627 3;JKN DR RIZKI; 5.2.0.201712280730 4 137536
1#0##0#0#0.0#2018-02-10 13:34:07#0#08:35:00#16:00:00#12:00:00 1
e68e9619ec071b1e63a03d4020b93618 0 0 263898 0 0 204932
0 0 0 0 342048 0 0 0 0 0
3201126 B 1 BS 1 14/01/2018 18/01/2018 23/07/1961 0 1
1 K81.0;E13.9;A41.9;D29.1 88.74 - - None None None None B-4-
(BERAT) 9188400 0 0 - 0 - 0 - 0 - 0
9188400 13803325 0 5 0 0 0 SUHARYANTO D380347
irene; 5.2.0.201712280730 4 134886
1#1#vvip#3#4614925#0.0#2018-02-19 10:21:08#0#12:00:00#12:00:00#12:00:00
2 4755e297cae139e1d53e46b9cc957ebc 0 7065000 1408000 0
0 26000 0 0 0 0 903021 0 0 0 4401304
0
3201126 B 3 BS 1 16/01/2018 18/01/2018 14/05/2013 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1520076 0 3 0 0 0 SHILVIA CAMELLIA
0001462135083 3;JKN DR RIZKI; 5.2.0.201712280730 4 136175
1#0##0#0#0.0#2018-03-02 20:55:04#0#12:00:00#12:00:00#12:00:00 1
a297ce7c20da55c44c125ae13bd46d0f 0 0 241100 0 0 364532
0 0 0 0 914444 0 0 0 0 0
3201126 B 1 BS 1 17/01/2018 18/01/2018 25/01/1986 0 2
1 E11.2;E87.7;D63.8;I10 90.59;99.04;89.52 - - None None None
None N-4-16-II None None None None None None PENYAKIT GINJAL DAN
SALURAN URIN LAIN-LAIN (SEDANG) 7385300 0 0 - 0 - 0
- 0 - 0 7385300 4178591 0 2 0 0 0
RINI SUWANTI d378716 31 11680 DR SRI KUN, SPPD
0138R01701180007928 0001304964538 3;JKN DR RIZKI; 5.2.0.201712280730
4 136799 1#0##0#0#0.0#2018-03-10
13:22:38#0#12:00:00#12:00:00#12:00:00 2 806998cf13f21b3437dcbbd859e9189a
0 0 818792 0 0 1498433 0 0 0 0
1861366 0 0 0 0 0
3201126 B 1 BS 1 16/01/2018 18/01/2018 10/04/1980 0 2
1 N20.0;K29.7 90.59;88.76;89.52 - - None None None None N-4-
13-I None None None None None None BATU URIN (RINGAN) 4784600 0
0 - 0 - 0 - 0 - 0 4784600 4587960
0 3 0 0 0 ISTI TRESNA KRISTANTO D091384 37 13795
DR BETTY DWI L, SPPD 0138R01701180006964 0000977934993 3;JKN DR
RIZKI; 5.2.0.201712280730 4 135543 1#0##0#0#0.0#2018-03-14
15:54:09#0#12:00:00#12:00:00#12:00:00 2 a7580d65a5a0f3b4f149b290f2c34d8c
0 0 582956 0 0 1335951 0 0 0 0
2669053 0 0 0 0 0
3201126 B 1 BS 1 16/01/2018 18/01/2018 16/05/1981 0 2
1 O82.9;Z37.0 74.0;66.39 - - None None None None O-6-10-I
6981500 0 0 - 0 - 0 - 0 - 0
6981500 14294484 0 3 0 0 0 YULISTIA MEILANIE PUTRI
F034671 36 13394 DR FX BHIMANTORO, SPOG 0138R01701180006987
0001627994169 3;JKN DR RIZKI; 5.2.0.201712280730 4 135549
1#0##0#0#0.0#2018-03-14 16:17:25#0#06:38:25#06:38:25#12:00:00 2
dc3c2ae9f4a5be333ab531ef1143a280 0 7098900 3818067 0 0
2272364 0 0 0 0 935153 0 0 0 170000
0
3201126 B 1 BS 1 17/01/2018 18/01/2018 11/04/1974 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6053486 0 2 0 0 0 DEWI PUSPASARI
D003860 43 15987 DR MAMAN H, SPOG 0138R01701180008130
0001256944757 3;JKN DR RIZKI; 5.2.0.201712280730 4 137093
1#0##0#0#0.0#2018-03-14 16:19:46#0#12:00:00#12:00:00#12:00:00 2
9aaf3d08ca36c2ee17f777847b3cf346 0 0 1184824 0 0
1183640 0 0 0 0 3522522 0 0 0 162500
0
3201126 B 1 BS 1 15/01/2018 18/01/2018 09/04/1946 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 5404356 0 4 0 0 0 ADOLF LOEN D387615
71 26214 DR ARU, SPPD 0138R01701180006745 0002040179163 3;JKN
DR RIZKI; 5.2.0.201712280730 4 135528 1#0##0#0#0.0#2018-03-15
08:26:17#0#12:00:00#12:00:00#12:00:00 2 84eb54426c9adb67a1469b17221188c9
0 0 269459 0 0 1976841 0 0 0 0
3158056 0 0 0 0 0
3201126 B 1 BS 1 11/01/2018 18/01/2018 23/04/1979 0 2
1 D38.1;Q25.0;A18.2;A15.3 - - - None None None None J-4-
21-II None None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM
PERNAFASAN LAIN-LAIN (SEDANG) 6311700 0 0 - 0 - 0 -
0 - 0 6311700 12653315 0 8 0 0 0
MARTINI D379685 38 14143 DR AZRI NURIZAL SPPD KKV
0138R01701180005299 0001650133192 3;JKN DR RIZKI; 5.2.0.201712280730
4 133885 1#0##0#0#0.0#2018-03-15
11:09:06#0#12:00:00#12:00:00#12:00:00 2 1b23d1258cee864671d37acd532784ef
0 5467000 908580 0 0 5423948 0 0 0 0
853787 0 0 0 0 0
3201126 B 3 BS 1 17/01/2018 18/01/2018 14/08/1966 0 1
- 0 8908800 8650727 0 2 0 0 0 MUHAMAD
DAHLAN D386418 51 18784 DR SRI KUNMARTINI, SPPD 0138R01701180007741
0001211811243 3;JKN DR RIZKI; 5.2.0.201712280730 4 136389
1#0##0#0#0.0#2018-05-17 14:28:08#0#12:00:00#12:00:00#12:00:00 3
989936b72c648a2028f92250ebf96726 0 4498260 854792 0 0
2260740 0 0 0 0 967935 0 0 0 69000 0
3201126 B 3 BS 1 16/01/2018 18/01/2018 06/08/1947 0 1
1 N13.6;N20.1;N20.0;I10 87.44;88.19;89.52;56.0;59.8 - - None
None None None N-1-40-II None None None None None None PROSEDUR
PADA URETRA DAN TRANSURETRA (SEDANG) 10919500 0 0 - 0 -
0 - 0 - 0 10919500 15625086 0 3 0 0
0 BOAN SOLEH ATMAJA D383915 70 25731 DR SIDDHI ANDIKA, SPU
0138R01701180007150 0000512188029 3;JKN DR RIZKI; 5.2.2.201806040537
4 135680 1#0##0#0#0.0#2018-08-13
10:55:48#0#12:00:00#12:00:00#12:00:00 2 97f1d6af966fe800bb592175c1ae2bc7
0 6150260 5688000 0 0 2075624 0 0 0 0
1642202 0 0 0 69000 0
3201126 B 1 BS 1 16/01/2018 18/01/2018 27/04/1950 0 1
1 N21.0;N40;N18.1;I27.0 57.0;90.59;88.19;89.52;57.32 - - None
None None None N-1-40-II None None None None None None PROSEDUR
PADA URETRA DAN TRANSURETRA (SEDANG) 15287300 0 0 - 0 -
0 - 0 - 0 15287300 22428759 0 3 0 0
0 TODUNG PANABOR LUMBANTORUAN D205795 67 24736 DR HERY TIERA, SPU
0138R01701180007143 0000061053772 3;JKN DR RIZKI; 5.2.2.201806040537
4 135629 1#0##0#0#0.0#2018-08-14
11:59:05#0#12:00:00#12:00:00#00:00:00 3 aff295346c27990f062105ded8efb58e
0 9931500 8808317 0 0 2343942 0 0 0 0
1276000 0 0 0 69000 0
3201126 B 2 BS 1 17/01/2018 19/01/2018 18/02/2007 0 2
1 N39.0 - - - None None None None N-4-12-I None None
None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN) 2871200
0 0 - 0 - 0 - 0 - 0 2871200
2961770 0 3 0 0 0 AUREL REGINA FEBRIANTY D386465
10 3986 DR AULIA TANGKARI, SPA 0138R01701180007898 0001278811089
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136761
1#0##0#0#0.0#2018-02-03 11:51:54#0#12:00:00#12:00:00#12:00:00 2
3179ea4fde448494127441439fdca3f9 0 0 258408 0 0 968601
0 0 0 0 1734761 0 0 0 0 0
3201126 B 2 BS 1 19/01/2018 19/01/2018 05/10/1961 0 1
None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN) 3180100
0 0 - 0 - 0 - 0 - 0 3180100
3099855 0 1 0 0 0 KWAN KOK LIONG D297726 56
20560 DR MAYSAMIRAWATI SPS 0138R01701180008942 0002241301858 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 137835 1#0##0#0#0.0#2018-
02-05 07:19:25#0#12:00:00#12:00:00#12:00:00 1
9720f0ab15e85cb45a734d418bf383ed 0 0 371010 0 0
1995051 0 0 0 0 505000 0 0 0 228794
0
3201126 B 2 BS 1 13/01/2018 19/01/2018 25/12/1946 0 2
1 I51.7;J18.0;J46 - - - None None None None I-4-24-III
(BERAT) 9767800 0 0 - 0 - 0 - 0 - 0
9767800 9985949 0 7 0 0 0 ENIK SURATMI
D099923 71 25952 DR BOBBY DRASTYAWAN SPPA 0138R01701180006071
0000060707979 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134860
1#0##0#0#0.0#2018-02-05 07:31:12#0#12:00:00#12:00:00#00:00:00 1
29603f754b87c76ca88a6baee3d68f47 0 0 1479358 0 0
4292305 0 0 0 0 3535000 0 0 0 679286
0
3201126 B 2 BS 1 18/01/2018 19/01/2018 24/10/1983 0 1
- 0 4958500 3729549 0 2 0 0 0 WINDU
S.ANUGRAH D331384 34 12505 DR SRI KUNMARTINI, SPPD 0138R01701180008647
0001638965226 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137631
1#0##0#0#0.0#2018-02-05 15:09:46#0#12:00:00#12:00:00#12:00:00 1
51e7b924339e0fee3a0b36a0136a4b5f 0 0 499265 0 0
1001545 0 0 0 0 1046489 0 0 0 1182250
0
3201126 B 2 BS 1 14/01/2018 19/01/2018 05/11/1948 0 2
1 M13.86;H81.4 - - - None None None None M-4-18-I
None None None None None None PENYAKIT TULANG DAN SENDI LAIN-LAIN
(RINGAN) 3344900 0 0 - 0 - 0 - 0 - 0
3344900 5873835 0 6 0 0 0 SUTIYEM D387548
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135077
1#0##0#0#0.0#2018-02-05 15:12:42#0#12:00:00#12:00:00#12:00:00 1
8fec35c40ea69901d4e74b8d9e779f99 0 0 354040 0 0
2584525 0 0 0 0 2935270 0 0 0 0 0
3201126 B 2 BS 1 18/01/2018 19/01/2018 12/07/1983 0 2
1 O14.1 - - - None None None None W-4-16-II None None
None None None None GANGGUAN ANTEPARTUM (SEDANG) 3479400 0 0
- 0 - 0 - 0 - 0 3479400 3990398 0
2 0 0 0 YULIANTI D387876 34 12609 DR FERRY SPOG
0138R01701180008199 0001628849136 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 137103 1#0##0#0#0.0#2018-02-05
15:16:27#0#12:00:00#12:00:00#12:00:00 1 b445ee8c6bbf0f02e33f0158dee72233
0 0 580110 0 0 2103234 0 0 0 0
1307054 0 0 0 0 0
3201126 B 2 BS 1 17/01/2018 19/01/2018 03/05/1975 0 2
1 K80.0;K76.0 51.22 - - None None None None B-1-12-II None
None None None None None CHOLESISTEKTOMI TANPA LAPAROSKOPIK (SEDANG)
9394800 0 0 - 0 - 0 - 0 - 0
9394800 12890556 0 3 0 0 0 SAMIATI D384719
42 15600 DR E SURYA POHAN DR SPB KBD 0138R01701180007788
0001837358785 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136517
1#0##0#0#0.0#2018-02-05 15:21:19#0#12:00:00#12:00:00#12:00:00 1
71593dd4fbe9e3e7cba3bcdeb2fce36f 0 5326100 2693544 0 0
3781605 0 0 0 0 1089307 0 0 0 0 0
3201126 B 2 BS 1 17/01/2018 19/01/2018 17/05/2016 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1939984 0 3 0 0 0 AISYAH FARHANA
D346013 1 610 DR AWIDIYA, SPA 0138R01701180008008
0002045634513 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137042
1#0##0#0#0.0#2018-02-05 15:23:01#0#12:00:00#12:00:00#12:00:00 1
9e9822a462bad50f43ee37cc978750e8 0 0 238535 0 0 241034
0 0 0 0 1460415 0 0 0 0 0
3201126 B 1 BS 1 18/01/2018 19/01/2018 26/03/1961 0 2
1 N18.5;A49.9 39.95 - - None None None None N-4-10-I None
(RINGAN) 4639400 0 0 - 0 - 0 - 0 - 0
4639400 4804798 0 2 0 0 0 ERNA MARDIANA
0000093184075 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137641
1#1#vvip#2#165398#0.0#2018-02-07 07:51:44#0#12:00:00#12:00:00#00:00:00 1
08df68886777936dad1ef68dec0efe44 0 0 783705 0 0 562010
0 0 0 0 2276833 0 0 0 1182250 0
3201126 B 1 BS 1 18/01/2018 19/01/2018 15/08/1945 0 2
- 0 58821400 65500498 0 2 0 0 0 ASIAH
HUSEIN,HJ. D323473 72 26454 DR AZRI NURIZAL SPPD KKV
0138R01701180008351 0000060946571 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 137176 1#0##0#0#0.0#2018-02-07
13:35:42#0#12:00:00#12:00:00#12:00:00 1 fa2468c2ab15ce4f7fb6963429ce2a53
0 10260000 9619120 0 0 0 0 0 0 0
1256000 0 0 36496378 7869000 0
3201126 B 1 BS 1 10/01/2018 19/01/2018 25/11/1954 0 2
1 C20;K80.8;K76.0;K59.0 45.23 - - None None None None K-4-
0 0 - 0 - 0 - 0 - 0 9888000
19088664 0 10 0 0 0 ARIE ARYATI P D382190 63
23057 DR MUHAMMAD YAMIN LUBIS DR SP-PD-KGEH 0138R01701180004568
0001731445885 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 133025
1#0##0#0#0.0#2018-02-07 19:12:50#0#12:00:00#12:00:00#12:00:00 1
a513d57b65eb61e3d7d17227d1c2fdb6 0 7907000 3862120 0 0
4311044 0 0 0 0 1256000 0 0 0 1752500
0
3201126 B 3 BS 1 17/01/2018 19/01/2018 10/08/1969 0 1
1 G40.9;A91 - - - None None None None G-4-22-III None
- 0 - 0 - 0 - 0 3965000 3129352 0
3 0 0 0 ADE EMIR HARUN D384667 48 17692 DR
MAYSAMIRAWATI SPS 0138R01701180008136 0001739578004 3;JKN DR RIZKI;
5.2.0.201712280730 4 137095 1#0##0#0#0.0#2018-02-08
08:30:51#0#12:00:00#12:00:00#12:00:00 1 26cbf1c3a1b22f1fbb30a5bf287b0095
0 0 777100 0 0 1595528 0 0 0 0 756724
0 0 0 0 0
3201126 B 1 BS 1 18/01/2018 19/01/2018 15/04/1938 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 66474418 0 2 0 0 0 ABD SOMAD RAHMAN,H
0000060743867 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137630
1#0##0#0#0.0#2018-02-08 11:18:24#0#12:00:00#12:00:00#00:00:00 1
69d15da3262f65ea8b3752042abf35c3 0 9716500 9619120 0 0
0 0 0 0 0 1208600 0 0 38216198 7714000
0
3201126 B 3 BS 1 19/01/2018 19/01/2018 01/02/1932 0 1
5013100 0 0 - 0 - 0 - 0 - 0
5013100 3734281 0 1 0 0 0 ABDUL MUTOLIB
0001014284215 3;JKN DR RIZKI; 5.2.0.201712280730 4 137648
1#0##0#0#0.0#2018-02-08 11:25:22#0#00:00:00#16:00:00#12:00:00 1
eaae15dae3df138e6cbacefb831474eb 0 0 780498 0 0
1856484 0 0 0 0 551299 0 0 0 0 546000
3201126 B 3 BS 1 16/01/2018 19/01/2018 18/03/1965 0 2
1 I21.3;I11.0;I05.9 88.55;36.07;88.72;87.44 - - YY02 None None
0 - 0 - 0 45079800 71661029 0 4 1 3
0 SUDARTI d387688 52 19297 DR AZRI NURIZAL SPPD KKV
0138R01701180007094 0001740574179 3;JKN DR RIZKI; 5.2.0.201712280730
4 135551 1#0##0#0#0.0#2018-02-08
14:05:03#0#12:00:00#12:00:00#12:00:00 1 cbcd79340a6d265da89a1d5dc063bf6e
0 14520800 404900 0 0 43722329 0 0 0 0
4380000 0 0 0 1133000 7500000
3201126 B 3 BS 1 16/01/2018 19/01/2018 23/01/2003 0 2
7792500 0 0 - 0 - 0 - 0 - 0
7792500 11064019 0 4 0 0 0 HABIL PAMUNGKAS
0001740398804 3;JKN DR RIZKI; 5.2.0.201712280730 4 136199
1#0##0#0#0.0#2018-02-08 16:41:42#0#12:00:00#12:00:00#12:00:00 1
ba2f76a7f95391adc94d8e5494398da3 0 5274700 208850 0 0
4106155 0 0 0 0 1405314 0 0 0 69000 0
3201126 B 3 BS 1 13/01/2018 19/01/2018 01/02/1942 0 1
1 I50.0;I05.9;I48 89.52 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4144700
4473787 0 7 0 0 0 SAMAD D334279 75 27740 DR
5.2.0.201712280730 4 134873 1#0##0#0#0.0#2018-02-08
17:02:49#0#12:00:00#12:00:00#00:00:00 1 703bf32867e42d89fa70b6b427bd19ce
0 0 626219 0 0 2213890 0 0 0 0
1633678 0 0 0 0 0
3201126 B 3 BS 1 15/01/2018 19/01/2018 16/08/1982 0 2
1 K80.1 51.03;90.59;87.49 - - None None None None B-1-11-I
None None None None None None PROSEDUR SALURAN EMPEDU KOMPLEK (RINGAN)
6992800 0 0 - 0 - 0 - 0 - 0
6992800 10497444 0 5 0 0 0 SUCIATI D382799
35 12936 DR SURYA POHAN SPB 0138R01701180006574 0000629643767
3;JKN DR RIZKI; 5.2.0.201712280730 4 135124 1#0##0#0#0.0#2018-
02-08 17:08:37#0#12:00:00#12:00:00#12:00:00 1
3ff8a53e0ba625f6b8242804aaade9f1 0 4674484 0 0 0
3952711 0 0 0 0 1652749 0 0 0 0 217500
3201126 B 1 BS 1 18/01/2018 19/01/2018 01/04/1954 0 1
- 0 12472300 13980648 0 2 0 0 0 AMBAR YANTO
D387886 63 23303 DR SRI KUN, SPPD 0138R01701180008412
0000061122486 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137414
1#0##0#0#0.0#2018-02-08 21:27:42#0#12:00:00#12:00:00#12:00:00 1
3f463a1d6619ef8f893c7f8ac6a40dbd 0 6468200 3669967 0 0
2858859 0 0 0 0 914622 0 0 0 69000 0
3201126 B 1 BS 1 17/01/2018 19/01/2018 08/05/1967 0 2
1 D25.9;K66.0 68.29;54.59 - - None None None None K-1-11-I
None None None None None None ADHESIOLISIS PERITONEAL (RINGAN)
11578700 0 0 - 0 - 0 - 0 - 0
11578700 15023531 0 3 0 0 0 ENRI SUKARNI
d383678 50 18517 DR RM DHENI DANARDHONO SPOG 0138R01701180007581
0000061009817 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 136208
1#0##0#0#0.0#2018-02-09 11:40:21#0#12:00:00#12:00:00#12:00:00 1
a8034fb01ac884ac0d17fb7098394e01 0 7096000 4284119 0 0
0 0 0 0 0 3508412 0 0 0 135000 0
3201126 B 1 BS 1 14/01/2018 19/01/2018 12/05/1946 0 1
1 I21.3;I63.9;I11.0;E14.2 87.03 - - None None None None I-4-
14562700 0 0 - 0 - 0 - 0 - 0
14562700 14731695 0 6 0 0 0 NIAN DAIMAN,H,MBA.
0000061030394 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134883
1#0##0#0#0.0#2018-02-09 19:01:59#0#12:00:00#12:00:00#00:00:00 1
03c06417ef552f00ac1391cf4246f699 0 4962000 2298053 0 0
1226000 0 0 0 0 989756 0 0 0 5255886
0
3201126 B 3 BS 1 18/01/2018 19/01/2018 18/01/2018 2100 1
4 P22.9;Z38.1 - - - None None None None P-8-13-I None
None None None None None NEONATAL, BBL 2000 - 2499 GR TANPA PROSEDUR
MAYOR (RINGAN) 5483600 0 0 - 0 - 0 - 0 -
0 5483600 2516523 0 2 0 0 0 BAYI NY YULIANTI
d387877 0 0 DR AHMAD HIBBAN A WRIYA 0138R01701180008404
0002421029845 3;JKN DR RIZKI; 5.2.0.201712280730 4 137296
1#0##0#0#0.0#2018-02-10 11:43:45#0#04:30:00#01:10:00#12:00:00 1
e9486f24e6457ef892ca4ed6329b6994 0 0 921456 0 0 663435
0 0 0 0 471632 0 0 0 0 460000
3201126 B 3 BS 1 18/01/2018 19/01/2018 02/01/1948 0 2
4 E87.8;A41.9;R57.1;A09.9;L03.9 99.60;90.59;89.52;87.03 - - None
None None None E-4-11-III None None None None None None HIPOVOLEMIA
& GANGGUAN ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 -
0 - 0 6293300 6237341 0 2 0 0 0
HANDINI d085978 70 25584 DR AHMAD HIBBAN A WRIYA
0138R01701180008925 0002298871899 3;JKN DR RIZKI; 5.2.0.201712280730
4 137736 1#0##0#0#0.0#2018-02-10
11:59:15#0#12:00:00#12:00:00#12:00:00 1 4b14c8142cf5a9937cae03d2ec6120ea
0 0 566397 0 0 4385894 0 0 0 0 697050
0 0 0 0 588000
3201126 B 1 BS 1 16/01/2018 19/01/2018 23/10/2001 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4519982 0 4 0 0 0 NAJA IZZAH KURNIAWAN
D053934 16 5929 DR RASTRA, SPA 0138R01701180007278
0000036246317 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135969
1#0##0#0#0.0#2018-03-02 21:13:08#0#12:00:00#12:00:00#12:00:00 1
ad132a220745f55106806b9e3ff360a3 0 0 316331 0 0 587951
0 0 0 0 3419700 0 0 0 196000 0
3201126 B 1 BS 1 12/01/2018 19/01/2018 29/09/2004 0 1
1 Q54.9 58.47 - - None None None None N-1-40-I None None
None None None None PROSEDUR PADA URETRA DAN TRANSURETRA (RINGAN)
11257400 0 0 - 0 - 0 - 0 - 0
11257400 19377542 0 8 0 0 0 MUHAMMAD OMAR JOHANSYAH
0002053865169 3;JKN DR RIZKI; 5.2.0.201712280730 4 134579
1#0##0#0#0.0#2018-03-02 21:33:05#0#12:00:00#12:00:00#12:00:00 2
07a61ec4c9a1a12e6920d3cf0d1fc5f1 0 8949332 0 0 0
4220210 0 0 0 0 6063000 0 0 0 145000
0
3201126 B 1 BS 1 14/01/2018 19/01/2018 17/01/1953 0 2
1 I64;G81.9;I48 87.03 - - None None None None G-4-15-II
SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (SEDANG) 6844000 0 0
- 0 - 0 - 0 - 0 6844000 11769897 0
6 0 0 0 ARSIH SUNDARI D298938 64 23738 DR NURUL
KOMARI SPS 0138R01701180006322 0000061000907 3;JKN DR RIZKI;
5.2.0.201712280730 4 134907 1#0##0#0#0.0#2018-03-10
09:42:18#0#12:00:00#12:00:00#00:00:00 2 30dad5e7cd10943641e64356c80ff71c
0 0 923597 0 0 4330307 0 0 0 0
5757993 0 0 0 758000 0
3201126 B 1 BS 1 16/01/2018 19/01/2018 17/04/1968 0 2
1 I83.0;M79.66;I10 38.50 - - None None None None I-1-17-I
(RINGAN) 19082700 0 0 - 0 - 0 - 0 - 0
19082700 20363647 0 4 0 0 0 BERENLIT B. SEBAYANG
0138R01701180007558 0001799451933 3;JKN DR RIZKI; 5.2.0.201712280730
4 136202 1#0##0#0#0.0#2018-03-14
16:04:15#0#12:00:00#12:00:00#12:00:00 2 7469ae85c173057a23e6202f6c608b47
0 9792600 6639086 0 0 0 0 0 0 0
1345000 0 0 0 2586961 0
3201126 B 3 BS 1 19/01/2018 19/01/2018 01/02/1932 0 1
5013100 0 0 - 0 - 0 - 0 - 0
5013100 3734281 0 1 0 0 0 ABDUL MUTOLIB
0001014284215 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137648
1#0##0#0#0.0#2018-03-19 08:07:27#0#00:00:00#16:00:00#12:00:00 2
00c730f155761326689b980e46c857da 0 0 780498 0 0
1856484 0 0 0 0 551299 0 0 0 0 546000
3201126 B 3 BS 1 17/01/2018 19/01/2018 21/12/1942 0 1
1 A01.4;R10.1;K36;D29.1 87.64 - - None None None None A-4-
14-I None None None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 2080211 0 3 0 0 0 JASIMIN
KAMSO D381655 75 27421 DR BETTY DWI L, SPPD 0138R01701180008088
0001014278196 3;JKN DR RIZKI; 5.2.1.201804062320 4 137088
1#0##0#0#0.0#2018-05-07 12:03:01#0#12:00:00#12:00:00#12:00:00 2
a9d7dee1ce58e779f2488f0e8f28d081 0 0 183752 0 0
1031870 0 0 0 0 864589 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 19/01/2018 19/02/1943 0 1
1 J81 - - - None None None None J-4-21-I None None
LAIN (RINGAN) 2798500 0 0 - 0 - 0 - 0 -
0 2798500 4559314 0 1 0 0 0 BENNY BARIGUNA
0001336767873 3;JKN DR RIZKI; 5.2.1.201804062320 4 137647
1#0##0#0#0.0#2018-05-17 15:49:25#0#00:00:00#12:00:00#12:00:00 2
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3601430 0 0 0 0 605273 0 0 0 0 0
3201126 B 2 BS 1 17/01/2018 19/01/2018 12/03/1992 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2982445 0 3 0 0 0 RISTY RAMADHIYANTI
F143698 25 9442 DR ZULFAN, SPPD 0138R01701180008026
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1#0##0#0#0.0#2018-05-17 16:13:24#0#12:00:00#12:00:00#00:00:00 3
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3201126 B 3 BS 1 16/12/2017 19/01/2018 16/12/2017 1400 1
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4 123238 1#0##0#0#0.0#2018-09-10
15:18:25#0#12:00:00#12:00:00#12:00:00 2 04fe5a8fc2a9f6323835f9c8fe92f2c6
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3201126 B 1 BS 1 18/01/2018 20/01/2018 18/06/1989 0 2
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3201126 B 2 BS 1 18/01/2018 20/01/2018 05/08/1981 0 2
1 H81.1;G44.2 - - - None None None None U-4-11-I None
- 0 - 0 - 0 - 0 1821000 3870643 0
3 0 0 0 FITRI NURMALA DEWI D030766 36 13315 DR
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09:45:31#1#12:00:00#12:00:00#12:00:00 2 e857292570ed19107cee3034dd8f6708
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3201126 B 2 BS 1 19/01/2018 20/01/2018 17/04/2016 0 1
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1#0##0#0#0.0#2018-02-03 11:56:59#0#12:00:00#12:00:00#12:00:00 2
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1158885 0 0 0 0 370399 0 0 0 145000
0
3201126 B 2 BS 1 18/01/2018 20/01/2018 13/09/1979 0 2
LAIN-LAIN (SEDANG) 4628500 0 0 - 0 - 0 - 0
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BELANDINA SINLAELOE D092267 38 14007 DR ERDIYAN, SPOG
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13:59:54#0#12:00:00#12:00:00#00:00:00 1 89db6e2ceb74fa0db9da469a45d29d48
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1752515 0 0 0 0 0
3201126 B 2 BS 1 18/01/2018 20/01/2018 18/07/1988 0 2
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5.2.0.201712280730 4 137413 1#1#vvip#3#17981247#0.0#2018-02-03
14:03:27#0#12:00:00#12:00:00#12:00:00 1 8532ccb1d74283736f94567a0cbc7322
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3201126 B 2 BS 1 17/01/2018 20/01/2018 15/08/2013 0 2
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1#0##0#0#0.0#2018-02-05 14:36:07#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 15/01/2018 20/01/2018 24/04/1965 0 1
1 A09.9;A41.9 - - - None None None None K-4-17-III None
(BERAT) 3046500 0 0 - 0 - 0 - 0 - 0
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3201126 B 2 BS 1 18/01/2018 20/01/2018 22/12/1977 0 2
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RACHMAWATI DR,SPB(K)ONK 0138R01701180008726 0001631788569 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 137640 1#0##0#0#0.0#2018-
02-05 15:35:17#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 19/01/2018 20/01/2018 02/08/1927 0 2
1 J18.0;A41.9;I50.0 - - - None None None None J-4-16-III
None None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (BERAT)
7703700 0 0 - 0 - 0 - 0 - 0
7703700 5212707 0 2 0 0 0 SAARTJE AUGUSTINA
LEANDER D135080 90 33043 DR MOHAMAD NIZAM ERHAMZA SPP
0138R01701180009186 0001079424202 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138240 1#0##0#0#0.0#2018-02-05
17:29:44#0#12:00:00#12:00:00#12:00:00 1 34f1a9162dfbb694ca4b33bf7e0c1b1f
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1733018 0 0 0 0 0
3201126 B 1 BS 1 14/01/2018 20/01/2018 21/02/1984 0 2
1 K29.7;B34.9;J32.9 - - - None None None None K-4-11-I
3247500 0 0 - 0 - 0 - 0 - 0
3247500 10566417 0 7 0 0 0 RR.DWI ASIH INDRIANI
0001478149975 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 134875
1#0##0#0#0.0#2018-02-06 14:27:13#0#12:00:00#12:00:00#12:00:00 1
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4122525 0 0 0 0 6184261 0 0 0 0 0
3201126 B 1 BS 1 18/01/2018 20/01/2018 18/01/2018 3230 2
5118000 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-02-06 15:14:58#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 19/01/2018 20/01/2018 08/07/1937 0 2
1 F03;J18.0;E14.4;I50.0 - - - None None None None F-4-
16-III None None None None None None GANGGUAN OTAK ORGANIK LAIN-LAIN
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0 SITI SOELIN D387970 80 29415 DR. ARU ARIADNO, SPPD
0138R01701180008896 0000091945991 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 137699 1#0##0#0#0.0#2018-02-07
08:06:25#0#12:00:00#12:00:00#12:00:00 1 b141d1140805122bb0ba12e193274df8
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1926846 0 0 0 0 0
3201126 B 1 BS 1 17/01/2018 20/01/2018 27/08/1959 0 2
1 D33.2;G40.9 - - - None None None None G-4-26-II None
(SEDANG) 6023100 0 0 - 0 - 0 - 0 - 0
6023100 7140264 0 4 0 0 0 WIWIEK SUMIASTUTI
0001341249658 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137097
1#0##0#0#0.0#2018-02-07 08:25:08#0#12:00:00#12:00:00#00:00:00 1
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3709065 0 0 0 0 2836120 0 0 0 0 0
3201126 B 2 BS 1 18/01/2018 20/01/2018 08/08/1940 0 1
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E SUTISNA D359492 77 28287 DR PRIYO SUNARTO , SPJP
0138R01701180008715 0000060950215 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 137639 1#0##0#0#0.0#2018-02-07
08:40:06#0#12:00:00#12:00:00#00:00:00 1 b367921329309ccbadcfbd9bf8554876
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2298345 0 0 0 1825000 0
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1#0##0#0#0.0#2018-02-07 13:30:49#0#12:00:00#12:00:00#00:00:00 1
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0
3201126 B 3 BS 1 18/01/2018 20/01/2018 10/07/1969 0 1
1 I10;R04.0 89.52 - - None None None None I-4-17-II None
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14:27:32#0#12:00:00#12:00:00#12:00:00 1 bbc0f166adcadc93f6a15f0aea6520a4
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1025007 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 20/01/2018 01/06/1944 0 1
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4 137696 1#0##0#0#0.0#2018-02-08
15:06:06#0#12:00:00#12:00:00#12:00:00 1 e5ba2f0baed5d56af2308aadbc9f02ce
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3201126 B 1 BS 1 18/01/2018 20/01/2018 01/01/1991 0 2
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14702456 0 3 0 0 0 IFTITA RAHMI D377062 27
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3201126 B 1 BS 1 19/01/2018 20/01/2018 10/01/1942 0 1
1 I84.8;K29.7 - - - None None None None K-4-18-I None
2033900 0 0 - 0 - 0 - 0 - 0
2033900 1657715 0 2 0 0 0 WAGNER HAPPY PARTASUPENA
0001468573288 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138225
1#0##0#0#0.0#2018-02-09 20:25:22#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 1 BS 1 18/01/2018 20/01/2018 30/01/1965 0 2
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1#0##0#0#0.0#2018-02-09 20:28:58#0#12:00:00#12:00:00#00:00:00 1
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3940956 0 0 0 0 2007811 0 0 0 0 0
3201126 B 3 BS 1 15/01/2018 20/01/2018 01/03/1958 0 1
1 A16.5;R77.0;R18;I13.0 90.59;88.76;87.49;89.52;34.91 - - None
None None None J-4-15-III None None None None None None PERADANGAN
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4 135280 1#0##0#0#0.0#2018-02-10
10:10:56#0#12:00:00#12:00:00#12:00:00 1 523ab6ba7e5aee4e292ec475ddf45ff5
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2492734 0 0 0 0 0
3201126 B 3 BS 1 17/01/2018 20/01/2018 25/06/1947 0 1
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1#0##0#0#0.0#2018-02-10 11:23:34#0#12:00:00#12:00:00#00:00:00 1
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7500000
3201126 B 3 BS 1 19/01/2018 20/01/2018 01/01/1968 0 2
1 K29.5;I10 45.16 - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 2319600
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11:32:02#0#12:00:00#12:00:00#00:00:00 1 e0c7519614efae057edb2527b9e07043
0 1541988 116000 0 0 1142660 0 0 0 0
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3201126 B 3 BS 1 17/01/2018 20/01/2018 19/08/1981 0 2
1 E87.2;I13.2 87.44 - - None None None None E-4-11-III None
None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (BERAT)
6293300 0 0 - 0 - 0 - 0 - 0
6293300 5879005 0 4 0 0 0 IIN SUPRIATIN
0002282454371 3;JKN DR RIZKI; 5.2.0.201712280730 4 137041
1#0##0#0#0.0#2018-02-10 11:36:17#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 17/01/2018 20/01/2018 06/06/1984 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 7494153 0 4 0 0 0 MAGFIROH D387869
33 12278 DR MAMAN H, SPOG 0138R01701180008313 0001718733756 3;JKN
DR RIZKI; 5.2.0.201712280730 4 138272 1#0##0#0#0.0#2018-02-10
13:25:29#0#12:00:00#12:00:00#12:00:00 1 8cc73e66846918ba067f5223dcbcf098
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1128272 0 0 0 69000 0
3201126 B 3 BS 1 19/01/2018 20/01/2018 15/10/1978 0 1
1 S52.5 78.63 - - None None None None M-1-40-I None None
None None None None EKSISI LOKAL DAN PENGANGKATAN ALAT FIKSASI INTERNAL
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0001265076549 3;JKN DR RIZKI; 5.2.0.201712280730 4 137650
1#0##0#0#0.0#2018-02-10 13:29:39#0#12:00:00#12:00:00#00:00:00 1
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1514510 0 0 0 0 979233 0 0 0 0
1250000
3201126 B 3 BS 1 19/01/2018 20/01/2018 24/07/2015 0 2
None None None None PROSEDUR PADA DARAH DAN ORGAN PEMBENTUK DARAH LAIN-
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SADIYA d350223* 2 910 DR CATUR S, SPB 0138R01701180009051
0001771692851 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138218
1#0##0#0#0.0#2018-03-02 21:32:58#0#12:00:00#12:00:00#12:00:00 1
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2038471 0 0 0 0 486314 0 0 0 194000
0
3201126 B 1 BS 1 17/01/2018 20/01/2018 30/11/1982 0 2
1 M54.57;K35.2;D25.9 - - - None None None None M-4-
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 6048940 0 4 0 0 0 NOVIANTI BONTE,S.SOS
0001908517037 3;JKN DR RIZKI; 5.2.0.201712280730 4 136206
1#0##0#0#0.0#2018-03-15 09:12:40#0#12:00:00#12:00:00#12:00:00 2
6fd1331ac89562f45e1d2d8cb891f1ba 0 0 569290 0 0
1933925 0 0 0 0 3545725 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 20/01/2018 24/07/2015 0 2
LAIN (RINGAN) 5164200 0 0 - 0 - 0 - 0 -
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SADIYA d350223* 2 910 DR CATUR S, SPB 0138R01701180014801
0001771692851 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138218
1#0##0#0#0.0#2018-03-19 10:30:41#0#12:00:00#12:00:00#12:00:00 2
5e2cbf30955aa5ffaec2a22a5b149b47 0 3271900 1445976 0 0
2038471 0 0 0 0 486314 0 0 0 194000
0
3201126 B 2 BS 1 17/01/2018 20/01/2018 28/12/2009 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 11743040 0 4 0 0 0 HABIBIE AKMAL KUSUMA
D180741 8 2942 DR CATUR S, SPB 0138R01701180007879
0002257998838 3;JKN DR RIZKI; 5.2.1.201804062320 4 136720
1#0##0#0#0.0#2018-05-17 15:10:17#0#12:00:00#12:00:00#12:00:00 2
bca255c0bb4e5f59106785d95591e522 0 5763300 1897276 0 0
3189228 0 0 0 0 824236 0 0 0 0 69000
3201126 B 3 BS 1 17/01/2018 20/01/2018 23/11/1941 0 2
1 I64;E14.9;G81.9 93.19;87.03 - - None None None None G-4-
15-II None None None None None None KECEDERAAN PEMBULUH DARAH OTAK NON
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SPS 0138R01701180007859 0001210958785 3;JKN DR RIZKI; 5.2.2.201806040537
4 136646 1#0##0#0#0.0#2018-08-13
11:04:10#0#12:00:00#12:00:00#12:00:00 2 b826c436e5b595aaddff2cf1db67228a
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1489798 0 0 0 0 0
3201126 B 1 BS 1 18/01/2018 21/01/2018 01/04/2016 0 1
1 A49.9;G40.9 - - - None None None None A-4-14-II None
(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 2507756 0 4 0 0 0 ARSYAD ALFAHREZA
D379105 1 657 DR RASTRA, SPA 0138R01701180008645
0002070428275 3;JKN DR RIZKI; 5.2.0.201712280730 4 143604
1#0##0#0#0.0#2018-02-02 09:49:09#1#12:00:00#12:00:00#12:00:00 1
2a19a5dc345c224d3357ff1851af12bc 0 0 233280 0 0 779177
0 0 0 0 1495299 0 0 0 0 0
3201126 B 2 BS 1 20/01/2018 21/01/2018 05/11/1957 0 1
- 0 10690500 12172229 0 2 0 0 0 DRS. UTUH
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5.2.0.201712280730 4 138440 1#0##0#0#0.0#2018-02-03
11:33:40#0#12:00:00#12:00:00#12:00:00 1 d47e0df43ef8a2b459460279a5f48b05
0 4980100 3153245 0 0 3166570 0 0 0 0
872314 0 0 0 0 0
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BAMBANG DWIPUTRA SPJP 0138R01701180009156 0001376204951 3;JKN TANTIYO
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11:47:03#0#12:00:00#12:00:00#12:00:00 1 4fa623737e08f8073412b7a3d71676c0
0 3530000 2930600 0 0 4143430 0 0 0 0
951162 0 0 0 2128000 0
3201126 B 2 BS 1 19/01/2018 21/01/2018 27/12/2014 0 1
None None None None PROSEDUR PADA SKROTUM DAN PROSTAT NON KOMPLEK
(RINGAN) 5575500 0 0 - 0 - 0 - 0 - 0
5575500 8934158 0 3 0 0 0 MUAZAM KHALIL HAEDAR
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1#0##0#0#0.0#2018-02-03 11:54:36#0#12:00:00#12:00:00#12:00:00 1
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1684280 0 0 0 0 610478 0 0 0 145000
0
3201126 B 2 BS 1 17/01/2018 21/01/2018 01/01/1950 0 2
1 I51.7;I45.1;J18.0 - - - None None None None I-4-24-III
(BERAT) 9767800 0 0 - 0 - 0 - 0 - 0
9767800 10673981 0 5 0 0 0 SALBIYAH, HJ
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1#0##0#0#0.0#2018-02-05 07:37:25#0#07:32:48#07:32:48#12:00:00 1
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2744796 0 0 0 0 4353298 0 0 0 2546000
0
3201126 B 2 BS 1 19/01/2018 21/01/2018 09/04/1944 0 2
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2783600 0 0 - 0 - 0 - 0 - 0
2783600 3758846 0 3 0 0 0 HASNA ESSA d357084
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138216
1#0##0#0#0.0#2018-02-05 14:25:41#0#12:00:00#12:00:00#00:00:00 1
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2173416 0 0 0 0 1281906 0 0 0 0 0
3201126 B 2 BS 1 17/01/2018 21/01/2018 11/05/1972 0 1
1 I50.9;I34.0 - - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 4290800 3944527
0 5 0 0 0 USEP SAPUTRA D379335 45 16687 DR
AGOES KOOSHARTORO SPPD 0138R01701180008146 0001472682374 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 137096 1#0##0#0#0.0#2018-02-05
14:27:33#0#12:00:00#12:00:00#12:00:00 1 c5fbed06cb0230e32887d98a6e7c6f85
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2809053 0 0 0 0 0
3201126 B 2 BS 1 19/01/2018 21/01/2018 30/03/2001 0 2
1 J32.0;J01.2 22.9;22.11 - - None None None None U-1-12-I
None None None None None None PROSEDUR MASTOID DAN SINUS (RINGAN)
7892000 0 0 - 0 - 0 - 0 - 0
7892000 21766489 0 3 0 0 0 SEKAR GHEARAKSA NASUTION
D382658 16 6139 DR RISMAN S, SPTHT 0138R01701180008763
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1#1#vvip#3#13874489#0.0#2018-02-05 14:34:05#0#12:00:00#12:00:00#12:00:00
1 a636d71d7ceb1c7b2482b6fd9529da64 0 12368800 5011577 0
0 2913112 0 0 0 0 1473000 0 0 0 0
0
3201126 B 1 BS 1 20/01/2018 21/01/2018 06/06/1952 0 1
0 0 - 0 - 0 - 0 - 0 17095200
26752082 0 2 0 0 0 SOEMIRAN D368075 65 23969
TANTIYO S;16137 5.2.0.201712280730 4 138263 1#0##0#0#0.0#2018-
02-06 13:48:37#0#12:00:00#12:00:00#00:00:00 1
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3824042 0 0 0 0 1256000 0 0 0 7500000
0
3201126 B 1 BS 1 20/01/2018 21/01/2018 12/01/2018 0 1
0 - 0 - 0 - 0 - 0 5886000 2453944
0 2 0 0 0 BAYI NY ISNAENI UJI RAHAYU D388104 0
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TANTIYO S;16137 5.2.0.201712280730 4 138396 1#0##0#0#0.0#2018-
02-06 13:53:05#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1540538 0 0 0 170000 0
3201126 B 3 BS 1 19/01/2018 21/01/2018 01/08/1988 0 2
0 0 - 0 - 0 - 0 - 0 4986800
7626014 0 3 0 0 0 LIA FARASANIA D388020 29
10763 DR BAGUS T, SPOG 0138R01701180009368 0002142632068 3;JKN DR
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14:48:23#0#12:00:00#12:00:00#12:00:00 1 89a0736e8dfb4a44ed39c3079e769f9e
0 4393804 365340 0 0 1888972 0 0 0 0
780898 0 0 0 197000 0
3201126 B 1 BS 1 19/01/2018 21/01/2018 19/12/1983 0 2
1 A15.3;R04.2 - - - None None None None J-4-15-I None
None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (RINGAN)
6071100 0 0 - 0 - 0 - 0 - 0
6071100 5950514 0 3 0 0 0 HERA WATI D387968
34 12450 DR MOHAMAD NIZAM ERHAMZA SPP 0138R01701180008949
0001456658019 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137810
1#1#vvip#3#0#0.0#2018-02-06 16:31:14#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 4240286 0 0 0 0 0
3201126 B 1 BS 1 19/01/2018 21/01/2018 21/02/1959 0 2
1 E11.2;I12.0;D63.8 99.04;39.27 - - None None None None N-1-
- 0 12472300 14643766 0 3 0 0 0 ROSIYATI
0000044937145 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137940
1#0##0#0#0.0#2018-02-06 16:34:40#0#12:00:00#12:00:00#12:00:00 1
7382106ba551a97417c3320c0def8290 0 7159200 3669967 0 0
0 0 0 0 0 1083003 0 0 0 2731596 0
3201126 B 1 BS 1 19/01/2018 21/01/2018 26/08/1963 0 2
1 I13.1;E14.2;D63.8;I15.1 39.27;99.04 - - None None None None
- 0 - 0 12472300 14009523 0 3 0 0 0
NURAINI D388012 54 19870 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180009054 0000036232839 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138219 1#0##0#0#0.0#2018-02-07
07:38:08#0#12:00:00#12:00:00#12:00:00 1 94342fa7ac4490aa9e3910156055f53d
0 6468200 3669967 0 0 2829845 0 0 0 0
1041511 0 0 0 0 0
3201126 B 1 BS 1 20/01/2018 21/01/2018 18/03/1949 0 2
- 0 58821400 63731433 0 2 0 0 0 SUSMIYATI,
SH. D383728 68 25145 DR AGOES KOOSHARTORO SPPD-KKV 0138R01701180009378
0000060894033 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138241
1#0##0#0#0.0#2018-02-07 08:32:22#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 0 1256000 0 0 35225313 7569000
0
3201126 B 3 BS 1 18/01/2018 21/01/2018 15/07/1974 0 1
- 0 8908800 10862885 0 4 0 0 0 CEK NUNG
0001404621314 3;JKN DR RIZKI; 5.2.0.201712280730 4 145777
1#0##0#0#0.0#2018-02-07 10:12:19#0#12:00:00#12:00:00#12:00:00 2
7c501aee02f0fd9b028f3291b1870381 0 4498260 854792 0 0
4362677 0 0 0 0 1112656 0 0 0 34500 0
3201126 B 1 BS 1 20/01/2018 21/01/2018 06/06/1942 0 1
4 I21.9;K30;M54.59;I46.9 99.60 - - None None None None I-4-
14562700 0 0 - 0 - 0 - 0 - 0
14562700 3797883 0 2 0 0 0 RASIA BIN DJAJADI
0000044944762 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138450
1#0##0#0#0.0#2018-02-08 08:39:53#0#12:00:00#12:00:00#12:00:00 3
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2017872 0 0 0 0 1490960 0 0 0 0 0
3201126 B 1 BS 1 19/01/2018 21/01/2018 14/09/1958 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 60199585 0 3 0 0 0 SUPONO
0000048122289 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138214
1#0##0#0#0.0#2018-02-08 11:32:53#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 0 1256000 0 0 29548305 7569000
0
3201126 B 3 BS 1 20/01/2018 21/01/2018 13/06/1971 0 1
1 I20.9;K21.0 89.52 - - None None None None I-4-20-I None
4202600 0 0 - 0 - 0 - 0 - 0
4202600 888299 0 2 0 0 0 IWAN SETIAWAN
D388162 46 17023 DR WIDHI DEWANTA K AJI 0138R01701180009520
0001336241092 3;JKN DR RIZKI; 5.2.0.201712280730 4 138461
1#0##0#0#0.0#2018-02-08 11:37:13#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 347113 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 21/01/2018 04/06/1968 0 2
1 N18.5;D63.8;J90;J18.0 99.04;39.27 - - None None None None
- 0 - 0 19332400 12993091 0 3 0 0 0
TRI BUDI PERMANASARI D384969 49 18126 DR SRI KUNMARTINI, SPPD
0138R01701180009111 0001396519661 3;JKN DR RIZKI; 5.2.0.201712280730
4 138238 1#0##0#0#0.0#2018-02-08
15:53:11#0#12:00:00#12:00:00#12:00:00 1 d29f390f93853ff8b898299be746831b
0 6959280 1792916 0 0 2954381 0 0 0 0
1252014 0 0 0 34500 0
3201126 B 3 BS 1 17/01/2018 21/01/2018 08/10/1983 0 2
1 A91;K29.7 87.44 - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3824951 0 5 0 0 0 SUNNENA d387590
3;JKN DR RIZKI; 5.2.0.201712280730 4 137079 1#0##0#0#0.0#2018-
02-08 15:59:04#0#12:00:00#12:00:00#12:00:00 1
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1861474 0 0 0 0 1504730 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 21/01/2018 06/02/1959 0 2
1 I20.9;I08.9;I25.0;I50.0 88.55;36.07;89.52 - - YY02 None None
0 - 0 - 0 36446400 47876695 0 3 0 0
0 WARTI D379236 58 21532 DR BAMBANG DWIPUTRA SPJP
0138R01701180009162 0001740085424 3;JKN DR RIZKI; 5.2.0.201712280730
4 138221 1#0##0#0#0.0#2018-02-08
16:05:54#0#12:00:00#12:00:00#12:00:00 1 5f9eee340b827b0ca30c9af5b5308986
0 14520800 0 0 0 24167395 0 0 0 0
1688500 0 0 0 0 7500000
3201126 B 3 BS 1 19/01/2018 21/01/2018 28/02/1970 0 2
1 H81.1;K30 - - - None None None None U-4-11-I None
- 0 - 0 - 0 - 0 1517500 1734442 0
3 0 0 0 DEWI KOMARAENI D387501 47 17492 DR NURUL
5.2.0.201712280730 4 138217 1#0##0#0#0.0#2018-02-08
16:07:51#0#12:00:00#12:00:00#12:00:00 1 01e4a49ac12b53a5301300003e921fcc
0 0 189574 0 0 879400 0 0 0 0 665468
0 0 0 0 0
3201126 B 1 BS 1 19/01/2018 21/01/2018 18/12/2010 0 2
1 J35.2;J01.8 28.3 - - None None None None U-1-15-I None
0 0 - 0 - 0 - 0 - 0 5461000
10778375 0 3 0 0 0 ANASTASYA ALEMINA SUENITA
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0001428461717 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138220
1#0##0#0#0.0#2018-02-09 20:06:27#0#12:00:00#12:00:00#00:00:00 1
7b4e25fadd353cb74ee83ce37f0c6da3 0 5763800 1529080 0 0
0 0 0 0 0 906127 0 0 0 2579368 0
3201126 B 1 BS 1 18/01/2018 21/01/2018 07/07/1991 0 2
1 O82.9;O14.1 74.0 - - None None None None O-6-10-II None
None None None None None OPERASI PEMBEDAHAN CAESAR (SEDANG) 7567300
0 0 - 0 - 0 - 0 - 0 7567300
14330781 0 4 0 0 0 TUTI WIDANARTI D387942 26
9692 DR ARI K, SPOG 0138R01701180008717 0000082561476 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 137638 1#0##0#0#0.0#2018-
02-09 20:19:13#0#12:00:00#12:00:00#12:00:00 1
29b4fe6e66a9caf1dd730585844f9aee 0 7098900 2625882 0 0
623000 0 0 0 0 978528 0 0 0 3004471
0
3201126 B 1 BS 1 19/01/2018 21/01/2018 29/09/1969 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5593732 0 3 0 0 0 YAYAH RODIYAH,S.PD
D339053 48 17644 DR ARU 0138R01701180009292 0001273353625
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138226
1#0##0#0#0.0#2018-02-09 20:22:31#0#12:00:00#12:00:00#00:00:00 1
0aac2cf811648046a1c833ad6928a404 0 0 573641 0 0
1909896 0 0 0 0 1927945 0 0 0 1182250
0
3201126 B 3 BS 1 15/01/2018 21/01/2018 10/05/1962 0 1
1 I21.3;A41.9;I13.2;I69.4 39.95 - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 17384913 0 7 1 4 0 SUGANDI D374149
3;JKN DR RIZKI; 5.2.0.201712280730 4 135534 1#0##0#0#0.0#2018-
02-10 10:40:14#0#12:00:00#12:00:00#12:00:00 1
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8012123 0 0 0 0 6540581 0 0 0 0
1635000
3201126 B 3 BS 1 17/01/2018 21/01/2018 28/04/2013 0 1
1 A49.9;R10.4 87.64;88.76 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 3580476 0 5 0 0 0 ADITYA RAKA
SETIAJI D387834 4 1725 DR AWIDIYA, SPA 0138R01701180008047
0002139240407 3;JKN DR RIZKI; 5.2.0.201712280730 4 137077
1#0##0#0#0.0#2018-02-10 11:28:42#0#12:00:00#12:00:00#12:00:00 2
7002117f3035e3c4041824dd0880e295 0 0 236752 0 0
1854987 0 0 0 0 1488737 0 0 0 0 0
3201126 B 2 BS 1 21/01/2018 21/01/2018 01/01/1974 0 2
1 D48.6 85.11 - - None None None None L-4-14-I None None
3532800 0 0 - 0 - 0 - 0 - 0
3532800 3778474 0 1 0 0 0 AGNES SARIE D386934
3;JKN DR RIZKI; 5.2.0.201712280730 4 139103 1#0##0#0#0.0#2018-
03-02 21:25:34#0#12:00:00#12:00:00#12:00:00 1
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1735724 0 0 0 0 1283190 0 0 0 0 0
3201126 B 1 BS 1 18/01/2018 21/01/2018 25/07/1954 0 1
1 I83.0;M79.66 38.50 - - None None None None I-1-17-I
(RINGAN) 19082700 0 0 - 0 - 0 - 0 - 0
19082700 20419122 0 4 0 0 0 SARINAH BR HUTAGALUNG
d387029 63 23188 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180008701 0001258398685 3;JKN DR RIZKI; 5.2.0.201712280730
4 137636 1#0##0#0#0.0#2018-03-13
16:27:44#0#12:00:00#12:00:00#12:00:00 2 c720e3731443361111cd237015e67120
0 9792600 6744152 0 0 0 0 0 0 0
1395000 0 0 0 2487370 0
3201126 B 2 BS 1 18/01/2018 21/01/2018 20/01/1966 0 2
1 E13.2;I45.1;A49.9;D63.8 39.95;89.52;90.59;99.04 - - None None
None None N-4-16-II None None None None None None PENYAKIT GINJAL
DAN SALURAN URIN LAIN-LAIN (SEDANG) 6330300 0 0 - 0 - 0
- 0 - 0 6330300 7256699 0 4 0 0 0
ROSMAWATI d376434 51 18991 DR SRI KUN, SPPD 0138R01701180008566
0001859073311 3;JKN DR RIZKI; 5.2.1.201804062320 4 137582
1#0##0#0#0.0#2018-05-17 15:00:11#0#12:00:00#12:00:00#12:00:00 2
1800ec1d2eed82dbeae4ff7a9c38099a 0 0 499265 0 0
3287947 0 0 0 0 2287237 0 0 0 1182250
0
3201126 B 3 BS 1 21/01/2018 21/01/2018 04/01/1969 0 1
1 A49.9;R07.4;C11.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 774262 0 1 0 0 0 SUROTO
D388187 49 17914 DR IRVAN VERYADI 0138R01701180009609
0001338739986 3;JKN DR RIZKI; 5.2.1.201804062320 4 139556
1#0##0#0#0.0#2018-05-17 15:44:54#0#12:00:00#12:00:00#12:00:00 3
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0 0 0 0 339653 0 0 0 0 0
3201126 B 2 BS 1 17/01/2018 22/01/2018 20/10/2011 0 1
None None None None None INFEKSI NON BAKTERI SISTEM SARAF ,TIDAK
TERMASUK MENINGITIS VIRUS (BERAT) 9841500 0 0 - 0 - 0
- 0 - 0 9841500 11286018 0 6 0 0 0
NAJMYAZKA D239167 6 2281 DR NOVIK BUDIWARDHANA, SPA
0138R01701180008172 0001202919928 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 137101 1#0##0#0#0.0#2018-02-03
10:05:42#0#12:00:00#12:00:00#00:00:00 1 d9d65dacdb864000bb0e3d52b8f43454
0 0 683567 0 0 5319113 0 0 0 0
4347338 0 0 0 936000 0
3201126 B 2 BS 1 20/01/2018 22/01/2018 25/08/1996 0 2
0 - 0 - 0 - 0 - 0 2009900 4713198
0 3 0 0 0 MARYANI D388127 21 7818 DR ATJANG S,
5.2.0.201712280730 4 138441 1#0##0#0#0.0#2018-02-03
11:49:17#0#12:00:00#12:00:00#12:00:00 1 e39d49196cef19b12ed87949db24f105
0 3042700 454980 0 0 738178 0 0 0 0
349340 0 0 0 128000 0
3201126 B 2 BS 1 21/01/2018 22/01/2018 27/09/1975 0 1
1 S22.40;J94.2 - - - None None None None J-4-13-III
None None None None None None TRAUMA DADA (BERAT) 12864100 0
0 - 0 - 0 - 0 - 0 12864100 2955238
0 2 0 0 0 MUNIR D370952 42 15457 DR SOEGIONO, SPPD
0138R01701180009564 0001133938798 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138470 1#0##0#0#0.0#2018-02-05
08:39:50#0#12:00:00#12:00:00#00:00:00 1 9372c7a8de4d2b6b6638d306a2e8a1a2
0 0 498815 0 0 1227090 0 0 0 0
1229333 0 0 0 0 0
3201126 B 2 BS 1 15/01/2018 22/01/2018 06/02/1951 0 1
1 S06.50;I69.4;J40;I45.1;I49.3 87.03 - - None None None None
G-4-24-III None None None None None None TRAUMA KEPALA (BERAT)
7600700 0 0 - 0 - 0 - 0 - 0
7600700 16451562 0 8 0 0 0 KASIYAN D325520
66 24450 DR AL RASYID SPS 0138R01701180006370 0001274975919 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 134919 1#0##0#0#0.0#2018-
02-05 08:47:09#0#12:00:00#12:00:00#00:00:00 1
c462400a757d8e13ef85076c9af15717 0 0 726937 0 0
7882355 0 0 0 0 6156270 0 0 0 1686000
0
3201126 B 2 BS 1 17/01/2018 22/01/2018 15/11/1997 0 2
1 E13.2;E87.6 - - - None None None None N-4-16-II None
(SEDANG) 6330300 0 0 - 0 - 0 - 0 - 0
6330300 6713602 0 6 0 0 0 RACHMATIKA ANGGRAINI
0002033732709 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137022
1#0##0#0#0.0#2018-02-05 14:21:37#0#12:00:00#12:00:00#12:00:00 1
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3108123 0 0 0 0 3287708 0 0 0 0 0
3201126 B 1 BS 1 19/01/2018 22/01/2018 15/04/1991 0 2
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0 4 0 0 0 ANGGUN FITRY AFNI d373046 26 9776 DR
NINING H, SPOG 0138R01701180009061 0001626748604 3;JKN TANTIYO S;16137
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13:44:56#0#12:00:00#12:00:00#12:00:00 1 7613b70f1096a04b5e515aaa578ea0b9
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1321000 0 0 0 197000 0
3201126 B 1 BS 1 18/01/2018 22/01/2018 29/08/1944 0 2
1 I63.9;H81.4;J18.0;E87.1 - - - None None None None G-4-
- 0 12141100 7081957 0 5 0 0 0 NIBRAS
d387868 73 26805 DR HARDI PRANATA SPS 0138R01701180008183
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1#0##0#0#0.0#2018-02-06 15:20:03#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 20/01/2018 22/01/2018 22/06/1942 0 2
1 S42.2 79.01;93.53 - - None None None None M-4-12-I None
(RINGAN) 4126300 0 0 - 0 - 0 - 0 - 0
4126300 11366497 0 3 0 0 0 NAZLIDAR D388059
75 27606 DR BENNY H T, SPOT 0138R01701180009332 0000045638649
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138232
1#0##0#0#0.0#2018-02-06 15:40:56#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 17/01/2018 22/01/2018 03/01/1937 0 2
1 G40.9;I64 - - - None None None None G-4-22-III None
- 0 - 0 - 0 - 0 5551000 7463366 0
6 0 0 0 DEWIYAH D300363 81 29599 DR HARDI PRANATA
SPS 0138R01701180008155 0000061005971 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 137098 1#0##0#0#0.0#2018-02-07
13:24:19#0#12:00:00#12:00:00#00:00:00 1 864a01b319ae7365a912017fbaf1477a
0 0 480563 0 0 2563545 0 0 0 0
4419258 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 22/01/2018 27/03/1946 0 1
4 I21.9;N18.5;R07.4 - - - None None None None I-4-10-I
None None None None None None INFARK MYOKARD AKUT (RINGAN) 5660200
0 0 - 0 - 0 - 0 - 0 5660200
2483230 0 1 0 0 0 SUBEKTI D385042 71 26234
TANTIYO S;16137 5.2.0.201712280730 4 138804 1#0##0#0#0.0#2018-
02-07 19:39:31#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 969454 0 0 0 0 0
3201126 B 1 BS 1 20/01/2018 22/01/2018 23/11/1952 0 2
- 0 58821400 68944010 0 3 0 0 0 SUMIYARTI YS
0000039652165 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138462
1#0##0#0#0.0#2018-02-08 11:11:59#0#12:00:00#12:00:00#12:00:00 1
de90da83a99cebb1299690fab17c9dd4 0 10062000 9672120 0 0
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0
3201126 B 1 BS 1 20/01/2018 22/01/2018 15/05/1952 0 1
- 0 58821400 57724152 0 3 0 0 0 R.GUNTUR
SELAMAT SARAGI D372282 65 23991 DR AZRI NURIZAL SPPD KKV
0138R01701180009516 0001274523669 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138458 1#0##0#0#0.0#2018-02-08
11:28:32#0#12:00:00#12:00:00#12:00:00 1 6dad085cecf6c5797f2f32c0e96fafbf
0 10062000 9619120 0 0 0 0 0 0 0
1256000 0 0 28962032 7825000 0
3201126 B 3 BS 1 21/01/2018 22/01/2018 02/03/1964 0 1
1 N18.5;D63.8;B17.1;I50.0 99.04;39.95 - - None None None None
- 0 4132100 4471815 0 2 0 0 0 ROMLI
0001743644902 3;JKN DR RIZKI; 5.2.0.201712280730 4 138482
1#0##0#0#0.0#2018-02-08 13:50:31#0#12:00:00#12:00:00#00:00:00 1
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2132627 0 0 0 0 1914299 0 0 0 0 0
3201126 B 3 BS 1 20/01/2018 22/01/2018 06/11/1963 0 1
1 N18.5;D63.8;I25.0 99.04;39.42;87.44 - - None None None None
- 0 - 0 8908800 9546701 0 3 0 0 0
K A S D I D377733 54 19799 DR SRI KUN, SPPD 0138R01701180009488
0001439445194 3;JKN DR RIZKI; 5.2.0.201712280730 4 138451
1#0##0#0#0.0#2018-02-08 14:38:31#0#12:00:00#12:00:00#12:00:00 1
dadc51c4cd4369d671eabba481fd4f84 0 4874560 854792 0 0
2691798 0 0 0 0 1056551 0 0 0 69000 0
3201126 B 3 BS 1 20/01/2018 22/01/2018 31/12/1942 0 1
1 N18.5;D63.8;I50.0;I25.0 39.27;99.04 - - None None None None
- 0 - 0 8908800 2500000 0 3 0 0 0
ROSID d387134 75 27414 DR SRI KUN, SPPD 0138R01701180009471
0001482063478 3;JKN DR RIZKI; 5.2.0.201712280730 4 138690
1#0##0#0#0.0#2018-02-08 14:42:30#0#10:22:54#10:22:54#12:00:00 2
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0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 22/01/2018 17/04/1962 0 2
1 J18.0;A19.9;E87.1;E13.8;K29.7 87.44;88.76;89.52;99.17 - - None
None None None J-4-16-III None None None None None None SIMPLE
PNEUMONIA & WHOOPING COUGH (BERAT) 6419700 0 0 - 0 - 0
- 0 - 0 6419700 1000000 0 4 0 0 0
RINA MARNAH D387957 55 20366 DR SRI KUN, SPPD 0138R01701180008735
0001338087249 3;JKN DR RIZKI; 5.2.0.201712280730 4 137645
1#0##0#0#0.0#2018-02-08 14:47:38#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 17/01/2018 22/01/2018 19/08/1964 0 1
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6 0 0 0 HARTOYO D360544 53 19509 DR AGOES
KOOSHARTORO SPPD-KKV 0138R01701180008083 0002209835902 3;JKN DR RIZKI;
5.2.0.201712280730 4 137087 1#0##0#0#0.0#2018-02-08
14:54:27#0#12:00:00#12:00:00#00:00:00 1 25d24032081c102c31e2488b0d66709f
0 0 374803 0 0 199732 0 0 0 0
1663943 0 0 0 0 0
3201126 B 3 BS 1 13/01/2018 22/01/2018 28/10/1993 0 2
1 J18.0;J90;B17.8 34.91 - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 13611377 0 10 0 0 0 HARTATIK PUTRI ISLAMIA
0000511414828 3;JKN DR RIZKI; 5.2.0.201712280730 4 134866
1#0##0#0#0.0#2018-02-08 15:47:02#0#12:00:00#12:00:00#12:00:00 1
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6821313 0 0 0 0 3459964 0 0 0 0 0
3201126 B 1 BS 1 20/01/2018 22/01/2018 05/08/2017 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 4857134 0 3 0 0 0 MUHAMMAD GHIFARI
0002274693276 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138234
1#0##0#0#0.0#2018-02-09 20:08:47#0#12:00:00#12:00:00#12:00:00 2
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1662113 0 0 0 0 2686756 0 0 0 0 0
3201126 B 2 BS 1 21/01/2018 22/01/2018 02/07/1957 0 2
1 I13.2;D63.8 99.04 - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 4973600 4713964
0 2 0 0 0 MUHAYATI NY D331924 60 22118 DR SRI
KUNMARTINI, SPPD 0138R01701180009553 0001293884651 3;JKN DR RIZKI;
5.2.0.201712280730 4 138468 1#0##0#0#0.0#2018-03-02
21:28:34#0#12:00:00#12:00:00#00:00:00 1 961ff73dd119672e9836235e1bef431d
0 0 709388 0 0 1503936 0 0 0 0
1344390 0 0 0 0 1156250
3201126 B 3 BS 1 21/01/2018 22/01/2018 18/08/1945 0 1
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2832986 0 2 0 0 0 S MIHARDJA D321000
72 26454 DR IRVAN VERYADI 0138R01701180009595 0000060968935 3;JKN
DR RIZKI; 5.2.1.201804062320 4 139237 1#0##0#0#0.0#2018-05-17
15:47:46#0#12:00:00#12:00:00#12:00:00 2 9939162ffb3bfa50b28b085bc18f582b
0 0 1036171 0 0 1322479 0 0 0 0 474336
0 0 0 0 0
3201126 B 3 BS 1 21/01/2018 22/01/2018 22/02/1959 0 1
1 I10;E16.2 - - - None None None None I-4-17-I None
None None None None None HIPERTENSI (RINGAN) 1906700 0 0
- 0 - 0 - 0 - 0 1906700 1409585 0
2 0 0 0 ZULKIFLI ZAKARIA d388200 58 21518 DR ADRIAN
HANDARU 0138R01701180009654 0001743641223 3;JKN DR RIZKI;
5.2.2.201806040537 4 138488 1#0##0#0#0.0#2018-08-14
11:50:44#0#12:00:00#12:00:00#12:00:00 3 e81571eff9c5af84943d0597d2fbe8b6
0 0 171603 0 0 856766 0 0 0 0 381216
0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 22/01/2018 15/06/1936 0 2
1 I61.5;R40.2 57.94;96.07;87.03;96.05 - - None None None None
G-4-13-I None None None None None None PERDARAHAN INTRA KRANIAL
BUKAN TRAUMATIK (RINGAN) 2955200 0 0 - 0 - 0 -
0 - 0 2955200 6291747 0 1 0 0 0
SOPIYAH D388242 81 29806 DR MUHAMMAD RIZKI YUWANA
0138R01701180009919 0001739928374 3;JKN DR RIZKI; 5.2.2.201806040537
4 138679 1#0##0#0#0.0#2018-09-04
11:48:49#0#09:17:00#16:00:00#12:00:00 4 d7cdc2846773a9426b4da732c3fac5a5
0 0 1549245 0 0 3300892 0 0 0 0 700610
0 0 0 290000 451000
3201126 B 1 BS 1 20/01/2018 22/01/2018 20/01/2018 3260 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2971410 0 3 0 0 0 BY NY ANGGUN FITRY AFNI
D388096 0 0 DR AWIDIYA, SPA 0138R01701180014791
0002286982326 3;JKN irene; 5.2.2.201806040537 4 202575
1#0##0#0#0.0#2018-09-10 15:21:47#0#00:00:00#00:00:00#12:00:00 2
0fb0bad84152a585433fe015d5345eba 0 0 499620 0 0 88899
0 0 0 0 2382891 0 0 0 0 0
3201126 B 3 BS 1 21/01/2018 22/01/2018 18/08/1945 0 1
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2832986 0 2 0 0 0 S MIHARDJA D321000
72 26454 DR IRVAN VERYADI 0138R0170118V000016 0000060968935 3;JKN
DR RIZKI; 5.2.2.201806040537 4 228589 1#0##0#0#0.0#2018-09-29
15:43:42#0#00:00:00#00:00:00#12:00:00 1 0b8e6b8d1f029f98e7636371bbb77d83
0 2832986 0 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 2 BS 1 20/01/2018 23/01/2018 19/01/2006 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3736193 0 4 0 0 0 MUHAMMADZAKIATHALLAH
0001192532321 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139143
1#0##0#0#0.0#2018-02-02 10:41:44#0#12:00:00#12:00:00#12:00:00 1
034841a0e7c23b86d96710547f5b0c03 0 0 278711 0 0
1167058 0 0 0 0 2290424 0 0 0 0 0
3201126 B 2 BS 1 21/01/2018 23/01/2018 10/12/1975 0 2
1 S61.0;S56.4 83.73 - - None None None None M-1-50-I None
0 0 - 0 - 0 - 0 - 0 6397900
9760725 0 3 0 0 0 TITIN SUHARTINAH D060192 42
15383 DR BENNY H T, SPOT 0138R01701180009644 0001459631204 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 138481 1#0##0#0#0.0#2018-
02-03 11:30:49#0#17:37:38#17:37:38#00:00:00 1
f5a0a9224578edf9a7b25a9372d0a5cc 0 5388000 1972370 0 0
1616803 0 0 0 0 714552 0 0 0 69000 0
3201126 B 2 BS 1 21/01/2018 23/01/2018 02/07/1966 0 2
- 0 10690500 11386240 0 3 0 0 0 HJ. MARYATI
D386881 51 18831 DR SRI KUN, SPPD 0138R01701180009596
0001259148328 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138473
1#0##0#0#0.0#2018-02-05 17:23:11#0#12:00:00#12:00:00#12:00:00 1
77e0a4c147b715d4a558ea80e432e3ae 0 5326100 3153245 0 0
2136001 0 0 0 0 770894 0 0 0 0 0
3201126 B 2 BS 1 22/01/2018 23/01/2018 25/07/1958 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4023965 0 2 0 0 0 ROKIB D348894
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138838
1#0##0#0#0.0#2018-02-05 17:42:04#0#12:00:00#12:00:00#00:00:00 1
1438c9639187d8311aa8e9c5dfc77bc8 0 0 499265 0 0
1069200 0 0 0 0 1273250 0 0 0 1182250
0
3201126 B 2 BS 1 21/01/2018 23/01/2018 12/11/1992 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 5841686 0 3 0 0 0 RISCA SAMITA
D388222 25 9201 DR RM DHENI DANARDHONO SPOG 0138R01701180009694
0001634315231 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138496
1#0##0#0#0.0#2018-02-07 09:01:21#0#12:00:00#12:00:00#12:00:00 1
1c4fe9ad634aa6d6befea33b62a96aba 0 0 1266996 0 0
1238024 0 0 0 0 3302166 0 0 0 34500 0
3201126 B 2 BS 1 21/01/2018 23/01/2018 14/04/1962 0 1
- 0 10690500 12386372 0 3 0 0 0 WAGIYO
D385922 55 20371 DR SRI KUN, SPPD 0138R01701180009622
0002062603258 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138477
1#0##0#0#0.0#2018-02-07 09:04:41#0#12:00:00#12:00:00#12:00:00 1
3b96ee4b5f059a6b6e42b5538b88a45f 0 5326100 3153245 0 0
2971704 0 0 0 0 935323 0 0 0 0 0
3201126 B 1 BS 1 20/01/2018 23/01/2018 23/03/1999 0 2
None None None None PROSEDUR APPENDIK (RINGAN) 5424200 0 0
- 0 - 0 - 0 - 0 5424200 15594767 0
4 0 0 0 ALOYSIA PRASKALIN JELITA PUTRI D388033 18
6878 DR ASRI DWI R, SPB 0138R01701180009331 0002324656168 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 138231 1#0##0#0#0.0#2018-
02-07 18:19:07#0#12:00:00#12:00:00#12:00:00 1
ca7b937b852558f405028e75d2ea6ae9 0 0 2045018 0 0
4603331 0 0 0 0 8946418 0 0 0 0 0
3201126 B 1 BS 1 17/01/2018 23/01/2018 29/06/1951 0 1
1 E11.5;J18.0;K40.9;I10 88.74;87.44 - - None None None None
0 - 0 10244500 11307626 0 7 0 0 0 GATOT
PRIYANTO d055057 66 24309 DR HENDRIEK S, SPB 0138R01701180008169
0000041797934 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137100
1#0##0#0#0.0#2018-02-07 18:31:43#0#12:00:00#12:00:00#12:00:00 2
9677df99fa5c78b5d5486905b0c30100 0 0 1177695 0 0
4652180 0 0 0 0 5477751 0 0 0 0 0
3201126 B 3 BS 1 20/01/2018 23/01/2018 01/09/2016 0 2
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2249151 0 4 0 0 0 AL MIRA SYABILLAH PUTRI
d388092 1 506 DR RASTRA, SPA 0138R01701180009406
0002071801552 3;JKN DR RIZKI; 5.2.0.201712280730 4 138339
1#0##0#0#0.0#2018-02-08 08:32:26#0#12:00:00#12:00:00#12:00:00 1
ce74e211204ad9400081574de5553430 0 0 183752 0 0 670258
0 0 0 0 1225141 0 0 0 0 170000
3201126 B 3 BS 1 18/01/2018 23/01/2018 13/07/2010 0 1
1 J81;A09.9;G40.9;E63.9;E87.8 93.94 - - None None None None
0 - 0 - 0 4508300 5070876 0 6 0 0
0 MUHAMMAD SYAMIL KHAAS D360172 7 2746 DR AWIDIYA, SPA
0138R01701180008615 0001807601376 3;JKN DR RIZKI; 5.2.0.201712280730
4 137606 1#0##0#0#0.0#2018-02-08
10:55:35#0#12:00:00#12:00:00#00:00:00 1 da5aa7663f99bad098d879d7108c4ed3
0 0 511746 0 0 2623390 0 0 0 0
1935740 0 0 0 0 0
3201126 B 1 BS 1 21/01/2018 23/01/2018 19/10/1963 0 1
- 0 12472300 19001304 0 3 0 0 0 SUPANDI
D383785 54 19818 DR SRI KUN, SPPD 0138R01701180009660
0000042400912 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138487
1#0##0#0#0.0#2018-02-08 11:08:09#0#19:16:04#19:16:04#12:00:00 1
78fa8f3379d1135ed5be4b815217451a 0 8785400 6382692 0 0
2508212 0 0 0 0 1256000 0 0 0 69000 0
3201126 B 3 BS 1 21/01/2018 23/01/2018 17/01/1969 0 1
1 N18.5;I48;D63.8 39.27;99.04 - - None None None None N-1-
- 0 8908800 10862468 0 3 0 0 0 SAUBIH
0001770795415 3;JKN DR RIZKI; 5.2.0.201712280730 4 138478
1#0##0#0#0.0#2018-02-08 11:13:19#0#15:16:04#15:16:04#12:00:00 1
ed20641e3f86add6c7172dfcaeba3643 0 4874560 854792 0 0
3508487 0 0 0 0 1555629 0 0 0 69000 0
3201126 B 3 BS 1 19/01/2018 23/01/2018 17/11/2000 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3737250 0 5 0 0 0 MUHAMMAD RIZQI
VRAMASATYA D387991 17 6272 DR KRISTON SILITONGA, SPA
0138R01701180009373 0002063971383 3;JKN DR RIZKI; 5.2.0.201712280730
4 138239 1#0##0#0#0.0#2018-02-08
11:14:59#0#12:00:00#12:00:00#12:00:00 1 be594488f4a0a4b05c4be06b2e970704
0 0 241100 0 0 1740657 0 0 0 0
1585493 0 0 0 0 170000
3201126 B 3 BS 1 22/01/2018 23/01/2018 01/12/1955 0 1
- 0 45079800 57253150 0 2 0 0 0 BAHARUDDIN
0001460127047 3;JKN DR RIZKI; 5.2.0.201712280730 4 138575
1#0##0#0#0.0#2018-02-08 11:44:58#0#12:00:00#12:00:00#12:00:00 1
69d1e7fc166c0f9bc5b764f0b7ddfef5 0 13146640 1374160 0 0
33561350 0 0 0 0 1602000 0 0 0 69000
7500000
3201126 B 3 BS 1 21/01/2018 23/01/2018 10/04/1964 0 1
1 E11.2;D63.8;I10 99.04 - - None None None None N-4-16-II
LAIN (SEDANG) 5275200 0 0 - 0 - 0 - 0 -
0 5275200 3390919 0 3 0 0 0 NGADINO
0001960672037 3;JKN DR RIZKI; 5.2.0.201712280730 4 139329
1#0##0#0#0.0#2018-02-08 12:17:24#0#12:00:00#12:00:00#00:00:00 1
d4acc8600a01d20d906a74dc3859f155 0 0 527768 0 0 756565
0 0 0 0 2106586 0 0 0 0 0
3201126 B 1 BS 1 20/01/2018 23/01/2018 13/01/2018 0 1
0 - 0 - 0 - 0 - 0 5886000 4314246
0 4 0 0 0 BAYI NY SEPTI WULANDARI D388117 0 7
DR KHARNINA, SPA 0138R01701180009449 0002419627825 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 138445 1#0##0#0#0.0#2018-02-08
16:08:05#0#12:00:00#12:00:00#12:00:00 1 26879bf9fa80ae90aa67abdab0e2b1fb
0 0 582740 0 0 205266 0 0 0 0
3016240 0 0 0 510000 0
3201126 B 1 BS 1 16/01/2018 23/01/2018 14/05/1951 0 1
1 E10.7;I11.0;E87.6;R63.0;J18.0 - - - None None None None
- 0 - 0 8768000 10383696 0 8 0 0 0
RUSLIYANTO d258016 66 24354 DR. ARU ARIADNO, SPPD
0138R01701180007416 0000060721356 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 136198 1#0##0#0#0.0#2018-02-08
21:18:45#0#12:00:00#12:00:00#00:00:00 1 844436b3cbe4a3f4843db81f0ebe6919
0 0 1078622 0 0 2697267 0 0 0 0
5928500 0 0 0 679307 0
3201126 B 1 BS 1 21/01/2018 23/01/2018 15/04/1963 0 1
1 E13.9;I10;A41.9 - - - None None None None E-4-10-III
0 - 0 8768000 5343647 0 3 0 0 0 YOYO
EFENDI D386278 54 20005 DR. ARU ARIADNO, SPPD 0138R01701180009581
0001303697968 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138472
1#0##0#0#0.0#2018-02-08 21:23:16#0#12:00:00#12:00:00#12:00:00 1
6d5f4e5b07b2db03029f54ee704e970f 0 0 551420 0 0
2073643 0 0 0 0 2718584 0 0 0 0 0
3201126 B 1 BS 1 18/01/2018 23/01/2018 06/10/1995 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 18947422 0 6 0 0 0 PUTRI OMEGA SOLA GRASIA
SYAUTA D030648 22 8140 DR HENDRIEK S, SPB 0138R01701180008722
0001866950291 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137643
1#0##0#0#0.0#2018-02-08 21:32:12#0#12:00:00#12:00:00#12:00:00 1
58d5c68e908b99c2ef57dc7892840311 0 8541200 3575850 0 0
5485372 0 0 0 0 1276000 0 0 0 69000 0
3201126 B 3 BS 1 21/01/2018 23/01/2018 17/01/1969 0 1
1 N18.5;I48;D63.8 39.27;99.04 - - None None None None N-1-
- 0 8908800 10862468 0 3 0 0 0 SAUBIH
0001770795415 3;JKN irene; 5.2.0.201712280730 4 138478
1#0##0#0#0.0#2018-02-19 10:09:20#0#15:16:04#15:16:04#12:00:00 2
650c89e845cd91c9e254fa3b07c04e62 0 4874560 854792 0 0
3508487 0 0 0 0 1555629 0 0 0 69000 0
3201126 B 3 BS 1 23/01/2018 23/01/2018 06/10/2017 0 1
2 J18.9;Q24.9 93.94 - - None None None None J-4-16-II None
5077500 0 0 - 0 - 0 - 0 - 0
5077500 2632259 0 1 0 0 0 BY NY YUNI TIKA RATU
JAYA D378253 0 109 DR ADITIA NATA KUSUMA 0138R01701180010576
0002294373958 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139513
1#0##0#0#0.0#2018-02-23 08:45:33#0#12:00:00#12:00:00#00:00:00 1
bd9db1c9cdfc973b6b448c5cd76ebeec 0 0 325188 0 0
1213867 0 0 0 0 505204 0 0 0 290000
298000
3201126 B 2 BS 1 21/01/2018 23/01/2018 12/02/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2233429 0 3 0 0 0 MUHAMMAD ZACKY AL
GHIFARIE D323626 1 709 DR OTTY MITHA S, SPA 0138R01701180009668
0002035902712 3;JKN DR RIZKI; 5.2.0.201712280730 4 138491
1#0##0#0#0.0#2018-03-09 09:06:25#0#12:00:00#12:00:00#00:00:00 2
ba78a990f0457506dcbcbd019c31513b 0 0 207620 0 0 546197
0 0 0 0 1479612 0 0 0 0 0
3201126 B 3 BS 1 20/01/2018 23/01/2018 28/12/1998 0 2
1 A18.8;R11 - - - None None None None A-4-14-I None
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2596513 0 4 0 0 0 DESSY HANA CLAUDIA
D348060 19 6963 DR ARU, SPPD 0138R01701180009323
0001740360936 3;JKN DR RIZKI; 5.2.1.201804062320 4 138230
1#0##0#0#0.0#2018-05-07 12:09:10#0#12:00:00#12:00:00#00:00:00 2
22957c898958b27467f32cb3a7399bb3 0 0 261764 0 0
1086884 0 0 0 0 1247865 0 0 0 0 0
3201126 B 2 BS 1 20/01/2018 23/01/2018 16/04/1995 0 1
1 L03.8;I84.1 90.59 - - None None None None L-4-12-I None
None None None None None PERADANGAN KULIT/CELLULITIS (RINGAN)
2103200 0 0 - 0 - 0 - 0 - 0
2103200 3941899 0 4 0 0 0 NOOR AKBAR CHOIRY
D385072 22 8315 DR HENDRIEK SP B 0138R01701180009962
0002083134385 3;JKN DR RIZKI; 5.2.1.201804062320 4 138790
1#0##0#0#0.0#2018-05-17 15:02:13#0#12:00:00#12:00:00#12:00:00 2
edf22a307131763c4394a5722153e1d7 0 0 451331 0 0
1186687 0 0 0 0 2303881 0 0 0 0 0
3201126 B 3 BS 1 20/01/2018 23/01/2018 01/09/1940 0 2
1 E83.9;M54.57 87.24 - - None None None None E-4-12-I
None None None None None None GANGGUAN METABOLIK BAWAAN (RINGAN)
3395100 0 0 - 0 - 0 - 0 - 0
3395100 4488756 0 4 0 0 0 AMSIAH NASIR
0000510920199 3;JKN DR RIZKI; 5.2.2.201806040537 4 138459
1#0##0#0#0.0#2018-08-13 11:58:07#0#12:00:00#12:00:00#12:00:00 2
dc357f1f56764b716956db2573f35a32 0 0 517202 0 0
2686397 0 0 0 0 1285157 0 0 0 0 0
3201126 B 3 BS 1 19/01/2018 23/01/2018 20/12/1955 0 2
1 J18.0;K29.7;E14.9 87.44 - - None None None None J-4-16-I
(RINGAN) 3613200 0 0 - 0 - 0 - 0 - 0
3613200 8304590 0 5 0 0 0 DJIMAH D388030
3;JKN DR RIZKI; 5.2.2.201806040537 4 138223 1#0##0#0#0.0#2018-
08-13 12:04:39#0#12:00:00#12:00:00#12:00:00 2
a2432c0233640914584a9ebd968554f6 0 0 509975 0 0
4009324 0 0 0 0 3785291 0 0 0 0 0
3201126 B 1 BS 1 21/01/2018 23/01/2018 31/01/1946 0 1
1 H81.1;R10.4;I10 - - - None None None None U-4-11-I
None None None None None None DYSEQUILIBRIUM (RINGAN) 2124500 0
0 - 0 - 0 - 0 - 0 2124500 4778260
0 3 0 0 0 SUMARNO D388173 71 26288 DR ARU, SPPD
0138R01701180009546 0001260802607 3;JKN DR RIZKI; 5.2.2.201806040537
4 138466 1#0##0#0#0.0#2018-08-14
11:24:01#0#12:00:00#12:00:00#12:00:00 2 d124454036ea9ad9afa777aa1a3f9707
0 0 244205 0 0 1852459 0 0 0 0
2681596 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 23/01/2018 16/04/1978 0 2
1 Z51.1;C50.9 99.25 - - None None None None C-4-13-I None
None None None None None KEMOTERAPI (RINGAN) 3103000 0 0
- 0 - 0 - 0 - 0 3103000 7082833 0
2 0 0 0 ERWIN SUSANTI D343767 39 14526 DR.
RAHMAWATI SP.B ONK 0138R01701180010105 0001648823321 3;JKN DR RIZKI;
5.2.2.201806040537 4 138978 1#0##0#0#0.0#2018-09-06
17:20:24#0#12:00:00#12:00:00#12:00:00 2 4b9eaf6f7174c7b2e82415174bfefbcf
0 0 1002360 0 0 4029110 0 0 0 0
2051363 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 23/01/2018 11/05/1962 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 1671469 0 2 0 0 0 TN. NISIN D366080
3;JKN irene; 5.2.0.201712280730 4 139101 1#0##0#0#0.0#2018-
09-10 15:24:17#0#12:00:00#12:00:00#00:00:00 4
32d02d4f330bb9df2236e3c1abeac5cd 0 0 424889 0 0 671732
0 0 0 0 574848 0 0 0 0 0
3201126 B 2 BS 1 21/01/2018 24/01/2018 16/04/1984 0 2
0 0 - 0 - 0 - 0 - 0 5984100
16759538 0 4 0 0 0 ZANARIA LASE D292335 33
12333 DR FERRI SABARUDDIN SPOG 0138R01701180009669 0001370200577
3;JKN DR RIZKI; 5.2.0.201712280730 4 138490 1#0##0#0#0.0#2018-
02-02 09:26:23#1#12:00:00#12:00:00#12:00:00 3
ac9eb9cd91f194d865d075502fadc6f1 0 0 6234851 0 0
3975585 0 0 0 0 6352102 0 0 0 197000
0
3201126 B 2 BS 1 23/01/2018 24/01/2018 05/10/1972 0 2
0 - 0 - 0 - 0 - 0 7842900 10896925
0 2 0 0 0 SRI ANGKAT D387292 45 16546 DR H TEDDY H
5.2.0.201712280730 4 139113 1#0##0#0#0.0#2018-02-03
09:41:13#0#12:00:00#12:00:00#12:00:00 1 43a1bbe40c1be2991f5c904576de3285
0 4439100 2259012 0 0 3204930 0 0 0 0
712883 0 0 0 281000 0
3201126 B 2 BS 1 23/01/2018 24/01/2018 05/01/1952 0 1
1 I13.1;A15.3;A49.9 39.27 - - None None None None N-1-12-II
- 0 10690500 8187640 0 2 0 0 0 A.
SOPIANSYAH D249613 66 24125 DR DEDY PRATAMA SPBV 0138R01701180010604
0001480417492 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139362
1#0##0#0#0.0#2018-02-03 10:59:56#0#12:00:00#12:00:00#00:00:00 1
2aa4e01c01e4ff03b822312e99572a70 0 4564100 2138100 0 0
949800 0 0 0 0 535640 0 0 0 0 0
3201126 B 2 BS 1 21/01/2018 24/01/2018 10/05/1999 0 2
1 J01.9;A01.0 90.59 - - None None None None U-4-13-III None
LARINGOTRAKEITIS (BERAT) 3350500 0 0 - 0 - 0 -
0 - 0 3350500 3665228 0 4 0 0 0 NOVIA
ARDHANA D388199 18 6831 DR ARU, SPPD 0138R01701180009651
0001179951366 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138483
1#0##0#0#0.0#2018-02-03 11:15:57#0#12:00:00#12:00:00#12:00:00 1
f70805592d08c96f6321407a0209eaba 0 0 298025 0 0 0
0 0 0 0 2078281 0 0 0 1288922 0
3201126 B 2 BS 1 23/01/2018 24/01/2018 02/06/1952 0 1
1 N35.9;N39.0;I10 58.31 - - None None None None N-1-40-II
None None None None None None PROSEDUR PADA URETRA DAN TRANSURETRA
(SEDANG) 13103400 0 0 - 0 - 0 - 0 - 0
13103400 15749195 0 2 0 0 0 T. FIRDAUS HUSEIN
0001257761068 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139111
1#0##0#0#0.0#2018-02-03 14:12:25#0#12:00:00#12:00:00#12:00:00 1
04e3ef1212f1994de1448fd02b5d3ff5 0 0 6772484 0 0
2865290 0 0 0 0 4911100 0 0 0 1200321
0
3201126 B 2 BS 1 20/01/2018 24/01/2018 20/08/1947 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 12676424 0 5 0 0 0 CORNELIS ABAST
0001326337367 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138297
1#0##0#0#0.0#2018-02-05 07:08:41#0#12:00:00#12:00:00#00:00:00 1
2b9d1dd5b4a166160921d807c0c312a1 0 5684100 2092010 0 0
3896015 0 0 0 0 829299 0 0 0 175000
0
3201126 B 2 BS 1 23/01/2018 24/01/2018 13/01/1990 0 2
1 O80.9;Z37.0;O75.9 72.71 - - None None None None O-6-13-I
None None None None None None PERSALINAN VAGINAL (RINGAN) 2009900
0 0 - 0 - 0 - 0 - 0 2009900
5150440 0 2 0 0 0 DITA INDAH PURNAMA D312203
28 10237 DR FERRY SPOG 0138R01701180010380 0001737378584 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 139110 1#0##0#0#0.0#2018-
02-05 07:43:16#0#12:00:00#12:00:00#12:00:00 1
9e4ec4c24266f736bb3fa50f4b95ff01 0 0 454980 0 0
1359815 0 0 0 0 2982645 0 0 0 353000
0
3201126 B 2 BS 1 23/01/2018 24/01/2018 23/01/2018 3254 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1170229 0 2 0 0 0 MUHAMMAD AL FATIH
D388430 0 0 DR A.D. PASARIBU SP.A 0138R01701180011786
0002423414913 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140232
1#0##0#0#0.0#2018-02-05 16:18:41#0#12:00:00#12:00:00#12:00:00 1
9eac36daf5414f2c6f09c9091273b0e7 0 0 433812 0 0 88360
0 0 0 0 648057 0 0 0 0 0
3201126 B 1 BS 1 15/01/2018 24/01/2018 06/07/1953 0 2
4 Q21.1;A41.9;N18.5 99.21 - - None None None None I-4-18-III
JANTUNG (BERAT) 11742700 0 0 - 0 - 0 - 0 -
0 11742700 37780476 0 10 0 0 0 LOLOM RUSYATI
0001337035037 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 135902
1#1#vvip#10#26037776#0.0#2018-02-06 08:38:54#0#12:00:00#12:00:00#12:00:00
1 3c67c3acbc8bd80b354fedd7adba1ecf 0 0 2848000 0 0
18450476 0 0 0 0 11783000 0 0 0 4699000
0
3201126 B 3 BS 1 24/01/2018 24/01/2018 23/07/1961 0 1
4 K81.8;R57.1 87.44;99.60 - - None None None None B-4-14-III
None None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (BERAT)
6563200 0 0 - 0 - 0 - 0 - 0
6563200 5699869 0 1 0 0 0 SUHARYANTO D380347
56 20639 DR NIKEN PRABHA DUHITA 0138R01701180010872 0000037693776
3;JKN DR RIZKI; 5.2.0.201712280730 4 139521 1#0##0#0#0.0#2018-
02-06 11:32:06#0#00:00:00#15:30:00#12:00:00 1
379806ce8bd296d5aa0c4c4893ec2ebe 0 0 791688 0 0
3810292 0 0 0 0 679889 0 0 0 418000
0
3201126 B 3 BS 1 24/01/2018 24/01/2018 12/03/1976 0 2
1 F31.6;K30 93.96 - - None None None None F-4-13-I None
None None None None None GANGGUAN BIPOLAR (RINGAN) 3161300 0
0 - 0 - 0 - 0 - 0 3161300 1480941
0 1 0 0 0 NURHAYATI D388474 41 15293 DR RICO
ADITYA 0138R01701180011312 0001619670532 3;JKN DR RIZKI;
5.2.0.201712280730 4 139795 1#0##0#0#0.0#2018-02-06
11:35:08#0#09:08:00#16:00:00#12:00:00 1 56cefc773584c8b660f402fd50ec42df
0 0 284517 0 0 502540 0 0 0 0 403884
0 0 0 290000 0
3201126 B 3 BS 1 24/01/2018 24/01/2018 21/12/1965 0 1
1 E87.1;I73.9;E87.5 - - - None None None None E-4-11-I
2954900 0 0 - 0 - 0 - 0 - 0
2954900 1598680 0 1 0 0 0 HENJANG NURCAHYA BAYU
EDI D288905 52 19027 DR NIKEN PRABHA DUHITA 0138R01701180010887
0000036731428 3;JKN DR RIZKI; 5.2.0.201712280730 4 139469
1#0##0#0#0.0#2018-02-06 11:38:21#0#02:45:00#14:30:00#12:00:00 1
13b7e2ad920ecf31e3e3e945e4a88658 0 0 548811 0 0 656282
0 0 0 0 393587 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 24/01/2018 01/10/1981 0 1
1 N23;R10.4;K56.1 88.76;88.19 - - None None None None N-4-
13-II None None None None None None BATU URIN (SEDANG) 4122000 0
0 - 0 - 0 - 0 - 0 4122000 1738050
0 2 0 0 0 DONNY FERONIKA OCTORANO D388449 36 13263
DR DICKY KARUNDENG 0138R01701180010837 0000036737684 3;JKN DR
RIZKI; 5.2.0.201712280730 4 139457 1#0##0#0#0.0#2018-02-06
12:35:09#0#18:50:00#01:30:00#12:00:00 1 ad27b69642633bcb99cdbe7b7df62c8b
0 0 208764 0 0 1126582 0 0 0 0 402704
0 0 0 0 0
3201126 B 1 BS 1 24/01/2018 24/01/2018 16/07/1975 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3381465 0 1 0 0 0 MILA BASUKI D270698
TANTIYO S;16137 5.2.0.201712280730 4 139464 1#0##0#0#0.0#2018-
02-06 14:21:54#0#12:00:00#12:00:00#00:00:00 1
cf7f0b5857c89e4b0825bc3e1f0fb45f 0 0 470546 0 0 726452
0 0 0 0 1002217 0 0 0 1182250 0
3201126 B 3 BS 1 22/01/2018 24/01/2018 30/03/2017 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 1594500 0 3 0 0 0 MUHAMMAD ABDURRASYID
NURSYAMSI D388225 0 298 DR RASTRA, SPA 0138R01701180009990
0002264483428 3;JKN DR RIZKI; 5.2.0.201712280730 4 138857
1#0##0#0#0.0#2018-02-07 10:14:07#0#12:00:00#12:00:00#12:00:00 1
b6e255c98fed59039c96f674b4f5edbe 0 0 207620 0 0 467567
0 0 0 0 919313 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 24/01/2018 14/05/2014 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1714526 0 3 0 0 0 DANNISH HANS ARYAGHOSSAN
0002269966206 3;JKN DR RIZKI; 5.2.0.201712280730 4 138903
1#0##0#0#0.0#2018-02-07 13:01:37#0#12:00:00#12:00:00#12:00:00 1
c59704b7357b19c3966c56cc7de68906 0 0 241100 0 0 546261
0 0 0 0 927165 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 24/01/2018 15/03/1976 0 1
1 A01.0;A91 - - - None None None None A-4-14-III None
(BERAT) 4626600 0 0 - 0 - 0 - 0 - 0
4626600 4167461 0 3 0 0 0 SRI HARIYONO ,ST
0001891971911 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138498
1#0##0#0#0.0#2018-02-07 18:00:33#0#12:00:00#12:00:00#12:00:00 1
98a7e644dc53de502d9198cca8e6d6a6 0 0 456317 0 0 468506
0 0 0 0 3242638 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 24/01/2018 31/05/1942 0 2
0 - 0 - 0 - 0 - 0 3247500 3498490
0 3 0 0 0 RASIDAH ANHAR D388224 75 27630 DR
SOEGIONO, SPPD 0138R01701180009908 0000044721167 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138645 1#0##0#0#0.0#2018-02-07
18:02:56#0#12:00:00#12:00:00#12:00:00 1 b49e9e256602b0ea5a8532cde3872a67
0 0 404072 0 0 496545 0 0 0 0
2597873 0 0 0 0 0
3201126 B 1 BS 1 17/01/2018 24/01/2018 02/08/1950 0 1
1 K56.7;A41.9;E11.6;K29.7;K86.8 88.01 - - None None None None
K-4-15-III None None None None None None OBSTRUKSI SALURAN
GASTROINTESTINAL (BERAT) 8015600 0 0 - 0 - 0 -
0 - 0 8015600 14540063 0 8 0 0 0 HERRY
ISKANDAR E d387848 67 24640 DR SURYA POHAN SPB 0138R01701180008168
0000041045005 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137099
1#0##0#0#0.0#2018-02-07 18:11:05#0#12:00:00#12:00:00#12:00:00 1
2dfbfc95102e5430361ee3cb5146c55c 0 0 1017480 0 0
7078364 0 0 0 0 6444219 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 24/01/2018 27/12/1947 0 1
1 K29.7;I10 - - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 3247500
3714498 0 3 0 0 0 PAIMAN D388227 70 25594
DR SOEGIONO, SPPD 0138R01701180009716 0000039929253 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 138501 1#0##0#0#0.0#2018-02-07
18:17:20#0#12:00:00#12:00:00#12:00:00 1 bf2196db6906b8dd3c49b1a404878c4b
0 0 405278 0 0 697215 0 0 0 0
2612005 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 24/01/2018 28/04/1958 0 2
- 0 12472300 15318312 0 2 0 0 0 ENDANG TRI
ANI c057351 59 21820 DR SRI KUN, SPPD 0138R01701180010452
0001229233882 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139267
1#0##0#0#0.0#2018-02-08 08:30:12#0#12:00:00#12:00:00#12:00:00 1
a20586b7845d6c4494b35cd5d546023e 0 6468200 3669967 0 0
4033012 0 0 0 0 1078133 0 0 0 69000 0
3201126 B 1 BS 1 20/01/2018 24/01/2018 23/04/1980 0 1
None None None None BATU URIN (RINGAN) 4784600 0 0 -
0 - 0 - 0 - 0 4784600 6392324 0 5
0 0 0 RONALD N D388134 37 13786 DR. ARU ARIADNO, SPPD
0138R01701180009513 0000133709545 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138455 1#0##0#0#0.0#2018-02-08
08:34:23#0#12:00:00#12:00:00#12:00:00 1 0e27bd83c11ef643555872778731cdc9
0 0 536614 0 0 2287521 0 0 0 0
3568189 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 24/01/2018 19/03/1988 0 2
1 K36 47.09 - - None None None None K-1-13-I None None
- 0 - 0 - 0 - 0 5424200 9928084 0
3 0 0 0 DWI RAHAYUNINGTYAS D386919 29 10901 DR
SURYA POHAN SPB 0138R01701180009865 0001381998543 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138561 1#0##0#0#0.0#2018-02-08
10:29:16#0#12:00:00#12:00:00#12:00:00 1 031259e02cbc969e04d8ad810383b7b8
0 6534000 1573018 0 0 1046565 0 0 0 0
774501 0 0 0 0 0
3201126 B 1 BS 1 19/01/2018 24/01/2018 08/01/1986 0 2
1 G41.9;R51 90.59;89.52 - - None None None None G-4-22-I
None None None None None None SERANGAN KEJANG (RINGAN) 3718200
0 0 - 0 - 0 - 0 - 0 3718200
10748546 0 6 1 1 0 NILA DWI PRATIWI D001098 32
11699 DR HARDI PRANATA SPS 0138R01701180008732 0001907525441 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 137644 1#0##0#0#0.0#2018-
02-08 11:03:24#0#12:00:00#12:00:00#12:00:00 1
729e3fc90705f0f4cbae0cdb37437239 0 0 440638 0 0
4892732 0 0 0 0 5415176 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 24/01/2018 23/11/1968 0 2
1 C18.9;D63.8 45.23;89.52;90.59;99.04 - - None None None None
K-4-10-II None None None None None None TUMOR PENCERNAAN (SEDANG)
9888000 0 0 - 0 - 0 - 0 - 0
9888000 9845249 0 2 0 0 0 DWI RACHMA S
D010792 49 17958 DR ZULFAN, SPPD 0138R01701180010454
0000060497774 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139118
1#0##0#0#0.0#2018-02-08 11:14:57#0#12:00:00#12:00:00#12:00:00 1
cbd9e9f09de133f9737936ca26d71713 0 2454500 2884640 0 0
2057027 0 0 0 0 700082 1749000 0 0 0
0
3201126 B 3 BS 1 20/01/2018 24/01/2018 07/03/1970 0 1
1 K80.0 88.76;89.52 - - None None None None B-4-14-I None
4199800 0 0 - 0 - 0 - 0 - 0
4199800 4178463 0 5 0 0 0 SUPRIYATNO D388159
DR RIZKI; 5.2.0.201712280730 4 138460 1#0##0#0#0.0#2018-02-08
11:18:38#0#12:00:00#12:00:00#12:00:00 1 1b1577fd9ba94fcae14f38e6dad81f6a
0 0 430982 0 0 2396124 0 0 0 0
1351357 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 24/01/2018 28/12/1956 0 2
1 N35.9;N39.0;I10 58.0 - - None None None None N-1-40-II
(SEDANG) 10919500 0 0 - 0 - 0 - 0 - 0
10919500 12463379 0 2 0 0 0 DJASRIL SYARIF
D384382 61 22306 DR SIDHI,SPU 0138R01701180010418
0001740153071 3;JKN DR RIZKI; 5.2.0.201712280730 4 139112
1#0##0#0#0.0#2018-02-08 12:04:04#0#12:00:00#12:00:00#12:00:00 1
27f421536208b8009e96caf429557a40 0 4569856 5063000 0 0
1499162 0 0 0 0 1262361 0 0 0 69000 0
3201126 B 3 BS 1 21/01/2018 24/01/2018 12/11/1983 0 2
- 0 - 0 - 0 - 0 2168300 2739163 0
4 0 0 0 SUKINI D388175 34 12489 DR ATJANG S, SPOG
0138R01701180009549 0000511080311 3;JKN DR RIZKI; 5.2.0.201712280730
4 138467 1#0##0#0#0.0#2018-02-08
12:07:45#0#12:00:00#12:00:00#12:00:00 1 aec938a0bce2f24c5f787fb874393e95
0 0 498147 0 0 965818 0 0 0 0
1275198 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 24/01/2018 07/01/1961 0 1
1 A19.9;R57.1 - - - None None None None A-4-14-III None
(BERAT) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 4702501 0 2 0 0 0 NISAN D383472 57
20835 DR DICKY KARUNDENG 0138R01701180010859 0001739584192 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 139462 1#0##0#0#0.0#2018-
02-22 16:58:00#0#12:00:00#12:00:00#12:00:00 1
f5d9e2469275ddaae6fd2eaa006e8d87 0 0 297423 0 0
3040438 0 0 0 0 776640 0 0 0 290000
298000
3201126 B 3 BS 1 24/01/2018 24/01/2018 05/05/1958 0 2
1 I20.0;K30 - - - None None None None I-4-20-I None
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1270996 0 1 0 0 0 TITIN D382216 59
21814 DR NIKEN PRABHA DUHITA 0138R01701180011115 0002294241941 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 139677 1#0##0#0#0.0#2018-
02-22 17:01:16#0#12:00:00#12:00:00#12:00:00 1
098fd05d89b678117341a79ea19de449 0 0 378234 0 0 520613
0 0 0 0 372149 0 0 0 0 0
3201126 B 2 BS 1 22/01/2018 24/01/2018 12/11/1968 0 2
- 0 51950600 73972885 0 3 0 0 0 SUMINI
0001283774264 3;JKN DR RIZKI; 5.2.0.201712280730 4 138507
1#0##0#0#0.0#2018-03-09 09:02:18#0#12:00:00#12:00:00#12:00:00 2
219e07990d46b5a9b392877404fef2bd 0 0 73972885 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 24/01/2018 19/09/1966 0 1
1 T82.4;N18.5 88.60;39.50 - - None None None None I-1-20-I
None None None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN
(RINGAN) 21509500 0 0 - 0 - 0 - 0 - 0
21509500 26387060 0 2 0 0 0 FIRDA ANAS D364622
51 18754 DEDY PRATAMA,SPBV 0138R01701180010745 0001443393674 3;JKN
DR RIZKI; 5.2.0.201712280730 4 139414 1#0##0#0#0.0#2018-03-13
16:38:37#0#12:00:00#12:00:00#00:00:00 2 9cdd854e01adeaf844502049dc1aea97
0 5896000 4301900 0 0 69000 0 0 0 0
1200000 0 0 13707910 1212250 0
3201126 B 1 BS 1 23/01/2018 24/01/2018 12/01/1967 0 2
1 I12.0;J81;J18.0;D63.8 38.95;99.04;87.44 - - None None None
0 - 0 - 0 27065300 19295371 0 2 0 0
0 JAINI D378822 51 18639 DR SRI KUNMARTINI, SPPD
0138R01701180010785 0002282122809 3;JKN DR RIZKI; 5.2.0.201712280730
4 139451 1#0##0#0#0.0#2018-03-13
16:45:51#0#12:00:00#12:00:00#12:00:00 2 bb5f7be32db62b9be2c215a854af3f37
0 5896000 7901937 0 0 69000 0 0 0 0
1276000 0 0 0 4152434 0
3201126 B 2 BS 1 20/01/2018 24/01/2018 27/06/1952 0 2
1 I98.3;D64.9;K74.6 99.04;45.16;88.72;42.33 - - None None None
None K-4-18-II None None None None None None GANGGUAN SISTEM
PENCERNAAN LAIN-LAIN (SEDANG) 2941900 0 0 - 0 - 0 -
0 - 0 2941900 19312326 0 5 0 0 0
HADIJAH D370693 65 23948 DR. ARU ARIADNO, SPPD
0138R01701180009475 0000060714281 3;JKN DR RIZKI; 5.2.0.201712280730
4 138449 1#0##0#0#0.0#2018-03-29
10:59:08#0#12:00:00#12:00:00#00:00:00 2 cbddc764391316c8aa7594e391f646a2
0 0 6674200 0 0 6990626 0 0 0 0
3911500 0 0 0 1736000 0
3201126 B 3 BS 1 21/01/2018 24/01/2018 23/06/1945 0 2
1 I50.0;R11 - - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 3575600 2829507
0 4 0 0 0 ARMAH D388207 72 26510 DR. ARU ARIADNO,
4 138492 1#0##0#0#0.0#2018-05-07
12:07:42#0#12:00:00#12:00:00#12:00:00 2 78f783b59151c8a6013e3426e95df014
0 0 261764 0 0 1391135 0 0 0 0
1176608 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 24/01/2018 17/01/2018 3000 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2505889 0 2 0 0 0 BAYI NY NOVITRIA
0002421026818 3;JKN DR RIZKI; 5.2.1.201804062320 4 139366
1#0##0#0#0.0#2018-05-17 15:18:07#0#12:00:00#12:00:00#12:00:00 2
3d749b5a84c53ee80615af7c1a716147 0 0 513620 0 0 278332
0 0 0 0 1543937 0 0 0 0 170000
3201126 B 1 BS 1 17/01/2018 24/01/2018 15/06/1942 0 1
4 E11.2;R57.0;R57.2;I50.0 89.52 - - None None None None N-4-
16-III None None None None None None PENYAKIT GINJAL DAN SALURAN URIN
LAIN-LAIN (BERAT) 10134400 0 0 - 0 - 0 - 0 -
0 10134400 28159881 0 8 1 8 0 NAWAI HERMANTO
0001468398609 3;JKN DR RIZKI; 5.2.1.201804062320 4 137629
1#0##0#0#0.0#2018-05-17 15:41:59#0#12:00:00#12:00:00#00:00:00 3
8302f7ed313af7502e0ef8c4b9987a70 0 0 1715543 0 0
11693338 0 0 0 0 7830000 0 0 0 0
6921000
3201126 B 3 BS 1 22/01/2018 24/01/2018 23/02/1989 0 2
0 0 - 0 - 0 - 0 - 0 1674900
4001682 0 3 0 0 0 DWI RETNOWATI D376502 28
10560 DR ERDIYAN, SPOG 0138R01701180010551 0001453786828 3;JKN DR
RIZKI; 5.2.2.201806040537 4 139288 1#0##0#0#0.0#2018-08-13
11:09:14#0#12:00:00#12:00:00#12:00:00 2 1419c204c6a543494fde63a32e78117b
1866100 0 356000 0 0 1000916 0 0 0 0
778666 0 0 0 0 0
3201126 B 2 BS 1 24/01/2018 24/01/2018 12/10/1950 0 2
2 E87.6;R00.1 89.52 - - None None None None E-4-11-II None
None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (SEDANG)
5405900 0 0 - 0 - 0 - 0 - 0
5405900 7290471 0 1 0 0 0 TITING WARTINI,NY
0000061047639 3;JKN DR RIZKI; 5.2.0.201712280730 4 139710
1#0##0#0#0.0#2018-09-06 17:09:37#0#12:00:00#12:00:00#12:00:00 2
ea79b9e6be24b9ebb07835091f82b3d4 0 0 748313 0 0
1904211 0 0 0 0 3121947 0 0 0 580000
936000
3201126 B 3 BS 1 23/01/2018 24/01/2018 26/05/1961 0 2
1 K21.0;K29.6;K76.0;I10;A01.0 90.59;45.16 - - None None None
None K-4-12-III None None None None None None GANGGUAN ESOFAGUS
(BERAT) 6781600 0 0 - 0 - 0 - 0 - 0
6781600 6381526 0 2 0 0 0 TUTI N. D387345
3;JKN DR RIZKI; 5.2.2.201806040537 4 139461 1#0##0#0#0.0#2018-
10-01 13:57:47#0#12:00:00#12:00:00#12:00:00 2
b031948aad11d1e3b6d0d356b0e38a3c 0 2791248 53000 0 0
1119788 0 0 0 0 702990 0 0 0 34500
1680000
3201126 B 2 BS 1 21/01/2018 25/01/2018 11/06/1979 0 2
1 E10.5 90.59;89.52;87.49 - - None None None None I-4-15-I
None None None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN LAIN-
LAIN (RINGAN) 5378800 0 0 - 0 - 0 - 0 -
0 5378800 7336161 0 5 0 0 0 UNIK NURAENI
D279288 38 14104 DR ARU, SPPD 0138R01701180009683
0001642127591 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138493
1#0##0#0#0.0#2018-02-02 10:38:33#0#12:00:00#12:00:00#12:00:00 1
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4028428 0 0 0 0 2823436 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 25/01/2018 28/07/1987 0 2
1 O21.1;O22.4 - - - None None None None W-4-16-II None
0 - 0 - 0 - 0 - 0 3479400 1690267
0 1 0 0 0 SITI NUR AISAH D288319 30 11139 DR
ERDIYAN, SPOG 0138R01701180011518 0001443802239 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139867 1#0##0#0#0.0#2018-02-03
10:51:58#0#12:00:00#12:00:00#12:00:00 1 eda9389b362c07da840c885b4bf5beaa
0 0 419146 0 0 611543 0 0 0 0 659578
0 0 0 0 0
3201126 B 2 BS 1 22/01/2018 25/01/2018 24/07/1972 0 2
1 D24;D64.9;E87.6 85.20;99.04 - - None None None None L-1-
50-II None None None None None None PROSEDUR PADA PAYUDARA (SEDANG)
12622300 0 0 - 0 - 0 - 0 - 0
12622300 14959749 0 4 0 0 0 AISYAH SUGIARTI
0001620325809 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138667
1#0##0#0#0.0#2018-02-05 07:55:01#0#12:00:00#12:00:00#12:00:00 1
28c8d89f31f4e70fa2bda4257a817d2b 0 5269100 4039136 0 0
0 0 0 0 0 1179675 0 0 0 4471838 0
3201126 B 2 BS 1 22/01/2018 25/01/2018 19/09/2009 0 1
1 N47 64.2 - - None None None None V-1-11-I None None
None None None None PROSEDUR PADA PENIS (RINGAN) 11027800 0 0
- 0 - 0 - 0 - 0 11027800 7127434 0
4 0 0 0 SUKARYA D387844 8 3047 DR CATUR SUZANTARA
0138R01701180009718 0001845880446 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138502 1#0##0#0#0.0#2018-02-05
18:16:35#0#12:00:00#12:00:00#12:00:00 1 777c172d5d7634be2612f92443bbd0e6
0 3676000 662024 0 0 2122129 0 0 0 0
522281 0 0 0 145000 0
3201126 B 2 BS 1 21/01/2018 25/01/2018 05/07/2011 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3493760 0 5 0 0 0 AHMAD MUNZIRAI RIDWAN
D388213 6 2392 DR RASTRA, SPA 0138R01701180009659
0001469913603 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138485
1#0##0#0#0.0#2018-02-05 18:18:23#0#12:00:00#12:00:00#12:00:00 1
90309c20a6771d83b5766e0aafc0bb60 0 0 278711 0 0 642985
0 0 0 0 2572064 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 25/01/2018 29/05/1965 0 1
- 0 12472300 15534452 0 3 0 0 0 SONNY R B
SIANTURI D388380 52 19232 DR SRI KUNMARTINI, SPPD 0138R01701180011314
0001262194615 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139797
1#0##0#0#0.0#2018-02-06 13:50:57#0#12:00:00#12:00:00#12:00:00 1
e3623995ce4e94936285c16ca7a7aec7 0 6468200 3669967 0 0
4255012 0 0 0 0 1141273 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 25/01/2018 02/12/2015 0 1
(SEDANG) 2753900 0 0 - 0 - 0 - 0 - 0
2753900 1316859 0 4 0 0 0 ALFAGHIB ADNAN KHIAR
0001771605988 3;JKN DR RIZKI; 5.2.0.201712280730 4 138612
1#0##0#0#0.0#2018-02-06 14:59:11#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 123963 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 25/01/2018 15/01/2007 0 2
1 D56.1;T80.3 99.04 - - None None None None D-4-13-II None
SEL SICKLE (SEDANG) 4227600 0 0 - 0 - 0 - 0
- 0 4227600 2654343 0 3 0 0 0 RAHMA SEROJA
0001261517049 3;JKN DR RIZKI; 5.2.0.201712280730 4 139453
1#0##0#0#0.0#2018-02-06 15:20:21#0#12:00:00#12:00:00#12:00:00 1
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1285210 0 0 0 0 988649 0 0 0 0 0
3201126 B 3 BS 1 21/01/2018 25/01/2018 12/02/2011 0 2
1 K36 47.09;88.76;87.64 - - None None None None K-1-13-I
None None None None None None PROSEDUR APPENDIK (RINGAN) 3874400
0 0 - 0 - 0 - 0 - 0 3874400
11000069 0 5 0 0 0 AFIFAH NOOR KHALISHAH D387923
6 2535 DR ASRI RAHMAWATI SPB 0138R01701180009691 0001855723432
3;JKN DR RIZKI; 5.2.0.201712280730 4 139119 1#0##0#0#0.0#2018-
02-07 10:01:19#0#12:00:00#12:00:00#12:00:00 1
99cc796af453699505ea5ad86e0b1a8c 0 4920784 116000 0 0
4380654 0 0 0 0 1437631 0 0 0 145000
0
3201126 B 3 BS 1 21/01/2018 25/01/2018 26/06/2017 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 7295572 0 5 0 0 0 BAYI NY. SELLA DEYA
D388191 0 209 DR RASTRA, SPA 0138R01701180009600
0002238723538 3;JKN DR RIZKI; 5.2.0.201712280730 4 138475
1#0##0#0#0.0#2018-02-07 10:36:47#0#12:00:00#12:00:00#12:00:00 1
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4167192 0 0 0 0 1818280 0 0 0 0 170000
3201126 B 1 BS 1 21/01/2018 25/01/2018 10/01/1942 0 1
1 D64.9;I50.0;I84.1 99.04 - - None None None None D-4-13-II
None None None None None None GANGGUAN SEL DARAH MERAH SELAIN KRISIS
ANEMIA SEL SICKLE (SEDANG) 5918600 0 0 - 0 - 0 -
0 - 0 5918600 8263233 0 5 0 0 0 WAGNER
HAPPY PARTASUPENA D299236 76 27770 DR. ARU ARIADNO, SPPD
0138R01701180009633 0001468573288 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 138479 1#0##0#0#0.0#2018-02-07
18:24:14#0#12:00:00#12:00:00#00:00:00 1 2e5ee6daaa79a5dba1ef19245eb94cf8
0 0 576143 0 0 3215505 0 0 0 0
4471585 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 25/01/2018 15/09/1957 0 2
1 K80.1;A49.9;K29.7 - - - None None None None B-4-14-I
(RINGAN) 5879800 0 0 - 0 - 0 - 0 - 0
5879800 6243204 0 4 0 0 0 JETTY MIRANDA, NY
0000061055717 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138860
1#0##0#0#0.0#2018-02-07 18:26:30#0#12:00:00#12:00:00#12:00:00 1
17e46983b1f4510173acd09701ccfe88 0 0 468350 0 0
2216420 0 0 0 0 3558434 0 0 0 0 0
3201126 B 1 BS 1 19/01/2018 25/01/2018 23/10/1948 0 2
1 J18.0;I11.0 - - - None None None None J-4-16-III None
8987600 0 0 - 0 - 0 - 0 - 0
8987600 13294839 0 7 0 0 0 NY. T.PANGABEKTI
0000038633567 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138228
1#1#vvip#7#4307239#0.0#2018-02-07 18:38:53#0#12:00:00#12:00:00#12:00:00
1 46d9962784608e2bc61abdc23bdac032 0 0 1468547 0 0
2593036 0 0 0 0 9233257 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 25/01/2018 02/06/1948 0 1
1 D64.8;D17.5 99.04 - - None None None None D-4-13-I None
- 0 2987000 3223293 0 3 0 0 0 BUDI
PURNAWAN D376501 69 25437 DR SOEGIONO, SPPD 0138R01701180010655
0002311066361 3;JKN DR RIZKI; 5.2.0.201712280730 4 139384
1#0##0#0#0.0#2018-02-08 11:30:43#0#12:00:00#12:00:00#12:00:00 1
19b0593f6862f9ebabe5cd1ad657d33c 0 0 451179 0 0
1746244 0 0 0 0 1025870 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 25/01/2018 30/12/1998 0 1
1 N18.5;J81;D63.8;J18.0;I25.0 99.04;38.95;87.44 - - None None
- 0 - 0 - 0 19332400 15014730 0 3 0
0 0 RAMADHONY SAPUTRA D388358 19 6964 DR SRI KUNMARTINI, SPPD
0138R01701180010589 0001215406348 3;JKN DR RIZKI; 5.2.0.201712280730
4 139347 1#0##0#0#0.0#2018-02-08
11:50:39#0#12:00:00#12:00:00#12:00:00 1 616142ee93d691099784b74530447843
0 7381296 1370900 0 0 4636262 0 0 0 0
1557272 0 0 0 69000 0
3201126 B 3 BS 1 22/01/2018 25/01/2018 10/08/1969 0 1
1 L27.0;G40.9 - - - None None None None L-4-14-II None
None None None None None GANGGUAN PADA KULIT & PAYUDARA LAIN-LAIN
(SEDANG) 4422000 0 0 - 0 - 0 - 0 - 0
4422000 2104731 0 4 0 0 0 ADE EMIR HARUN
D384667 48 17697 DR SUKAMTO SPPD 0138R01701180010255
0001739578004 3;JKN DR RIZKI; 5.2.0.201712280730 4 139102
1#0##0#0#0.0#2018-02-08 13:54:40#0#12:00:00#12:00:00#12:00:00 1
7cbb021706a04b021a62d52c13f00fc1 0 0 370960 0 0 781078
0 0 0 0 952693 0 0 0 0 0
3201126 B 2 BS 1 18/01/2018 25/01/2018 17/09/2016 0 1
1 L02.2;A41.9 86.22 - - None None None None L-4-12-III None
None None None None None PERADANGAN KULIT/CELLULITIS (BERAT) 9198300
0 0 - 0 - 0 - 0 - 0 9198300
11830966 0 8 0 0 0 MUHAMMAD RASSYID ARRAFI D387925
1 488 DR CATUR SUZANTARA 0138R01701180008625 0002274515649
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137628
1#0##0#0#0.0#2018-02-12 08:53:36#0#12:00:00#12:00:00#12:00:00 1
899ed9e681719abe6235f4073709a9eb 0 6887500 704896 0 0
3169582 0 0 0 0 829988 0 0 0 239000
0
3201126 B 3 BS 1 24/01/2018 25/01/2018 23/06/1952 0 2
1 I69.4;L89.9 96.07;86.28 - - None None None None G-4-26-I
LAIN (RINGAN) 3587300 0 0 - 0 - 0 - 0 -
0 3587300 1167880 0 2 0 0 0 SURYANTI, HJ.
D291362 65 23956 DR TANTIYO SETIYOWATI 0138R01701180011492
0000046066757 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139857
1#0##0#0#0.0#2018-02-28 09:15:13#0#12:00:00#12:00:00#12:00:00 1
1b4440b210a2a25678c42321eb36e178 479616 0 322857 0 0
0 0 0 0 0 0 0 0 0 365403 0
3201126 B 1 BS 1 23/01/2018 25/01/2018 14/07/2012 0 2
- 0 - 0 - 0 - 0 5424200 12591784 0
3 0 0 0 TATIOMA RAELYN AURORA TITIS HANINDHITA D249231
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139109
1#0##0#0#0.0#2018-03-02 21:15:53#0#12:00:00#12:00:00#12:00:00 1
f7248ec8ef41722dcbf921cabdd58aaf 0 7187200 1677776 0 0
2702046 0 0 0 0 823762 0 0 0 201000
0
3201126 B 1 BS 1 25/01/2018 25/01/2018 31/01/2014 0 1
1 Z53.0;L04.9;J45.9 93.94 - - None None None None Z-4-12-I
None None None None None None FAKTOR-FAKTOR YANG MEMPENGARUHI STATUS
KESEHATAN LAIN-LAIN (RINGAN) 2627300 0 0 - 0 - 0 -
0 - 0 2627300 2000000 0 1 0 0 0
MUHAMMAD SUNAN NURUZZAMAN D337885 3 1455 DR CATUR SUZANTARA
0138R01701180011742 0002260168165 3;JKN DR RIZKI; 5.2.0.201712280730
4 140102 1#0##0#0#0.0#2018-03-02
21:16:41#0#12:00:00#12:00:00#12:00:00 1 93f0a981306eccbf7f23cca6901473f3
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 24/01/2018 25/01/2018 19/02/1968 0 2
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 3045690 0 2 0 0 0 RUMAYA SIMALANGO
0001256684185 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139466
1#0##0#0#0.0#2018-03-02 21:22:38#0#12:00:00#12:00:00#12:00:00 1
cf7f9e0c5d8b5faca64a7493750dc0bd 0 0 321830 0 0
1972609 0 0 0 0 526000 0 0 0 225251
0
3201126 B 1 BS 1 23/01/2018 25/01/2018 21/12/1993 0 2
0 - 0 - 0 - 0 - 0 7464200 12246176
0 3 0 0 0 MIA NIVIA SARI D386644 24 8799 DR
HENDRIEK S, SPB 0138R01701180010832 0002102752473 3;JKN DR RIZKI;
5.2.0.201712280730 4 139455 1#0##0#0#0.0#2018-03-10
14:04:52#0#12:00:00#12:00:00#12:00:00 2 da4f4d3b8174a22012df002e145d79f0
0 0 2653529 0 0 2394995 0 0 0 0
6241500 0 0 0 956152 0
3201126 B 3 BS 1 24/01/2018 25/01/2018 17/01/1969 0 1
- 0 8908800 10717756 0 2 0 0 0 SAUBIH
0001770795415 3;JKN DR RIZKI; 5.2.1.201804062320 4 139854
1#0##0#0#0.0#2018-05-17 14:46:14#0#12:00:00#12:00:00#12:00:00 2
641d44b1be88e138be092ae862c5df77 0 4615652 737400 0 0
4279042 0 0 0 0 1016662 0 0 0 69000 0
3201126 B 2 BS 1 20/01/2018 25/01/2018 27/03/1970 0 1
1 G20;R45.3;E87.6;R00.1;D69.6 - - - None None None None
G-4-11-II None None None None None None TUMOR SISTEM SARAF & GANGGUAN
DEGENERATIF (SEDANG) 7287300 0 0 - 0 - 0 - 0
- 0 7287300 10509997 0 6 0 0 0 RICKY
M.H.SIMAMORA d355708 47 17466 DR NURUL KOMARI SPS
0138R01701180009333 0002207066591 3;JKN DR RIZKI; 5.2.1.201804062320
4 138233 1#0##0#0#0.0#2018-05-17
15:09:35#0#12:00:00#12:00:00#00:00:00 2 4d1749d48c613bddbe5bd6482324abaf
0 0 854604 0 0 4080323 0 0 0 0
2792070 0 0 0 0 2783000
3201126 B 2 BS 1 24/01/2018 25/01/2018 11/07/1975 0 2
LAIN-LAIN (SEDANG) 4628500 0 0 - 0 - 0 - 0
- 0 4628500 4064687 0 2 0 0 0 YULIA
RACHMAH D388426 42 15538 DR MAMAN H, SPOG 0138R01701180011268
0002326482876 3;JKN DR RIZKI; 5.2.1.201804062320 4 139790
1#0##0#0#0.0#2018-05-17 15:17:32#0#12:00:00#12:00:00#12:00:00 2
b24752eeef6d565b7b07c2041b17f58e 0 0 469565 0 0
2165208 0 0 0 0 1301914 0 0 0 0 128000
3201126 B 1 BS 1 21/01/2018 25/01/2018 04/12/2000 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4917966 0 5 0 0 0 FIKRI RAMADHAN
0001815251984 3;JKN DR RIZKI; 5.2.1.201804062320 4 138497
1#0##0#0#0.0#2018-05-17 15:41:19#0#12:00:00#12:00:00#12:00:00 2
0253aa698526fba796f2663af270adcc 0 0 316330 0 0
1129900 0 0 0 0 3471736 0 0 0 0 0
3201126 B 2 BS 1 22/01/2018 25/01/2018 25/01/1954 0 2
1 D61.9 99.04;99.23 - - None None None None D-4-13-I None
- 0 3584400 5331185 0 4 0 0 0 SUNDARI
0000036784675 3;JKN DR RIZKI; 5.2.1.201804062320 4 139106
1#0##0#0#0.0#2018-05-18 08:08:36#0#12:00:00#12:00:00#00:00:00 2
6bcaaf42651c7d0924ec673971411653 0 0 322596 0 0
3118820 0 0 0 0 1515000 0 0 0 374769
0
3201126 B 1 BS 1 20/01/2018 25/01/2018 05/09/1945 0 2
1 K21.0;N39.0;A49.9;R33 - - - None None None None K-4-
12-II None None None None None None GANGGUAN ESOFAGUS (SEDANG) 5739000
0 0 - 0 - 0 - 0 - 0 5739000
8064041 0 6 0 0 0 THERESIA L.W. SORONGAN D060047
3;JKN DR RIZKI; 5.2.0.201712280730 4 138759 1#0##0#0#0.0#2018-
08-13 12:36:36#0#12:00:00#12:00:00#12:00:00 2
6b2eb4a95da8db1680c3eee6b1b2aa69 0 0 399995 0 0
2769992 0 0 0 0 4894054 0 0 0 0 0
3201126 B 2 BS 1 23/01/2018 25/01/2018 22/03/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2485701 0 3 0 0 0 FARLY RAFFASYA ANWAR
D362414 1 672 DR AWIDIYA, SPA 0138R01701180010767
0002221077712 3;JKN DR RIZKI; 5.2.2.201806040537 4 139445
1#0##0#0#0.0#2018-09-06 14:32:21#0#12:00:00#12:00:00#00:00:00 2
9871e0d9d1d311b31c25816041e196b6 0 0 238535 0 0 543550
0 0 0 0 1703616 0 0 0 0 0
3201126 B 3 BS 1 24/01/2018 25/01/2018 01/03/1962 0 1
- 0 8908800 10002996 0 2 0 0 0 BASIMIN
0000369507295 3;JKN irene; 5.2.0.201712280730 4 139859
1#0##0#0#0.0#2018-09-10 15:28:01#0#12:00:00#12:00:00#12:00:00 5
f534d781f2349639e571c05661f67f9b 0 4897204 455848 0 0
3611042 0 0 0 0 969902 0 0 0 69000 0
3201126 B 2 BS 1 24/01/2018 26/01/2018 02/01/1993 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10323815 0 3 0 0 0 DEWI SRI JAYANTI D288085 25
9153 DR ERDIYAN, SPOG 0138R01701180011342 0001769705515 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 139829 1#0##0#0#0.0#2018-
02-02 11:47:37#0#12:00:00#12:00:00#00:00:00 1
1410478dc75583bbb2b72a714f7d78d6 0 6014290 2090753 0 0
2177772 0 0 0 0 0 0 0 0 41000 0
3201126 B 2 BS 1 22/01/2018 26/01/2018 04/07/1951 0 1
1 I63.9;G81.9;E78.5 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 5261039 0 5 0 0 0 ABDU RAHMAN
0001476822183 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139791
1#0##0#0#0.0#2018-02-06 10:39:40#0#12:00:00#12:00:00#12:00:00 1
a76dcfaa89807e37cdb9da30d2bf2f00 0 0 882140 0 0
2493719 0 0 0 0 1885180 0 0 0 0 0
3201126 B 3 BS 1 24/01/2018 26/01/2018 03/10/1947 0 2
4 I11.0;I48;I25.0 90.59;87.49;89.52;99.60 - - None None None
(SEDANG) 4144700 0 0 - 0 - 0 - 0 - 0
4144700 4297701 0 3 0 0 0 RAMESAH D375963
70 25681 DR BAMBANG DWIPUTRA SPJP 0138R01701180010877
0001739645548 3;JKN DR RIZKI; 5.2.0.201712280730 4 139467
1#0##0#0#0.0#2018-02-06 12:17:36#0#12:00:00#12:00:00#12:00:00 1
7b111c3d5aa98e4b2ef3ecbad2279445 0 0 632429 0 0
2206614 0 0 0 0 1458658 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 26/01/2018 08/10/1976 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5307193 0 2 0 0 0 MUK LIM D349314
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140497
1#0##0#0#0.0#2018-02-06 14:08:01#0#12:00:00#12:00:00#00:00:00 1
c3e154a46885e2ae734e7441974919fb 0 0 573641 0 0
1642102 0 0 0 0 1909200 0 0 0 1182250
0
3201126 B 1 BS 1 24/01/2018 26/01/2018 05/04/1972 0 1
1 K29.7;A01.0;R51 - - - None None None None K-4-11-III
None None None None None None GASTRITIS & ULKUS PEPTIKUM (BERAT)
5538000 0 0 - 0 - 0 - 0 - 0
5538000 3078674 0 3 0 0 0 MARUBA LUMBAN TORUAN
0001626164482 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139864
1#0##0#0#0.0#2018-02-06 14:13:46#0#12:00:00#12:00:00#12:00:00 1
6085d167ea0c62c2cef2c0917a43c080 0 0 338858 0 0 950407
0 0 0 0 1789409 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 26/01/2018 01/02/1945 0 1
1 D29.1 60.29 - - None None None None V-1-14-I None None
None None None None PENGANGKATAN PROSTAT MELALUI URETRA (RINGAN)
12373100 0 0 - 0 - 0 - 0 - 0
12373100 25588825 0 4 0 0 0 BURHANI D376797
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139332
1#0##0#0#0.0#2018-02-06 14:30:10#0#12:00:00#12:00:00#12:00:00 1
b20c9b650bc7ec136406fe2202e7e8b9 0 10483600 7839468 0 0
5137757 0 0 0 0 1301000 0 0 0 827000
0
3201126 B 1 BS 1 25/01/2018 26/01/2018 14/06/1957 0 1
1 E14.2;I13.1 39.27 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 10720009 0 2 0 0 0 DANIEL NGADIMIN
0001261234462 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140318
1#0##0#0#0.0#2018-02-06 14:36:47#0#12:00:00#12:00:00#00:00:00 1
d1e103aabb7d568092a097f448a5756d 0 6468200 2494460 0 0
931040 0 0 0 0 757309 0 0 0 69000 0
3201126 B 1 BS 1 24/01/2018 26/01/2018 03/03/1954 0 1
1 J18.0;E87.1;I10 - - - None None None None J-4-16-II
(SEDANG) 7108500 0 0 - 0 - 0 - 0 - 0
7108500 5696984 0 3 0 0 0 HENDRAMAN D372856
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139468
1#0##0#0#0.0#2018-02-06 14:43:16#0#12:00:00#12:00:00#12:00:00 1
e0c7be1b848aa19c36fce283b7744d07 0 0 468350 0 0
2486934 0 0 0 0 2741700 0 0 0 0 0
3201126 B 3 BS 1 24/01/2018 26/01/2018 08/12/1953 0 1
1 I67.9;I10;E78.5 87.03;89.52 - - None None None None G-4-
26-I None None None None None None GANGGUAN - PENYAKIT SISTEM SARAF LAIN-
LAIN (RINGAN) 3587300 0 0 - 0 - 0 - 0 -
0 3587300 4048755 0 3 0 0 0 TUKIYAT
0001459305595 3;JKN DR RIZKI; 5.2.0.201712280730 4 139792
1#0##0#0#0.0#2018-02-06 15:23:13#0#12:00:00#12:00:00#12:00:00 1
6dbaa00845111587955864200d40d310 0 0 356903 0 0
2611980 0 0 0 0 1079872 0 0 0 0 0
3201126 B 3 BS 1 25/01/2018 26/01/2018 05/03/1976 0 2
- 0 8908800 9551265 0 2 0 0 0 MINTARSIH
0001403692694 3;JKN DR RIZKI; 5.2.0.201712280730 4 140493
1#0##0#0#0.0#2018-02-06 15:28:11#0#12:00:00#12:00:00#12:00:00 1
6e11ab7ea3619627b4de24e01bd066b5 0 4874560 854792 0 0
2580564 0 0 0 0 1206849 0 0 0 34500 0
3201126 B 3 BS 1 25/01/2018 26/01/2018 15/09/1972 0 2
1 G56.0;M62.54;M65.34 82.01;04.43 - - None None None None
M-1-80-II None None None None None None PROSEDUR ANGGOTA TUBUH ATAS
(SEDANG) 10298800 0 0 - 0 - 0 - 0 - 0
10298800 10309172 0 2 0 0 0 NURYATI D375187
45 16568 DR BENNY H T, SPOT 0138R01701180011754 0001260124839
3;JKN DR RIZKI; 5.2.0.201712280730 4 140151 1#0##0#0#0.0#2018-
02-07 10:34:36#0#12:00:00#12:00:00#12:00:00 1
adfec7c4c8d79a4a352f16bb2a7b679c 0 4444160 86720 0 0
1244860 0 0 0 0 4388432 0 0 0 145000
0
3201126 B 3 BS 1 25/01/2018 26/01/2018 04/06/2013 0 1
1467400 0 0 - 0 - 0 - 0 - 0
1467400 3741695 0 2 0 0 0 MUHAMMAD RAFKA ALHADIIY
0001739817718 3;JKN DR RIZKI; 5.2.0.201712280730 4 140202
1#0##0#0#0.0#2018-02-07 12:34:27#0#12:00:00#12:00:00#12:00:00 1
8daa62c676efaad9f3deaaca1f912ab6 0 2426872 0 0 0 523039
0 0 0 0 646784 0 0 0 145000 0
3201126 B 1 BS 1 24/01/2018 26/01/2018 28/02/2015 0 1
- 0 - 0 - 0 - 0 3718200 4052637 0
3 0 0 0 DAFFA BRILLIAN DHANI D388463 2 1061 DR
OTTY MITHA S, SPA 0138R01701180011323 0001830115023 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139802 1#0##0#0#0.0#2018-02-08
09:00:15#0#12:00:00#12:00:00#12:00:00 1 8a292851cfa2e771f1acd44df4df7285
0 0 598616 0 0 819895 0 0 0 0
2634126 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 26/01/2018 07/07/1965 0 1
1 I63.9;I25.0;E75.6;I21.9 87.03;99.19 - - None None None None
0 - 0 12141100 8491562 0 5 0 0 0 HAMDAN
d388297 52 19192 DR MAYSAM I., SPS 0138R01701180010290
0002100195573 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139100
1#0##0#0#0.0#2018-02-08 09:22:40#0#12:00:00#12:00:00#12:00:00 1
b44e9d8209af0e7947161f648eac1ea0 0 0 1117063 0 0
3668976 0 0 0 0 3705523 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 26/01/2018 12/09/1983 0 2
1 S52.5;Z34.8 78.63 - - None None None None M-1-40-I None
INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 - 0 -
0 6041900 11234967 0 2 0 0 0 RENI TRESNAWATI
0000204991222 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140321
1#0##0#0#0.0#2018-02-08 16:50:14#0#12:00:00#12:00:00#12:00:00 1
ec4f24d46860c9da93bd19c60867ff0c 0 6833600 2316732 0 0
1128637 0 0 0 0 810998 0 0 0 145000
0
3201126 B 1 BS 1 17/01/2018 26/01/2018 07/07/1989 0 1
1 K56.7;A15.3;A41.9 45.93;46.04;54.59 - - None None None None
K-1-20-III None None None None None None PROSEDUR INTESTINAL KOMPLEKS
(BERAT) 34761000 0 0 - 0 - 0 - 0 - 0
34761000 40330224 0 10 0 0 0 EFA JULIAN IVAN PRIMA
d373430 28 10421 DR E SURYA POHAN DR SPB KBD 0138R01701180008134
0001339530816 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 137094
1#0##0#0#0.0#2018-02-08 21:52:16#0#12:00:00#12:00:00#12:00:00 1
dafd8e5f4aad9beec24fde13c67387be 0 13938600 6904088 0 0
975500 0 0 0 0 1301000 0 0 0 17211036
0
3201126 B 1 BS 1 25/01/2018 26/01/2018 22/01/1987 0 1
(RINGAN) 6041900 0 0 - 0 - 0 - 0 - 0
6041900 10912782 0 2 0 0 0 BAYU ADIPRADANA
0000210630453 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140231
1#0##0#0#0.0#2018-02-08 22:06:29#0#12:00:00#12:00:00#12:00:00 1
fed9fda686b222bcef2ec03593bb0315 0 6833600 2369732 0 0
850530 0 0 0 0 782920 0 0 0 76000 0
3201126 B 3 BS 1 25/01/2018 26/01/2018 10/08/1934 0 1
1 S06.50 - - - None None None None G-4-24-I None
None None None None None TRAUMA KEPALA (RINGAN) 3043100 0 0
- 0 - 0 - 0 - 0 3043100 743289 0
2 0 0 0 SYAWAL HASSAN D388615 83 30484 DR DINI
DANIATY 0138R01701180012230 0001811786319 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140634 1#0##0#0#0.0#2018-02-23
09:15:47#0#12:00:00#12:00:00#12:00:00 1 b6f58a09bf8b542e3f369069ad160d17
0 0 273879 0 0 131784 0 0 0 0 337626
0 0 0 0 0
3201126 B 2 BS 1 20/01/2018 26/01/2018 05/01/2016 0 2
1 J22;R56.0 - - - None None None None J-4-21-II None
LAIN-LAIN (SEDANG) 5410000 0 0 - 0 - 0 - 0
- 0 5410000 5630374 0 7 0 0 0 HANA KAYSHA
RAHMA D343942 2 746 DR RASTRA, SPA 0138R01701180009497
0001966011287 3;JKN DR RIZKI; 5.2.0.201712280730 4 138454
1#0##0#0#0.0#2018-03-09 08:38:52#0#18:37:58#18:37:58#12:00:00 2
57e8d852bbef7087d563f3d40b3a34a4 0 0 339830 0 0
1568702 0 0 0 0 3721842 0 0 0 0 0
3201126 B 2 BS 1 22/01/2018 26/01/2018 30/12/1989 0 2
None None None None GANGGUAN PANKREAS SELAIN TUMOR (RINGAN) 5288900
0 0 - 0 - 0 - 0 - 0 5288900
12023262 0 5 0 0 0 KINANTI AYU WENINGTYAS D324352
3;JKN DR RIZKI; 5.2.0.201712280730 4 138500
1#1#vip#4#5509300#75.0#2018-03-09 08:40:29#0#12:00:00#12:00:00#12:00:00
2 f4dc9e80f1c8689fb9b86ae76df6a820 0 0 1071111 0 0
3764582 0 0 0 0 7187569 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 26/01/2018 27/12/1968 0 2
0 - 0 - 0 - 0 - 0 9150100 11872167
0 2 0 0 0 RUSMIATI D356003 49 17926 DR HENDRIEK
S, SPB 0138R01701180011547 0001840897337 3;JKN DR RIZKI;
5.2.0.201712280730 4 139873 1#0##0#0#0.0#2018-03-09
09:13:55#0#12:00:00#12:00:00#00:00:00 2 fb7f465c3506610f3e1d2444c7c64f39
0 0 2625028 0 0 2353455 0 0 0 0
6748684 0 0 0 145000 0
3201126 B 2 BS 1 23/01/2018 26/01/2018 16/08/1987 0 2
2 A15.5;J39.0 - - - None None None None J-4-15-II None
6217100 0 0 - 0 - 0 - 0 - 0
6217100 6924205 0 4 0 0 0 PARDIANTI D388421
30 11118 DR. INDAH TRISNAWATY SP.THT 0138R01701180011534
0001840013076 3;JKN DR RIZKI; 5.2.0.201712280730 4 139874
1#0##0#0#0.0#2018-03-10 09:40:09#0#12:00:00#12:00:00#12:00:00 2
bdf471cb57a0eb5c7e01fb6533173870 0 0 517715 0 0
4115005 0 0 0 0 2291485 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 26/01/2018 14/07/1958 0 2
1 H81.1;E14.9;S00.8;I10 90.59 - - None None None None U-4-
11-I None None None None None None DYSEQUILIBRIUM (RINGAN) 2124500 0
0 - 0 - 0 - 0 - 0 2124500 2609039
0 2 0 0 0 DONNA DAMANIK D388622 59 21745 DR
5.2.0.201712280730 4 140495 1#0##0#0#0.0#2018-03-15
08:31:34#0#12:00:00#12:00:00#12:00:00 2 0fdc58c1a2f39a9786fbfcceb13f5057
0 0 331082 0 0 519272 0 0 0 0
1758685 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 26/01/2018 17/02/1978 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 5804708 0 2 0 0 0 PENI HASTARI
D359669 39 14587 DR ARJU A, SPOG 0138R01701180011855
0001649273477 3;JKN DR RIZKI; 5.2.0.201712280730 4 140314
1#0##0#0#0.0#2018-03-29 10:56:48#0#12:00:00#12:00:00#00:00:00 2
d7e17e9ff8dc8857f6fa3bac2763ab9b 0 0 888996 0 0
1488965 0 0 0 0 3281747 0 0 0 145000
0
3201126 B 3 BS 1 21/01/2018 26/01/2018 01/06/1948 0 1
None None None None None BATU URIN (RINGAN) 3417600 0 0
- 0 - 0 - 0 - 0 3417600 5488381 0
6 0 0 0 M. SALIM D388176 69 25436 DR. ARU ARIADNO,
4 138469 1#0##0#0#0.0#2018-05-07
11:54:09#0#12:00:00#12:00:00#12:00:00 2 2a1bf31dc81d53b05ad93e888847fdfa
0 0 498941 0 0 3026387 0 0 0 0
1963053 0 0 0 0 0
3201126 B 3 BS 1 26/01/2018 26/01/2018 09/04/1944 0 2
None None None None INFARK MYOKARD AKUT (RINGAN) 4043000 0 0
- 0 - 0 - 0 - 0 4043000 2883490 0
1 0 0 0 HASNA ESSA d357084 73 26955 DR AHMAD HIBBAN A
WRIYA 0138R01701180012128 0001473645576 3;JKN DR RIZKI; 5.2.1.201804062320
4 141302 1#0##0#0#0.0#2018-05-17
14:45:33#0#12:00:00#12:00:00#00:00:00 2 eddec158b2a6d2c0538982386b2c841e
0 0 363870 0 0 2041980 0 0 0 0 477640
0 0 0 0 0
3201126 B 3 BS 1 09/01/2018 26/01/2018 07/06/1967 0 1
1 A35;J18.0;A41.9;R56.8;E87.3 86.22;96.05;96.72;99.56;31.1 - -
None None None None J-1-01-III None None None None None None
VENTILASI MEKANIKAL LONG TERM DENGAN TRAKEOSTOMI (BERAT) 69600200 0
0 - 0 - 0 - 0 - 0 69600200 165416670
0 18 1 3 96 HARUN D387001 50 18479 DR EVA INDAHWATI
SPAN 0138R01701180003458 0001291961362 3;JKN DR RIZKI; 5.2.1.201804062320
4 131661 1#0##0#0#0.0#2018-05-18
08:39:36#0#12:00:00#12:00:00#12:00:00 2 c43453b6fd312581f684095411fb3435
0 20966000 40928467 0 0 76885203 0 0 0 0
1256000 0 0 0 0 25381000
3201126 B 2 BS 1 25/01/2018 26/01/2018 27/06/2017 0 1
1 Q38.1 25.92 - - None None None None U-4-14-I None None
None None None None PENYAKIT MULUT DAN GIGI (RINGAN) 4425900 0
0 - 0 - 0 - 0 - 0 4425900 7047199
0 2 0 0 0 RAJENDRA ARKANA ALFITRAH d387831 0
212 DR CATUR SUZANTARA 0138R01701180011709 0002260872191 3;JKN
DR RIZKI; 5.2.2.201806040537 4 140027 1#0##0#0#0.0#2018-08-13
11:23:36#0#12:00:00#12:00:00#12:00:00 2 8e791af1bee64c63b7a7e61142af3b2e
0 5351100 63000 0 0 213567 0 0 0 0
1347032 0 0 0 72500 0
3201126 B 3 BS 1 23/01/2018 26/01/2018 18/09/1962 0 2
1 N13.6;E11.2;N20.1 59.8;56.0 - - None None None None N-1-
40-II None None None None None None PROSEDUR PADA URETRA DAN TRANSURETRA
(SEDANG) 10919500 0 0 - 0 - 0 - 0 - 0
10919500 13253234 0 4 0 0 0 SRI RAHAYU D383117
55 20216 DR SIDHI,SPU 0138R01701180010499 0002274964975 3;JKN
DR RIZKI; 5.2.2.201806040537 4 139137 1#0##0#0#0.0#2018-08-13
11:52:16#0#12:00:00#12:00:00#12:00:00 2 ffa32aed9a83f65c8e7e2f5cb504e777
0 3917200 6007760 0 0 1772240 0 0 0 0
1487034 0 0 0 69000 0
3201126 B 2 BS 1 25/01/2018 26/01/2018 05/10/1959 0 2
1 I73.8;R02 84.01;90.59 - - None None None None M-1-80-II
None None None None None None PROSEDUR ANGGOTA TUBUH ATAS (SEDANG)
12358500 0 0 - 0 - 0 - 0 - 0
12358500 8424142 0 2 0 0 0 SRI SURYANI D379577
DR RIZKI; 5.2.2.201806040537 4 140479 1#0##0#0#0.0#2018-08-14
11:05:35#0#12:00:00#12:00:00#12:00:00 2 1039507952cef80dafdea018a7a57dc7
0 4911100 2081280 0 0 755650 0 0 0 0
607112 0 0 0 69000 0
3201126 B 1 BS 1 25/01/2018 26/01/2018 01/08/1953 0 2
1 E14.2 39.27 - - None None None None N-1-12-I None None
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 13096118 0 2 0 0 0 AUGUSTIEN A. SUNDALANGI
0001472918488 3;JKN DR RIZKI; 5.2.2.201806040537 4 140233
1#0##0#0#0.0#2018-09-06 12:03:09#0#12:00:00#12:00:00#00:00:00 2
1309511c4ff6c0a9279979db6b43d7f2 0 0 3669967 0 0
1796196 0 0 0 0 7560955 0 0 0 69000 0
3201126 B 2 BS 1 12/01/2018 26/01/2018 12/07/1962 0 1
1 K56.7;K40.4 90.59;87.49;88.76;88.01;45.62;45.94 - - None None
None None K-1-20-III None None None None None None PROSEDUR
INTESTINAL KOMPLEKS (BERAT) 29795100 0 0 - 0 - 0 -
0 - 0 29795100 50804291 0 15 0 0 0 DJOLI
ISKANDAR D387317 55 20273 DR E SURYA POHAN DR SPB KBD
0138R01701180005466 0001647246677 3;JKN irene; 5.2.1.201804062320
4 134140 1#0##0#0#0.0#2018-09-10
15:29:14#0#12:00:00#12:00:00#12:00:00 3 990e8cbbf2f4a3aefcf3cc3cedc778c1
0 0 9587432 0 0 23226359 0 0 0 0
16474500 0 0 0 0 1516000
3201126 B 2 BS 1 24/01/2018 27/01/2018 15/10/1964 0 2
1 I95.9;A49.9;J06.9 - - - None None None None I-4-24-I
(RINGAN) 3355000 0 0 - 0 - 0 - 0 - 0
3355000 3388344 0 4 0 0 0 SURATMI D388491
TANTIYO S;16137 5.2.0.201712280730 4 139861 1#0##0#0#0.0#2018-
02-05 16:31:07#0#12:00:00#12:00:00#12:00:00 1
254dd5395490066d9b0d4f39cf3981d8 0 0 298025 0 0
1327652 0 0 0 0 1762667 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 27/01/2018 04/01/1969 0 1
1 C11.9 - - - None None None None U-4-10-I None None
None None None None NEOPLASMA TELINGA, HIDUNG, MULUT DAN TENGGOROKAN
(RINGAN) 4584100 0 0 - 0 - 0 - 0 - 0
4584100 6661300 0 3 0 0 0 SUROTO D388187
TANTIYO S;16137 5.2.0.201712280730 4 140300 1#0##0#0#0.0#2018-
02-05 17:20:25#0#12:00:00#12:00:00#12:00:00 1
9dc0fd0decb4ed97a50f93ec084f3fd3 0 0 396809 0 0
4287705 0 0 0 0 1976786 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 27/01/2018 12/07/1970 0 2
1 A01.0;K29.7;J06.9 90.59 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 3511007 0 3 0 0 0 ENDANG
SUMARNI D388563 47 17364 DR SRI KUN, SPPD 0138R01701180011520
0001733509416 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139869
1#0##0#0#0.0#2018-02-05 17:45:01#0#12:00:00#12:00:00#12:00:00 1
b324e71f2c342bdb5310048e898a9d32 0 0 298025 0 0
1442290 0 0 0 0 1770692 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 27/01/2018 31/03/2015 0 1
1 A01.0;N39.0 88.75 - - None None None None A-4-14-II None
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 3443723 0 3 0 0 0 GEO KENZIE ERLANDO
0001870787261 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140490
1#0##0#0#0.0#2018-02-05 18:23:06#0#12:00:00#12:00:00#00:00:00 1
aec2401f5052094d7a316c68699f5b88 0 0 298025 0 0
1379408 0 0 0 0 1766290 0 0 0 0 0
3201126 B 2 BS 1 24/01/2018 27/01/2018 20/05/1961 0 2
1 I63.9;I10 90.59;87.03;89.52 - - None None None None G-4-
14-I None None None None None None KECEDERAAN PEMBULUH DARAH OTAK DENGAN
INFARK (RINGAN) 6015800 0 0 - 0 - 0 - 0 -
0 6015800 4096309 0 4 0 0 0 MARSANAH
0000061024206 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139863
1#0##0#0#0.0#2018-02-05 18:25:35#0#12:00:00#12:00:00#12:00:00 1
2bd5a28e0bd536d44abe9a6e3afeba27 0 0 440432 0 0
1846894 0 0 0 0 1808983 0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 27/01/2018 31/12/1968 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4586192 0 2 0 0 0 INDRAWAN RUSMAN
0001621275952 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140891
1#0##0#0#0.0#2018-02-06 08:02:40#0#12:00:00#12:00:00#00:00:00 2
431e36166b842d4d8b94533ffbeb6804 0 0 573641 0 0
1313770 0 0 0 0 1516531 0 0 0 1182250
0
3201126 B 1 BS 1 22/01/2018 27/01/2018 24/05/1952 0 2
4 I63.9;J90;J18.0;R57.2;R77.0 99.60 - - None None None None
0 - 0 12141100 36211915 0 6 0 0 0
MURNIATI D384107 65 23984 DR. ARU ARIADNO, SPPD
0138R01701180010310 0002320174901 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139107 1#1#vvip#6#24070815#0.0#2018-02-06
08:28:00#0#12:00:00#12:00:00#12:00:00 2 750ebb9c468d91b5b295fc4cd479a7b3
0 0 1315000 0 0 25399415 0 0 0 0
6934500 0 0 0 2563000 0
3201126 B 3 BS 1 26/01/2018 27/01/2018 02/06/1984 0 2
0 - 0 - 0 - 0 - 0 2319600 5138390
0 2 0 0 0 SUNDARI D301792 33 12291 DR. ARU
ARIADNO, SPPD 0138R01701180012537 0001465465162 3;JKN DR RIZKI;
5.2.0.201712280730 4 140893 1#0##0#0#0.0#2018-02-06
12:09:19#0#12:00:00#12:00:00#12:00:00 2 1c33821c29f5e27318d13015b9b113ab
0 1299284 53000 0 0 1235450 0 0 0 0 801656
0 0 0 0 1749000
3201126 B 3 BS 1 26/01/2018 27/01/2018 16/07/1969 0 1
- 0 8908800 9464089 0 2 0 0 0 ACHMAD
WINARNO YASA D388359 48 17726 DR SRI KUNMARTINI, SPPD
0138R01701180012455 0001730288035 3;JKN DR RIZKI; 5.2.0.201712280730
4 140881 1#0##0#0#0.0#2018-02-06
12:14:20#0#12:00:00#12:00:00#12:00:00 2 25a5f2733531fa4b74a5b244b208dada
0 4874560 854792 0 0 2739077 0 0 0 0
995660 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 27/01/2018 01/03/1958 0 1
1 N18.5;J91;R77.0 34.91;87.44 - - None None None None N-4-
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 1000000 0 6 0 0 0 SAIFUL
0001014240396 3;JKN DR RIZKI; 5.2.0.201712280730 4 139069
1#0##0#0#0.0#2018-02-06 14:43:44#0#12:00:00#12:00:00#12:00:00 1
dba4b571db9c9690b0a81fef7043eba5 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 27/01/2018 27/12/1960 0 2
1 M54.56;H81.1 90.59;89.52 - - None None None None M-4-
(RINGAN) 3687800 0 0 - 0 - 0 - 0 - 0
3687800 5299829 0 6 0 0 0 SARI D322115 57
DR RIZKI; 5.2.0.201712280730 4 138499 1#0##0#0#0.0#2018-02-07
10:02:40#0#12:00:00#12:00:00#00:00:00 1 5d48c0d44c872fe3844001668e739d21
0 0 490902 0 0 2858209 0 0 0 0
1950718 0 0 0 0 0
3201126 B 3 BS 1 25/01/2018 27/01/2018 17/08/1992 0 1
1 D14.3;D21.0 87.44;88.01 - - None None None None J-4-14-I
None None None None None None TUMOR PARU (RINGAN) 4414600 0
0 - 0 - 0 - 0 - 0 4414600 5558789
0 3 0 0 0 ABDUROHMAN NUGRAHA D386437 25 9292
RIZKI; 5.2.0.201712280730 4 140095 1#0##0#0#0.0#2018-02-07
10:44:14#0#12:00:00#12:00:00#12:00:00 1 746234459be7caf5910798fc6355a13f
0 0 929200 0 0 3450930 0 0 0 0
1178659 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 27/01/2018 16/08/1997 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2469759 0 5 0 0 0 TRESNA WATI D388438
20 7465 DR SUKAMTO SPPD 0138R01701180010840 0001732508471 3;JKN
DR RIZKI; 5.2.0.201712280730 4 139459 1#0##0#0#0.0#2018-02-07
12:15:41#0#12:00:00#12:00:00#12:00:00 1 f059284da17e97f8da3d1f642a46c71a
0 0 450980 0 0 779206 0 0 0 0
1239573 0 0 0 0 0
3201126 B 3 BS 1 25/01/2018 27/01/2018 12/04/1995 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1637870 0 3 0 0 0 YESSY VALENTIN ANASTASIA
AMBARITA D388636 22 8324 DR SOEGIONO, SPPD 0138R01701180012001
0001803885625 3;JKN DR RIZKI; 5.2.0.201712280730 4 140500
1#0##0#0#0.0#2018-02-07 12:18:42#0#12:00:00#12:00:00#12:00:00 2
89a0d228f6a4b144144fa3e645f14ced 0 0 409013 0 0 393207
0 0 0 0 835650 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 27/01/2018 15/06/1998 0 1
1 J15.9;J17.0;A16.0 90.59;87.49;88.73;93.94 - - None None None
None J-4-16-I None None None None None None SIMPLE PNEUMONIA &
WHOOPING COUGH (RINGAN) 3613200 0 0 - 0 - 0 - 0
- 0 3613200 8444171 0 5 0 0 0 IBRAHIM
IRSYAD D388334 19 7162 DR MOHAMAD NIZAM ERHAMZA SPP
0138R01701180010311 0001222537915 3;JKN DR RIZKI; 5.2.0.201712280730
4 139108 1#0##0#0#0.0#2018-02-07
12:22:09#0#12:00:00#12:00:00#12:00:00 1 2351b12987e5db98242f77eba1650eb9
0 0 378188 0 0 4008561 0 0 0 0
4057422 0 0 0 0 0
3201126 B 3 BS 1 20/01/2018 27/01/2018 01/05/1954 0 2
1 A86;E14.2;A41.9 90.59;89.52;87.44;87.03;93.96 - - None None
None None G-4-19-III None None None None None None INFEKSI NON
BAKTERI SISTEM SARAF ,TIDAK TERMASUK MENINGITIS VIRUS (BERAT) 8201200 0
0 - 0 - 0 - 0 - 0 8201200 16332688
0 8 1 1 0 LINCE S. D388164 63 23275 DR ARU, SPPD
0138R01701180009529 0001739943516 3;JKN DR RIZKI; 5.2.0.201712280730
4 138463 1#0##0#0#0.0#2018-02-07
12:32:54#0#12:00:00#12:00:00#12:00:00 1 b913dd1adfd512bfbfe0a58017f7a9ce
0 0 679290 0 0 9884904 0 0 0 0
3545494 0 0 0 870000 1353000
3201126 B 3 BS 1 25/01/2018 27/01/2018 20/12/1955 0 2
- 0 3502700 1393817 0 3 0 0 0 DJIMAH
0001214051545 3;JKN DR RIZKI; 5.2.0.201712280730 4 140502
1#0##0#0#0.0#2018-02-07 12:35:48#0#12:00:00#12:00:00#12:00:00 1
06b2b5c75d2ebf2f024d1f7ce3b0dc6c 0 0 368243 0 0 205890
0 0 0 0 819684 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 27/01/2018 29/04/1977 0 2
1 I64;I20.9;G81.9 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 6844000 6514165 0
5 0 0 0 HALIMATUSSA DIAH D083984 40 14879 DR
5.2.0.201712280730 4 139395 1#0##0#0#0.0#2018-03-15
09:41:04#0#12:00:00#12:00:00#12:00:00 2 ff47ffe767115c00f5f697b71ac64666
0 0 404025 0 0 2533980 0 0 0 0
3576160 0 0 0 0 0
3201126 B 3 BS 1 25/01/2018 27/01/2018 17/10/1975 0 1
3 J18.0;E11.9;A16.1 90.59;89.52 - - None None None None J-4-
16-I None None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH
(RINGAN) 3613200 0 0 - 0 - 0 - 0 - 0
3613200 6276249 0 3 0 0 0 HENDRA D388562
42 15441 DR ARU, SPPD 0138R01701180011527 0001771713077 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 139872 1#0##0#0#0.0#2018-
03-19 08:32:46#0#12:00:00#12:00:00#12:00:00 2
96a75a06017a4662b7b401c02a671cfb 0 0 616661 0 0
3351992 0 0 0 0 2307596 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 27/01/2018 22/07/2010 0 2
1 S20.1;S21.1 86.22 - - None None None None L-4-13-II None
None None None None None TRAUMA PADA KULIT, JARINGAN BAWAH KULIT DAN
PAYUDARA (SEDANG) 3361900 0 0 - 0 - 0 - 0 -
0 3361900 8706529 0 3 0 0 0 SHAKIRA VELLA
RISTA D388621 7 2744 DR HENDRIEK S, SPB 0138R01701180011964
0002095068633 3;JKN DR RIZKI; 5.2.1.201804062320 4 140491
1#0##0#0#0.0#2018-05-17 15:42:31#0#12:00:00#12:00:00#12:00:00 2
7a6f87a1a3afb5a89e025f90060ffbf3 0 4854100 969940 0 0
2101903 0 0 0 0 635586 0 0 0 0 145000
3201126 B 3 BS 1 26/01/2018 27/01/2018 17/05/1962 0 1
1 D43.2;A41.9;R57.1;L89.2 - - - None None None None G-4-
26-III None None None None None None GANGGUAN - PENYAKIT SISTEM SARAF
LAIN-LAIN (BERAT) 6240100 0 0 - 0 - 0 - 0 -
0 6240100 1889973 0 2 0 0 0 TENI INDRA DURIAT
D388760 55 20343 DR DINI DANIATY 0138R01701180012627
0001482778372 3;JKN irene; 5.2.2.201806040537 4 141080
1#0##0#0#0.0#2018-09-10 15:28:50#0#12:00:00#12:00:00#12:00:00 3
dec61986b3f676cae1c3678f41ea8ff5 0 0 803061 0 0
1086912 0 0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 20/01/2018 28/01/2018 22/07/1985 0 2
1 G82.3;K30 87.44;88.76 - - None None None None G-4-10-I
None None None None None None KECEDERAAN & GANGGUAN TULANG BELAKANG
(RINGAN) 4236000 0 0 - 0 - 0 - 0 - 0
4236000 9696889 0 9 0 0 0 VYLGA DELIMA YUSUF
D144171 32 11870 DR MAYSAMIRAWATI SPS 0000000002500 00001 3;JKN
DR RIZKI; 5.2.0.201712280730 4 141786 1#0##0#0#0.0#2018-02-02
10:08:33#0#09:40:02#09:40:02#00:00:00 1 96f44f013fc4148fcc103a070d7dcf98
0 0 476600 0 0 6192913 0 0 0 0
3027376 0 0 0 0 0
3201126 B 2 BS 1 24/01/2018 28/01/2018 03/03/1965 0 1
1 D29.1;K29.7;R33;N39.0 - - - None None None None V-4-
11-II None None None None None None PENYAKIT SISTEM REPRODUKSI LAKI-LAKI
SELAIN TUMOR (SEDANG) 5945900 0 0 - 0 - 0 - 0
- 0 5945900 4435468 0 5 0 0 0 ABDUL AZIS
0000037031938 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139862
1#0##0#0#0.0#2018-02-05 17:56:09#0#12:00:00#12:00:00#12:00:00 1
48504eaa51fa95d86a85072da5f90fb1 0 0 410840 0 0
1688457 0 0 0 0 2336171 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 28/01/2018 11/12/1983 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10556573 0 4 0 0 0 RUBIAH D388433 34 12464
DR MAMAN H, SPOG 0138R01701180012006 0001196396829 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 140501 1#0##0#0#0.0#2018-02-05
17:58:18#0#12:00:00#12:00:00#12:00:00 1 e1f0aac5fd7c2f5bec969aa84f776025
0 5269900 2569481 0 0 1738575 0 0 0 0
690617 0 0 0 288000 0
3201126 B 2 BS 1 26/01/2018 28/01/2018 20/01/1966 0 2
1 N18.5;D63.8;A04.9 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3176733 0 3 0 0 0 ROSMAWATI
d376434 52 18999 DR SRI KUN, SPPD 0138R01701180012611
0001859073311 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140904
1#0##0#0#0.0#2018-02-06 09:42:21#0#12:00:00#12:00:00#12:00:00 1
b4a8e1dff714c6512507e463c8167eea 0 0 499265 0 0
1433644 0 0 0 0 1243824 0 0 0 0 0
3201126 B 3 BS 1 25/01/2018 28/01/2018 16/11/2017 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 2799146 0 4 0 0 0 BAYI NY WIDIYAWATI
D382076 0 70 DR RASTRA, SPA 0138R01701180012012
0002310456251 3;JKN DR RIZKI; 5.2.0.201712280730 4 140504
1#0##0#0#0.0#2018-02-06 11:26:48#0#12:00:00#12:00:00#12:00:00 1
bcd60e4348d93e83955fc1b72b2bc8f2 0 0 378188 0 0
1422836 0 0 0 0 998122 0 0 0 0 0
3201126 B 2 BS 1 23/01/2018 28/01/2018 10/04/1955 0 1
1 I63.9;J18.0;I50.0;I25.0 - - - None None None None G-4-
- 0 10406600 10509266 0 6 0 0 0 SETIA BUDI
SEMBIRING D372861 62 22934 DR AZRI NURIZAL SPPD KKV
0138R01701180010819 0001723593262 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139454 1#0##0#0#0.0#2018-02-06
11:41:58#0#12:00:00#12:00:00#12:00:00 1 c2e0a33f5d0b75020dca9c4402977a1e
0 0 662300 0 0 5379444 0 0 0 0
4467522 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 28/01/2018 14/12/1959 0 2
1 A01.0;I10 - - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3895304 0 4 0 0 0 ANNIE MANURUNG
0000033150227 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140498
1#0##0#0#0.0#2018-02-06 14:02:14#0#12:00:00#12:00:00#00:00:00 1
ee407c0113ada440f8dc4ca17c5948cc 0 0 338888 0 0 497085
0 0 0 0 3059331 0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 28/01/2018 21/12/2007 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 5693042 0 3 0 0 0 IQBAL MARLOPO
PURNAMASIDI C240998 10 3689 DR VERA MUNA MANOE, SPA 0138R01701180012580
0001335363658 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140894
1#0##0#0#0.0#2018-02-06 14:04:43#0#12:00:00#12:00:00#12:00:00 1
7f82b1fee1dadc46273f8b6bd654dd8f 0 0 376362 0 0
2920738 0 0 0 0 2395942 0 0 0 0 0
3201126 B 1 BS 1 24/01/2018 28/01/2018 31/03/1954 0 1
1 J32.9;J33.9;T78.2 93.94 - - None None None None U-4-13-II
None None None None None None PERADANGAN EPIGLOTIS, TELINGA TENGAH,
ISPA DAN LARINGOTRAKEITIS (SEDANG) 3268200 0 0 - 0 - 0
- 0 - 0 3268200 6937954 0 5 0 0 0
PRAYITNO RAMONA D021524 63 23310 DR ASNOMINANDA, SPHT
0138R01701180011493 0001460946802 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139858 1#0##0#0#0.0#2018-02-06
14:48:08#0#12:00:00#12:00:00#00:00:00 1 c6b09750a83369a7ef6686a04f96d397
0 0 400137 0 0 2498432 0 0 0 0
4039385 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 28/01/2018 01/03/1963 0 2
1 I11.0;I48 93.96;89.52 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4144700
8138801 0 6 1 4 0 ETY RUSMIYATI D388394 54
3;JKN DR RIZKI; 5.2.0.201712280730 4 139460 1#0##0#0#0.0#2018-
02-06 14:56:12#0#12:00:00#12:00:00#12:00:00 1
fcbea1b147681eb56de655a2f8df5b40 0 0 426024 0 0
1164332 0 0 0 0 4196445 0 0 0 0
2352000
3201126 B 3 BS 1 22/01/2018 28/01/2018 28/03/1976 0 1
1 E14.5 86.22;86.69 - - None None None None L-1-30-I None
None None None None None PEMINDAHAN KULIT TANPA LUKA BAKAR (RINGAN)
8883500 0 0 - 0 - 0 - 0 - 0
8883500 9835669 0 7 0 0 0 HERMAN SUSANTO
0001388641948 3;JKN DR RIZKI; 5.2.0.201712280730 4 139099
1#0##0#0#0.0#2018-02-06 15:33:59#0#12:00:00#12:00:00#12:00:00 1
89deb7698c3395ed6c954f2e827224f7 0 5203880 63000 0 0
2710320 0 0 0 0 1858469 0 0 0 0 0
3201126 B 3 BS 1 25/01/2018 28/01/2018 06/05/1985 0 2
1 O40;O42.9;O64.8;O82.9;Z37.0 74.0 - - None None None None
O-6-10-I None None None None None None OPERASI PEMBEDAHAN CAESAR
(RINGAN) 4986800 0 0 - 0 - 0 - 0 - 0
4986800 8244495 0 4 0 0 0 MAHARANI D388643
DR RIZKI; 5.2.0.201712280730 4 140496 1#0##0#0#0.0#2018-02-07
12:59:39#0#12:00:00#12:00:00#12:00:00 1 946b3869aa0e9778e316ac864f1be058
0 4393804 418340 0 0 1873076 0 0 0 0
1362275 0 0 0 69000 128000
3201126 B 3 BS 1 26/01/2018 28/01/2018 07/02/1982 0 2
1 J32.0;J32.2;J30.0;J34.2 22.50;21.5 - - None None None None
U-1-20-I None None None None None None PROSEDUR TENGGOROKAN, MULUT,
HIDUNG DAN TELINGA LAIN-LAIN (RINGAN) 6189700 0 0 - 0 -
0 - 0 - 0 6189700 12813391 0 3 0 0
0 JUWARIAH D385146 35 13137 DR RISMAN S, SPTHT
0138R01701180012049 0001453953925 3;JKN DR RIZKI; 5.2.0.201712280730
4 140513 1#0##0#0#0.0#2018-02-08
08:43:31#0#12:00:00#12:00:00#12:00:00 1 8a416cd452e340356de3392105488c90
0 7477772 375000 0 0 3329860 0 0 0 0
1413259 0 0 0 217500 0
3201126 B 2 BS 1 24/01/2018 28/01/2018 20/10/2011 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 5429152 0 5 0 0 0 NAJMYAZKA D239167
6 2288 DR NOVIK BUDIWARDHANA, SPA 0138R01701180011519
0001202919928 3;JKN DR RIZKI; 5.2.0.201712280730 4 139868
1#0##0#0#0.0#2018-03-02 21:05:53#0#12:00:00#12:00:00#00:00:00 1
d92925e5a8d325ef63437a1ff379f105 0 0 298024 0 0
2729950 0 0 0 0 2401178 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 28/01/2018 22/07/1967 0 2
1 S42.40;I69.4 79.31 - - None None None None M-1-80-I
None None None None None None PROSEDUR ANGGOTA TUBUH ATAS (RINGAN)
12140800 0 0 - 0 - 0 - 0 - 0
12140800 26678692 0 4 0 0 0 SILVIA CHRISTINA.S
0001303511049 3;JKN DR RIZKI; 5.2.1.201804062320 4 140494
1#0##0#0#0.0#2018-05-17 14:48:05#0#12:00:00#12:00:00#00:00:00 1
734fa5e47bac6f6e77015b2fdda6fa22 0 11145300 11339225 0 0
2968167 0 0 0 0 1226000 0 0 0 0 0
3201126 B 3 BS 1 26/01/2018 28/01/2018 29/04/2005 0 1
1 D56.9;R58 99.04 - - None None None None D-4-13-I None
- 0 2987000 2749253 0 3 0 0 0 MUHAMMAD
RAFLI FAZRIAN D384285 12 4655 DR VERA MUNA MANOE, SPA
0138R01701180012590 0001263251755 3;JKN DR RIZKI; 5.2.1.201804062320
4 140896 1#0##0#0#0.0#2018-05-17
14:59:40#0#12:00:00#12:00:00#12:00:00 2 ee1c72a0f8a0eadf962409c288cbfd62
0 0 268830 0 0 1748565 0 0 0 0 731858
0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 28/01/2018 22/04/1985 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 25814212 0 4 0 0 0 RURI SETYA HARI KARTIKA
d212365 32 11966 DR FX BHIMANTORO, SPOG 0138R01701180011997
0002313279033 3;JKN DR RIZKI; 5.2.1.201804062320 4 140499
1#1#vvip#4#18832712#0.0#2018-05-17 15:43:34#0#12:00:00#12:00:00#12:00:00
3 7f1b34a302739ceeeba27b304a486766 0 9409200 9213000 0
0 5822012 0 0 0 0 1301000 0 0 0 0
69000
3201126 B 3 BS 1 27/01/2018 28/01/2018 01/02/1945 0 1
1 R33;R31 57.94;90.59 - - None None None None N-4-15-I
None None None None None None GEJALA,TANDA GANGGUAN GINJAL DAN SALURAN
URIN (RINGAN) 3018300 0 0 - 0 - 0 - 0 -
0 3018300 918917 0 2 0 0 0 BURHANI
D376797 72 26658 DR AHMAD HIBBAN A WRIYA 0138R01701180012871
0002197791955 3;JKN DR RIZKI; 5.2.1.201804062320 4 141065
1#0##0#0#0.0#2018-05-17 15:46:43#0#12:00:00#12:00:00#12:00:00 2
2d25c24e017a4381cd290fa76523ac27 0 0 271647 0 0 280154
0 0 0 0 367116 0 0 0 0 0
3201126 B 2 BS 1 26/01/2018 28/01/2018 04/06/1958 0 2
1 C18.9;D63.0 99.04 - - None None None None K-4-10-II None
None None None None None TUMOR PENCERNAAN (SEDANG) 8475400 0
0 - 0 - 0 - 0 - 0 8475400 3699988
0 3 0 0 0 ELISABETH ELLEN.T. LH D363093 59 21786
RIZKI; 5.2.2.201806040537 4 140898 1#0##0#0#0.0#2018-08-14
11:07:30#0#12:00:00#12:00:00#00:00:00 2 f5497c1b554c19b5955d8ccb62308a4a
0 0 539531 0 0 1584902 0 0 0 0
1575555 0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 28/01/2018 13/01/1960 0 2
- 0 12472300 15008472 0 3 0 0 0 SUHATMIE.
H.S D003750 58 21198 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01701180012487 0001285776314 3;JKN DR RIZKI; 5.2.2.201806040537
4 140887 1#0##0#0#0.0#2018-09-07
16:05:56#0#12:00:00#12:00:00#12:00:00 3 21eb5e349fbb5b061afc37c35c228577
0 6813700 3669967 0 0 3367942 0 0 0 0
981863 0 0 0 175000 0
3201126 B 1 BS 1 27/01/2018 28/01/2018 31/03/1950 0 2
1 I12.0;E14.9;D63.8 39.27;99.04 - - None None None None N-1-
- 0 12472300 13812477 0 2 0 0 0 NURLAELA
0001845558246 3;JKN irene; 5.2.2.201806040537 4 141056
1#0##0#0#0.0#2018-09-10 15:29:59#0#12:00:00#12:00:00#12:00:00 4
d9982dd3e6304b78cf0fa5b8c60f105c 0 6648200 3669967 0 0
2495690 0 0 0 0 929620 0 0 0 69000 0
3201126 B 1 BS 1 26/01/2018 29/01/2018 29/03/1968 0 2
1 K29.7;K73.9;E87.6 - - - None None None None K-4-11-II
None None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG)
4615000 0 0 - 0 - 0 - 0 - 0
4615000 5751163 0 4 0 0 0 LINDA FRIDA PURBA
D021179 49 18200 DR ARU, SPPD 0138R01701180012028
0001257112642 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140507
1#0##0#0#0.0#2018-02-05 19:35:54#0#12:00:00#12:00:00#12:00:00 1
fb40fa7226ab28d1f58e533ad77edc35 0 0 345274 0 0
1879645 0 0 0 0 3526244 0 0 0 0 0
3201126 B 1 BS 1 27/01/2018 29/01/2018 11/01/1954 0 2
- 0 - 0 - 0 - 0 5005900 3916233 0
3 0 0 0 SUMIRAH D377765 64 23392 DR AGOES
KOOSHARTORO SPPD-KKV 0138R01701180012697 0000164586227 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 140945 1#0##0#0#0.0#2018-02-05
19:40:08#0#12:00:00#12:00:00#12:00:00 1 00724bb2c299f19463b3e418a66e7be7
0 0 503531 0 0 787500 0 0 0 0
2625202 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 29/01/2018 18/03/1949 0 2
1 I21.9;I49.3;I11.0 - - - None None None None I-4-10-III
0 0 - 0 - 0 - 0 - 0 14562700
8281615 0 5 0 0 0 SUSMIYATI, SH. D383728 68
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140098
1#0##0#0#0.0#2018-02-05 19:44:31#0#12:00:00#12:00:00#12:00:00 1
9ade5919ecc018f30ed865b5fbdf3c95 0 0 940040 0 0
2868787 0 0 0 0 4472788 0 0 0 0 0
3201126 B 1 BS 1 27/01/2018 29/01/2018 12/08/1945 0 1
- 0 58821400 58912920 0 3 0 0 0 DODONG
ROCHENDY D380241 72 26466 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180012666 0002195600995 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140910 1#0##0#0#0.0#2018-02-05
20:14:10#0#12:00:00#12:00:00#12:00:00 1 d706f296874fb19eb869d7a63742a988
0 10753000 9619120 0 0 0 0 0 0 0
1256000 0 0 29715800 7569000 0
3201126 B 1 BS 1 25/01/2018 29/01/2018 07/09/1997 0 2
1 A16.1;J18.9;K21.9 - - - None None None None J-4-15-I
None None None None None None PERADANGAN DAN INFEKSI PERNAFASAN
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 8990787 0 5 0 0 0 NADHILLAH KUSINDRIANI
0000165823108 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140492
1#1#vvip#5#2919687#0.0#2018-02-06 07:40:34#0#12:00:00#12:00:00#12:00:00
2 59f42c97c3e8a78c16426699d97c9263 0 0 1009198 0 0
1579907 0 0 0 0 6401682 0 0 0 0 0
3201126 B 1 BS 1 28/01/2018 29/01/2018 02/09/1964 0 2
0 - 0 - 0 - 0 - 0 3247500 6142201
0 2 0 0 0 YANI MULYANI D387609 53 19506 DR
ZULFAN, SPPD 0138R01701180013002 0001139523096 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141093 1#0##0#0#0.0#2018-02-06
07:59:34#0#12:00:00#12:00:00#12:00:00 1 cd8764cc4090db4e4e90dec8eb270e84
0 0 1398200 0 0 953675 0 0 0 0
2041326 0 0 0 1749000 0
3201126 B 1 BS 1 27/01/2018 29/01/2018 20/04/1974 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 54561542 0 3 0 0 0 ZULKIFLY DJUFRI
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0001623369104 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140942
1#0##0#0#0.0#2018-02-06 08:19:01#0#12:00:00#12:00:00#12:00:00 1
c949e75a9b052df462258efe4557fe22 0 0 3003220 0 0 0
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3201126 B 2 BS 1 27/01/2018 29/01/2018 06/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 14653000
15508323 0 3 0 0 0 NINIH D388313 72 26533 DR
AGOES KOOSHARTORO SPPD-KKV 0138R01701180012640 0001454929097 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 140907 1#0##0#0#0.0#2018-
02-06 08:56:21#0#12:00:00#12:00:00#12:00:00 1
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4167160 0 0 0 0 6384563 0 0 0 2026000
0
3201126 B 2 BS 1 27/01/2018 29/01/2018 29/12/1954 0 1
- 0 51950600 65312792 0 3 0 0 0 DADANG
SUDANA D291401 63 23040 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180012667 0001287164924 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140911 1#0##0#0#0.0#2018-02-06
09:32:43#0#12:00:00#12:00:00#00:00:00 1 27f38916d51e820998472c06690d5409
0 9401000 8244960 0 0 0 0 0 0 0
1226000 0 0 38871832 7569000 0
3201126 B 2 BS 1 28/01/2018 29/01/2018 11/06/1984 0 1
- 0 10690500 12554981 0 2 0 0 0 RAIHAN
0001658104176 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141078
1#0##0#0#0.0#2018-02-06 09:39:07#0#12:00:00#12:00:00#12:00:00 1
741cfbb5fa03e587501a4fa8db67e1c8 0 4457100 3153245 0 0
4032782 0 0 0 0 821354 0 0 0 90500 0
3201126 B 2 BS 1 24/01/2018 29/01/2018 20/01/1965 0 1
1 I21.9;J18.0;I11.0 - - - None None None None I-4-10-III
0 0 - 0 - 0 - 0 - 0 12482300
12143787 0 6 0 0 0 YOPI KAMBEY D293093 53 19362
TANTIYO S;16137 5.2.0.201712280730 4 139851 1#0##0#0#0.0#2018-
02-06 09:46:39#0#12:00:00#12:00:00#00:00:00 1
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4083514 0 0 0 0 6495453 0 0 0 1176000
0
3201126 B 2 BS 1 28/01/2018 29/01/2018 19/06/1996 0 2
1 R10.3 - - - None None None None K-4-17-I None None
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1868899 0 2 0 0 0 DEA PUSPITA SARI
D292749 21 7893 YASMIN SURYANDARI BACHTIAR. DR. SPB
0138R01701180012967 0001107848744 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141083 1#0##0#0#0.0#2018-02-06
10:01:09#0#12:00:00#12:00:00#00:00:00 1 fa08e108539204d926d939a9ac06cc0a
0 0 344535 0 0 573600 0 0 0 0 950764
0 0 0 0 0
3201126 B 2 BS 1 27/01/2018 29/01/2018 12/05/1959 0 2
1 E16.2;N18.5 87.03 - - None None None None E-4-10-I None
- 0 4203300 6407846 0 3 0 0 0 KUSMIATI
LESTARI D379536 58 21445 DR SRI KUNMARTINI, SPPD 0138R01701180012635
0001289034044 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140906
1#0##0#0#0.0#2018-02-06 10:28:37#0#12:00:00#12:00:00#12:00:00 1
65cbd53eb910c4a9fdb0b726a51f0e84 0 0 431297 0 0
3280344 0 0 0 0 2696205 0 0 0 0 0
3201126 B 2 BS 1 25/01/2018 29/01/2018 19/02/1994 0 2
1 O14.1;O82.9;O45.9;O99.0 74.0;99.04 - - None None None None
(SEDANG) 6486300 0 0 - 0 - 0 - 0 - 0
6486300 18079887 0 5 0 0 0 FEBIANA EKASIWI
0138R01701180011528 0002084292731 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139871 1#0##0#0#0.0#2018-02-06
11:03:43#0#12:00:00#12:00:00#12:00:00 1 0743b20762f5406bc3f36d3a2ac0baf6
0 8665900 2365164 0 0 5005026 0 0 0 0
1258797 0 0 0 785000 0
3201126 B 3 BS 1 26/01/2018 29/01/2018 29/07/1961 0 2
None None None None GANGGUAN ESOFAGUS (RINGAN) 2954900 0 0
- 0 - 0 - 0 - 0 2954900 3800681 0
4 0 0 0 ENDANG LISTIOWATY D304970 56 20635 DR SOEGIONO,
SPPD 0138R0171180012245 0001155637023 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140723 1#0##0#0#0.0#2018-02-06
11:44:48#0#12:55:51#12:55:51#00:00:00 1 dfca730d7c8766936af72a987987ea9e
0 0 261764 0 0 1244274 0 0 0 0
2294643 0 0 0 0 0
3201126 B 3 BS 1 23/01/2018 29/01/2018 20/01/1970 0 2
1 E11.5;N39.0;J18.0;I10 84.11;87.44;88.28 - - None None None
None M-1-30-III None None None None None None PROSEDUR KAKI (BERAT)
20251400 0 0 - 0 - 0 - 0 - 0
20251400 17127842 0 7 0 0 0 ANIH D388414 48
17535 DR SRI KUN, SPPD 0138R01701180011768 0001470667217 3;JKN DR
RIZKI; 5.2.0.201712280730 4 140207 1#0##0#0#0.0#2018-02-06
11:48:13#0#12:00:00#12:00:00#12:00:00 1 76a9818cb24aaf41d9be63e396c9db03
0 7058356 1752524 0 0 5895449 0 0 0 0
2352513 0 0 0 69000 0
3201126 B 2 BS 1 24/01/2018 29/01/2018 20/01/1971 0 2
1 I48;I11.0;I05.0 - - - None None None None I-4-19-III
(BERAT) 8754900 0 0 - 0 - 0 - 0 - 0
8754900 9649368 0 6 0 0 0 HENDRINA CHRISTINA P.
0001717053996 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139598
1#0##0#0#0.0#2018-02-06 11:50:54#0#12:00:00#12:00:00#12:00:00 1
672c9de9f678f1978f6bb9dbbfe983f8 0 0 852524 0 0
2523577 0 0 0 0 4791267 0 0 0 1482000
0
3201126 B 3 BS 1 27/01/2018 29/01/2018 10/10/1965 0 1
- 0 36446400 55837210 0 3 0 0 0 HAMDANI
d388309 52 19102 DR AGOES KOOSHARTORO SPPD-KKV 0138R01701180012643
0000500764678 3;JKN DR RIZKI; 5.2.0.201712280730 4 140908
1#0##0#0#0.0#2018-02-06 14:18:45#0#12:00:00#12:00:00#12:00:00 2
80c668c490bc9c3948894d34992f0f0e 0 11250884 1543236 0 0
33699090 0 0 0 0 1775000 0 0 0 69000
7500000
3201126 B 3 BS 1 23/01/2018 29/01/2018 25/08/1942 0 1
1 J18.8;I25.0;I08.9;I11.0 87.44 - - None None None None J-4-
16-III None None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH
(BERAT) 6419700 0 0 - 0 - 0 - 0 - 0
6419700 5100642 0 7 0 0 0 PETRUS HERMAN LOEN
0000510007509 3;JKN DR RIZKI; 5.2.0.201712280730 4 139458
1#0##0#0#0.0#2018-02-06 14:22:13#0#12:00:00#12:00:00#00:00:00 1
50f7821ea6e29b0e99513a7123d974ef 0 0 641970 0 0
2344485 0 0 0 0 2114187 0 0 0 0 0
3201126 B 3 BS 1 26/01/2018 29/01/2018 11/03/2017 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2037534 0 4 0 0 0 MALIQUE SALMAN ABDULLAH
d388699 0 321 DR RASTRA, SPA 0138R01701180012583
0002238190053 3;JKN DR RIZKI; 5.2.0.201712280730 4 140895
1#0##0#0#0.0#2018-02-06 14:33:24#0#12:00:00#12:00:00#12:00:00 1
1178145c97337d96981921950ad330e0 0 0 207620 0 0 705117
0 0 0 0 1124797 0 0 0 0 0
3201126 B 3 BS 1 27/01/2018 29/01/2018 29/12/1943 0 2
- 0 8908800 10177363 0 3 0 0 0 HJ. SAHLAH
D388792 74 27058 DR SRI KUN, SPPD 0138R01701180012814
0001229201381 3;JKN DR RIZKI; 5.2.0.201712280730 4 141057
1#0##0#0#0.0#2018-02-06 14:36:40#0#12:00:00#12:00:00#12:00:00 1
ba15f6f25a70600ce7adbcc38c97bda8 0 4874560 854792 0 0
3224702 0 0 0 0 1154309 0 0 0 69000 0
3201126 B 3 BS 1 25/01/2018 29/01/2018 01/05/1965 0 1
1 I63.9;E11.9 87.03 - - None None None None G-4-14-I None
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 7112681 0 5 0 0 0 SUGIARTO D388646
52 19262 DR MAYSAMIRAWATI SPS 0138R01701180012027 0000510212158
3;JKN DR RIZKI; 5.2.0.201712280730 4 140506 1#0##0#0#0.0#2018-
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4777510 0 0 0 0 1543316 0 0 0 0 0
3201126 B 3 BS 1 24/01/2018 29/01/2018 01/10/2004 0 2
1 D56.1;R55;K29.7;K59.0 99.04;87.44;89.14 - - None None None
None D-4-13-I None None None None None None GANGGUAN SEL DARAH MERAH
SELAIN KRISIS ANEMIA SEL SICKLE (RINGAN) 2987000 0 0 - 0 -
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0 OKTARIAS ANANDA R D386020 13 4863 DR VERA MUNA MANOE, SPA
0138R01701180011458 0001014393644 3;JKN DR RIZKI; 5.2.0.201712280730
4 139856 1#0##0#0#0.0#2018-02-06
15:18:07#0#12:00:00#12:00:00#12:00:00 1 4d776c51078ebc1fabf20775507f243a
0 0 779730 0 0 5340289 0 0 0 0
1770716 0 0 0 0 0
3201126 B 3 BS 1 26/01/2018 29/01/2018 31/10/1991 0 2
1 O15.1;O80.9;Z37.0 72.71 - - None None None None O-6-12-III
None None None None None None PERSALINAN VAGINAL DENGAN PROSEDUR SELAIN
STERILISASI &/ DILATASI & KURET (BERAT) 3786700 0 0 - 0 -
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0 SUCI ROSITA D388671 26 9584 DR MAMAN H, SPOG
0138R01701180012190 0000371050086 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140600 1#0##0#0#0.0#2018-02-22
12:01:29#0#12:00:00#12:00:00#12:00:00 1 450495a2f439f8820d81c34b45d612bb
0 3901600 969340 0 0 6484188 0 0 0 0
959069 0 0 298000 290000 0
3201126 B 2 BS 1 26/01/2018 29/01/2018 24/10/1983 0 1
1 N18.5;J90 34.91;39.95 - - None None None None N-4-10-III
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 10257087 0 4 0 0 0 WINDU S. ANUGRAH
TN D331384 34 12513 DR IRVAN VERYADI 0138R01701180012029
0001638965226 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140509
1#0##0#0#0.0#2018-02-22 14:40:21#0#12:00:00#12:00:00#00:00:00 1
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3273953 0 0 0 0 3873274 0 0 0 0 0
3201126 B 3 BS 1 28/01/2018 29/01/2018 08/04/1941 0 1
1 N18.5;R57.2;I25.2;E87.6;R57.0 - - - None None None None
- 0 6077700 5385342 0 2 0 0 0
SUPRIYADI,DRS D337700 76 28054 DR DICKY KARUNDENG
0138R01701180012992 0000060892479 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141090 1#0##0#0#0.0#2018-02-22
16:55:59#0#12:00:00#12:00:00#00:00:00 1 5b4e6271a9d795f0085b51481cb1f32c
0 0 371889 0 0 4226141 0 0 0 0 659312
0 0 0 0 128000
3201126 B 3 BS 1 29/01/2018 29/01/2018 01/03/1962 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 1015136 0 1 0 0 0 BASIMIN
0000369507295 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141493
1#0##0#0#0.0#2018-02-23 08:50:29#0#12:00:00#12:00:00#12:00:00 1
59ba4169371c259c0a9b1edfde8358b4 0 0 390645 0 0 269080
0 0 0 0 355411 0 0 0 0 0
3201126 B 3 BS 1 24/01/2018 29/01/2018 09/05/1971 0 1
1 I63.9;N18.9;R77.0 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4620485 0 6 0 0 0 ANTONIUS ANDI
WIJAYA D388542 46 17062 DR SRI KUN, SPPD 0138R01701180011513
0001771691332 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139865
1#0##0#0#0.0#2018-02-23 10:15:44#0#12:00:00#12:00:00#12:00:00 1
40c0a53844b0ee85dd0a7c337d21d129 0 0 457242 0 0
2519968 0 0 0 0 1643275 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 29/01/2018 29/04/2005 0 1
1 D56.1 - - - None None None None D-4-13-I None None
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 504323 0 1 0 0 0 MUHAMMAD RAFLI
FAZRIAN D384285 12 4658 DR VERA MUNA MANOE, SPA 0138R01701180013595
0001263251755 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141715
1#0##0#0#0.0#2018-02-28 17:12:02#0#12:00:00#12:00:00#12:00:00 1
1367ac9c25d6ed94e8128616448731be 0 0 268830 0 0 0
0 0 0 0 0 0 0 0 235493 0
3201126 B 2 BS 1 26/01/2018 29/01/2018 15/01/2018 0 2
0 - 0 - 0 - 0 - 0 5045200 5204730
0 4 0 0 0 BAYI NY FAUZIAH CHAIRUNNISA D388552 0
11 DR AULIA TANGKARI, SPA 0138R01701180012534 0002325157852 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 140889 1#0##0#0#0.0#2018-
03-02 21:20:20#0#12:00:00#12:00:00#12:00:00 1
dab4f63b90118e73552bfa3669f97213 0 0 454068 0 0 203666
0 0 0 0 2754996 0 0 0 1792000 0
3201126 B 1 BS 1 25/01/2018 29/01/2018 19/02/2012 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5304877 0 5 0 0 0 ILLUMINATA ATTALA
SHAQUILLE D271316 5 2167 DR RASTRA, SPA 0138R01701180011923
0001645856212 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140480
1#0##0#0#0.0#2018-03-02 21:24:56#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 4252048 0 0 0 26000 0
3201126 B 2 BS 1 26/01/2018 29/01/2018 28/10/2017 0 1
1 J18.0 - - - None None None None J-4-16-I None None
4335900 0 0 - 0 - 0 - 0 - 0
4335900 3547832 0 4 0 0 0 RAKHA VIRENDRA SUHAYA
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0002303376783 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140512
1#0##0#0#0.0#2018-03-02 21:26:50#0#12:00:00#12:00:00#12:00:00 1
91a0492ea5b07e1012ea7c6131fc32ea 0 0 443231 0 0 826601
0 0 0 0 2252000 0 0 0 26000 0
3201126 B 2 BS 1 28/01/2018 29/01/2018 19/06/1996 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1868399 0 2 0 0 0 DEA PUSPITA SARI
0001107848744 3;JKN DR RIZKI; 5.2.0.201712280730 4 141084
1#0##0#0#0.0#2018-03-10 09:30:02#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 950264 0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 29/01/2018 07/08/2017 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 4626296 0 4 0 0 0 IBRAHIM HAFIDZ AZHAR
0002253854316 3;JKN DR RIZKI; 5.2.0.201712280730 4 140903
1#0##0#0#0.0#2018-03-10 09:37:36#0#12:00:00#12:00:00#12:00:00 2
138cd8fa727b8c16a767da1b1c1d52eb 0 0 508265 0 0
1446376 0 0 0 0 2671655 0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 29/01/2018 15/10/2012 0 1
None None None None None PROSEDUR APPENDIK (SEDANG) 5966600 0
0 - 0 - 0 - 0 - 0 5966600 13484722
0 4 0 0 0 MUHAMMAD ZAID AMEGO D343275 5 1929
DR RASTRA, SPA 0138R01701180012033 0001883411425 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 140510 1#0##0#0#0.0#2018-03-12
16:08:09#0#12:00:00#12:00:00#12:00:00 3 ab0910afbf9106185952ee81621d0198
0 7878200 832428 0 0 3720916 0 0 0 0
908178 0 0 0 145000 0
3201126 B 2 BS 1 26/01/2018 29/01/2018 24/10/1983 0 1
1 N18.5;J90 34.91;39.95 - - None None None None N-4-10-III
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 10257087 0 4 0 0 0 WINDU S. ANUGRAH
TN D331384 34 12513 DR IRVAN VERYADI 0138R01701180014802
0001638965226 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140509
1#0##0#0#0.0#2018-03-19 08:43:19#0#12:00:00#12:00:00#00:00:00 2
305b0f6dd2e72bead37db3684e41b0e2 0 0 3109860 0 0
3273953 0 0 0 0 3873274 0 0 0 0 0
3201126 B 1 BS 1 21/01/2018 29/01/2018 18/03/1973 0 1
1 I63.9;E14.4 - - - None None None None G-4-14-II None
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 15742683 0 9 0 0 0 HANAFI D388062
44 16380 DR HARDI PRANATA SPS 0138R01701180009566 0001467700266
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 138471
1#0##0#0#0.0#2018-03-19 15:28:27#0#12:00:00#12:00:00#12:00:00 4
8da65db0ba2493492440409136e5e0a5 0 0 1126860 0 0
6530928 0 0 0 0 8084895 0 0 0 0 0
3201126 B 1 BS 1 22/01/2018 29/01/2018 30/11/1982 0 2
0 - 0 - 0 - 0 - 0 5424200 19330972
0 8 0 0 0 NOVIANTI BONTE,S.SOS D157468 35 12837
DR HENDRIEK S, SPB 0138R01701180010300 0001908517037 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 139104 1#0##0#0#0.0#2018-
03-28 07:44:20#0#12:00:00#12:00:00#12:00:00 3
fe56cf72d4ca681dd56303c30029bb94 0 9923200 2215420 0 0
5771352 0 0 0 0 1200000 0 0 0 221000
0
3201126 B 1 BS 1 28/01/2018 29/01/2018 08/09/1956 0 1
1 I12.0;D63.8;I25.0 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5903196 0 2 0 0 0 MUSLIH
0001457564534 3;JKN DR RIZKI; 5.2.1.201804062320 4 141086
1#0##0#0#0.0#2018-05-17 15:06:03#0#12:00:00#12:00:00#00:00:00 2
07fc3869f0a31e6749addb4cea2d65c1 0 0 573641 0 0
2199115 0 0 0 0 3130440 0 0 0 0 0
3201126 B 3 BS 1 27/01/2018 29/01/2018 19/08/1981 0 2
- 0 8908800 15604927 0 3 0 0 0 IIN
SUPRIATIN D385388 36 13310 DR. ARU ARIADNO, SPPD 0138R01701180012669
0002282454371 3;JKN DR RIZKI; 5.2.1.201804062320 4 140912
1#0##0#0#0.0#2018-05-17 15:09:01#0#12:00:00#12:00:00#12:00:00 2
ba2f1349115ccc7f04c6fdaba8fee9b3 0 3935500 2725640 0 0
6740654 0 0 0 0 2203133 0 0 0 0 0
3201126 B 3 BS 1 27/01/2018 29/01/2018 21/08/1965 0 2
1 I50.0;R11;E14.9 87.44 - - None None None None I-4-12-I
None None None None None None KEGAGALAN JANTUNG (RINGAN) 3575600
0 0 - 0 - 0 - 0 - 0 3575600
4312970 0 3 0 0 0 MARTINI D376222 52 19152
DR ARU, SPPD 0138R01701180012630 0001740359171 3;JKN ECHI;
5.2.1.201804062320 4 141328 1#0##0#0#0.0#2018-05-19
13:24:14#0#12:00:00#12:00:00#12:00:00 3 1ea0a9280aaa7e6a9e6b17435dc84afe
0 0 616660 0 0 2599153 0 0 0 0
1097157 0 0 0 0 0
3201126 B 2 BS 1 26/01/2018 29/01/2018 29/07/1961 0 2
- 0 - 0 - 0 - 0 3545800 3800681 0
4 0 0 0 ENDANG LISTIOWATY D304970 56 20635 DR SOEGIONO,
4 151800 1#0##0#0#0.0#2018-08-13
10:38:35#0#12:00:00#12:00:00#00:00:00 2 5193aa7b29a730e5088bc99427f99615
0 0 3800681 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 22/01/2018 30/01/2018 16/01/1946 0 2
1 I64;M47.82;E87.1 87.03;90.59;89.52 - - None None None None
OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (SEDANG) 6844000
0 0 - 0 - 0 - 0 - 0 6844000
21082886 0 9 0 0 0 SRI MARYATI,BA. D312256 72
TANTIYO S;16137 5.2.0.201712280730 4 139105
1#1#vvip#9#14238886#0.0#2018-02-05 20:27:23#0#12:00:00#12:00:00#00:00:00
1 6bb95b85302a3d0bbe0c45d186892f30 0 0 4536000 0 0
4016886 0 0 0 0 12530000 0 0 0 0 0
3201126 B 1 BS 1 25/01/2018 30/01/2018 22/12/1960 0 1
1 D64.9;G44.2;A01.0;M54.52 99.04;87.03 - - None None None
None D-4-13-III None None None None None None GANGGUAN SEL DARAH MERAH
SELAIN KRISIS ANEMIA SEL SICKLE (BERAT) 7570100 0 0 - 0 -
0 - 0 - 0 7570100 22627402 0 6 0 0
0 UMAR SYAH HS D388570 57 20853 DR BETTY DWI L, SPPD
0138R01701180011524 0001421029293 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139870 1#1#vvip#6#15057302#0.0#2018-02-06
07:42:40#0#12:00:00#12:00:00#12:00:00 2 d08ba2291be275e9b8411f9259d2c5c5
0 0 2835000 0 0 8948402 0 0 0 0
10844000 0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 30/01/2018 25/08/2016 0 1
1 A85.8;J45.9;R56.0 - - - None None None None G-4-19-II
None None None None None None INFEKSI NON BAKTERI SISTEM SARAF ,TIDAK
TERMASUK MENINGITIS VIRUS (SEDANG) 8745000 0 0 - 0 - 0
- 0 - 0 8745000 5078789 0 5 0 0 0
ASYTAR SALIM GHALI ASYA D342594 1 519 DR AULIA TANGKARI, SPA
0138R01701180012610 0002077408214 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140901 1#0##0#0#0.0#2018-02-06
07:54:11#0#12:00:00#12:00:00#00:00:00 1 959ca89b696c79d69543c95996e0b699
0 0 692764 0 0 903768 0 0 0 0
3482257 0 0 0 0 0
3201126 B 1 BS 1 29/01/2018 30/01/2018 19/02/1964 0 1
1 I20.0;I25.0;I11.0;I49.3 - - - None None None None I-4-
20-III None None None None None None ANGINA PEKTORIS DAN NYERI DADA
(BERAT) 9856000 0 0 - 0 - 0 - 0 - 0
9856000 2961321 0 2 0 0 0 SUPRIYANTO D287002
0001095080646 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141725
1#0##0#0#0.0#2018-02-06 08:12:00#0#12:00:00#12:00:00#12:00:00 1
943399cc645c02aaeca501cd673cf6af 0 0 940040 0 0 585050
0 0 0 0 1436231 0 0 0 0 0
3201126 B 2 BS 1 28/01/2018 30/01/2018 06/08/2017 0 2
None None None None ASTHMA & BRONKIOLITIS (RINGAN) 2671100 0
0 - 0 - 0 - 0 - 0 2671100 1926759
0 3 0 0 0 BAYI NY NIKEN PRABHA DUHITA D372858 0
175 DR KRISTON SILITONGA, SPA 0138R01701180012945 0002274323128
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141079
1#0##0#0#0.0#2018-02-06 09:24:27#0#12:00:00#12:00:00#12:00:00 1
8460426fbeb3a2ba7b801f962fc38562 0 0 240399 0 0 524310
0 0 0 0 1162050 0 0 0 0 0
3201126 B 2 BS 1 27/01/2018 30/01/2018 29/09/1955 0 2
1 I49.3;K29.7;I50.0 - - - None None None None I-4-19-II
(SEDANG) 7333600 0 0 - 0 - 0 - 0 - 0
7333600 5672740 0 4 0 0 0 LIE WINDY RAMLI
0001797652124 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140913
1#0##0#0#0.0#2018-02-06 10:35:44#0#12:00:00#12:00:00#00:00:00 1
d8e102f765c875d1bfd8bb02fce93889 0 0 713024 0 0
2542602 0 0 0 0 2417114 0 0 0 0 0
3201126 B 2 BS 1 26/01/2018 30/01/2018 04/05/2005 0 2
SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0 -
0 3584400 6062670 0 5 0 0 0 MEISYA ADELIA
PUTRI D388719 12 4650 DR VERA MUNA MANOE, SPA 0138R01701180012587
0001339282258 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140897
1#0##0#0#0.0#2018-02-06 10:54:19#0#12:00:00#12:00:00#12:00:00 1
a59f125403bf12b2410f5afad9f25ad6 0 0 322596 0 0 0
0 0 4265451 0 1474623 0 0 0 0 0
3201126 B 3 BS 1 28/01/2018 30/01/2018 12/05/2017 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2601989 0 3 0 0 0 MUHAMMAD UZAIR DZUN
NURAIN D388888 0 261 DR AWIDIYA, SPA 0138R01701180012892
0002288098304 3;JKN DR RIZKI; 5.2.0.201712280730 4 141072
1#0##0#0#0.0#2018-02-06 11:41:04#0#12:00:00#12:00:00#12:00:00 1
dd0fa31de92b3f4f6786a5595359322f 0 0 257183 0 0
1019582 0 0 0 0 985224 0 0 0 340000
0
3201126 B 3 BS 1 27/01/2018 30/01/2018 27/11/1945 0 1
1 K71.6;J22;E14.9;K29.7 89.52 - - None None None None B-4-
13-I None None None None None None GANGGUAN HATI LAIN-LAIN (RINGAN)
4204300 0 0 - 0 - 0 - 0 - 0
4204300 5993589 0 4 0 0 0 KARSO D370579 72
DR RIZKI; 5.2.0.201712280730 4 141060 1#0##0#0#0.0#2018-02-06
12:05:20#0#12:00:00#12:00:00#00:00:00 1 66a2303c9c71fbf7fba430e26ec79db4
0 0 727720 0 0 1977265 0 0 0 0
3288604 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 30/01/2018 26/01/1952 0 1
10401900 0 0 - 0 - 0 - 0 - 0
10401900 10578634 0 9 1 4 0 MANGAPUL L. TOBING
0002081150717 3;JKN DR RIZKI; 5.2.0.201712280730 4 138503
1#0##0#0#0.0#2018-02-06 14:06:31#0#12:00:00#12:00:00#00:00:00 1
77ff95a262e9cff272e92843cf76cd5c 0 0 752390 0 0
3585184 0 0 0 0 5525060 0 0 0 0 716000
3201126 B 3 BS 1 26/01/2018 30/01/2018 01/06/1966 0 2
1 M06.88;T08.0 87.24 - - None None None None M-4-16-II
None None None None None None GANGGUAN JARINGAN KONEKTIF (SEDANG)
4691000 0 0 - 0 - 0 - 0 - 0
4691000 5488261 0 5 0 0 0 YUNIAR BAYU NIRWANA
d368310 51 18867 DR NURUL KOMARI SPS 0138R01701180012300
0001014225208 3;JKN DR RIZKI; 5.2.0.201712280730 4 140732
1#0##0#0#0.0#2018-02-06 14:10:36#0#12:00:00#12:00:00#00:00:00 1
82fcbbdea872fe28ab1946eef67b6406 0 0 308735 0 0
3479481 0 0 0 0 1700045 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 30/01/2018 19/03/1977 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 58411900 0 2 0 0 0 MARULI SUKARNO
0001731212436 3;JKN DR RIZKI; 5.2.0.201712280730 4 141255
1#0##0#0#0.0#2018-02-06 16:44:08#0#12:00:00#12:00:00#12:00:00 1
1977b80dfc56a427f93b53f3c59e8183 0 7650000 6870800 0 0
34720100 0 0 0 0 1602000 0 0 0 0
7569000
3201126 B 3 BS 1 28/01/2018 30/01/2018 04/10/1979 0 2
LAIN (SEDANG) 5275200 0 0 - 0 - 0 - 0 -
0 5275200 5334959 0 3 0 0 0 OKKY INDARTI DEWI
0001269336508 3;JKN DR RIZKI; 5.2.0.201712280730 4 141081
1#0##0#0#0.0#2018-02-07 09:03:46#0#12:00:00#12:00:00#00:00:00 2
6cdb3e61b83fe36f21a8a5edde6555f8 0 0 424889 0 0
2589804 0 0 0 0 2320266 0 0 0 0 0
3201126 B 1 BS 1 23/01/2018 30/01/2018 04/05/1995 0 2
1 M32.9;R50.9;J22;A41.9 - - - None None None None M-4-
16-III None None None None None None GANGGUAN JARINGAN KONEKTIF (BERAT)
11032700 0 0 - 0 - 0 - 0 - 0
11032700 12030322 0 8 0 0 0 BADRIA PERMATASARI
0001797940359 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139669
1#0##0#0#0.0#2018-02-12 08:55:20#0#12:00:00#12:00:00#12:00:00 1
8634a9659d5f374460bca3c902d1ef9c 0 5467000 1061640 0 0
0 0 0 0 0 813030 0 0 0 4688652 0
3201126 B 1 BS 1 29/01/2018 30/01/2018 28/03/1954 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 59630016 0 2 0 0 0 NAZARIUS MULYADI
0001466484311 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141184
1#0##0#0#0.0#2018-02-22 15:08:14#0#12:00:00#12:00:00#12:00:00 1
fc81ac74d9c58edb033b439862c750a8 0 10062000 9619120 0 0
31123896 0 0 0 0 1256000 0 0 7500000 69000
0
3201126 B 2 BS 1 27/01/2018 30/01/2018 04/11/2015 0 1
1 B34.9;K12.1 - - - None None None None A-4-13-II None
3200900 0 0 - 0 - 0 - 0 - 0
3200900 2969260 0 4 0 0 0 ABINAYA MESHACH
D388836 2 815 DR RASTRA, SPA 0138R01701180012855
0002260756541 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141061
1#0##0#0#0.0#2018-02-23 10:07:28#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 2032751 0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 30/01/2018 10/06/1978 0 2
(RINGAN) 3695900 0 0 - 0 - 0 - 0 - 0
3695900 1458074 0 1 0 0 0 NURAINI d389043
39 14479 DR NIKEN PRABHA 0138R01701180013910 0001740399928 3;JKN
YULIA N. MAIWA;15092 5.2.0.201712280730 4 143274
1#0##0#0#0.0#2018-03-01 15:50:13#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 384388 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 30/01/2018 18/01/1964 0 1
3 I61.9;G81.9;I10 87.03;87.44;89.52 - - None None None None
G-4-13-II None None None None None None PERDARAHAN INTRA KRANIAL
BUKAN TRAUMATIK (SEDANG) 5153300 0 0 - 0 - 0 -
0 - 0 5153300 3633099 0 2 0 0 0
DARMANSYAH SAMBAS D180127 54 19735 DR MUHAMMAD RIZKI YUWANA
0138R01701180013540 0001628817489 3;JKN YULIA N. MAIWA;15092
5.2.0.201712280730 4 141714 1#0##0#0#0.0#2018-03-01
15:54:57#0#14:10:00#23:00:00#12:00:00 2 2df72f36c03c2f151f7a2fd2ff4e62d4
0 0 368658 0 0 2719762 0 0 0 0 544679
0 0 0 0 0
3201126 B 1 BS 1 26/01/2018 30/01/2018 11/02/2011 0 1
1 D64.9;J18.9;B20.9 87.44 - - None None None None D-4-13-III
ANEMIA SEL SICKLE (BERAT) 7570100 0 0 - 0 - 0 -
0 - 0 7570100 7056735 0 5 0 0 0 MILAN
SADEWO D219845 6 2541 DR NIA KURNIATI, SPA 0138R01701180013345
0001203038425 3;JKN DR RIZKI; 5.2.0.201712280730 4 141468
1#0##0#0#0.0#2018-03-02 21:12:40#0#12:00:00#12:00:00#00:00:00 1
7d7b3d5ef5214f1c134a52c6da81d354 0 0 548370 0 0
2896709 0 0 0 0 3611656 0 0 0 0 0
3201126 B 2 BS 1 28/01/2018 30/01/2018 13/01/2017 0 2
0 0 - 0 - 0 - 0 - 0 2871200
3300959 0 3 0 0 0 VARISHA ALMEIRA NASYA D387018
3;JKN DR RIZKI; 5.2.0.201712280730 4 141069 1#0##0#0#0.0#2018-
03-10 09:15:04#0#12:00:00#12:00:00#12:00:00 2
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0 0 0 0 1756951 0 0 0 340000 0
3201126 B 3 BS 1 26/01/2018 30/01/2018 01/04/1986 0 2
1 K36;N70.0 90.59;89.52 - - None None None None K-4-18-II
(SEDANG) 2451500 0 0 - 0 - 0 - 0 - 0
2451500 1000000 0 5 0 0 0 NURSYAMSIAH D388725
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140899
1#0##0#0#0.0#2018-03-19 08:36:41#0#12:00:00#12:00:00#12:00:00 2
864c7c665d974aa65af7cc4c2edf9e29 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 28/01/2018 30/01/2018 17/01/1969 0 1
- 0 8908800 9312303 0 3 0 0 0 SAUBIH
0138R01701180013010 0001770795415 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141094 1#0##0#0#0.0#2018-03-19
13:42:20#0#12:00:00#12:00:00#12:00:00 2 62a16ea338384f01950f710c5dcdeb5f
0 3542920 106000 0 0 4682167 0 0 0 0
981216 0 0 0 0 0
3201126 B 2 BS 1 24/01/2018 30/01/2018 17/07/1972 0 2
1 N61 85.99 - - None None None None L-1-50-I None None
0 - 0 - 0 - 0 - 0 7842900 15103093
0 7 0 0 0 SARWANI D218212 45 16627 DR HENDRIEK
5.2.1.201804062320 4 139866 1#0##0#0#0.0#2018-05-17
15:06:41#0#12:00:00#12:00:00#00:00:00 2 11e45289afa955e72b8495da1616a3b8
0 6099100 2327441 0 0 5517499 0 0 0 0
1014053 0 0 0 0 145000
3201126 B 1 BS 1 22/01/2018 30/01/2018 01/01/1948 0 1
3 E87.6;F02.3;I20.0;A49.9;K29.7;R57.0 93.94;87.03 - - None None
None None E-4-11-III None None None None None None HIPOVOLEMIA &
GANGGUAN ELEKROLIT (BERAT) 8810600 0 0 - 0 - 0 -
0 - 0 8810600 5000000 0 9 1 3 0 HM
JUSUF ABUBAKAR D076505 70 25589 DR. ARU ARIADNO, SPPD
0138R01701180009931 0000061015847 3;JKN DR RIZKI; 5.2.2.201806040537
4 138724 1#0##0#0#0.0#2018-08-14
11:47:13#0#12:00:00#12:00:00#12:00:00 3 c182455ea3cadacbc488ad4cb8b93cd1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
3201126 B 3 BS 1 30/01/2018 30/01/2018 18/09/1959 0 2
None None None None GANGGUAN - PENYAKIT SISTEM SARAF LAIN-LAIN (RINGAN)
3587300 0 0 - 0 - 0 - 0 - 0
3587300 1542353 0 1 0 0 0 RAMINI D370123
DR RIZKI; 5.2.2.201806040537 4 141731 1#0##0#0#0.0#2018-08-14
12:06:09#0#12:00:00#12:00:00#00:00:00 3 fd89c75238966e96507bd739a1bec11d
0 0 451179 0 0 265272 0 0 0 0 407902
0 0 0 290000 128000
3201126 B 2 BS 1 29/01/2018 30/01/2018 06/12/1954 0 2
1 K29.7;K31.7;Q40.1 45.16;45.42 - - None None None None K-4-
2783600 0 0 - 0 - 0 - 0 - 0
2783600 5669511 0 2 0 0 0 YUMANI D388374
DR RIZKI; 5.2.2.201806040537 4 141718 1#0##0#0#0.0#2018-09-06
09:03:28#0#12:00:00#12:00:00#12:00:00 2 2ade0318fd00470ed9a2f0ce7d38c691
0 0 779408 0 0 1406700 0 0 0 0
1734403 0 0 0 1749000 0
3201126 B 1 BS 1 29/01/2018 30/01/2018 16/12/1964 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 13294459 0 2 0 0 0 SUNARJASA
D388930 53 19402 DR SRI KUN, SPPD 0138R01701180013282
0001741647407 3;JKN DR RIZKI; 5.2.2.201806040537 4 141382
1#0##0#0#0.0#2018-09-06 12:01:52#0#12:00:00#12:00:00#12:00:00 2
93dfcca1232b41ed4628a1613b76c16b 0 6468200 3669967 0 0
2157061 0 0 0 0 895731 0 0 0 103500
0
3201126 B 1 BS 1 28/01/2018 31/01/2018 28/08/2002 0 2
1 A15.3;R50.9;K29.7 - - - None None None None J-4-15-I
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 8111793 0 4 0 0 0 REGINA BRIGITA
SIMANJUNTAK D041095 15 5632 DR VERA MUNA MANOE, SPA 0138R01701180012965
0001516995999 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141082
1#1#vvip#4#2040693#0.0#2018-02-05 19:09:52#0#12:00:00#12:00:00#12:00:00
1 e318ecdc277e3b2ea10949a2d5fd4079 0 0 634963 0 0
2407652 0 0 0 0 5069178 0 0 0 0 0
3201126 B 1 BS 1 29/01/2018 31/01/2018 06/03/1969 0 2
0 0 - 0 - 0 - 0 - 0 11569900
22695432 0 3 0 0 0 TOYIBAH D326805 48 17861
DR ERDIYAN, SPOG 0138R01701180013060 0000060529678 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 141096 1#1#vip#1#8677425#75.0#2018-
02-05 19:51:11#0#12:00:00#12:00:00#12:00:00 1
d95e7d70010a3bdd5629070fc6c3f686 0 9309100 7343037 0 0
4612295 0 0 0 0 1286000 0 0 0 145000
0
3201126 B 1 BS 1 24/01/2018 31/01/2018 23/03/2017 0 1
1 J18.0;A09.9;B37.9 93.94 - - None None None None J-4-16-II
(SEDANG) 7108500 0 0 - 0 - 0 - 0 - 0
7108500 11505336 0 8 0 0 0 BAYI NY MELINDA
KRISNAWATI D369058 0 307 DR RASTRA, SPA 0138R01701180010875
0002236690034 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139465
1#0##0#0#0.0#2018-02-05 20:05:24#0#12:00:00#12:00:00#12:00:00 1
7a94f5c207dcb6dd59aa6c0885772b7b 0 0 508265 0 0
3454385 0 0 0 0 6248000 0 0 0 1294686
0
3201126 B 1 BS 1 27/01/2018 31/01/2018 23/05/1972 0 1
1 S72.80;M84.06;M62.56 77.25;79.35;77.75 - - None None None
None M-1-20-II None None None None None None PROSEDUR PAHA DAN SENDI
PANGGUL (SEDANG) 22787900 0 0 - 0 - 0 - 0 -
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0001338042036 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140909
1#0##0#0#0.0#2018-02-05 20:11:50#0#12:00:00#12:00:00#12:00:00 1
6ae187664ecce84ddb126f05a922ec93 0 0 12672930 0 0
4566805 0 0 0 0 1295000 0 0 11836300 0
0
3201126 B 1 BS 1 23/01/2018 31/01/2018 28/11/1938 0 2
1 I63.9;G81.9;I48;I10;E87.6 87.03 - - None None None None
0 - 0 9673300 12300649 0 9 0 0 0
ZUBAIDAH D143128 79 28911 DR MAYSAMIRAWATI SPS
0138R01701180010805 0000024826577 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139456 1#0##0#0#0.0#2018-02-06
08:30:20#0#12:00:00#12:00:00#12:00:00 1 1b600c638e89ddb461b338ec20f2865d
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7514215 0 0 0 0 0
3201126 B 2 BS 1 30/01/2018 31/01/2018 27/12/2003 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2013709 0 2 0 0 0 NADIA SUCI RAHMANI
0001466495526 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141727
1#0##0#0#0.0#2018-02-06 11:05:24#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1167738 0 0 0 0 0
3201126 B 2 BS 1 24/01/2018 31/01/2018 17/11/1967 0 2
1 K40.3;K66.0 53.03;90.59;89.52;54.59 - - None None None None
K-1-11-I None None None None None None ADHESIOLISIS PERITONEAL
(RINGAN) 9924600 0 0 - 0 - 0 - 0 - 0
9924600 18912177 0 8 0 0 0 EMILIA HILIA
0001470190781 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139860
1#0##0#0#0.0#2018-02-06 11:15:32#0#12:00:00#12:00:00#00:00:00 1
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7366777 0 0 0 0 1276000 0 0 0 217500
0
3201126 B 2 BS 1 30/01/2018 31/01/2018 17/12/1949 0 1
9649200 0 0 - 0 - 0 - 0 - 0
9649200 12909222 0 2 0 0 0 DENNY W SUMANTI
d301746 68 24881 DR HERY TIERA, SPU 0138R01701180013742
0000060706102 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141734
1#0##0#0#0.0#2018-02-06 11:24:04#0#12:00:00#12:00:00#00:00:00 1
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2144425 0 0 0 0 844529 0 0 0 90500 0
3201126 B 2 BS 1 23/01/2018 31/01/2018 17/06/2011 0 1
1 G04.9;B34.9;R56.8 - - - None None None None G-4-19-II
- 0 - 0 7495700 14082340 0 9 0 0 0
LYAN GALIH RAFI RAHENDI D388178 6 2412 DR RASTRA, SPA
0138R01701180010804 0002103387208 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139452 1#0##0#0#0.0#2018-02-06
11:27:44#0#12:00:00#12:00:00#12:00:00 1 1c4be98281a7b7fb7ec81662cf3005b8
0 0 802570 0 0 7989995 0 0 0 0
5289775 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 31/01/2018 06/03/1996 0 2
0 - 0 - 0 - 0 - 0 5331600 7591292
0 3 0 0 0 MUTIARA YOHANA GULTOM D232917 21 7999
DR HENDRIEK SP B 0138R01701180013615 0001389802847 3;JKN DR RIZKI;
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12:22:19#0#12:00:00#12:00:00#12:00:00 1 cbe9666aab6efea754bccbd6a58b898d
0 4209348 63000 0 0 2351317 0 0 0 0 898627
0 0 0 69000 0
3201126 B 3 BS 1 27/01/2018 31/01/2018 16/10/1975 0 2
1 K58.9;M54.56;K81.9 - - - None None None None K-4-
18-I None None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN
(RINGAN) 1452800 0 0 - 0 - 0 - 0 - 0
1452800 3716101 0 5 0 0 0 STELLA ELIZABETH.F
D237770 42 15444 DR ARU, SPPD 0138R01701180013370
0001483884292 3;JKN DR RIZKI; 5.2.0.201712280730 4 141470
1#0##0#0#0.0#2018-02-06 15:57:32#0#12:00:00#12:00:00#12:00:00 1
aa418247780f525e9128d72f92515309 0 0 384902 0 0
2010090 0 0 0 0 1321109 0 0 0 0 0
3201126 B 3 BS 1 22/01/2018 31/01/2018 04/04/1998 0 1
1 K35.2;K85.9;A41.9 54.11;88.19;88.01 - - None None None None
K-1-40-III None None None None None None PROSEDUR SISTEM PENCERNAAN
LAIN-LAIN (BERAT) 15009700 0 0 - 0 - 0 - 0 -
0 15009700 24277764 0 10 0 0 0 MUHAMMAD RIDWAN
0001335892667 3;JKN DR RIZKI; 5.2.0.201712280730 4 138859
1#0##0#0#0.0#2018-02-06 16:24:08#0#12:00:00#12:00:00#12:00:00 1
9720136370a6f152e85e7b27f6ec4f0a 0 7295516 353194 0 0
13528054 0 0 0 0 2956000 0 0 0 145000
0
3201126 B 3 BS 1 26/01/2018 31/01/2018 12/11/1983 0 2
1 O21.1;O99.2;O98.4 - - - None None None None W-4-16-II
None None None None None None GANGGUAN ANTEPARTUM (SEDANG) 2899500
0 0 - 0 - 0 - 0 - 0 2899500
5990781 0 6 0 0 0 SUKINI D388175 34 12494
DR ERDIYAN, SPOG 0138R01701180012478 0000511080311 3;JKN DR RIZKI;
5.2.0.201712280730 4 140890 1#0##0#0#0.0#2018-02-06
16:50:42#0#12:00:00#12:00:00#12:00:00 1 b9f5b14c372308322cffae62a3914cd1
0 0 616955 0 0 3046406 0 0 0 0
1909420 0 0 0 418000 0
3201126 B 2 BS 1 29/01/2018 31/01/2018 04/03/1985 0 2
0 - 0 - 0 - 0 - 0 5984100 12281662
0 3 0 0 0 RINI ROSMAYANI d371338 32 12019 ENDANG
TRI KURNIADEWI DR SPOG 0138R01701180013016 0001660082387 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 145701 1#0##0#0#0.0#2018-02-07
08:45:02#1#12:00:00#12:00:00#12:00:00 1 04f9a57b86d06cc34551498a02e779cb
0 4906000 4261040 0 0 2039649 0 0 0 0
803473 0 0 0 271500 0
3201126 B 2 BS 1 30/01/2018 31/01/2018 24/04/1965 0 1
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BOHARI D387597 52 19274 DR ZULFAN, SPPD 0138R01701180013640
0001257136795 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141726
1#0##0#0#0.0#2018-02-22 14:23:44#0#12:00:00#12:00:00#12:00:00 1
3860948b6046e3395602e810e47a28aa 0 1722500 1784296 0 0
2287590 0 0 0 0 585542 0 0 1680000 34500
0
3201126 B 1 BS 1 30/01/2018 31/01/2018 14/01/1954 0 2
1 I12.0;D63.8;J18.0 38.95;99.04;99.21 - - None None None None
- 0 - 0 27065300 14819507 0 2 0 0 0
SRI HENDARJANI D389073 64 23392 DR SRI KUN, SPPD
0138R01701180014074 0000036153167 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142255 1#0##0#0#0.0#2018-02-22
14:27:27#0#12:00:00#12:00:00#12:00:00 1 7e27517246a2a2e59ca83817c8246422
0 5896000 3669967 0 0 4228040 0 0 0 0
1025500 0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 31/01/2018 24/05/1965 0 2
1 I87.2;N18.5 38.93;39.50 - - None None None None I-1-20-I
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
15363900 20520976 0 2 0 0 0 NING ANDRIYANI
0001089754659 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141790
1#0##0#0#0.0#2018-02-22 15:06:59#0#12:00:00#12:00:00#12:00:00 1
68ec033add4d72f6b7a4822138c47adc 0 3062500 3072780 0 0
13060696 0 0 0 0 1256000 0 0 0 69000 0
3201126 B 3 BS 1 30/01/2018 31/01/2018 25/05/1974 0 1
1 N18.5;D63.8;I11.9 99.04;38.95 - - None None None None N-1-
- 0 8908800 32893527 0 2 0 0 0 HIDAYAT
D389054 43 15956 DR SRI KUN, SPPD 0138R01701180014713
0001212017736 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142840
1#0##0#0#0.0#2018-02-22 16:48:28#0#12:00:00#12:00:00#12:00:00 1
4d35a29990a27f6ea9542039776791d6 0 4498260 854792 0 0
3988975 0 0 0 0 23517000 0 0 0 34500 0
3201126 B 3 BS 1 30/01/2018 31/01/2018 25/09/1965 0 2
- 0 8908800 10513662 0 2 0 0 0 DJOHAR
SETYOWATI D380179 52 19120 DR SRI KUNMARTINI, SPPD 0138R01701180014197
0002196417036 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142419
1#0##0#0#0.0#2018-02-22 16:59:53#0#12:00:00#12:00:00#12:00:00 1
20868a4494dd897609720fa9b05a5357 0 4924788 428264 0 0
4243800 0 0 0 0 916810 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 31/01/2018 28/06/2015 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 3226999 0 3 0 0 0 MUHAMMAD RAEF AL FATH
0001881906502 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141716
1#0##0#0#0.0#2018-02-23 09:19:42#0#12:00:00#12:00:00#12:00:00 1
6060a9ca6b3658b5a9bbfe8bffb77c3a 0 0 231209 0 0 761178
0 0 0 0 2234612 0 0 0 0 0
3201126 B 3 BS 1 27/01/2018 31/01/2018 26/09/1976 0 1
1 S43.0;N18.5;D63.8 99.04;79.70 - - None None None None M-4-
12-II None None None None None None FRAKTUR/DISLOKASI SELAIN FEMUR DAN PELVIS
(SEDANG) 4902300 0 0 - 0 - 0 - 0 - 0
4902300 6842775 0 5 0 0 0 DORMAN LIBRANDO P S TN
0001743628138 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141064
1#0##0#0#0.0#2018-02-23 09:22:58#0#12:00:00#12:00:00#00:00:00 1
85d3a909726cc48d4832f285ce09639e 0 0 600207 0 0
3384160 0 0 0 0 2858408 0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 31/01/2018 06/02/2002 0 1
1 L04.0 83.39 - - None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 5331600 7224844
0 2 0 0 0 MUHAMAD IKHSAN ALHARIS D388368 15 5837
DR H. H PUAR, SPB 0138R01701180013727 0002325534175 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 141733 1#0##0#0#0.0#2018-02-23
10:01:47#0#12:00:00#12:00:00#12:00:00 1 6394a95f513bfb8b5afa71b550505b6c
0 4209348 53000 0 0 1942843 0 0 0 0 874653
0 0 0 145000 0
3201126 B 1 BS 1 30/01/2018 31/01/2018 24/03/1950 0 1
1 N18.5;D63.8;J90 39.27;99.04 - - None None None None N-1-
- 0 - 0 27065300 13813819 0 2 0 0 0
MARULLOH D381575 67 24784 DR SRI KUN, SPPD 0138R01701180014082
0001465949586 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142176
1#0##0#0#0.0#2018-02-23 10:03:42#0#12:00:00#12:00:00#12:00:00 1
968c1738693a03fbd0253b6667f19e31 0 8017540 738627 0 0
2612444 0 0 0 0 2341708 0 0 0 103500
0
3201126 B 3 BS 1 30/01/2018 31/01/2018 06/09/1970 0 2
- 0 8908800 10437434 0 2 0 0 0 NY ANI
D389064 47 17313 DR SRI KUN, SPPD 0138R01701180014198
0000369054044 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142418
1#0##0#0#0.0#2018-02-23 10:17:23#0#12:00:00#12:00:00#12:00:00 1
c1b4dbdb378b484628e2e11f736230b2 0 4498260 854792 0 0
4051559 0 0 0 0 998323 0 0 0 34500 0
3201126 B 3 BS 1 31/01/2018 31/01/2018 17/05/1962 0 1
1 A41.9;J81 - - - None None None None A-4-10-III None
- 0 - 0 - 0 - 0 5838600 3305139 0
1 0 0 0 TENI INDRA DURIAT D388760 55 20348 DR DICKY
PRATAMA 0138R01701180014443 0001482778372 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149052 1#0##0#0#0.0#2018-02-23
10:30:00#0#12:00:00#12:00:00#12:00:00 1 0fc17b74d55ecbd2e8f0f725ee6e10cc
0 0 803061 0 0 1996854 0 0 0 0 505224
0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 31/01/2018 17/10/1985 0 1
1 I13.1;K30 90.59;89.52 - - None None None None N-4-10-I
GINJAL (RINGAN) 3313800 0 0 - 0 - 0 - 0 -
0 3313800 2920072 0 2 0 0 0 SAPRUL HADI
SATRIA D319169 32 11793 DR AHMAD HIBBAN A WRIYA 0138R01701180014177
0001281304427 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142415
1#0##0#0#0.0#2018-02-23 10:57:50#0#12:00:00#12:00:00#00:00:00 1
21f008ac198383359f613b0fd531a794 0 0 371889 0 0 911900
0 0 0 0 1636283 0 0 0 0 0
3201126 B 1 BS 1 28/01/2018 31/01/2018 25/12/1957 0 2
(RINGAN) 7018400 0 0 - 0 - 0 - 0 - 0
7018400 10263896 0 4 0 0 0 ITJEU KRISMIATI
0000041430734 3;JKN DR RIZKI; 5.2.0.201712280730 4 141092
1#1#vvip#4#3245496#0.0#2018-03-02 21:09:10#0#12:00:00#12:00:00#12:00:00
1 d97a9e7be15858240ce158a0613374e9 0 0 1158398 0 0
4581720 0 0 0 0 4523778 0 0 0 0 0
3201126 B 1 BS 1 30/01/2018 31/01/2018 15/02/2003 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2685737 0 2 0 0 0 THARIQ ATTAR O.PUTRA T
0001634840673 3;JKN DR RIZKI; 5.2.0.201712280730 4 141730
1#0##0#0#0.0#2018-03-10 09:36:15#0#12:00:00#12:00:00#12:00:00 2
0a33470e280db24846013ad192064ba4 0 0 338858 0 0 583177
0 0 0 0 1763702 0 0 0 0 0
3201126 B 1 BS 1 27/01/2018 31/01/2018 11/12/1978 0 1
1 A91;R57.9 - - - None None None None A-4-13-II None
3734400 0 0 - 0 - 0 - 0 - 0
3734400 7786757 0 5 0 0 0 YUDAH MAULANA
0001270795217 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 140905
1#0##0#0#0.0#2018-03-28 07:46:17#0#12:00:00#12:00:00#12:00:00 2
9f9bcbd048974bd6b5e3d7d2f7a71c22 0 0 551420 0 0
2794923 0 0 0 0 4440414 0 0 0 0 0
3201126 B 2 BS 1 28/01/2018 31/01/2018 03/12/1943 0 2
1 I64;E11.9 87.03 - - None None None None G-4-15-I None
PENYUMBATAN PRE-CEREBRAL TANPA INFARK (RINGAN) 4915400 0 0 - 0
- 0 - 0 - 0 4915400 4875024 0 4 0
0 0 NINA KURNIASIH D388886 74 27085 DR MAYSAMIRAWATI SPS
0138R01701180012889 0001720282814 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141070 1#0##0#0#0.0#2018-03-28
11:23:42#0#12:00:00#12:00:00#12:00:00 2 539986568a7177b56785877cdca0b6bd
0 0 882140 0 0 1627957 0 0 0 0
2364927 0 0 0 0 0
3201126 B 1 BS 1 29/01/2018 31/01/2018 31/12/1949 0 2
4 I48;R57.1;R57.0;I63.9;K31.9 87.44;87.03 - - None None None
None I-4-19-III None None None None None None GANGGUAN KONDUKSI &
ARITMIA JANTUNG (BERAT) 10214100 0 0 - 0 - 0 - 0
- 0 10214100 14252670 0 3 1 2 0 SLAMET PUJI
ASTUTI D374673 68 24866 DR AZRI NURIZAL SPPD KKV
0138R01701180013306 0001798895902 3;JKN DR RIZKI; 5.2.1.201804062320
4 141418 1#0##0#0#0.0#2018-05-17
15:13:18#0#12:00:00#12:00:00#00:00:00 2 ae7236ad3389dd7302ff811d16eed588
0 0 1192580 0 0 8550172 0 0 0 0
3445918 0 0 0 0 1064000
3201126 B 3 BS 1 30/01/2018 31/01/2018 15/07/1953 0 1
1 N35.9;I10 56.31;58.5 - - None None None None N-1-40-I
(RINGAN) 8041000 0 0 - 0 - 0 - 0 - 0
8041000 14063016 0 2 0 0 0 HERU D378631 64
23575 DR HERY TIERA, SPU 0138R01701180013784 0001739854462 3;JKN
DR RIZKI; 5.2.1.201804062320 4 141745 1#0##0#0#0.0#2018-05-18
08:05:05#0#12:00:00#12:00:00#12:00:00 2 7b76c8d7ed1e71f7d944c33a1b5babb2
0 6951780 4455410 0 0 1244816 0 0 0 0
1342010 0 0 0 69000 0
3201126 B 2 BS 1 27/01/2018 31/01/2018 28/03/1997 0 2
1 K21.9;A91 - - - None None None None K-4-12-III None
None None None None None GANGGUAN ESOFAGUS (BERAT) 8137900 0
0 - 0 - 0 - 0 - 0 8137900 11822690
0 5 0 0 0 ADINDA PARAMAPUTRI D011545 20 7610
DR SRI KUN, SPPD 0138R01701180012819 0001300700147 3;JKN DR RIZKI;
5.2.0.201712280730 4 141058 1#1#vvip#1#3684790#0.0#2018-08-13
10:33:12#0#12:00:00#12:00:00#12:00:00 3 eaacd3d5b25647720b55652418633a69
0 0 1548336 0 0 3667407 0 0 0 0
6606947 0 0 0 0 0
3201126 B 3 BS 1 28/01/2018 31/01/2018 30/05/2017 0 1
1 A09.9;J06.9;R21 - - - None None None None K-4-17-I
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2130015 0 4 0 0 0 AKSEL DWI PUTRA FERYAN
0002254578941 3;JKN DR RIZKI; 5.2.2.201806040537 4 141088
1#0##0#0#0.0#2018-08-14 12:07:45#0#12:00:00#12:00:00#12:00:00 3
71d47a837bff89eeca9adbd7cd592295 0 0 207620 0 0 468548
0 0 0 0 1130847 0 0 0 323000 0
3201126 B 2 BS 1 29/01/2018 31/01/2018 23/04/1952 0 2
1 I13.1;J91;J22;D63.8 99.04 - - None None None None N-4-
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 5969643 0 3 0 0 0 KUSMIYATI
0001423720596 3;JKN DR RIZKI; 5.2.1.201804062320 4 141473
1#0##0#0#0.0#2018-08-14 12:12:25#0#12:00:00#12:00:00#12:00:00 4
a377954b19cf27999b085efe113406e1 0 0 709388 0 0
2172468 0 0 0 0 3087787 0 0 0 0 0
3201126 B 2 BS 1 29/01/2018 31/01/2018 10/11/2000 0 2
1 O80.9;Z37.0;A63.0;O99.0 73.59;71.3;99.04 - - None None None
None W-1-30-II None None None None None None PROSEDUR PADA VAGINA,
SERVIK & VULVA (SEDANG) 8929300 0 0 - 0 - 0 - 0
- 0 8929300 10266907 0 3 0 0 0 JIHAN NOVIRA
D386374 17 6289 DR FERRY SPOG 0138R01701180013233
0002319734799 3;JKN DR RIZKI; 5.2.2.201806040537 4 141400
1#0##0#0#0.0#2018-09-25 19:01:36#0#12:00:00#12:00:00#12:00:00 2
b2f79b884b846a3b46ebeb1d26562e1b 0 3060700 2176440 0 0
3941100 0 0 0 0 822667 0 0 0 266000
0
3201126 B 1 BS 1 31/01/2018 01/02/2018 04/06/1964 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5528897 0 2 0 0 0 ZAENUDIN TN d375732
53 19599 DR ARU, SPPD 0138R01701180014758 0000061071581 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 142846 1#0##0#0#0.0#2018-
02-13 16:18:35#0#12:00:00#12:00:00#00:00:00 1
4a88168ad121f97d84a459df5eb94d47 0 0 573641 0 0
2194802 0 0 0 0 2760454 0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 01/02/2018 01/08/1976 0 2
1 A41.9;R57.2;E87.1 - - - None None None None A-4-10-II
0 - 0 - 0 - 0 - 0 4330300 6819771
0 3 0 0 0 INDAH SUZANTI D383993 41 15157 DR
DICKI PRATAMA 0138R01701180014192 0000510417753 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142417 1#0##0#0#0.0#2018-02-17
12:41:53#0#12:00:00#12:00:00#12:00:00 1 d681f89ba1fa7c57cb207ff55bb309e0
0 0 299970 0 0 5025648 0 0 0 0 753153
0 0 0 290000 451000
3201126 B 1 BS 1 28/01/2018 01/02/2018 25/05/1963 0 1
- 0 58821400 54031146 0 5 0 0 0 SETIADI
0001102594026 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141085
1#0##0#0#0.0#2018-02-21 14:46:03#0#12:00:00#12:00:00#00:00:00 1
6062aad979845b9b9e73d37c2a90cf9a 0 12135000 9672120 0 0
23399026 0 0 0 0 1256000 0 0 7500000 69000
0
3201126 B 3 BS 1 31/01/2018 01/02/2018 30/12/1938 0 1
- 0 8908800 8726708 0 2 0 0 0 ADANG
D389166 79 28887 DR SRI KUN, SPPD 0138R01701180014765
0001740443117 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142847
1#0##0#0#0.0#2018-02-22 11:45:14#0#12:00:00#12:00:00#12:00:00 1
19c3624f843c7fefd2d5e4c15fa9b129 0 3532300 2636552 0 0
1861950 0 0 0 0 626906 0 0 0 69000 0
3201126 B 2 BS 1 30/01/2018 01/02/2018 22/02/2017 0 2
0 0 - 0 - 0 - 0 - 0 2871200
2486897 0 3 0 0 0 ARSYILA ANZANI FEBRIANA D389127
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142420
1#0##0#0#0.0#2018-02-22 11:55:32#0#12:00:00#12:00:00#12:00:00 1
5f8ea564946d9060ac4f4f55448d7d50 0 0 311400 0 0 976803
0 0 0 0 1198694 0 0 0 0 0
3201126 B 3 BS 1 31/01/2018 01/02/2018 23/11/1964 0 1
1 E11.2;I10;J90 38.95 - - None None None None N-1-12-III
ALAT DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0
- 0 19332400 9909379 0 2 0 0 0 BERESMAN
HUTAGAOL D389168 53 19427 DR SRI KUN, SPPD 0138R01701180014774
0001217892396 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142849
1#0##0#0#0.0#2018-02-22 12:31:16#0#12:00:00#12:00:00#12:00:00 1
39a0d85fed0a212794e887ad5d5b685b 0 3066000 2636552 0 0
3433550 0 0 0 0 704277 0 0 0 69000 0
3201126 B 3 BS 1 31/01/2018 01/02/2018 21/08/1969 0 2
- 0 8908800 9775749 0 2 0 0 0 KURNAESIH
D389159 48 17695 DR SRI KUN, SPPD 0138R01701180014733
0001860445359 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142843
1#0##0#0#0.0#2018-02-22 12:42:09#0#12:00:00#12:00:00#12:00:00 1
211280ada08c3b7fd2a2c14375df0d3e 0 3352300 2636552 0 0
3022362 0 0 0 0 695535 0 0 0 69000 0
3201126 B 2 BS 1 31/01/2018 01/02/2018 13/11/1945 0 2
- 0 10690500 11517097 0 2 0 0 0 HJ.NURHAYATI
0001285736152 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142839
1#0##0#0#0.0#2018-02-22 13:58:17#0#12:00:00#12:00:00#12:00:00 1
af0f34679acc1b60a936503105b18d6e 0 4703600 3153245 0 0
2781797 0 0 0 0 809455 0 0 0 69000 0
3201126 B 2 BS 1 31/01/2018 01/02/2018 14/07/1989 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 5885360 0 2 0 0 0 LIES FADILAH
D304551 28 10428 DR ATJANG S, SPOG 0138R01701180014524
0001808751666 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142749
1#0##0#0#0.0#2018-02-22 13:59:40#0#12:00:00#12:00:00#00:00:00 1
ab1a8cf5af1d06f7138b297661289653 0 2882000 1138996 0 0
1354340 0 0 0 0 441024 0 0 0 69000 0
3201126 B 2 BS 1 31/01/2018 01/02/2018 20/10/1957 0 2
1 G45.9;E11.4;E75.6 90.59;89.52;87.49;87.03 - - None None None
None G-4-16-II None None None None None None ISKEMIK TRANSIENT
(SEDANG) 5379700 0 0 - 0 - 0 - 0 - 0
5379700 3489605 0 2 0 0 0 JEANNE ATJE D360743
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142422
1#0##0#0#0.0#2018-02-22 14:06:56#0#12:00:00#12:00:00#00:00:00 1
945ba4f41bf135ca954180ae1fb79176 0 0 590173 0 0
1635140 0 0 0 0 1264292 0 0 0 0 0
3201126 B 1 BS 1 30/01/2018 01/02/2018 04/09/1950 0 2
1 C78.5;C50.9 99.21;99.15 - - None None None None K-4-10-I
None None None None None None TUMOR PENCERNAAN (RINGAN) 6881700
0 0 - 0 - 0 - 0 - 0 6881700
4221311 0 3 0 0 0 SIM WIE NIO D313486 67 24620
DR ZULFAN, SPPD 0138R01701180013912 0001259265971 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 141945 1#0##0#0#0.0#2018-02-22
14:12:38#0#12:00:00#12:00:00#00:00:00 1 b8eced0e69b4d4bb83b472b2147fbfb4
0 0 345275 0 0 1230875 0 0 0 0
2645161 0 0 0 0 0
3201126 B 1 BS 1 31/01/2018 01/02/2018 10/09/1984 0 1
- 0 - 0 5576700 7595183 0 2 0 0 0
ROBERT RICHARD STANLEY D388511 33 12196 DR ZULFAN, SPPD
0138R01701180014212 0001766116269 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142424 1#0##0#0#0.0#2018-02-22
14:29:32#0#12:00:00#12:00:00#12:00:00 1 4beaeb453db9394ac1dc989ea943606d
0 2064500 866136 0 0 2362666 0 0 0 0
552881 0 0 0 1749000 0
3201126 B 3 BS 1 31/01/2018 01/02/2018 05/12/1972 0 1
- 0 45079800 60015962 0 2 0 0 0 ASWAN
0002247683815 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142435
1#0##0#0#0.0#2018-02-22 15:10:16#0#12:00:00#12:00:00#12:00:00 1
2579bf0e1c23b01e74358cdb9eb0cfea 0 8014000 5144120 0 0
38032842 0 0 0 0 1256000 0 0 7500000 69000
0
3201126 B 3 BS 1 31/01/2018 01/02/2018 26/05/1980 0 1
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 7732693 0 2 0 0 0 EDWIN KUSNANDAR
0002090950659 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142808
1#0##0#0#0.0#2018-02-22 16:00:32#0#12:00:00#12:00:00#12:00:00 1
6b18a4338b6e472285565d2294c2f4bb 0 3528800 1311745 0 0
2261271 0 0 0 0 561877 0 0 0 69000 0
3201126 B 3 BS 1 28/01/2018 01/02/2018 03/04/2017 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4098757 0 5 0 0 0 ARINI AYUNINDYA INARA
D388876 0 300 DR AWIDIYA, SPA 0138R01701180012890
0001734061779 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141071
1#0##0#0#0.0#2018-02-22 16:43:12#0#12:00:00#12:00:00#12:00:00 1
915fa4cd4977c8317a77e01bb2ddbf45 0 0 378188 0 0
1771426 0 0 0 0 1609143 0 0 0 0 340000
3201126 B 3 BS 1 30/01/2018 01/02/2018 02/01/1995 0 1
1 S42.00 78.61 - - None None None None J-1-30-I None
None None None None None PROSEDUR SISTEM PERNAFASAN KOMPLEKS (RINGAN)
7310800 0 0 - 0 - 0 - 0 - 0
7310800 10296828 0 3 0 0 0 ULFA NURHUDA NOSYA
d338521 23 8429 DR RAY HENDRY, SPOT 0138R01701180014185
0001458860894 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142416
1#0##0#0#0.0#2018-02-22 16:50:34#0#12:00:00#12:00:00#00:00:00 1
8e25598032df5a64144231d8765bbfbf 0 5467624 1250000 0 0
2252080 0 0 0 0 1182124 0 0 0 145000
0
3201126 B 3 BS 1 30/01/2018 01/02/2018 02/05/1977 0 2
1 Q85.0 83.39 - - None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 5331600 7283734
0 3 0 0 0 YANTI D388361 40 14883 DR H. H PUAR, SPB
0138R01701180014159 0001740367214 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142413 1#0##0#0#0.0#2018-02-22
16:53:05#0#12:00:00#12:00:00#12:00:00 1 b23cd8998577c66bdff49ebd816e24cb
0 4209348 63000 0 0 1890880 0 0 0 0
1051506 0 0 0 69000 0
3201126 B 2 BS 1 30/01/2018 01/02/2018 16/10/1993 0 2
0 0 - 0 - 0 - 0 - 0 5984100
9811080 0 3 0 0 0 NANA HARYANI D389047 24
8872 DR BAGUS T, SPOG 0138R01701180013844 0001793301232 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 141824 1#0##0#0#0.0#2018-
02-22 17:09:27#0#12:00:00#12:00:00#12:00:00 1
bb60b6f47e7e30d11d656651609d9d04 0 0 2090753 0 0
1500581 0 0 0 0 6022746 0 0 0 69000 128000
3201126 B 3 BS 1 30/01/2018 01/02/2018 15/12/2010 0 1
1 N00.9;I15.1;R18 - - - None None None None N-4-11-II
None None None None None None PERADANGAN GINJAL (SEDANG) 4444500
0 0 - 0 - 0 - 0 - 0 4444500
3164951 0 3 0 0 0 MUHAMMAD RIZKY FAUZAN D389038
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141728
1#0##0#0#0.0#2018-02-23 08:19:24#0#12:00:00#12:00:00#12:00:00 1
ab6f59b6abb05717d9e64ee9997f9dce 0 0 289034 0 0
1853864 0 0 0 0 1022053 0 0 0 0 0
3201126 B 2 BS 1 31/01/2018 01/02/2018 19/07/1965 0 2
- 0 10690500 11051741 0 2 0 0 0 HJ. SRI
AMALIAH D378627 52 19189 DR SRI KUNMARTINI, SPPD 0138R01701180014479
0001262119329 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142670
1#0##0#0#0.0#2018-02-23 08:21:16#0#12:00:00#12:00:00#12:00:00 1
ea498ea7208bf2a73efdf7275e010a7e 0 5747200 1015145 0 0
2431385 0 0 0 0 1789011 0 0 0 69000 0
3201126 B 1 BS 1 29/01/2018 01/02/2018 12/02/1952 0 2
1 E11.4;S09.9;N39.0 87.03 - - None None None None G-4-17-II
None None None None None None GANGUAN SARAF KRANIAL DAN PERIFER
(SEDANG) 8256200 0 0 - 0 - 0 - 0 - 0
8256200 5865961 0 4 0 0 0 S KARMINAH D303816
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141467
1#0##0#0#0.0#2018-02-23 09:57:37#0#12:00:00#12:00:00#00:00:00 1
d2eb9390785e8811e2961bda13b6d592 0 0 669698 0 0
1662509 0 0 0 0 3533754 0 0 0 0 0
3201126 B 1 BS 1 31/01/2018 01/02/2018 16/10/1998 0 1
1 J35.0;J35.3 28.3 - - None None None None U-1-15-I None
0 0 - 0 - 0 - 0 - 0 5461000
9984165 0 2 0 0 0 DIMAS AROIWIBOWO D388157 19
7047 DR ASNOMINANDA, SPHT 0138R01701180014307 0000197393027 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 142432 1#0##0#0#0.0#2018-
02-23 10:09:52#0#12:00:00#12:00:00#12:00:00 1
a3abc09203f469a9abbae11cdfc8f63e 0 5474000 489880 0 0
1842115 0 0 0 0 2109170 0 0 0 69000 0
3201126 B 3 BS 1 26/01/2018 01/02/2018 26/01/2018 2500 1
1 P22.9;Q39.0;P22.1 96.72;09.44;99.15 - - None None None None
P-8-07-II None None None None None None NEONATAL, BERAT BADAN LAHIR
GROUP-5 DENGAN PROSEDUR MAYOR (SEDANG) 14296600 0 0 - 0 -
0 - 0 - 0 14296600 4000000 0 7 1 7
168 MAHARANI BY NY D388662 0 0 DR AULIA TANGKARI, SPA
01234567891011 9876543210 3;JKN DR RIZKI; 5.2.0.201712280730 4
142934 1#0##0#0#0.0#2018-02-27 09:42:59#0#09:02:47#09:02:47#07:02:00
1 c5c092bb6df96ee40b641778a58848b7 0 0 0 3000000 0
0 0 1000002 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 01/02/2018 01/02/2018 01/09/1952 0 2
2 I64;A15.3;A41.9 - - - None None None None G-4-15-III
SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (BERAT) 6899800 0 0
- 0 - 0 - 0 - 0 6899800 5393789 0
1 0 0 0 MARIAM BT PANJUL D389241 65 23894 DR WIDHI
DEWANTA K AJI 0138R01702180000277 0000511478908 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 143156 1#0##0#0#0.0#2018-02-28
18:28:04#0#12:00:00#12:00:00#12:00:00 1 3b1a56acde62d4135925d75da177166e
0 0 620982 0 0 4130942 0 0 0 0 641865
0 0 0 0 0
3201126 B 2 BS 1 30/01/2018 01/02/2018 30/01/2018 2948 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1701704 0 3 0 0 0 BAYI NY NANA HARYANI
0002316895064 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143775
1#0##0#0#0.0#2018-03-01 23:04:51#0#12:00:00#12:00:00#12:00:00 1
4454bf9410d380df2f3b384d771c32f7 0 0 1701704 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 29/01/2018 01/02/2018 25/07/1958 0 1
1 N18.5;K29.7;J81 39.95 - - None None None None N-4-10-III
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 7611693 0 4 0 0 0 ROKIB D348894
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142523
1#0##0#0#0.0#2018-03-01 23:40:48#0#12:00:00#12:00:00#00:00:00 1
158f02f8e8bafb007aa97b00d7b7172e 0 1812500 1462320 0 0
2656662 0 0 0 0 497961 0 0 0 1182250
0
3201126 B 2 BS 1 31/01/2018 01/02/2018 12/05/1959 0 2
1 N18.5;I82.9 88.40;39.50 - - None None None None I-1-20-II
(SEDANG) 23032500 0 0 - 0 - 0 - 0 - 0
23032500 28297537 0 2 0 0 0 KUSMIATI LESTARI
0001289034044 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142426
1#0##0#0#0.0#2018-03-01 23:45:02#0#12:00:00#12:00:00#12:00:00 1
9f371023315ce7a1b675daea683dd2e5 0 5344000 6732425 0 0
0 0 0 0 0 1256000 0 0 0 14965112 0
3201126 B 3 BS 1 31/01/2018 01/02/2018 06/04/1941 0 1
2 I21.1;K92.1 - - - None None None None I-4-10-I None
None None None None None INFARK MYOKARD AKUT (RINGAN) 4043000 0
0 - 0 - 0 - 0 - 0 4043000 1293627
0 2 0 0 0 DRS. H. UMARAN D387775 76 28059 DR
DINI DANIATY 0138R01701180014785 0000057280184 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142854 1#0##0#0#0.0#2018-03-19
08:47:39#0#12:00:00#12:00:00#12:00:00 2 f521e9d911525ed48d9ec56af09fae1a
0 0 220635 0 0 270260 0 0 0 0 343593
0 0 0 459139 0
3201126 B 1 BS 1 29/01/2018 01/02/2018 22/07/1967 0 2
1 S42.30;I69.4 - - - None None None None M-4-12-I
None None None None None None FRAKTUR/DISLOKASI SELAIN FEMUR DAN PELVIS
(RINGAN) 4126300 0 0 - 0 - 0 - 0 - 0
4126300 3717684 0 4 0 0 0 SILVIA CHRISTINA.S
0001303511049 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141719
1#0##0#0#0.0#2018-03-19 09:12:52#0#12:00:00#12:00:00#00:00:00 3
33be10950c1ee431bd7ac2e3b445214e 0 0 236051 0 0 869420
0 0 0 0 2612213 0 0 0 0 0
3201126 B 3 BS 1 31/01/2018 01/02/2018 01/01/1950 0 2
1 I61.9;J18.0;I12.0 90.59;87.03;89.52 - - None None None None
G-4-13-III None None None None None None PERDARAHAN INTRA KRANIAL
BUKAN TRAUMATIK (BERAT) 6111900 0 0 - 0 - 0 - 0
- 0 6111900 8022897 0 2 0 0 0 ROHAJA
d389186 68 24867 DR AHMAD HIBBAN A WRIYA 0138R01701180014732
0000060853397 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142842
1#0##0#0#0.0#2018-03-19 10:11:19#0#12:00:00#12:00:00#12:00:00 2
1e04fa9ff9cdedc904f1ec824fa0b016 0 0 660087 0 0
6251448 0 0 0 0 1111362 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 01/02/2018 09/05/1961 0 2
1 R10.1;R17 - - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2996788 0 4 0 0 0 HADIJAH D388981
3;JKN DR RIZKI; 5.2.1.201804062320 4 141895 1#0##0#0#0.0#2018-
05-05 11:37:43#0#12:00:00#12:00:00#12:00:00 2
a84e72e0ed5dec8c59b582050352b9de 0 0 349676 0 0
1899060 0 0 0 0 748052 0 0 0 0 0
3201126 B 1 BS 1 31/01/2018 01/02/2018 20/06/1971 0 2
15-II None None None None None None KATETERISASI JANTUNG (SEDANG) 8877800
0 0 - 0 - 0 - 0 - 0 8877800
13794932 0 2 0 0 0 LUCYA DEWITA D000810 46
3;JKN DR RIZKI; 5.2.1.201804062320 4 142527 1#0##0#0#0.0#2018-
05-05 11:58:07#0#12:00:00#12:00:00#00:00:00 2
282d756d6cd51618e70bbb03eeaa5a08 0 4795000 1775560 0 0
4196900 0 0 0 0 958472 0 0 2000000 69000
0
3201126 B 1 BS 1 28/01/2018 01/02/2018 12/05/1944 0 2
1 I63.9;D64.9;I11.0;G81.9;D69.6 87.03;99.04;99.05 - - None None
None None G-4-14-III None None None None None None KECEDERAAN
0 - 0 - 0 12141100 14344506 0 5 0 0
0 R TATAN TATIANAH D388909 73 26924 DR AZRI NURIZAL SPPD KKV
0138R01701180012976 0000060848493 3;JKN DR RIZKI; 5.2.1.201804062320
4 141087 1#0##0#0#0.0#2018-05-16
10:18:33#0#12:00:00#12:00:00#12:00:00 2 cfed7e219f6dcce0494e152943c295e5
0 0 1267110 0 0 8553470 0 0 0 0
4523926 0 0 0 0 0
3201126 B 3 BS 1 29/01/2018 01/02/2018 13/01/1980 0 2
1 K80.8;B17.8;A49.9 88.76 - - None None None None B-4-14-II
(SEDANG) 4899600 0 0 - 0 - 0 - 0 - 0
4899600 3846371 0 4 0 0 0 WARNIATY NY D388965
38 13896 DR. ARU ARIADNO, SPPD 0138r01701180013483 0001771625305
3;JKN DR RIZKI; 5.2.1.201804062320 4 141678 1#0##0#0#0.0#2018-
05-16 10:24:25#0#16:13:36#16:13:36#00:00:00 2
312354fa39be63e3eace89923f1ef0fb 0 0 493964 0 0
2022775 0 0 0 0 1329632 0 0 0 0 0
3201126 B 1 BS 1 17/01/2018 01/02/2018 19/06/1961 0 2
1 E11.5;A41.9;E87.6;I10 86.22 - - None None None None I-4-
15-III None None None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN
LAIN-LAIN (BERAT) 10244500 0 0 - 0 - 0 - 0 -
0 10244500 32086237 0 16 0 0 0 DWI LISTIANINGSIH
0002064285685 3;JKN DR RIZKI; 5.2.1.201804062320 4 137089
1#0##0#0#0.0#2018-05-16 11:07:15#0#12:00:00#12:00:00#00:00:00 2
817196409c5fc1a5beba5d9d51037c65 0 7518792 1383693 0 0
10148252 0 0 0 0 12966500 0 0 0 69000 0
3201126 B 3 BS 1 31/01/2018 01/02/2018 20/07/1958 0 2
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 58020833 0 2 0 0 0 SITI AMINAH
0000511287895 3;JKN DR RIZKI; 5.2.2.201806040537 4 142428
1#0##0#0#0.0#2018-08-14 15:25:56#0#12:00:00#12:00:00#12:00:00 3
26f793125c335521b2f0449c934a94f2 0 7627500 5144120 0 0
36296213 0 0 0 0 1256000 0 0 7628000 69000
0
3201126 B 3 BS 1 26/01/2018 01/02/2018 01/09/2009 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 16357057 0 7 0 0 0 RIZKY RHAMADAN
D388692 8 3069 DR CATUR S, SPB 0138R01701180012398
0002218709463 3;JKN DR RIZKI; 5.2.2.201806040537 4 140842
1#0##0#0#0.0#2018-09-06 14:28:31#0#12:00:00#12:00:00#12:00:00 2
8fececc1aa72fea8bdb3793369702253 0 5280800 193925 0 0
8307744 0 0 0 0 2357088 0 0 0 217500
0
3201126 B 1 BS 1 01/02/2018 02/02/2018 28/06/2006 0 1
5480800 0 0 - 0 - 0 - 0 - 0
5480800 3909530 0 2 0 0 0 MUHAMMAD FAEYZA DEVAN
ISYRAQYUDA D236476 11 4236 DR NOVIK BUDIWARDHANA, SPA
0138R01702180000013 0001737572747 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142857 1#0##0#0#0.0#2018-02-13
16:15:09#0#12:00:00#12:00:00#12:00:00 1 9bf2263c1cdacca4f160fe0a38146ce5
0 0 546272 0 0 818994 0 0 0 0
2246264 0 0 0 0 298000
3201126 B 3 BS 1 01/02/2018 02/02/2018 28/02/1982 0 1
1 C02.9;D64.9;E87.1 - - - None None None None U-4-10-II
None None None None None None NEOPLASMA TELINGA, HIDUNG, MULUT DAN
TENGGOROKAN (SEDANG) 8483000 0 0 - 0 - 0 - 0
- 0 8483000 3087671 0 2 0 0 0 NIK KURNIA
HADIANZAH D359442 35 13122 DR ADITIA NATA KUSUMA 0138R01702180000544
0000042060418 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143433
1#0##0#0#0.0#2018-02-17 11:00:51#0#12:00:00#12:00:00#12:00:00 1
475674fb5abc18cb60b87c1a6611284c 0 0 763470 0 0
1099204 0 0 0 0 508997 0 0 0 290000
426000
3201126 B 3 BS 1 01/02/2018 02/02/2018 03/02/1964 0 1
1 N18.5;T82.8 88.60;38.95 - - None None None None N-1-12-III
- 0 19332400 23249075 0 2 0 0 0 SAPRIAT
ROSTIADI D319745 53 19722 DR DEDY PRATAMA SPBV 0138R01702180000316
0001740096775 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143169
1#0##0#0#0.0#2018-02-21 14:41:37#0#12:00:00#12:00:00#00:00:00 1
99514e0efe114bf4e013f1ca86430136 0 3062500 3866480 0 0
14995095 0 0 0 0 1256000 0 0 0 69000 0
3201126 B 1 BS 1 31/01/2018 02/02/2018 22/04/1966 0 2
- 0 58821400 64498140 0 3 0 0 0 FRANSINA
MAIRUHU a189885 51 18912 DR AGOES KOOSHARTORO SPPD-KKV
0138R01701180014444 0001767390794 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142585 1#0##0#0#0.0#2018-02-21
15:06:15#0#12:00:00#12:00:00#12:00:00 1 3de73cc200bd67b6cbd6d7541940006c
0 10771000 9619120 0 0 35283020 0 0 0 0
1256000 0 0 7500000 69000 0
3201126 B 2 BS 1 01/02/2018 02/02/2018 05/01/1952 0 1
1 N18.5;T85.8;D63.8 38.95;99.04;88.77 - - None None None None
- 0 - 0 10690500 19326747 0 2 0 0 0
A. SOPIANSYAH D249613 66 24134 DR. ARU ARIADNO, SPPD
0138R01702180000398 0001480417492 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 143357 1#0##0#0#0.0#2018-02-21
15:56:58#0#12:00:00#12:00:00#00:00:00 1 44281a8a23598536f5211b44081d31b4
0 4439100 3153245 0 0 10409402 0 0 0 0
1256000 0 0 0 69000 0
3201126 B 3 BS 1 29/01/2018 02/02/2018 01/01/1954 0 1
1 M79.98;Q27.3 83.39 - - None None None None M-1-50-II
None None None None None None PROSEDUR JARINGAN LUNAK (SEDANG)
8847700 0 0 - 0 - 0 - 0 - 0
8847700 11483551 0 5 0 0 0 ELON D381168 64
23404 DR HENDRIEK S, SPB 0138R01701180013614 0000511366498 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 141721 1#0##0#0#0.0#2018-
02-21 15:59:53#0#12:00:00#12:00:00#12:00:00 1
129df8f79c598734733f61a691e06d3a 0 3408500 2477356 0 0
4406435 0 0 0 0 1122260 0 0 0 69000 0
3201126 B 2 BS 1 29/01/2018 02/02/2018 20/04/1954 0 1
1 I11.0;E87.6 - - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 4973600 6647064
0 5 0 0 0 WAHYUDI D388923 63 23295 DR AZRI
5.2.0.201712280730 4 141095 1#0##0#0#0.0#2018-02-22
14:50:43#0#12:00:00#12:00:00#12:00:00 1 73b2ffa4175273c8c8ec026274ec7be2
0 0 1121172 0 0 2540037 0 0 0 0
2985855 0 0 0 0 0
3201126 B 1 BS 1 31/01/2018 02/02/2018 16/02/1983 0 1
1 T24.3;E10.5 86.22 - - None None None None S-4-16-II None
None None None None None LUKA BAKAR (SEDANG) 9475900 0 0
- 0 - 0 - 0 - 0 9475900 11708607 0
3 0 0 0 JORGO GAUTAMA d389184 34 12768 DR HENDRIEK
SP B 0138R01701180014753 0001743807453 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142845 1#0##0#0#0.0#2018-02-22
16:18:01#0#12:00:00#12:00:00#12:00:00 1 067e046e0a54ca214a61d0c65ef549e1
0 6331500 2124096 0 0 2362027 0 0 0 0
821984 0 0 0 69000 0
3201126 B 3 BS 1 30/01/2018 02/02/2018 01/11/2003 0 2
1 M79.26;B02.2 - - - None None None None G-4-17-II
(SEDANG) 5897300 0 0 - 0 - 0 - 0 - 0
5897300 2188123 0 4 0 0 0 CRISTINE MAGDALIN
NAINGGOLAN D389105 14 5204 DR OTTY MITHA S, SPA 0138R01701180014203
0001319350983 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142421
1#0##0#0#0.0#2018-02-28 17:16:09#0#12:00:00#12:00:00#12:00:00 1
fb08072eff5046d031057893fc751097 0 0 385604 0 0 844371
0 0 0 0 958148 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 02/02/2018 27/11/1979 0 1
- 0 12472300 14915932 0 2 0 0 0 DEDY
0000164837531 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143157
1#0##0#0#0.0#2018-03-01 18:36:59#0#12:00:00#12:00:00#12:00:00 1
296c5f80a6c0e312e5eb2f47e866c953 0 7008460 1175507 0 0
4283656 0 0 0 0 2413809 0 0 0 34500 0
3201126 B 3 BS 1 31/01/2018 02/02/2018 11/05/1962 0 1
1 N18.5;D63.8;A49.9 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2547674 0 3 0 0 0 TN. NISIN
0000509944162 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142841
1#0##0#0#0.0#2018-03-01 23:28:21#0#12:00:00#12:00:00#00:00:00 1
d458f74bd632fd25cde4c9bf1ff78cca 0 0 424889 0 0
1227615 0 0 0 0 702500 0 0 0 192670
0
3201126 B 3 BS 1 30/01/2018 02/02/2018 25/12/1958 0 1
1 I63.9;G81.9;K92.0;I10;I45.1 87.03 - - None None None None
0 - 0 6909500 3958005 0 4 0 0 0
MUHAMAD d389058 59 21586 DR NURUL KOMARI SPS
0138R01701180014121 0002091650319 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142299 1#0##0#0#0.0#2018-03-01
23:32:39#0#12:00:00#12:00:00#12:00:00 1 db8c21840240a9d375d3cb680def12e1
0 0 557179 0 0 2063891 0 0 0 0
1310935 0 0 0 26000 0
3201126 B 1 BS 1 31/01/2018 02/02/2018 09/10/1984 0 2
1 N64.9;D64.9 99.04;85.24 - - None None None None L-1-50-II
14726100 0 0 - 0 - 0 - 0 - 0
14726100 16545955 0 3 0 0 0 HERLINA PURNAMASARI. SE
D127697 33 12167 DR. RAHMAWATI SP.B ONK 0138R01701180014289
0000204254594 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142431
1#0##0#0#0.0#2018-03-01 23:36:24#0#12:00:00#12:00:00#12:00:00 1
73c07d8e9f1c0f6eb2b488cd5a138c59 0 7177200 4186308 0 0
3806501 0 0 0 0 1158446 0 0 0 217500
0
3201126 B 1 BS 1 29/01/2018 02/02/2018 04/12/2014 0 1
1 E16.2;R56.8 - - - None None None None E-4-10-II None
- 0 6852200 6507924 0 5 0 0 0 ADZKIYA
HASNA MUTHMAINNAH D356561 3 1152 DR RASTRA, SPA 0138R01701180013321
0002080697275 3;JKN DR RIZKI; 5.2.0.201712280730 4 141445
1#0##0#0#0.0#2018-03-02 08:31:01#0#12:00:00#12:00:00#00:00:00 1
c7e3a2dc93be93fa340aaa08717975bb 0 0 738220 0 0
1412959 0 0 0 0 4356745 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 02/02/2018 14/02/1978 0 2
1 K21.0;M14.6 - - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 4136800 3118464
0 2 0 0 0 IMELDA S BUTARBUTAR D381221 39 14597
RIZKI; 5.2.1.201804062320 4 142862 1#0##0#0#0.0#2018-05-05
12:01:35#0#12:00:00#12:00:00#12:00:00 3 06783c3a70e9bfc60a4ffc8ee2b9c486
0 0 398275 0 0 928177 0 0 0 0
1792012 0 0 0 0 0
3201126 B 1 BS 1 27/01/2018 02/02/2018 24/06/1977 0 1
1 A41.9;R10.4;D64.9;J20.9;A09.9 99.04;87.44;99.21 - - None None
None None A-4-10-II None None None None None None SEPTIKEMIA
(SEDANG) 6062400 0 0 - 0 - 0 - 0 - 0
6062400 13964175 0 7 0 0 0 RIZKI KAMO D347629
3;JKN DR RIZKI; 5.2.1.201804062320 4 141066 1#0##0#0#0.0#2018-
05-16 10:28:12#0#12:00:00#12:00:00#12:00:00 3
27383cf54ed8f11bd05186313dcaf3fc 0 0 864197 0 0
7474434 0 0 0 0 5625544 0 0 0 0 0
3201126 B 2 BS 1 01/02/2018 02/02/2018 13/09/1979 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 5634081 0 2 0 0 0 RIBKA BELANDINA
SINLAELOE D092267 38 14021 DR ERDIYAN, SPOG 0138R01702180000077
0001273512543 3;JKN DR RIZKI; 5.2.1.201804062320 4 142864
1#0##0#0#0.0#2018-05-16 11:11:16#0#12:00:00#12:00:00#00:00:00 2
bd809b0c434962f6e6d4c94cb1ee6b7b 0 0 835996 0 0
1455000 0 0 0 0 3270585 0 0 0 72500 0
3201126 B 3 BS 1 01/02/2018 02/02/2018 01/10/1983 0 1
4 I47.2;I20.9;I11.0;I46.9 99.60 - - None None None None I-4-
19-III None None None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG
(BERAT) 7295800 0 0 - 0 - 0 - 0 - 0
7295800 10340832 0 2 0 0 0 SAHRUL SUJATI
0000512836571 3;JKN DR RIZKI; 5.2.1.201804062320 4 143429
1#0##0#0#0.0#2018-05-16 11:29:31#0#12:00:00#12:00:00#12:00:00 3
99e62e4133526425946d9cc7a3f72ca4 1000000 1619000 606341 0
0 6260745 0 0 0 0 717746 0 0 0 137000
0
3201126 B 3 BS 1 27/01/2018 02/02/2018 24/10/1948 0 2
1 I21.3;I20.9;K29.7;J81 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 14705196 0 7 0 0 0 RUSMINI d388763
3;JKN DR RIZKI; 5.2.1.201804062320 4 142939 1#0##0#0#0.0#2018-
08-16 10:28:32#0#12:00:00#12:00:00#12:00:00 3
14d7baf36eff49252665c315fefa80b8 0 4281000 1093190 0 0
4790984 0 0 0 0 988022 0 0 2102000
1450000 0
3201126 B 2 BS 1 01/02/2018 02/02/2018 01/09/1984 0 1
1 S62.30;M24.44 79.34 - - None None None None M-1-80-I
10406400 0 0 - 0 - 0 - 0 - 0
10406400 11333607 0 2 0 0 0 SHANDY HALIM SUSANTO
0138R01702180000258 0001452166536 3;JKN DR RIZKI; 5.2.0.201712280730
4 143119 1#0##0#0#0.0#2018-09-05
15:37:57#0#12:00:00#12:00:00#12:00:00 3 050be9612b2549a51e22ec552efe702d
0 7264292 0 0 0 2099364 0 0 0 0
1752451 0 0 0 217500 0
3201126 B 1 BS 1 23/01/2018 03/02/2018 23/08/1970 0 1
1 I73.9;E10.7;I11.9;L03.1;J18.9;D64.9 86.22;93.94;99.04 - - None
None None None I-4-15-III None None None None None None PENYAKIT
PEMBULUH DARAH PERIFER DAN LAIN-LAIN (BERAT) 10244500 0 0 - 0
- 0 - 0 - 0 10244500 30504968 0 12 0
0 0 TRI CHARMANDITO WIBOWO D258854 47 17320 DEDY PRATAMA,SPBV
0138R01701180010864 0001515109465 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 139463 1#0##0#0#0.0#2018-02-13
14:24:34#0#12:00:00#12:00:00#00:00:00 1 6c0b5a17a4e5ba6152b5f183c4d93948
0 6904388 864126 0 0 13510454 0 0 0 0
9157000 0 0 0 69000 0
3201126 B 1 BS 1 29/01/2018 03/02/2018 15/04/1963 0 1
1 I21.9;I47.1;E11.9 - - - None None None None I-4-10-II
0 0 - 0 - 0 - 0 - 0 10107000
11070761 0 6 0 0 0 YOYO EFENDI D386278 54 20013
TANTIYO S;16137 5.2.0.201712280730 4 141720 1#0##0#0#0.0#2018-
02-13 14:40:19#0#20:55:54#20:55:54#12:00:00 1
2b3df74ee35a9114419c25ab402b06d9 0 0 601080 0 0
3062926 0 0 0 0 5481755 0 0 0 1925000
0
3201126 B 3 BS 1 30/01/2018 03/02/2018 01/05/1991 0 1
1 D34 06.2 - - None None None None E-1-20-I None None
None None None None PROSEDUR PADA TIROID, PARATIROID DAN SALURAN
TIROGLOSAL (RINGAN) 7516400 0 0 - 0 - 0 - 0
- 0 7516400 11633325 0 5 0 0 0 NANA CAHYADI
0000513157645 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141754
1#0##0#0#0.0#2018-02-13 14:49:31#0#12:00:00#12:00:00#12:00:00 1
49a67c4f8ae35887bbd35ed1d153a30a 0 4821092 75164 0 0
4817510 0 0 0 0 1702059 0 0 0 217500
0
3201126 B 2 BS 1 01/02/2018 03/02/2018 08/10/1979 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10110351 0 3 0 0 0 TITIK HARTATIK D080743 38
13996 DR ARJU A, SPOG 0138R01702180000120 0001639132582 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 142887 1#0##0#0#0.0#2018-
02-13 14:58:31#0#12:00:00#12:00:00#12:00:00 1
3c5910c58c92baaafb8e4a6053d13637 0 5981653 170000 0 0
1862273 0 0 0 0 2027425 0 0 0 69000 0
3201126 B 1 BS 1 30/01/2018 03/02/2018 07/05/1953 0 1
12373100 0 0 - 0 - 0 - 0 - 0
12373100 26329613 0 5 0 0 0 MOH TOHIR,H,SKM
d381473 64 23644 DR SIDDHI ANDIKA, SPU 0138R01701180013710
0000157502362 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141732
1#0##0#0#0.0#2018-02-13 15:03:23#0#12:00:00#12:00:00#12:00:00 1
90295f1b0b391adc3a910dfda51df28b 0 8541200 8959392 0 0
7206021 0 0 0 0 1256000 0 0 0 69000 298000
3201126 B 2 BS 1 01/02/2018 03/02/2018 19/09/1964 0 2
1 E87.6;A09.9;I10 - - - None None None None E-4-11-I
3545800 0 0 - 0 - 0 - 0 - 0
3545800 3508891 0 3 0 0 0 SYAHRIDA DALIMUNTHE
0001867989069 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143363
1#0##0#0#0.0#2018-02-13 16:09:42#0#12:00:00#12:00:00#00:00:00 1
4884fe97e6387bb9ec3dc1bfc8b82dfe 0 0 372122 0 0
1366215 0 0 0 0 1770554 0 0 0 0 0
3201126 B 3 BS 1 31/01/2018 03/02/2018 29/04/2005 0 1
- 0 4227600 7616112 0 4 0 0 0 MUHAMMAD
RAFLI FAZRIAN D384285 12 4660 DR VERA MUNA MANOE, SPA
0138R01701180014762 0001263251755 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142850 1#0##0#0#0.0#2018-02-13
16:12:45#0#12:00:00#12:00:00#12:00:00 1 abb8f8434bc16ff6ab75dbd5f14b68e6
0 0 321830 0 0 5718032 0 0 0 0
1576250 0 0 0 0 0
3201126 B 2 BS 1 01/02/2018 03/02/2018 01/02/2018 2455 2
(RINGAN) 6580300 0 0 - 0 - 0 - 0 - 0
6580300 3587492 0 3 0 0 0 FATHIYA KHAYRA
d389284 0 0 DR AWIDIYA, SPA 0138R01702180001217
0002426510395 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144337
1#1#vip#3#1096700#0.0#2018-02-17 08:35:22#0#12:00:00#12:00:00#12:00:00 1
a7cef0162ea8a26b1a01c858c179ad4c 0 0 1075397 0 0 88899
0 0 0 0 2423196 0 0 0 0 0
3201126 B 2 BS 1 01/02/2018 03/02/2018 11/01/1982 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 23349367 0 3 0 0 0 RINA JANUARITA
0001259358232 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142863
1#1#vvip#3#17365267#0.0#2018-02-17 08:55:54#0#12:00:00#12:00:00#12:00:00
2 29214c88fc1695eea72ea2fccaff2ead 0 14540737 53000 0 0
3724630 0 0 0 0 4834000 0 0 0 69000 128000
3201126 B 1 BS 1 02/02/2018 03/02/2018 01/03/2012 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 3947927 0 2 0 0 0 AQMARUL IKHSAN
0001274835126 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144075
1#0##0#0#0.0#2018-02-17 09:26:08#0#12:00:00#12:00:00#00:00:00 1
73a8f67b607eda70054af2d4b7ba57c1 0 0 376362 0 0
2070789 0 0 0 0 1500776 0 0 0 0 0
3201126 B 2 BS 1 02/02/2018 03/02/2018 10/06/1977 0 2
1 N85.1;N92.1;D62 69.09;99.04 - - None None None None W-1-
11-II None None None None None None PROSEDUR DILATASI, KURET, INTRAUTERIN &
SERVIK (SEDANG) 3046400 0 0 - 0 - 0 - 0 -
0 3046400 7433526 0 2 0 0 0 TRI SULASYUNI
D389303 40 14847 DR MAMAN H, SPOG 0138R01702180000897
0001186184992 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143937
1#0##0#0#0.0#2018-02-17 09:30:40#0#12:00:00#12:00:00#12:00:00 2
f8acae9c42815d83ac6eb9047f33b0b3 0 2788996 293000 0 0
2991225 0 0 0 0 1360305 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 03/02/2018 01/02/2018 3438 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3034947 0 3 0 0 0 BAYI NY AYUDIA RETNO
LESTARI D389249 0 0 DR AWIDIYA, SPA 0138R01702180000351
0002420307371 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143244
1#1#vvip#3#0#0.0#2018-02-17 10:39:01#0#12:00:00#12:00:00#12:00:00 1
a389e7caaf3ca237bbb2bfba8a462323 0 0 310000 0 0 88899
0 0 0 0 2636048 0 0 0 0 0
3201126 B 2 BS 1 01/02/2018 03/02/2018 06/04/2016 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2923256 0 3 0 0 0 ALLEA QUEENSHA ZAHIRA
D352548 1 666 DR RASTRA, SPA 0138R01702180000002
0002196990191 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142856
1#0##0#0#0.0#2018-02-22 15:54:47#0#12:00:00#12:00:00#00:00:00 1
cd7b5e6601b8cd397731387ed78961ec 0 0 238535 0 0 952480
0 0 0 0 1732241 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 03/02/2018 29/12/2011 0 2
7684500 0 0 - 0 - 0 - 0 - 0
7684500 10749772 0 2 0 0 0 RAHMA ZAHIRA
D227021 6 2227 DR ASRI DWI R, SPB 0138R01702180000651
0001648822678 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143463
1#0##0#0#0.0#2018-02-22 15:55:52#0#12:00:00#12:00:00#12:00:00 1
6aa0bb2f756c8c6ff561dae4ee31fb53 0 6468200 2151660 0 0
1225656 0 0 0 0 759256 0 0 0 145000
0
3201126 B 3 BS 1 01/02/2018 03/02/2018 24/11/2000 0 2
1 A01.0;K29.6 99.21;90.59 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 1844560 0 3 0 0 0 USWATUN
KHASANAH D389210 17 6278 DR SOEGIONO, SPPD 0138R01702180000260
0001740362207 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143155
1#0##0#0#0.0#2018-02-22 15:56:55#0#12:00:00#12:00:00#12:00:00 1
c70b4a4e46118f43504d86663fa9f5f6 0 0 257183 0 0 651705
0 0 0 0 935672 0 0 0 0 0
3201126 B 3 BS 1 01/02/2018 03/02/2018 17/08/1992 0 1
1 D36.0;D15.2 83.39 - - None None None None M-1-50-I None
0 0 - 0 - 0 - 0 - 0 5331600
8602475 0 3 0 0 0 ABDUROHMAN NUGRAHA D386437
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143426
1#0##0#0#0.0#2018-02-22 16:08:41#0#12:00:00#12:00:00#12:00:00 1
b2c5d74820fc01f8455a9b40aa3108ca 0 3235500 1445976 0 0
3084720 0 0 0 0 618779 0 0 0 217500
0
3201126 B 2 BS 1 31/01/2018 03/02/2018 19/06/1996 0 2
- 0 - 0 - 0 - 0 4649300 9643859 0
4 0 0 0 DEA PUSPITA SARI D292749 21 7896 YASMIN
SURYANDARI BACHTIAR. DR. SPB 0138R01701180014752 0001107848744 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 142844 1#0##0#0#0.0#2018-
02-22 16:13:15#0#12:00:00#12:00:00#00:00:00 1
78a8b571a4c93b2edf67ba57fccb11ac 0 5061600 1417804 0 0
2388548 0 0 0 0 706907 0 0 0 69000 0
3201126 B 1 BS 1 27/01/2018 03/02/2018 25/03/1934 0 2
1 I63.9;I10;E87.1;G20 87.03 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 18086754 0 8 0 0 0 RUSTI PURBA
0001257557376 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141054
1#1#vvip#8#8413454#0.0#2018-02-22 16:24:11#0#12:00:00#12:00:00#00:00:00
1 2054f730c55e172122afd3a5c2e57034 0 0 825024 0 0
6439984 0 0 0 0 10821746 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 03/02/2018 03/02/2007 0 2
0 - 0 - 0 - 0 - 0 5461000 10329705
0 2 0 0 0 DINI CAHYA FEBRIYANTI D121280 10 4017
DR RISMAN S, SPTHT 0138R01702180000622 0001623404417 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 143449 1#0##0#0#0.0#2018-
02-22 16:25:33#0#12:00:00#12:00:00#00:00:00 1
229ccfc3e66c13c3951748ce0813fc65 0 5763800 1529080 0 0
2160050 0 0 0 0 731775 0 0 0 145000
0
3201126 B 1 BS 1 30/01/2018 03/02/2018 22/10/1956 0 1
1 I11.0;J18.0 - - - None None None None I-4-12-III None
None None None None None KEGAGALAN JANTUNG (BERAT) 6963100 0
0 - 0 - 0 - 0 - 0 6963100 8816607
0 5 0 0 0 DJUNAIDI D389052 61 22380 DR AZRI
5.2.0.201712280730 4 141876 1#0##0#0#0.0#2018-02-22
16:28:38#0#12:00:00#12:00:00#12:00:00 1 73356bb63411ab2435ed85006f0b6d56
0 0 2202420 0 0 2286400 0 0 0 0
4327787 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 03/02/2018 23/09/1984 0 2
1 O82.9;M35.0 74.0 - - None None None None O-6-10-I None
0 0 - 0 - 0 - 0 - 0 6981500
12744139 0 3 0 0 0 DEBORA TARABUNGA SIAHAAN
D111476 33 12184 DR FERRI SABARUDDIN SPOG 0138R01702180000101
0001647273295 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142865
1#0##0#0#0.0#2018-02-28 17:25:55#0#12:00:00#12:00:00#12:00:00 1
630d5f15dcc56738bb580eacec6779c5 0 6962720 69815 0 0
2649875 0 0 0 0 2992729 0 0 0 69000 0
3201126 B 3 BS 1 02/02/2018 03/02/2018 07/09/2015 0 1
1467400 0 0 - 0 - 0 - 0 - 0
1467400 3671024 0 2 0 0 0 ABRAHAM EL ABDULLAH
DALIMUNTE D386485 2 879 DR CATUR SUZANTARA 0138R01702180001086
0001873514698 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144086
1#0##0#0#0.0#2018-02-28 17:46:44#0#12:00:00#12:00:00#12:00:00 1
ea2873f773be9cd7b6093cbba1c6b5bd 0 2189000 410872 0 0
804992 0 0 0 0 266160 0 0 0 0 0
3201126 B 3 BS 1 03/02/2018 03/02/2018 14/11/1946 0 1
1 M06.8;K30 - - - None None None None M-4-16-I None
0 0 - 0 - 0 - 0 - 0 2841500 882685
0 1 0 0 0 SUKAMDI D042020 71 26014 DR RENDRA
RAMADYA 0138R01702180001200 0000060727408 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 144336 1#0##0#0#0.0#2018-02-28
18:31:05#0#12:00:00#12:00:00#00:00:00 1 b1e8dcca87b364897bc2f696d7e1ed7b
0 0 255735 0 0 280204 0 0 0 0 346746
0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 03/02/2018 28/08/1962 0 1
- 0 58821400 62793220 0 2 0 0 0 AGUS H.
TAMBA D385283 55 20247 DR AZRI NURIZAL SPPD KKV 0138R01702180000590
0000038201106 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143439
1#0##0#0#0.0#2018-02-28 18:32:54#0#12:00:00#12:00:00#12:00:00 1
63b5af2524e7fecc2fd3e28e33ab6632 0 8680000 9619120 0 0
34287100 0 0 0 0 2638000 0 0 0 69000
7500000
3201126 B 1 BS 1 27/01/2018 03/02/2018 07/06/1953 0 1
1 E14.5;A48.0;M86.56 84.12 - - None None None None M-1-
02-III None None None None None None AMPUTASI (BERAT) 35990300 0
0 - 0 - 0 - 0 - 0 35990300 33324621
0 8 0 0 0 MUHAJIR D338732 64 23610 DR SRI
KUNMARTINI, SPPD 0138R01701180012757 0001261197742 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141059 1#0##0#0#0.0#2018-03-01
18:25:30#0#12:00:00#12:00:00#00:00:00 1 cd18295c7683e6e2ae36ddb356d26a64
0 14591284 4777736 0 0 7118101 0 0 0 0
6768500 0 0 0 69000 0
3201126 B 1 BS 1 31/01/2018 03/02/2018 11/09/1985 0 2
0 - 0 - 0 - 0 - 0 6981500 24464820
0 4 0 0 0 AYUDIA RETNO LESTARI D198556 32 11830
DR NINING H, SPOG 0138R01701180014783 0001653092829 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 142852 1#1#vvip#4#17483320#0.0#2018-
03-01 23:08:16#0#12:00:00#12:00:00#12:00:00 1
f8ed1d446d3ca404fef0bd58f9d395c8 0 8973200 9034000 0 0
5102620 0 0 0 0 1286000 0 0 0 69000 0
3201126 B 1 BS 1 02/02/2018 03/02/2018 23/02/2016 0 1
1 S62.61;S66.1 79.34;79.84;79.64 - - None None None None
M-1-80-I None None None None None None PROSEDUR ANGGOTA TUBUH ATAS
(RINGAN) 12140800 0 0 - 0 - 0 - 0 - 0
12140800 18262191 0 2 0 0 0 MUHAMMAD SULTHAN MIKHAIL
0002247717306 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144084
1#0##0#0#0.0#2018-03-12 15:53:27#0#12:00:00#12:00:00#12:00:00 2
49338f6c56c0cfb7694a7c0ae01959c7 0 9763300 5448832 0 0
1634336 0 0 0 0 1270723 145000 0 0 0
0
3201126 B 1 BS 1 26/01/2018 03/02/2018 26/01/2018 3054 1
1 P03.4;P28.5;P36.9;P58.2 96.72;88.76;99.82 - - None None None
None P-8-07-II None None None None None None NEONATAL, BERAT BADAN
LAHIR GROUP-5 DENGAN PROSEDUR MAYOR (SEDANG) 20015200 0 0 - 0
- 0 - 0 - 0 20015200 42394399 0 9 0
0 0 ATHALLA RAZQA WARDHANA D388684 0 0 DR AULIA TANGKARI,
SPA 0138R01701180012495 0002424076277 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 140888 1#0##0#0#0.0#2018-03-19
10:00:59#0#12:00:00#12:00:00#12:00:00 2 c939f18ae8bfb536c7d303d89270c050
0 0 747620 0 0 16427279 0 0 0 0
11970500 0 0 13249000 0 0
3201126 B 3 BS 1 02/02/2018 03/02/2018 26/05/1961 0 2
1 K80.2;R18;I48;I49.3 - - - None None None None B-4-
(BERAT) 6563200 0 0 - 0 - 0 - 0 - 0
6563200 5119105 0 2 0 0 0 TUTI N. D387345
56 20706 DR TANTIYO SETIYOWATI 0138R01702180000972 0001740038185
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144056
1#0##0#0#0.0#2018-03-19 10:16:07#0#12:00:00#12:00:00#12:00:00 2
6b31f3adb94b12cf337e33a090a9d0fd 0 0 590688 0 0
3904522 0 0 0 0 623895 0 0 0 0 0
3201126 B 1 BS 1 27/01/2018 03/02/2018 25/03/1934 0 2
1 I63.9;I10;E87.1;G20 87.03 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 18086754 0 8 0 0 0 RUSTI PURBA
0001257557376 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141054
1#1#vvip#8#8413454#0.0#2018-03-19 10:38:00#0#12:00:00#12:00:00#00:00:00
2 b741c00bec861dc9e73f5907cfbe6e7c 0 0 825024 0 0
6439984 0 0 0 0 10821746 0 0 0 0 0
3201126 B 2 BS 1 28/01/2018 03/02/2018 21/11/1963 0 1
1 E11.9;R11;H81.3 87.03 - - None None None None E-4-10-I
0 - 0 4203300 9285234 0 7 0 0 0 ADE
SUHARDIMAN D388908 54 19792 DR ARU, SPPD 0138R01701180013000
0001261076253 3;JKN DR RIZKI; 5.2.1.201804062320 4 141091
1#0##0#0#0.0#2018-05-05 12:06:09#0#12:00:00#12:00:00#12:00:00 2
4784e7c23aee2674e26d8e561dc9a1d9 0 0 409013 0 0
5212776 0 0 0 0 0 0 0 0 3663445 0
3201126 B 1 BS 1 31/01/2018 03/02/2018 27/06/1986 0 2
0 0 - 0 - 0 - 0 - 0 6981500
23544544 0 4 0 0 0 MARDIYAH RAMLI D388078 31
11541 DR NINING H, SPOG 0138R01701180014777 0001107115121 3;JKN DR
RIZKI; 5.2.1.201804062320 4 142851 1#1#vvip#4#16563044#0.0#2018-
05-16 10:35:44#0#12:00:00#12:00:00#12:00:00 2
b008a71e2e7c9eddd0c64f08ea336c1c 0 14540737 175176 0 0
3787631 0 0 0 0 4844000 0 0 0 69000 128000
3201126 B 3 BS 1 01/02/2018 03/02/2018 04/04/1959 0 1
- 0 8908800 10648741 0 3 0 0 0 NUROHIM
0001740522418 3;JKN DR RIZKI; 5.2.1.201804062320 4 143427
1#0##0#0#0.0#2018-05-16 10:58:59#0#12:00:00#12:00:00#12:00:00 2
413c855679b1870ec96bd28dcccbf463 0 4498260 854792 0 0
3899542 0 0 0 0 1361647 0 0 0 34500 0
3201126 B 3 BS 1 01/02/2018 03/02/2018 14/05/2002 0 1
None None None None PENYAKIT SISTEM REPRODUKSI LAKI-LAKI SELAIN TUMOR
(RINGAN) 3692900 0 0 - 0 - 0 - 0 - 0
3692900 6852666 0 3 0 0 0 M. RIVAI D389162
3;JKN DR RIZKI; 5.2.1.201804062320 4 142861 1#0##0#0#0.0#2018-
05-16 11:00:35#0#12:00:00#12:00:00#12:00:00 2
832c452f8020b7c54569d1bf76aa29fb 0 3235500 596756 0 0
2371105 0 0 0 0 504305 0 0 0 145000
0
3201126 B 3 BS 1 02/02/2018 03/02/2018 10/08/1950 0 1
1 E11.9;I64;F00.9;J44.1;K30 90.59;87.03;89.52 - - None None
None None E-4-10-III None None None None None None PENYAKIT KENCING
MANIS & GANGGUAN NUTRISI/ METABOLIK (BERAT) 6262900 0 0 - 0
- 0 - 0 - 0 6262900 1366979 0 2 0
0 0 BARNAS D325873 67 24648 DR AHMAD HIBBAN A WRIYA
0138R01702180001061 0001268653522 3;JKN DR RIZKI; 5.2.1.201804062320
4 144082 1#0##0#0#0.0#2018-08-16
10:01:50#0#12:00:00#12:00:00#12:00:00 3 a40d25ee32f964f1f83633fef129067a
0 0 687546 0 0 301004 0 0 0 0 378429
0 0 0 0 0
3201126 B 3 BS 1 31/01/2018 04/02/2018 26/06/1976 0 2
1 E14.1;J18.0 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 6262900 0 0 - 0 - 0 - 0 -
0 6262900 5196896 0 5 0 0 0 YUNI INDRAWATI
0001472537643 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142853
1#0##0#0#0.0#2018-02-13 14:55:45#0#12:00:00#12:00:00#12:00:00 1
16ba978398992241be6b7924c58a001a 0 0 616661 0 0
3162251 0 0 0 0 1417984 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 04/02/2018 09/07/1989 0 2
1 O82.9;O99.0 74.0;99.04 - - None None None None O-6-10-II
7567300 0 0 - 0 - 0 - 0 - 0
7567300 19468956 0 3 0 0 0 SRI SUPRIYATI
d374489 28 10435 DR FERRI SABARUDDIN SPOG 0138R01702180000678
0002319255731 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143531
1#1#vvip#3#11901656#0.0#2018-02-13 15:23:53#0#12:00:00#12:00:00#12:00:00
1 0a654e7a00e2c1ef54b0df32cf0c7054 0 11181400 122176 0
0 3280380 0 0 0 0 4816000 0 0 0 69000
0
3201126 B 2 BS 1 31/01/2018 04/02/2018 03/11/2017 0 2
1 L00;B37.0 - - - None None None None L-4-10-II None
None None None None None PENYAKIT KULIT MAYOR (SEDANG) 2454700 0
0 - 0 - 0 - 0 - 0 2454700 6780008
0 5 0 0 0 BAYI NY SELLI ARISKA D389129 0 89
DR OTTY MITHA S, SPA 0138R01701180014209 0002286086321 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 142423 1#0##0#0#0.0#2018-
02-13 16:20:37#0#12:00:00#12:00:00#12:00:00 1
78e480f2fb8d1e93b999471d32ffaebc 0 0 243332 0 0
1707124 0 0 0 0 4489552 0 0 0 0 340000
3201126 B 1 BS 1 31/01/2018 04/02/2018 22/10/1964 0 1
1 K80.1;D29.1;K29.7;E13.9 - - - None None None None B-4-
14-I None None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN
(RINGAN) 5879800 0 0 - 0 - 0 - 0 - 0
5879800 7086993 0 5 0 0 0 SIGIT IRIANTO
D389201 53 19459 DR ARU, SPPD 0138R01701180014789
0002246926138 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142855
1#0##0#0#0.0#2018-02-15 11:46:51#0#12:00:00#12:00:00#12:00:00 1
95544ecc4c8def6c87ec58e242b1ff45 0 0 582182 0 0
2891176 0 0 0 0 3613635 0 0 0 0 0
3201126 B 2 BS 1 02/02/2018 04/02/2018 18/12/1964 0 1
1 T14.51;S96.2 79.60;39.32 - - None None None None M-1-
60-I None None None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN
0 - 0 9584600 12118118 0 3 0 0 0
GIYATNO D389340 53 19404 DR HENDRIEK SP B 0138R01702180000981
0001387940275 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144061
1#0##0#0#0.0#2018-02-15 11:53:39#0#12:00:00#12:00:00#12:00:00 1
1e733f588f0965987bc19401d9a04d8e 0 6292788 596592 0 0
3020964 0 0 0 0 2138774 0 0 0 69000 0
3201126 B 2 BS 1 02/02/2018 04/02/2018 05/07/1979 0 1
5043100 0 0 - 0 - 0 - 0 - 0
5043100 4444704 0 3 0 0 0 JUNAEDI IRVAN
D389348 38 14092 DR AZRI SPJP 0138R01702180001034
0001465986431 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144077
1#0##0#0#0.0#2018-02-15 12:31:23#0#12:00:00#12:00:00#12:00:00 1
bab6848037482f7192eb25c6e48c25e2 0 0 858779 0 0
1754150 0 0 0 0 1831775 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 04/02/2018 31/12/1961 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 4201568 0 3 0 0 0 TOHADI
0002317266044 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144078
1#0##0#0#0.0#2018-02-15 12:34:14#0#12:00:00#12:00:00#12:00:00 1
6dd1ac9e0580b8de11c4df8fcda3e957 0 0 453879 0 0
1449320 0 0 0 0 2298369 0 0 0 0 0
3201126 B 2 BS 1 02/02/2018 04/02/2018 16/08/1984 0 2
0 0 - 0 - 0 - 0 - 0 3479400
3629880 0 3 0 0 0 ETIK RUSMIYATI D362297 33
12223 DR ERDIYAN, SPOG 0138R01702180000945 0001657997616 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 144035 1#0##0#0#0.0#2018-
02-17 11:15:38#0#12:00:00#12:00:00#00:00:00 1
af1c643b84644471fa0406248bde2452 0 0 492603 0 0 974808
0 0 0 0 1778469 0 0 384000 0 0
3201126 B 3 BS 1 03/02/2018 04/02/2018 01/12/1958 0 2
15-III None None None None None None KATETERISASI JANTUNG (BERAT)
12210800 0 0 - 0 - 0 - 0 - 0
12210800 10150309 0 2 0 0 0 ROHANI D358837
0000511026287 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144175
1#0##0#0#0.0#2018-02-17 11:19:28#0#12:00:00#12:00:00#00:00:00 1
e221a00ef191e98c59a328118f28a80e 0 3045800 0 0 0
3940470 0 0 0 0 1036039 0 0 0 0
2128000
3201126 B 1 BS 1 03/02/2018 04/02/2018 05/03/1963 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 9830440 0 2 0 0 0 YASIR D387102
54 20059 DR DEDY PRATAMA SPBV 0138R01702180001144 0000040677963
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144183
1#0##0#0#0.0#2018-02-17 11:35:20#0#12:00:00#12:00:00#12:00:00 1
36b6328a344b6ef95cf386623e0911de 0 6301540 60767 0 0
1417020 0 0 0 0 2051113 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 04/02/2018 10/10/1979 0 2
0 - 0 - 0 - 0 - 0 6981500 26348357
0 4 0 0 0 NURHASANAH D080509 38 13994 DR ARJU A,
5.2.0.201712280730 4 142902 1#1#vvip#4#19366857#0.0#2018-02-22
16:33:31#0#12:00:00#12:00:00#12:00:00 1 bf8ffbc23ac4cce9773b9364740b5227
0 10286200 9305000 0 0 5269157 0 0 0 0
1291000 0 0 0 197000 0
3201126 B 3 BS 1 29/01/2018 04/02/2018 29/01/2018 2121 1
1 P03.8;P22.9;P36.9 - - - None None None None P-8-13-II
None None None None None None NEONATAL, BBL 2000 - 2499 GR TANPA
PROSEDUR MAYOR (SEDANG) 8554400 0 0 - 0 - 0 - 0
- 0 8554400 11601092 0 7 0 0 0 JIHAN NOVIRA
BY NY D388962 0 0 DR AULIA TANGKARI, SPA 00000111110000 123456789
3;JKN DR RIZKI; 5.2.0.201712280730 4 142926 1#0##0#0#0.0#2018-
02-27 09:41:10#0#08:58:44#08:58:44#00:00:00 2
a5e53b8457cd93f0ebfee6e2faa8a637 0 0 546524 0 0
2568618 0 0 0 0 6251950 0 0 0 0
2234000
3201126 B 2 BS 1 29/01/2018 04/02/2018 10/10/2005 0 2
5405900 0 0 - 0 - 0 - 0 - 0
5405900 12011066 0 7 0 0 0 NAZWA PUTRI DEWI
0002033733363 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141717
1#0##0#0#0.0#2018-02-28 17:14:11#0#12:00:00#12:00:00#12:00:00 1
a298a019d51d8bd0856358decd28e1cc 0 0 593589 0 0
6057706 0 0 0 0 4679771 0 0 0 0 680000
3201126 B 3 BS 1 03/02/2018 04/02/2018 03/10/1965 0 1
0 - 0 - 0 - 0 - 0 12210800 11979311
0 2 0 0 0 TASWAN D388713 52 19116 DR AGOES
KOOSHARTORO SPPD 0138R01702180001132 0001338023733 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 144115 1#0##0#0#0.0#2018-02-28
18:29:46#0#12:00:00#12:00:00#12:00:00 1 483c18dec4702360cd1fda3ef49597ba
0 4517160 0 0 0 4306458 0 0 0 0
1155693 0 0 0 0 2000000
3201126 B 1 BS 1 31/01/2018 04/02/2018 21/09/1992 0 2
1 A15.2;R04.2 90.59 - - None None None None J-4-15-I None
6071100 0 0 - 0 - 0 - 0 - 0
6071100 6536740 0 5 0 0 0 SEPTIANA PRAKAS PRATIWI
0001797974673 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142694
1#0##0#0#0.0#2018-03-01 17:53:45#0#12:00:00#12:00:00#12:00:00 1
7c3c44255e2791e782bc46d2fbc2d986 0 0 660110 0 0
1499993 0 0 0 0 4376637 0 0 0 0 0
3201126 B 2 BS 1 01/02/2018 04/02/2018 13/08/1978 0 2
1 D21.9 83.39;90.59;89.52 - - None None None None M-1-50-I
None None None None None None PROSEDUR JARINGAN LUNAK (RINGAN)
6397900 0 0 - 0 - 0 - 0 - 0
6397900 9418710 0 4 0 0 0 IMELDA TRESKA SIAHAYA
0002327420564 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144369
1#0##0#0#0.0#2018-03-01 18:38:02#0#12:00:00#12:00:00#12:00:00 1
5c7ebf330477e76702b3fb2432408a64 0 5400512 63000 0 0
1969021 0 0 0 0 1917177 0 0 0 69000 0
3201126 B 1 BS 1 03/02/2018 04/02/2018 01/08/1953 0 2
1 Q27.3;E13.2 39.42;90.59;89.52 - - None None None None N-1-
- 0 12472300 16903391 0 2 0 0 0 AUGUSTIEN A.
SUNDALANGI D319145 64 23562 DR DEDY PRATAMA SPBV 0138R01702180001149
0001472918488 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144155
1#0##0#0#0.0#2018-03-01 18:42:26#0#12:00:00#12:00:00#00:00:00 1
ed8ca595f25c52926a0af43de2123fee 0 4514000 2670240 0 0
7160322 0 0 0 0 2558829 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 04/02/2018 17/09/1945 0 2
1 S82.20;S82.40 79.36;90.59;89.52;37.28 - - None None None
None M-1-70-I None None None None None None PROSEDUR LUTUT DAN
TUNGKAI BAWAH SELAIN KAKI (RINGAN) 21357400 0 0 - 0 - 0
- 0 - 0 21357400 23669422 0 3 0 0 0
ZAWIRNA D005849 72 26436 DR BENNY H T, SPOT
0138R01702180001065 0000061057945 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 144083 1#0##0#0#0.0#2018-03-01
18:45:41#0#12:00:00#12:00:00#12:00:00 1 f10390013b3d778225991e255e64dd24
0 14361372 266574 0 0 3933476 0 0 0 0
2608000 0 0 0 0 2500000
3201126 B 3 BS 1 04/02/2018 04/02/2018 09/05/1944 0 1
1 K30;R07.4 89.52 - - None None None None K-4-18-I None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1233239 0 1 0 0 0 HEINTJE LEANDER
D285392 73 26934 DR ADRIAN HANDARU 0138R01702180001329
0001258294781 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144356
1#0##0#0#0.0#2018-03-19 10:09:28#0#12:00:00#12:00:00#12:00:00 2
f26cbcaccc170668d190e569007205f7 0 0 156906 0 0 706654
0 0 0 0 369679 0 0 0 0 0
3201126 B 1 BS 1 03/02/2018 04/02/2018 06/09/1966 0 1
1 I63.9 - - - None None None None G-4-14-I None None
7018400 0 0 - 0 - 0 - 0 - 0
7018400 11770200 0 2 0 0 0 IWAN SETIAWAN
D387371 51 18778 DR. RAKHMAD HIDAYAT, SP.S (K) 0138R01702180001122
0001741619439 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 144091
1#0##0#0#0.0#2018-05-16 10:40:47#0#12:00:00#12:00:00#12:00:00 4
d413b6a9a92c7c237b0b47db9378e615 0 4514000 1403680 0 0
3674507 0 0 0 0 2178013 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 04/02/2018 01/11/1952 0 1
1 G45.9;I63.9;E14.9 87.03 - - None None None None G-4-16-III
None None None None None None ISKEMIK TRANSIENT (BERAT) 8938000
0 0 - 0 - 0 - 0 - 0 8938000
7820411 0 4 0 0 0 SLAMET MUSTIKA D389291 65
23833 DR NURUL KOMARI SPS 0138R01702180000524 0000042011526 3;JKN
DR RIZKI; 5.2.1.201804062320 4 143431 1#0##0#0#0.0#2018-05-16
11:03:19#0#12:00:00#12:00:00#12:00:00 2 81e2de85bd79ad6b4290c40e03aa2ff6
0 0 1020330 0 0 3483965 0 0 0 0
3316116 0 0 0 0 0
3201126 B 1 BS 1 30/01/2018 04/02/2018 22/07/1996 0 1
1 A09.9 90.59 - - None None None None K-4-17-I None None
2405100 0 0 - 0 - 0 - 0 - 0
2405100 6334091 0 6 0 0 0 ELDA MUSJARITA
D389101 21 7862 DR ARU, SPPD 0138R01701180014494
0001456816421 3;JKN DR RIZKI; 5.2.1.201804062320 4 142691
1#0##0#0#0.0#2018-05-16 11:04:41#0#12:00:00#12:00:00#12:00:00 2
515bba3f1e0f1d32ab1a2714f817d5a9 0 0 269459 0 0
1701252 0 0 0 0 4363380 0 0 0 0 0
3201126 B 2 BS 1 31/01/2018 04/02/2018 24/08/1992 0 2
1 O00.9;D62 66.62;99.04 - - None None None None W-1-20-II
12391500 0 0 - 0 - 0 - 0 - 0
12391500 36325652 0 5 0 0 0 ZENNI RISTIA SUSANTI
0001656138486 3;JKN DR RIZKI; 5.2.0.201712280730 4 142859
1#1#vvip#5#23934152#0.0#2018-09-05 16:58:55#0#12:00:00#12:00:00#12:00:00
3 597441733842da2067e9b46e49dfae57 0 17392000 1209000 0
0 9409152 0 0 0 0 8098000 0 0 0 217500
0
3201126 B 1 BS 1 03/02/2018 05/02/2018 14/06/1957 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 16471922 0 3 0 0 0 DANIEL NGADIMIN
0001261234462 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144150
1#0##0#0#0.0#2018-02-15 14:30:52#0#12:00:00#12:00:00#00:00:00 1
4a36d92edf0306e211605955db63e169 0 5729340 0 0 0
7565980 0 0 0 0 3176602 0 0 0 0 0
3201126 B 3 BS 1 01/02/2018 05/02/2018 03/10/1979 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2661766 0 5 0 0 0 HENDRO D116821
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145224
1#0##0#0#0.0#2018-02-17 11:01:54#0#12:00:00#12:00:00#12:00:00 1
b38c81c1df955cc4e87aff341769a057 0 0 241100 0 0 995532
0 0 0 0 1425134 0 0 0 0 0
3201126 B 1 BS 1 31/01/2018 05/02/2018 02/01/1954 0 1
1 E16.2;N18.4;D63.8;N20.2 99.04 - - None None None None E-4-
10-II None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
NUTRISI/ METABOLIK (SEDANG) 6852200 0 0 - 0 - 0 -
0 - 0 6852200 13674972 0 6 0 0 0 ARIF
FARIDI d309677 64 23405 DR. ARU ARIADNO, SPPD 0138R01701180014217
0000040009961 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142427
1#0##0#0#0.0#2018-02-17 11:08:40#0#12:00:00#12:00:00#12:00:00 1
967bb1c904f232630b7ccf616d28cf0c 0 0 669698 0 0
6346650 0 0 0 0 5900624 0 0 0 290000
468000
3201126 B 1 BS 1 03/02/2018 05/02/2018 10/05/1966 0 2
1 H81.1;I10 90.59;89.52 - - None None None None U-4-11-I
0 - 0 - 0 - 0 - 0 2124500 4419217
0 3 0 0 0 NANI d389411 51 18897 DR MAYSAMIRAWATI
5.2.0.201712280730 4 144329 1#0##0#0#0.0#2018-02-17
11:12:21#0#12:00:00#12:00:00#00:00:00 1 a1fce9da028f494d785b574fc7b0d47f
0 0 244204 0 0 1516905 0 0 0 0
2658108 0 0 0 0 0
3201126 B 3 BS 1 02/02/2018 05/02/2018 14/03/1990 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1824192 0 4 0 0 0 MARCHO NICOLAS LOEN
0000510931427 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144087
1#0##0#0#0.0#2018-02-17 11:42:02#0#12:00:00#12:00:00#12:00:00 1
aae00199ce87a6bfdba802da3894b561 0 0 241100 0 0 648752
0 0 0 0 934340 0 0 0 0 0
3201126 B 3 BS 1 04/02/2018 05/02/2018 12/07/1957 0 1
1 R73.9 99.17 - - None None None None E-4-10-I None None
None None None None PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 1304626 0 2 0 0 0 JOKO TRIYONO
0000037649553 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144370
1#0##0#0#0.0#2018-02-17 12:26:54#0#12:00:00#12:00:00#00:00:00 1
9316cf5679b4247cbf35954810df115f 0 0 315243 0 0 615034
0 0 0 0 374349 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 05/02/2018 01/02/2018 3551 2
1 P59.9;P03.4;T80.4 99.82 - - None None None None P-8-17-II
None None None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR
MAYOR (SEDANG) 9212400 0 0 - 0 - 0 - 0 -
0 9212400 5851793 0 5 0 0 0 BAYI NY NURHASANAH
D389274 0 0 DR AWIDIYA, SPA 0138R01702180001349
0002426450264 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144360
1#1#vvip#5#0#0.0#2018-02-19 16:27:53#0#12:00:00#12:00:00#12:00:00 1
ad44146854f3ff87e392d7d25cf6d898 0 0 852000 0 0 330965
0 0 0 0 4328828 0 0 0 0 340000
3201126 B 1 BS 1 02/02/2018 05/02/2018 28/04/1984 0 2
1 Z87.5;D26.9 74.4;68.29 - - None None None None W-1-20-I
11569900 0 0 - 0 - 0 - 0 - 0
11569900 38650282 0 4 0 0 0 GIANTI FARAZ
D264641 33 12333 DR NOVI RESISTANTIE, SPOG 0138R01702180001084
0000200757486 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144085
1#1#vvip#4#27080382#0.0#2018-02-22 16:31:58#0#12:00:00#12:00:00#12:00:00
1 1ba2bb1f35b732a639eb6689a3d8055d 0 12180650 18654250 0
0 6434382 0 0 0 0 1253000 0 0 0 128000
0
3201126 B 3 BS 1 01/02/2018 05/02/2018 14/02/2011 0 2
(BERAT) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 2803219 0 5 0 0 0 KHAYLA JASMINE
D389277 6 2544 DR AWIDIYA, SPA 0138R01702180000471
0001208925549 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143428
1#0##0#0#0.0#2018-02-22 16:35:14#0#12:00:00#12:00:00#12:00:00 1
aac03e717ebdb140bced71cc7797873c 0 0 207620 0 0
1071211 0 0 0 0 1524388 0 0 0 0 0
3201126 B 3 BS 1 31/01/2018 05/02/2018 31/12/1949 0 1
- 0 45079800 71647280 0 6 1 5 0 SAMIN HS
0001459427095 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142436
1#0##0#0#0.0#2018-02-28 17:09:13#0#12:00:00#12:00:00#12:00:00 1
a92ef3609b522fccd6ae844cf59ef8f7 0 14520800 404900 0 0
40400580 0 0 0 0 5812000 0 0 0 3009000
7500000
3201126 B 1 BS 1 03/02/2018 05/02/2018 27/04/1943 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 62839810 0 3 0 0 0 PONIMAN
0000156492876 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144345
1#0##0#0#0.0#2018-02-28 17:52:10#0#12:00:00#12:00:00#00:00:00 1
6388d58669185f7d4b657f2077a44ddd 0 18299120 0 0 0
34432690 0 0 0 0 2608000 0 0 0 0
7500000
3201126 B 3 BS 1 04/02/2018 05/02/2018 29/08/1993 0 2
- 0 - 0 - 0 - 0 2168300 1959708 0
2 0 0 0 NINA RATNASARI D389508 24 8925 DR MAMAN H,
5.2.0.201712280730 4 144367 1#0##0#0#0.0#2018-02-28
18:05:06#0#12:00:00#12:00:00#12:00:00 1 e486cf752fc1e4094cfb789375048249
0 0 498147 0 0 189856 0 0 0 0 611705
0 0 0 276000 384000
3201126 B 2 BS 1 03/02/2018 05/02/2018 31/12/1960 0 2
- 0 51950600 56318510 0 3 0 0 0 MUJINEM
0001455247361 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144343
1#0##0#0#0.0#2018-02-28 18:07:42#0#12:00:00#12:00:00#12:00:00 1
1a5e17828bbc7a96566eb40f6f87c57b 0 16400960 0 0 0
30154050 0 0 0 0 2263500 0 0 0 0
7500000
3201126 B 1 BS 1 03/02/2018 05/02/2018 14/12/1959 0 2
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 51593125 0 3 0 0 0 UPI RIAHERTINA
0001382031922 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144346
1#0##0#0#0.0#2018-02-28 18:19:28#0#12:00:00#12:00:00#12:00:00 1
a542ff222c97415d98db23e8c1ea9542 0 18299120 0 0 0
23186005 0 0 0 0 2608000 0 0 0 0
7500000
3201126 B 2 BS 1 03/02/2018 05/02/2018 10/11/1948 0 1
- 0 51950600 58806785 0 3 0 0 0 AZWIR .R
0001283548217 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144341
1#0##0#0#0.0#2018-02-28 18:20:31#0#12:00:00#12:00:00#12:00:00 1
3afdce417d508bbad16e6795adac70e9 0 16400960 0 0 0
32642325 0 0 0 0 2263500 0 0 0 0
7500000
3201126 B 1 BS 1 03/02/2018 05/02/2018 25/09/1949 0 1
0 0 - 0 - 0 - 0 - 0 17095200
14701597 0 3 0 0 0 DEDEN MULYADI D385869 68
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144344
1#0##0#0#0.0#2018-02-28 18:25:13#0#12:00:00#12:00:00#12:00:00 1
b02d8e2152c604f55797c3177923e3f5 0 6814040 0 0 0
3172270 0 0 0 0 2715287 0 0 0 0
2000000
3201126 B 1 BS 1 03/02/2018 05/02/2018 31/03/1963 0 1
- 0 58821400 52539770 0 3 0 0 0 IYUS RUSTANA
0000039910274 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144342
1#0##0#0#0.0#2018-02-28 18:26:27#0#12:00:00#12:00:00#12:00:00 1
979c07d20a2cf8816f7f91b0ff7c3d3c 0 18299120 0 0 0
23787150 0 0 0 0 2953500 0 0 0 0
7500000
3201126 B 2 BS 1 05/02/2018 05/02/2018 16/04/1965 0 1
1 Z53.0;N18.5;K40.9 - - - None None None None Z-4-12-I
0 - 0 2252000 2151749 0 1 0 0 0 YAHYA
0001155907473 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144490
1#0##0#0#0.0#2018-03-01 18:31:08#0#12:00:00#12:00:00#00:00:00 1
7e821d08599a2ad933af66650cdac328 0 0 202680 0 0
1277300 0 0 0 0 671769 0 0 0 0 0
3201126 B 2 BS 1 02/02/2018 05/02/2018 22/01/1985 0 1
1 G72.3;E87.6;I49.3;A04.9 - - - None None None None G-4-
LAIN-LAIN (BERAT) 7488200 0 0 - 0 - 0 - 0 -
0 7488200 5974313 0 4 0 0 0 BUDI ARIANTO
0001448641967 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143436
1#0##0#0#0.0#2018-03-01 18:32:04#0#12:00:00#12:00:00#12:00:00 1
91dd794a3a9990804facb650a0818fcc 0 0 726938 0 0
2810532 0 0 0 0 2436843 0 0 0 0 0
3201126 B 1 BS 1 03/02/2018 05/02/2018 11/05/1973 0 1
1 I20.0;I50.0 - - - None None None None I-4-20-II None
6795600 0 0 - 0 - 0 - 0 - 0
6795600 5309515 0 3 0 0 0 DIK HANSEN D141665
0000036224155 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144327
1#0##0#0#0.0#2018-03-01 18:34:12#0#12:00:00#12:00:00#12:00:00 1
178995083cbef9142110808cee6cc217 0 0 1016504 0 0
1576660 0 0 0 0 2716351 0 0 0 0 0
3201126 B 3 BS 1 03/02/2018 05/02/2018 19/08/1981 0 2
1 N18.5;I50.1 39.95;90.59;89.52 - - None None None None N-4-
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 5489992 0 3 0 0 0 IIN SUPRIATIN
D385388 36 13317 DR ARU, SPPD 0138R01702180001169
0002282454371 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144290
1#0##0#0#0.0#2018-03-01 18:35:59#0#12:00:00#12:00:00#12:00:00 1
24d888208cf67657886462022e7b4cc7 0 0 351242 0 0
2493342 0 0 0 0 2645408 0 0 0 0 0
3201126 B 1 BS 1 03/02/2018 05/02/2018 20/03/1969 0 1
1 R10.1 90.59;88.76;89.52 - - None None None None K-4-17-I
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4246649 0 3 0 0 0 ZAINAL ARIFIN
D389391 48 17852 DR ZULFAN, SPPD 0138R01702180001097
0001477088199 3;JKN DR RIZKI; 5.2.1.201804062320 4 144089
1#0##0#0#0.0#2018-05-05 11:39:41#0#12:00:00#12:00:00#12:00:00 2
ac7af57053fc2eba7024461fb67e2a2c 0 0 345275 0 0
1254556 0 0 0 0 2646818 0 0 0 0 0
3201126 B 1 BS 1 30/01/2018 05/02/2018 01/02/1945 0 1
1 N02.8;N99.9;D63.8;R33 90.59;99.04;57.0 - - None None None
None N-1-40-II None None None None None None PROSEDUR PADA URETRA DAN
TRANSURETRA (SEDANG) 15287300 0 0 - 0 - 0 - 0
- 0 15287300 28622367 0 7 1 1 0 BURHANI
0002197791955 3;JKN DR RIZKI; 5.2.1.201804062320 4 141729
1#0##0#0#0.0#2018-05-16 10:15:52#0#12:00:00#12:00:00#12:00:00 2
c2e9b8ef62e4ec2af9564f62ebddf6e1 0 6377768 4723024 0 0
11318075 0 0 0 0 5836500 0 0 0 69000 298000
3201126 B 1 BS 1 02/02/2018 05/02/2018 25/11/1976 0 2
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 5841814 0 4 0 0 0 DEDE NURLAELA
0000060485051 3;JKN DR RIZKI; 5.2.1.201804062320 4 143435
1#0##0#0#0.0#2018-05-16 10:25:49#0#12:00:00#12:00:00#12:00:00 5
f2c939a8500cf4040870b5bbe486e0ff 0 0 345274 0 0
1964365 0 0 0 0 3532175 0 0 0 0 0
3201126 B 2 BS 1 04/02/2018 05/02/2018 01/11/1964 0 2
1 E04.9;R25.1 06.11;90.59 - - None None None None E-4-13-II
None None None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN
(SEDANG) 6498800 0 0 - 0 - 0 - 0 - 0
6498800 6499127 0 2 0 0 0 ENY RETNO PURWANINGSIH
D388717 53 19453 RACHMAWATI DR,SPB(K)ONK 0138R01702180001428
0002280598659 3;JKN DR RIZKI; 5.2.1.201804062320 4 144374
1#0##0#0#0.0#2018-05-16 10:30:49#0#12:00:00#12:00:00#12:00:00 2
3ce3322cb2545cb252d2d08e909ff7e4 0 3609100 887300 0 0
1046550 0 0 0 0 956177 0 0 0 0 0
3201126 B 3 BS 1 03/02/2018 05/02/2018 02/03/1964 0 1
I-4-12-II None None None None None None KEGAGALAN JANTUNG (SEDANG)
4144700 0 0 - 0 - 0 - 0 - 0
4144700 4949012 0 3 0 0 0 ROMLI TN D325831
53 19696 DR SRI KUMARTINI 0138R01702180001119 0001743644902 3;JKN
DR RIZKI; 5.2.1.201804062320 4 144090 1#0##0#0#0.0#2018-05-16
10:57:15#0#12:00:00#12:00:00#00:00:00 2 855f5205224556ac214f2a13ad04e130
0 0 599993 0 0 2054002 0 0 0 0
2295017 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 05/02/2018 05/12/1959 0 2
1 K21.9;K31.7;K29.4 45.16;90.59;89.52;87.49 - - None None None
None K-4-12-I None None None None None None GANGGUAN ESOFAGUS
(RINGAN) 4136800 0 0 - 0 - 0 - 0 - 0
4136800 6190077 0 2 0 0 0 ROSMAWATI SIREGAR
D380915 58 21246 DR ZULFAN, SPPD 0138R01702180001417
0000060997702 3;JKN DR RIZKI; 5.2.2.201806040537 4 144372
1#0##0#0#0.0#2018-09-05 18:20:32#0#12:00:00#12:00:00#12:00:00 2
5734ef7c968c3cad5995e2794486f9e3 0 1929000 1274304 0 0
875815 0 0 0 0 430958 0 0 0 1680000
0
3201126 B 1 BS 1 28/01/2018 06/02/2018 10/05/1962 0 1
1 C71.8;R40.0;G81.9 90.59;89.52;87.03 - - None None None None
G-4-11-II None None None None None None TUMOR SISTEM SARAF & GANGGUAN
DEGENERATIF (SEDANG) 8501800 0 0 - 0 - 0 - 0
- 0 8501800 24487157 0 10 1 0 0 DEDY MAIZAL
D359575 55 20352 DR MAYSAM I., SPS 0138R01701180012895
0000043446014 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141073
1#1#vip#10#6376350#75.0#2018-02-17 11:29:28#0#12:00:00#12:00:00#00:00:00
1 a83aa467c7b797d37a503bdf6979606e 0 0 1540812 0 0
8808345 0 0 0 0 13202000 0 0 596000 0
340000
3201126 B 3 BS 1 06/02/2018 06/02/2018 12/09/1968 0 2
4 J81;R57.2;A19.9;J96.9 99.60 - - None None None None J-4-
21-III None None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM
PERNAFASAN LAIN-LAIN (BERAT) 6291000 0 0 - 0 - 0 -
0 - 0 6291000 7122621 0 1 0 0 0 SUSUN
APIKA D389631 49 18044 DR YOHANNES DWINANDA 0138R01702180002381
0001272450317 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145429
1#0##0#0#0.0#2018-02-17 11:50:06#0#12:00:00#12:00:00#12:00:00 1
e38fd9f14b4a425c9ccda69cccc160b6 1000000 0 566190 0 0
4866886 0 0 0 0 689545 0 0 0 0 0
3201126 B 3 BS 1 06/02/2018 06/02/2018 07/06/1940 0 1
1 J44.1;I50.0 93.94 - - None None None None J-4-17-II None
None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (SEDANG)
4417400 0 0 - 0 - 0 - 0 - 0
4417400 3958009 0 1 0 0 0 SOEKAMTO D347689
77 28368 DR VINSENSIA NOVI KARTIKA 0138R01702180002423
0001338516527 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145491
1#0##0#0#0.0#2018-02-21 11:12:12#0#12:00:00#12:00:00#12:00:00 1
5ece3814b95fb86475de8cb1f4bb4465 0 0 566190 0 0
2825884 0 0 0 0 565935 0 0 0 0 0
3201126 B 2 BS 1 20/01/2018 06/02/2018 30/12/1933 0 2
1 G31.0;E10.7;R56.8;E87.6;A41.9;I10;F00.9;R77.0;E87.1;D63.8
89.52;90.59;99.04;87.03;87.49 - - None None None None G-4-11-III
None None None None None None TUMOR SISTEM SARAF & GANGGUAN DEGENERATIF
(BERAT) 10707500 0 0 - 0 - 0 - 0 - 0
10707500 57143444 0 18 1 12 0 RISA SITI ALPIAH
D172742 84 30702 DR CATUR BANUAJI SPS 0138R01701180010099
0000044411815 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139160
1#0##0#0#0.0#2018-02-28 17:34:13#0#12:00:00#12:00:00#12:00:00 1
e18fcba40dab0007e09fc4be8c516551 0 0 1026466 0 0
32042478 0 0 0 0 15080500 0 0 0 3480000
5514000
3201126 B 3 BS 1 05/02/2018 06/02/2018 28/03/2014 0 1
1467400 0 0 - 0 - 0 - 0 - 0
1467400 4179897 0 2 0 0 0 AFIHADID RIZKY
D387710 3 1410 DR CATUR S, SPB 0138R01702180001766
0001290728777 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144740
1#0##0#0#0.0#2018-02-28 17:36:44#0#12:00:00#12:00:00#12:00:00 1
a2ac37f132172cddf39f889500c73d47 0 2426872 63000 0 0 869574
0 0 0 0 675451 0 0 0 145000 0
3201126 B 3 BS 1 27/01/2018 06/02/2018 11/10/1963 0 1
1 J18.9;I08.9;I11.0;N18.4;I25.0 - - - None None None None
COUGH (BERAT) 6419700 0 0 - 0 - 0 - 0 -
0 6419700 19937742 0 11 0 0 0 AHMAD KAHFI
0001260570598 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141062
1#0##0#0#0.0#2018-02-28 17:41:48#0#12:00:00#12:00:00#00:00:00 1
cdfa8be1d19580d11af2f3c64a6d8ef7 0 0 807892 0 0
7210850 0 0 0 0 8343000 0 0 0 3576000
0
3201126 B 3 BS 1 27/01/2018 06/02/2018 12/09/1948 0 1
1 D64.9;K29.0;E11.8;S72.0 99.04 - - None None None None D-4-
- 0 - 0 5407200 13895919 0 11 0 0 0
SYAFEI B NAMAN D388858 69 25339 DR ARU, SPPD
0138R01701180012856 0001739716716 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 141063 1#0##0#0#0.0#2018-02-28
17:45:48#0#12:00:00#12:00:00#12:00:00 1 5d7efb0611f7b8e5d30c201e0ca3210a
0 0 539484 0 0 9791356 0 0 0 0
3565079 0 0 0 0 0
3201126 B 2 BS 1 30/01/2018 06/02/2018 13/04/1984 0 1
1 N18.5;E87.6;J81;D63.8 38.95;99.04;39.95 - - None None None
0 - 0 - 0 23198900 32222415 0 8 0 0
0 HEZRON PANDIANGAN D388984 33 12345 DR SRI KUN, SPPD
0138R01701180014408 0001336724368 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142525 1#0##0#0#0.0#2018-02-28
17:48:44#0#12:00:00#12:00:00#12:00:00 1 027e0dcd4ad96650f93ba21525317455
0 9489100 3260150 0 0 14558665 0 0 0 0
3568500 0 0 0 1346000 0
3201126 B 1 BS 1 04/02/2018 06/02/2018 13/09/2011 0 2
0 0 - 0 - 0 - 0 - 0 3349800
3412184 0 3 0 0 0 DEVINA NAURIFA HUMAIRA D295386
6 2336 DR RASTRA, SPA 0138R01702180001322 0002226236872 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 144355 1#0##0#0#0.0#2018-
02-28 17:49:47#0#12:00:00#12:00:00#12:00:00 1
03eb2e72452fb9b0c4e88d19b6181656 0 0 354482 0 0 465475
0 0 0 0 2592227 0 0 0 0 0
3201126 B 3 BS 1 05/02/2018 06/02/2018 12/05/1981 0 2
1 E04.1 06.2 - - None None None None E-1-20-I None None
- 0 7516400 10972199 0 2 0 0 0 RETNOWATI
d386001 36 13418 RACHMAWATI DR,SPB(K)ONK 0138R01702180001540
0001740132718 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144394
1#0##0#0#0.0#2018-02-28 18:04:00#0#12:00:00#12:00:00#12:00:00 1
91fec46a92402e48aa86afbdbad53f5c 0 3062500 2104592 0 0
4576300 0 0 0 0 793807 0 0 0 435000
0
3201126 B 2 BS 1 04/02/2018 06/02/2018 04/10/2014 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 3324262 0 3 0 0 0 SAKHA ALMAIR AZZABIR
0002044574976 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144373
1#0##0#0#0.0#2018-02-28 18:24:08#0#12:00:00#12:00:00#12:00:00 1
cad8940e8fe497dc6a3d329574c858e0 0 0 443231 0 0
1330056 0 0 0 0 1550975 0 0 0 0 0
3201126 B 2 BS 1 01/02/2018 06/02/2018 01/03/1954 0 2
1 M19.86;K29.7 - - - None None None None M-4-18-I
None None None None None None PENYAKIT TULANG DAN SENDI LAIN-LAIN
(RINGAN) 3344900 0 0 - 0 - 0 - 0 - 0
3344900 7146240 0 6 0 0 0 HENY HERAWATY
0001276622144 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143432
1#0##0#0#0.0#2018-02-28 18:36:42#0#12:00:00#12:00:00#00:00:00 1
db912f806f5d63158c29e2f91bb09fe2 0 0 451285 0 0
4181444 0 0 0 0 2513511 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 06/02/2018 17/03/1967 0 2
1 M79.11;R07.3 87.49;90.59;89.52 - - None None None None
M-4-20-I None None None None None None TANDA, GEJALA & PERADANGAN
MUSKULOSKELETAL (RINGAN) 4105100 0 0 - 0 - 0 -
0 - 0 4105100 4423558 0 3 0 0 0 NUR
HATMAWATI D029377 50 18587 DR MOHAMMAD AULIA HERDIYANA,SPOT
0138R01702180001280 0001629265678 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 144348 1#0##0#0#0.0#2018-02-28
18:43:14#0#12:00:00#12:00:00#00:00:00 1 96202dd37b8b66c0f834ec9e2fdb8dfa
0 0 582524 0 0 1182642 0 0 0 0
2658392 0 0 0 0 0
3201126 B 1 BS 1 03/02/2018 06/02/2018 02/10/1962 0 2
1 K29.7;E10.8 90.59;89.52 - - None None None None K-4-11-II
4615000 0 0 - 0 - 0 - 0 - 0
4615000 6416871 0 4 0 0 0 RUMINTANG MANURUNG
D331386 55 20213 DR ARU, SPPD 0138R01702180001190
0000061066833 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144332
1#0##0#0#0.0#2018-03-01 16:13:24#0#12:00:00#12:00:00#12:00:00 1
d19b70529fa567ff35abcadef7352dac 0 0 521350 0 0
2325726 0 0 0 0 3569795 0 0 0 0 0
3201126 B 2 BS 1 03/02/2018 06/02/2018 13/12/2011 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3516389 0 4 0 0 0 M FANDY BACHRUDIN PUTRA
D389349 6 2244 DR AWIDIYA, SPA 0138R01702180001090
0001182975322 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144088
1#0##0#0#0.0#2018-03-01 16:14:54#0#12:00:00#12:00:00#12:00:00 1
b400563d649626bbe381ba913e280051 0 0 298025 0 0 942320
0 0 0 0 2276044 0 0 0 0 0
3201126 B 2 BS 1 03/02/2018 06/02/2018 30/07/1992 0 2
0 0 - 0 - 0 - 0 - 0 2871200
3933986 0 4 0 0 0 TRI YULIANI D389458 25 9319
DR ARU, SPPD 0138R01702180001238 0001284299763 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 144340 1#0##0#0#0.0#2018-03-01
16:22:38#0#12:00:00#12:00:00#12:00:00 1 f546cafb67b6f4fa0adbe45167cc79e3
0 0 298025 0 0 1540097 0 0 0 0
2095864 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 06/02/2018 26/06/1962 0 2
1 N18.5;I13.1;E11.2;J18.0 39.95;38.95 - - None None None None
- 0 - 0 27065300 22145955 0 5 0 0 0
JUNIAR SIHOTANG D389314 55 20310 DR SRI KUN, SPPD
0138R01702180000557 0000037682458 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 143438 1#0##0#0#0.0#2018-03-01
16:29:16#0#12:00:00#12:00:00#12:00:00 1 b629076b75d24a9dde0ea149c54547ac
0 0 3794689 0 0 6713516 0 0 0 0
11015250 0 0 0 324500 298000
3201126 B 1 BS 1 03/02/2018 06/02/2018 12/04/1979 0 2
1 R07.4 90.59;89.52;87.49 - - None None None None I-4-20-I
5883600 0 0 - 0 - 0 - 0 - 0
5883600 5601975 0 4 0 0 0 EKA WIDIASTUTI
d005015 38 14177 DR ARU, SPPD 0138R01702180001127
0001465995914 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144095
1#0##0#0#0.0#2018-03-01 16:30:34#0#12:00:00#12:00:00#12:00:00 1
0acefd2c6b0476b4b11abbdf98d4a1f7 0 0 582524 0 0
1502967 0 0 0 0 3516484 0 0 0 0 0
3201126 B 1 BS 1 03/02/2018 06/02/2018 11/04/1957 0 2
1 E13.2;I10 - - - None None None None N-4-16-I None
(RINGAN) 5174200 0 0 - 0 - 0 - 0 - 0
5174200 5996936 0 4 0 0 0 TARYUNI D300278
60 22213 DR PRIYO SUNARTO , SPJP 0138R01702180001231 0001850149078
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144338
1#0##0#0#0.0#2018-03-01 16:32:31#0#12:00:00#12:00:00#00:00:00 1
26abc34fa1b19f7f25765ccd8321e0b0 0 0 363760 0 0
2436353 0 0 0 0 3196823 0 0 0 0 0
3201126 B 1 BS 1 02/02/2018 06/02/2018 30/08/1964 0 2
1 I20.0;E11.6;I11.9;J18.9 - - - None None None None I-4-
(BERAT) 9856000 0 0 - 0 - 0 - 0 - 0
9856000 8844983 0 5 0 0 0 A DARYATI D389316
0000042074436 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143437
1#0##0#0#0.0#2018-03-01 16:34:42#0#12:00:00#12:00:00#12:00:00 1
2419681b199c0778bac0426db507d293 0 0 664604 0 0
3670735 0 0 0 0 4509644 0 0 0 0 0
3201126 B 3 BS 1 01/02/2018 06/02/2018 01/03/1953 0 2
1 M43.16;I11.9;B37.8 - - - None None None None M-4-
17-III None None None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG
BELAKANG (BERAT) 7202600 0 0 - 0 - 0 - 0 -
0 7202600 4673596 0 6 0 0 0 YATI D389212
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142860
1#0##0#0#0.0#2018-03-01 18:03:27#0#12:00:00#12:00:00#12:00:00 1
dc67774a3eb6a0d08dde50519e824626 0 0 773680 0 0
1990167 0 0 0 0 1909749 0 0 0 0 0
3201126 B 3 BS 1 05/02/2018 06/02/2018 10/05/1979 0 2
None None None None PROSEDUR ABORSI (RINGAN) 2201100 0 0
- 0 - 0 - 0 - 0 2201100 4516354 0
2 0 0 0 YETTI D263106 38 14151 DR ERDIYAN, SPOG
0138R01702180001587 0001454146198 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 144502 1#0##0#0#0.0#2018-03-01
18:20:45#0#12:00:00#12:00:00#12:00:00 1 b06521dc3e3ad2598a5b92047b8b2a85
0 2632308 63000 0 0 1054584 0 0 0 0 697462
0 0 0 69000 0
3201126 B 2 BS 1 05/02/2018 06/02/2018 13/12/2016 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 8253139 0 2 0 0 0 UWAIS AL FARUQ
D387199 1 419 DR CATUR S, SPB 0138R01702180001747
0002208004661 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144711
1#0##0#0#0.0#2018-03-01 18:22:56#0#12:00:00#12:00:00#12:00:00 1
9573b08bc491dfaa906511827b0540b1 0 5257572 0 0 0
1500642 0 0 0 0 1425925 0 0 0 69000 0
3201126 B 2 BS 1 05/02/2018 06/02/2018 14/07/1959 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 5081680 0 2 0 0 0 SARJANI
0001317938231 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144748
1#0##0#0#0.0#2018-03-12 11:52:51#0#12:00:00#12:00:00#00:00:00 3
2c0fb8e9b9a1fc58cc690240a23c3f47 0 0 499265 0 0
2057720 0 0 0 0 2524695 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 06/02/2018 05/10/1954 0 2
1 I10;H81.1 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 2669400 9788777 0
6 0 0 0 HERAWATY D031347 63 23130 DR MAYSAM I., SPS
0138R01702180000368 0000061014868 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 143281 1#1#vvip#1#7119377#0.0#2018-03-19
09:41:33#0#12:00:00#12:00:00#12:00:00 2 aa1da46d98211ef2d85d7da459464749
0 0 526430 0 0 1933960 0 0 0 0
7328387 0 0 0 0 0
3201126 B 2 BS 1 04/02/2018 06/02/2018 26/03/1983 0 2
- 0 10690500 12788318 0 3 0 0 0 FADILAH
ARIESARI D389221 34 12734 DR SRI KUN, SPPD 0138R01702180001361
0001633705942 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144364
1#0##0#0#0.0#2018-03-19 10:05:45#0#12:00:00#12:00:00#12:00:00 2
33bbfef893d522b2514956cf08fc19ff 0 5326100 3153245 0 0
3347354 0 0 0 0 892619 0 0 0 69000 0
3201126 B 2 BS 1 30/01/2018 06/02/2018 13/04/1984 0 1
1 N18.5;E87.6;J81;D63.8 38.95;99.04;39.95 - - None None None
0 - 0 - 0 23198900 32222415 0 8 0 0
0 HEZRON PANDIANGAN D388984 33 12345 DR SRI KUN, SPPD
0138R01701180014804 0001336724368 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142525 1#0##0#0#0.0#2018-03-19
10:47:24#0#12:00:00#12:00:00#12:00:00 2 f0499a9ca65543b5808f586aea362a86
0 9489100 3260150 0 0 14558665 0 0 0 0
3568500 0 0 0 1346000 0
3201126 B 2 BS 1 03/02/2018 06/02/2018 12/11/1961 0 2
1 I64;G81.9;E75.6 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 5866300 5601743 0
4 0 0 0 SRI HANDAYANI d389392 56 20537 DR NURUL
5.2.0.201712280730 4 144621 1#0##0#0#0.0#2018-03-28
16:18:50#0#12:00:00#12:00:00#12:00:00 2 de27485c95fa0cec9cbb554f34440475
0 0 799226 0 0 2390048 0 0 0 0
2412469 0 0 0 0 0
3201126 B 2 BS 1 03/02/2018 06/02/2018 25/10/1968 0 2
1 K21.0;K45.8 88.76 - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 3545800 4306686
0 4 0 0 0 MULYANA D362752 49 17998 DR ARU, SPPD
0138R01702180001237 0001205211846 3;JKN DR RIZKI; 5.2.1.201804062320
4 144339 1#0##0#0#0.0#2018-05-16
10:25:06#0#12:00:00#12:00:00#00:00:00 2 90b1cdb0ba7b00fecc73c2c048741899
0 0 372122 0 0 1814318 0 0 0 0
2120246 0 0 0 0 0
3201126 B 2 BS 1 04/02/2018 06/02/2018 23/12/1982 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3320961 0 3 0 0 0 RATIH WIDIANDINI
D073738 35 12827 DR ARU, SPPD 0138R01702180001442
0001745175519 3;JKN DR RIZKI; 5.2.1.201804062320 4 144378
1#0##0#0#0.0#2018-05-16 10:28:40#0#12:00:00#12:00:00#12:00:00 3
39790d80ff23b2f7accf7a2ad61eff98 0 0 298025 0 0
1769677 0 0 0 0 1253259 0 0 0 0 0
3201126 B 3 BS 1 01/02/2018 06/02/2018 22/10/1965 0 2
1 I64;E78.5;G51.8 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 6142630 0
6 0 0 0 ROSLINDA. S d389300 52 19095 DR NURUL KOMARI
SPS 0138R01702180000519 0001283992018 3;JKN DR RIZKI; 5.2.1.201804062320
4 143430 1#0##0#0#0.0#2018-05-16
10:54:29#0#12:00:00#12:00:00#12:00:00 2 9e6114ea4dce6ee53d78fbe6b51be034
0 0 743949 0 0 3479327 0 0 0 0
1919354 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 06/02/2018 07/05/1954 0 1
1 K29.0;I98.3;D63.8 45.16;99.04;89.52;90.59 - - None None None
None K-4-11-II None None None None None None GASTRITIS & ULKUS
PEPTIKUM (SEDANG) 3955700 0 0 - 0 - 0 - 0 -
0 3955700 12261187 0 1 0 0 0 JEMO D388966
DR RIZKI; 5.2.0.201712280730 4 145040 1#0##0#0#0.0#2018-08-16
09:56:25#0#12:00:00#12:00:00#12:00:00 2 fb446f91c3e0663e70a16cd1e1c495a4
0 4934600 1170596 0 0 2028857 0 0 0 0
4058134 0 0 0 69000 0
3201126 B 3 BS 1 05/02/2018 06/02/2018 12/07/1967 0 2
1 K21.0;I10;K29.0 45.16;90.59;89.52 - - None None None None
K-4-12-III None None None None None None GANGGUAN ESOFAGUS (BERAT)
6781600 0 0 - 0 - 0 - 0 - 0
6781600 5869425 0 2 0 0 0 ERLINA NASUTION
0001740568026 3;JKN DR RIZKI; 5.2.2.201806040537 4 145036
1#0##0#0#0.0#2018-09-05 18:14:41#0#12:00:00#12:00:00#00:00:00 3
9d9409653286660cf070f0473758ed59 0 1155500 2072664 0 0
452280 0 0 0 0 439981 0 0 0 1749000
0
3201126 B 3 BS 1 29/01/2018 07/02/2018 26/08/1944 0 1
1 J44.9;E87.1;I11.0;K29.7 93.94;88.72 - - None None None None
J-4-17-III None None None None None None PENYAKIT PARU OBSTRUKTIF
KRONIS (BERAT) 5797000 0 0 - 0 - 0 - 0 -
0 5797000 11601292 0 10 0 0 0 DARYUS TAMPUBOLON
d354844 73 26819 DR MOHAMAD NIZAM ERHAMZA SPP 0138R01701180013252
0002205846922 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 141311
1#0##0#0#0.0#2018-02-15 14:01:41#0#12:00:00#12:00:00#00:00:00 1
cdedb6dbc9705d5d8379a01a6a3c0b93 0 0 1048710 0 0
6045619 0 0 0 0 3414963 0 0 0 580000
512000
3201126 B 1 BS 1 05/02/2018 07/02/2018 18/05/1982 0 1
1 B34.9;K30 - - - None None None None A-4-13-I None
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3255995 0 3 0 0 0 HAFIDH ADITAMA
0001256058009 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144802
1#0##0#0#0.0#2018-02-15 14:08:16#0#12:00:00#12:00:00#12:00:00 1
6f0e430d3322d94e4e8dacbe887f108f 0 0 269459 0 0 404527
0 0 0 0 2582009 0 0 0 0 0
3201126 B 1 BS 1 05/02/2018 07/02/2018 28/04/1951 0 2
1 E10.1;K29.6 90.59 - - None None None None E-4-10-I None
- 0 4903800 4585903 0 3 0 0 0 ZURHEIMI
BAKAR D023035 66 24390 DR ARU, SPPD 0138R01702180002299
0001280303627 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145228
1#0##0#0#0.0#2018-02-15 14:33:20#0#12:00:00#12:00:00#00:00:00 1
4e1354dde8d54133a36e252e8c42b544 0 0 494342 0 0
2203549 0 0 0 0 1888012 0 0 0 0 0
3201126 B 3 BS 1 02/02/2018 07/02/2018 28/05/1946 0 1
1 C22.9;R18;J90 - - - None None None None B-4-11-III
None None None None None None TUMOR SISTEM HEPATOBILLIARI DAN PANCREAS
(BERAT) 8268200 0 0 - 0 - 0 - 0 - 0
8268200 6196875 0 6 0 0 0 ENAND TANASALE
D379088 71 26183 DR ARU, SPPD 0138R01702180001025
0001743643337 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144076
1#0##0#0#0.0#2018-02-15 14:55:33#0#12:00:00#12:00:00#12:00:00 1
d1251ccc9d292a998cbe094e97074de9 0 0 744140 0 0
3529832 0 0 0 0 1922903 0 0 0 0 0
3201126 B 1 BS 1 06/02/2018 07/02/2018 09/09/2014 0 1
1 L02.2 86.22;86.59 - - None None None None L-4-12-I None
2453800 0 0 - 0 - 0 - 0 - 0
2453800 8430281 0 2 0 0 0 RAFKA ANANDA SURAHMAN
D370843 3 1246 DR CATUR S, SPB 0138R01702180002379
0002233698996 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145431
1#0##0#0#0.0#2018-02-17 08:33:02#0#12:00:00#12:00:00#00:00:00 2
a2fc89f279ae7da2faaec53628b6257e 0 5148064 0 0 0
1220203 0 0 0 0 1989514 0 0 0 72500 0
3201126 B 3 BS 1 05/02/2018 07/02/2018 07/07/1978 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1814158 0 3 0 0 0 PUJI HARTI D119578
TANTIYO S;16137 5.2.0.201712280730 4 144751 1#0##0#0#0.0#2018-
02-17 09:00:22#0#12:00:00#12:00:00#12:00:00 1
f084da265a407123517774093d85f1c1 0 0 409013 0 0 471462
0 0 0 0 933683 0 0 0 0 0
3201126 B 3 BS 1 06/02/2018 07/02/2018 24/04/1962 0 1
1 N18.5;D63.8;J18.0;I15.1 99.04;87.44 - - None None None None
- 0 6077700 2929526 0 2 0 0 0 SUHADI
0001278846731 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145427
1#0##0#0#0.0#2018-02-17 09:13:04#0#12:00:00#12:00:00#12:00:00 1
b243e77cfbd375abfbaaca3763353828 0 0 599993 0 0
1585882 0 0 0 0 743650 0 0 0 0 0
3201126 B 2 BS 1 05/02/2018 07/02/2018 26/07/1973 0 1
1 I12.0;D63.8;K29.7 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4095848 0 3 0 0 0 SUMARTANA
D369438 44 16265 DR SRI KUN, SPPD 0138R01702180002112
0001101686411 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145034
1#0##0#0#0.0#2018-02-17 09:15:11#0#12:00:00#12:00:00#00:00:00 1
c9b3475a1439d48d32655ccb9db9c9a1 0 0 446265 0 0
2048130 0 0 0 0 1601453 0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 07/02/2018 24/04/1955 0 1
1 C22.0;D63.8;C79.5;C78.0;J90 99.04;90.59;89.52;87.49;88.76 - -
None None None None B-4-11-III None None None None None None TUMOR
SISTEM HEPATOBILLIARI DAN PANCREAS (BERAT) 8268200 0 0 - 0
- 0 - 0 - 0 8268200 15854812 0 9 0
0 0 R. WARMAN ARDAN D334223 62 22927 DR. ARU ARIADNO, SPPD
0138R01701180014166 0001280475268 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142414 1#0##0#0#0.0#2018-02-17
09:24:27#0#12:00:00#12:00:00#12:00:00 1 68baee6e602c2423bce906bf4bbb6ab7
0 0 797136 0 0 8726945 0 0 0 0
6330731 0 0 0 0 0
3201126 B 3 BS 1 30/01/2018 07/02/2018 01/04/1960 0 2
1 I20.9;I50.0;J91;E10.1;I25.1 90.59;89.52 - - None None None
None I-4-20-III None None None None None None ANGINA PEKTORIS DAN
NYERI DADA (BERAT) 7040000 0 0 - 0 - 0 - 0
- 0 7040000 9181667 0 9 0 0 0 YATI PARINAH
0000511480877 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142157
1#0##0#0#0.0#2018-02-17 09:36:40#0#12:00:00#12:00:00#12:00:00 1
f0baff75d12c37c26546b7bbeeed5dc7 0 0 1104290 0 0
5083707 0 0 0 0 2993668 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 07/02/2018 07/12/1958 0 2
1 E87.1;I11.9;J18.0;E13.4 87.03;87.44 - - None None None None
ELEKROLIT (BERAT) 8810600 0 0 - 0 - 0 - 0 -
0 8810600 8022117 0 4 1 1 0 KRISPINA UPA
0000193691968 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144349
1#0##0#0#0.0#2018-02-17 10:42:57#0#12:00:00#12:00:00#00:00:00 1
9c0c5ec99b22e02dd5121f14beaa2e74 0 0 575234 0 0
2992072 0 0 0 0 3858811 0 0 596000 0
0
3201126 B 3 BS 1 05/02/2018 07/02/2018 25/11/2016 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1532174 0 3 0 0 0 AQILLA ARASYA
D389531 1 437 DR RASTRA, SPA 0138R01702180002104
0002204212408 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145033
1#0##0#0#0.0#2018-02-17 10:44:24#0#12:00:00#12:00:00#12:00:00 1
88dddf85cc77ca2761329bfcf0a610d3 0 0 207620 0 0 409318
0 0 0 0 915236 0 0 0 0 0
3201126 B 1 BS 1 05/02/2018 07/02/2018 05/01/2006 0 1
1 G40.9;R56.0 - - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 3718200 4039507
0 3 0 0 0 MUHAMMAD JANUAR SATRIA AJI D259667 12
4414 DR HUDA HILMAN 0138R01702180001456 0001640056318 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 144381 1#0##0#0#0.0#2018-
02-17 10:47:02#0#12:00:00#12:00:00#12:00:00 1
3746c38c71c38d74e9a5b248d9cbe31b 0 0 387638 0 0 555902
0 0 0 0 2633267 0 0 462700 0 0
3201126 B 1 BS 1 05/02/2018 07/02/2018 05/10/2002 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3544304 0 3 0 0 0 HAWRA INSIYYOH TUSTARI
g059662 15 5602 DR A.D. PASARIBU SP.A 0138R01702180001464
0001808489608 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144385
1#0##0#0#0.0#2018-02-17 10:48:13#0#12:00:00#12:00:00#12:00:00 1
8d0471fba73370441dc51d5fa1b9f914 0 0 338858 0 0 604576
0 0 0 0 2600870 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 07/02/2018 04/06/1957 0 2
1 I63.9;R13;K29.7;E75.6;G81.9 87.03 - - None None None None
0 - 0 9673300 11592181 0 7 0 0 0 YONG
LIP NGO D324053 60 22157 DR. ARU ARIADNO, SPPD 0138R01702180000546
0001448013802 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143434
1#0##0#0#0.0#2018-02-17 10:50:38#0#12:00:00#12:00:00#12:00:00 1
28886cac4c086f3d0404c355ce63f2f3 0 0 1117061 0 0
5004753 0 0 0 0 5470367 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 07/02/2018 23/03/1955 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 4293166 0 2 0 0 0 ASTUTI D365706
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145246
1#0##0#0#0.0#2018-02-17 11:37:47#0#12:00:00#12:00:00#00:00:00 1
f9aac991dae4e9f2a151477c82458c31 0 0 499265 0 0
1320790 0 0 0 0 2473111 0 0 0 0 0
3201126 B 1 BS 1 03/02/2018 07/02/2018 03/01/1959 0 2
1 G44.2;H81.1 - - - None None None None G-4-23-I None
3710200 0 0 - 0 - 0 - 0 - 0
3710200 5283600 0 5 0 0 0 EMMY SUSIANTY,NY
0000036152223 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144347
1#0##0#0#0.0#2018-02-17 11:39:53#0#12:00:00#12:00:00#12:00:00 1
005c6e4e11ba27bac788d214ccdb7316 0 0 244205 0 0
1543739 0 0 0 0 3495656 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 07/02/2018 20/05/1942 0 1
0 - 0 - 0 - 0 - 0 5660200 8024336
0 4 1 1 0 ARDI HARTOJO D373941 75 27654 DR
BAMBANG DWIPUTRA SPJP 0138R01702180001306 0000060946244 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 144354 1#0##0#0#0.0#2018-02-17
12:17:58#0#12:00:00#12:00:00#12:00:00 1 7e57144d966b3384f608f2cef0d2ecd1
0 0 1078624 0 0 1910755 0 0 0 0
3858957 0 0 0 580000 596000
3201126 B 3 BS 1 31/01/2018 07/02/2018 06/08/1947 0 1
1 I63.9;E16.2;D63.8;R63.0;K30;A41.9 87.03;88.76;87.49;89.52;90.59 -
- None None None None G-4-14-III None None None None None None
KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK (BERAT) 8672200 0 0
- 0 - 0 - 0 - 0 8672200 10379153 0
8 0 0 0 BOAN SOLEH ATMAJA D383915 70 25746 DR ARU, SPPD
0138R01701180014769 0000512188029 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 142848 1#0##0#0#0.0#2018-02-17
12:20:46#0#12:00:00#12:00:00#12:00:00 1 17e5739b697cd356364da33d20b992b5
0 0 813043 0 0 6825600 0 0 0 0
2740510 0 0 0 0 0
3201126 B 3 BS 1 06/02/2018 07/02/2018 24/11/1960 0 1
None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (RINGAN)
3688800 0 0 - 0 - 0 - 0 - 0
3688800 1267246 0 2 0 0 0 SUDIRMAN,SH D140600
0000042708699 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145638
1#0##0#0#0.0#2018-02-17 12:23:06#0#12:00:00#12:00:00#00:00:00 1
eec4b37fad3b442289f88fe4d86825a0 0 0 331992 0 0 563350
0 0 0 0 371904 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 07/02/2018 23/08/1955 0 2
1 K74.6;R18;B18.0;D63.8 99.04;89.52;87.49 - - None None None
None B-4-13-II None None None None None None GANGGUAN HATI LAIN-LAIN
(SEDANG) 6857000 0 0 - 0 - 0 - 0 - 0
6857000 7864547 0 4 0 0 0 EKO RETNO SRI HANDINI
D389500 62 22811 DR ARU, SPPD 0138R01702180001360
0000158121371 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144363
1#0##0#0#0.0#2018-02-17 12:55:36#0#12:00:00#12:00:00#12:00:00 1
a44452f22e1d7be95fba9c183393bb6b 0 0 968363 0 0
3231681 0 0 0 0 3664503 0 0 0 0 0
3201126 B 2 BS 1 04/02/2018 07/02/2018 02/03/2007 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3233667 0 4 0 0 0 DZAHFA ALI MUFTI N
D366286 10 3992 DR RASTRA, SPA 0138R01702180001294
0001171017077 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144350
1#0##0#0#0.0#2018-02-19 15:52:54#0#12:00:00#12:00:00#00:00:00 1
58bfbc3abacbbd648403c441a1e9629d 0 0 207620 0 0 768499
0 0 0 0 2257548 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 07/02/2018 05/07/1964 0 1
1 E10.2;J18.0;D63.8 38.95;99.04 - - None None None None N-1-
- 0 - 0 23198900 15788937 0 2 0 0 0
BANTA AYUSAN d389649 53 19574 DR SRI KUN, SPPD
0138R01702180002327 0001874825436 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 145314 1#0##0#0#0.0#2018-02-21
08:24:20#0#12:00:00#12:00:00#12:00:00 1 d450d9c2d3c55882b75ec9c45b7a608f
0 4650820 521774 0 0 8628422 0 0 0 0
1918921 0 0 0 69000 0
3201126 B 3 BS 1 05/02/2018 07/02/2018 01/12/1957 0 1
1 N18.5;I15.1;D63.8 99.04;38.95 - - None None None None N-1-
- 0 8908800 15073535 0 3 0 0 0 MURTOWO
0000511824982 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144758
1#0##0#0#0.0#2018-02-21 08:29:49#0#12:00:00#12:00:00#12:00:00 1
d352c581d0a886cf0ae67a18254fc3d5 0 4498260 854792 0 0
8090364 0 0 0 0 1561119 0 0 0 69000 0
3201126 B 1 BS 1 05/02/2018 07/02/2018 08/08/1941 0 2
0 0 - 0 - 0 - 0 - 0 17095200
23215557 0 3 0 0 0 MOEDRIKAH D389527 76 27940
DR RIZKI; 5.2.0.201712280730 4 144386 1#0##0#0#0.0#2018-02-28
14:22:36#0#12:00:00#12:00:00#12:00:00 1 db9b1b427aca413416890adb0a3ff168
0 13014120 53000 0 0 6763437 0 0 0 0
3329000 0 0 0 56000 0
3201126 B 3 BS 1 06/02/2018 07/02/2018 31/12/1949 0 1
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 5823231 0 2 0 0 0 SAMIN HS D389095
0001459427095 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
145430 1#0##0#0#0.0#2018-03-01 14:29:41#0#12:00:00#12:00:00#12:00:00
1 ff5b39cac590fd9e7fc61e9a014d8248 0 0 709622 0 0
2354650 0 0 0 0 2170959 0 0 0 588000
0
3201126 B 1 BS 1 05/02/2018 07/02/2018 10/10/1962 0 1
- 0 46734600 53818227 0 3 0 0 0 INDRI
HIRWONO D381852 55 20207 DR AZRI NURIZAL SPPD KKV
5.2.0.201712280730 4 144384 1#0##0#0#0.0#2018-03-01
16:22:23#0#12:00:00#12:00:00#12:00:00 1 6cc127b7f04eb6f9a832c6147d9e53f4
0 10391160 53000 0 0 32476067 0 0 0 0
3329000 0 0 0 69000 7500000
3201126 B 2 BS 1 06/02/2018 07/02/2018 05/10/1959 0 2
1 E14.5 17.71;39.50 - - None None None None I-1-20-I None
None None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN
(RINGAN) 18436700 0 0 - 0 - 0 - 0 - 0
18436700 13474957 0 2 0 0 0 SRI SURYANI D379577
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145664
1#0##0#0#0.0#2018-03-02 07:28:22#0#12:00:00#12:00:00#12:00:00 1
2be673964dcb36c176266ed5b54fdae4 0 4439100 3687340 0 0
4341978 0 0 0 0 937539 0 0 0 69000 0
3201126 B 1 BS 1 06/02/2018 07/02/2018 15/03/1961 0 2
0 - 0 - 0 - 0 - 0 4136800 4956512
0 2 0 0 0 HJ. U. LUTFIAH D388931 56 20782 DR
5.2.0.201712280730 4 145674 1#0##0#0#0.0#2018-03-02
09:52:53#0#12:00:00#12:00:00#12:00:00 1 06f85233d53b31b033e10ba277a2e6da
0 1719872 0 0 0 779882 0 0 0 0 673258
0 0 0 103500 1680000
3201126 B 2 BS 1 06/02/2018 07/02/2018 23/03/1955 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 4293166 0 2 0 0 0 ASTUTI D365706
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145246
1#0##0#0#0.0#2018-03-13 07:47:42#0#12:00:00#12:00:00#00:00:00 2
6f9a3168fc084769cdced229d7272fae 0 0 499265 0 0
1320790 0 0 0 0 2473111 0 0 0 0 0
3201126 B 2 BS 1 05/02/2018 07/02/2018 08/07/1965 0 2
1 I48;E11.9;E07.9 - - - None None None None I-4-19-I
(RINGAN) 4697800 0 0 - 0 - 0 - 0 - 0
4697800 3431064 0 3 0 0 0 SALMAH d369904
0001184618294 3;JKN DR RIZKI; 5.2.0.201712280730 4 144383
1#0##0#0#0.0#2018-03-29 09:13:16#0#12:00:00#12:00:00#12:00:00 2
1e4cf092ef6ecfffd7782cb9f0a561b3 0 0 713024 0 0 952578
0 0 0 0 1765462 0 0 0 0 0
3201126 B 1 BS 1 06/02/2018 07/02/2018 22/08/1956 0 2
1 K21.9;B34.9 - - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 4136800 2859588
0 2 0 0 0 TJOET AUGUSTINE D017417 61 22448 DR
5.2.1.201804062320 4 145182 1#0##0#0#0.0#2018-05-05
11:42:58#0#12:00:00#12:00:00#00:00:00 2 7fd1c30be49e9684b2ec1faa36b90d23
0 0 425312 0 0 659200 0 0 0 0
1775076 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 07/02/2018 06/04/1977 0 2
1 N39.0;R10.1 90.59;88.76;89.52;57.94 - - None None None None
N-4-12-I None None None None None None INFEKSI GINJAL DAN SALURAN
URIN (RINGAN) 3349800 0 0 - 0 - 0 - 0 -
0 3349800 5490873 0 4 0 0 0 SETYOWATI
D107684 40 14914 DR ARU, SPPD 0138R01702180001304
0001282628946 3;JKN DR RIZKI; 5.2.1.201804062320 4 144352
1#0##0#0#0.0#2018-05-05 11:44:41#0#12:00:00#12:00:00#12:00:00 2
4115bba97f91ab53618c5e6b4605d289 0 0 433304 0 0
1548353 0 0 0 0 3509216 0 0 0 0 0
3201126 B 2 BS 1 30/01/2018 07/02/2018 12/07/1962 0 1
None None None None None None PROSEDUR INTESTINAL KOMPLEKS (RINGAN)
14609500 0 0 - 0 - 0 - 0 - 0
14609500 25978373 0 9 0 0 0 DJOLI ISKANDAR
0001647246677 3;JKN DR RIZKI; 5.2.1.201804062320 4 141846
1#0##0#0#0.0#2018-05-16 10:14:25#0#12:00:00#12:00:00#12:00:00 2
10b1e5fffbeb28053751eca474aa5dec 0 10292160 199095 0 0
9986118 0 0 0 0 5066000 0 0 0 435000
0
3201126 B 3 BS 1 06/02/2018 07/02/2018 01/01/1963 0 2
4 E11.9;R57.2;R57.0;R57.1 - - - None None None None E-4-
0 - 0 6262900 11316301 0 2 0 0 0 HUSNAH
0001457036008 3;JKN DR RIZKI; 5.2.1.201804062320 4 145039
1#0##0#0#0.0#2018-05-16 10:38:10#0#12:00:00#12:00:00#12:00:00 2
ac38490d62a8195014a454f30adf857a 0 0 711575 0 0
7028407 0 0 0 0 2512319 0 0 0 0
1064000
3201126 B 1 BS 1 06/02/2018 07/02/2018 28/03/1958 0 2
1 K51.9;K57.3;N39.0;D12.8 45.23 - - None None None None K-4-
13-II None None None None None None DIVERTIKULITIS, DIVERTIKULOSIS DAN
PENYAKIT PERADANGAN USUS BESAR (SEDANG) 7213800 0 0 - 0 -
0 - 0 - 0 7213800 8331902 0 2 0 0
0 PONIYEM D388661 59 21865 DR BETTY DWI L, SPPD
0138R01702180002303 0000060894685 3;JKN DR RIZKI; 5.2.2.201806040537
4 145244 1#0##0#0#0.0#2018-09-05
18:18:59#0#12:00:00#12:00:00#12:00:00 2 af216d5916bc314ed8b8e6ec15bbba63
0 2912364 72138 0 0 1615322 0 0 0 0
1983078 0 0 0 69000 1680000
3201126 B 3 BS 1 05/02/2018 08/02/2018 10/03/1966 0 2
(BERAT) 7040000 0 0 - 0 - 0 - 0 - 0
7040000 2583412 0 4 0 0 0 ASIH D389529 51
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144422
1#0##0#0#0.0#2018-02-17 11:47:24#0#12:00:00#12:00:00#12:00:00 1
8cbe1a28b9a1812f9c33c216747dde35 0 0 702737 0 0 633667
0 0 0 0 1247008 0 0 0 0 0
3201126 B 1 BS 1 05/02/2018 08/02/2018 09/09/1959 0 2
1 I21.9;I48;I11.0;R57.0 - - - None None None None I-4-
14562700 0 0 - 0 - 0 - 0 - 0
14562700 12311719 0 4 1 0 0 HAMIDAH D323673
0001470066614 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144382
1#0##0#0#0.0#2018-02-17 12:07:53#0#12:00:00#12:00:00#00:00:00 1
923b17355c8325236bc064f84608a1d3 0 0 1715543 0 0
4074736 0 0 0 0 4231440 0 0 0 580000
1710000
3201126 B 1 BS 1 06/02/2018 08/02/2018 29/09/2004 0 1
1 L02.8 86.22 - - None None None None L-4-12-I None None
None None None None PERADANGAN KULIT/CELLULITIS (RINGAN) 2453800
0 0 - 0 - 0 - 0 - 0 2453800
9895661 0 3 0 0 0 MUHAMMAD OMAR JOHANSYAH D386496
13 4878 DR CATUR S, SPB 0138R01702180002335 0002053865169 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 145347 1#0##0#0#0.0#2018-
02-17 12:12:33#0#12:00:00#12:00:00#12:00:00 1
148c1edfa1cc582fb5e5f3a0513dcd2b 0 5148064 63000 0 0
1763217 0 0 0 0 2776380 0 0 0 145000
0
3201126 B 2 BS 1 04/02/2018 08/02/2018 18/08/1954 0 1
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 60023096 0 5 0 0 0 ARTIM D384681
0001341573131 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144351
1#0##0#0#0.0#2018-02-17 12:13:47#0#12:00:00#12:00:00#12:00:00 1
fc0892ebdc55655ec5872c3e36974daf 0 16400960 0 0 0
34066136 0 0 0 0 2056000 0 0 0 0
7500000
3201126 B 3 BS 1 05/02/2018 08/02/2018 02/06/1948 0 1
1 E87.1;D63.0;D12.6;R77.0 99.04 - - None None None None E-4-
11-II None None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (SEDANG)
4504900 0 0 - 0 - 0 - 0 - 0
4504900 6729704 0 4 0 0 0 BUDI PURNAWAN
0002311066361 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145044
1#0##0#0#0.0#2018-02-17 12:30:54#0#12:00:00#12:00:00#12:00:00 1
0e050599309bcb1599de7b0be7979019 0 0 511441 0 0
4963002 0 0 0 0 1255261 0 0 0 0 0
3201126 B 2 BS 1 05/02/2018 08/02/2018 29/09/1955 0 2
(BERAT) 8448000 0 0 - 0 - 0 - 0 - 0
8448000 4329351 0 4 0 0 0 LIE WINDY RAMLI
0001797652124 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144424
1#0##0#0#0.0#2018-02-17 12:37:23#0#12:00:00#12:00:00#00:00:00 1
928a1ba4374bd117458c71b6d8031e33 0 0 504323 0 0
1170799 0 0 0 0 2654229 0 0 0 0 0
3201126 B 3 BS 1 07/02/2018 08/02/2018 21/08/1969 0 2
1 E11.2;D63.8 99.04;89.52;90.59;87.49 - - None None None None
N-4-16-II None None None None None None PENYAKIT GINJAL DAN SALURAN
URIN LAIN-LAIN (SEDANG) 5275200 0 0 - 0 - 0 - 0
- 0 5275200 2159293 0 2 0 0 0 KURNAESIH
D389159 48 17702 DR SRI KUN, SPPD 0138R01702180003239
0001860445359 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146245
1#0##0#0#0.0#2018-02-19 08:28:03#0#12:00:00#12:00:00#12:00:00 1
0f1878ef79a6dd092c651cfb7f218746 0 0 371889 0 0
1180642 0 0 0 0 606762 0 0 0 0 0
3201126 B 1 BS 1 01/02/2018 08/02/2018 22/08/1941 0 1
1 I21.9;I50.0;E10.8;D29.1;R33 - - - None None None None
I-4-10-II None None None None None None INFARK MYOKARD AKUT (SEDANG)
10107000 0 0 - 0 - 0 - 0 - 0
10107000 25937886 0 8 0 0 0 LUTFI JUSUF KAHFI
D389198 76 27922 DR ARU, SPPD 0138R01702180000010
0001079201226 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 142858
1#1#vvip#8#15830886#0.0#2018-02-19 09:17:09#0#12:00:00#12:00:00#12:00:00
1 1513b564bb5cb3d55564a7835ddcbaa7 0 0 3385900 0 0
7502986 0 0 0 0 12560000 0 0 0 2030000
459000
3201126 B 3 BS 1 04/02/2018 08/02/2018 28/07/1999 0 2
1 O82.9;Z37.0;O99.0 74.99;99.04 - - None None None None O-6-
10-II None None None None None None OPERASI PEMBEDAHAN CAESAR (SEDANG)
5405200 0 0 - 0 - 0 - 0 - 0
5405200 11345167 0 5 0 0 0 NURDIANA D389526
TANTIYO S;16137 5.2.0.201712280730 4 145032 1#0##0#0#0.0#2018-
02-19 09:23:04#0#12:00:00#12:00:00#12:00:00 1
3380ac18a4e01ac864c21f30715e9a36 0 4510956 699260 0 0
4429744 0 0 0 0 1380207 0 0 0 69000 256000
3201126 B 2 BS 1 24/01/2018 08/02/2018 12/10/1957 0 1
1 E14.7;L97;A41.9;A48.0 86.22;84.17;84.12 - - None None None
None M-1-02-III None None None None None None AMPUTASI (BERAT)
30848800 0 0 - 0 - 0 - 0 - 0
30848800 44594988 0 16 0 0 0 M.USMAN ZAIN
0001309721681 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 139639
1#0##0#0#0.0#2018-02-19 14:27:32#0#12:00:00#12:00:00#12:00:00 1
51eb5b8f8b3502d3f5820d09f62db4fd 0 12718764 4777732 0 0
18243492 0 0 0 0 8786000 0 0 0 69000 0
3201126 B 1 BS 1 06/02/2018 08/02/2018 23/02/1986 0 2
0 0 - 0 - 0 - 0 - 0 3710200
3459789 0 3 0 0 0 FEBRY IMMANUELLA D389634 31
TANTIYO S;16137 5.2.0.201712280730 4 145043 1#0##0#0#0.0#2018-
02-19 14:29:36#0#12:00:00#12:00:00#12:00:00 1
fa5d0a185869296f4039f1e7742416e6 0 0 386918 0 0 477530
0 0 0 0 2595341 0 0 0 0 0
3201126 B 1 BS 1 05/02/2018 08/02/2018 12/01/1967 0 2
1 E10.7;I13.2 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 8768000 0 0 - 0 - 0 - 0 -
0 8768000 10119522 0 4 1 1 0 JAINI D378822
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145037
1#0##0#0#0.0#2018-02-19 14:46:46#0#12:00:00#12:00:00#12:00:00 1
db8568f1f1d99778932c86f56d2b39d1 0 0 845675 0 0
2570322 0 0 0 0 5527525 0 0 0 580000
596000
3201126 B 3 BS 1 06/02/2018 08/02/2018 22/01/1965 0 2
- 0 8908800 10978429 0 3 0 0 0 TUTI MAULANA
0001744806971 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145432
1#0##0#0#0.0#2018-02-19 16:08:08#0#12:00:00#12:00:00#12:00:00 1
5e16a0642b4d759f6ce49a36b4095555 0 4498260 854792 0 0
4470662 0 0 0 0 1120215 0 0 0 34500 0
3201126 B 1 BS 1 07/02/2018 08/02/2018 25/08/1949 0 1
1 K29.6;I69.4;D63.8 90.59;87.49;99.04 - - None None None None
K-4-11-II None None None None None None GASTRITIS & ULKUS PEPTIKUM
(SEDANG) 4615000 0 0 - 0 - 0 - 0 - 0
4615000 6064302 0 2 0 0 0 SUGIYANTO D354985
68 25003 DR ARU, SPPD 0138R01702180002726 0000060883266 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 145676 1#0##0#0#0.0#2018-
02-19 16:29:35#0#12:00:00#12:00:00#00:00:00 1
74d075933e203e59d001ef30fa1fa1b1 0 0 468350 0 0
3611222 0 0 0 0 1984730 0 0 0 0 0
3201126 B 3 BS 1 05/02/2018 08/02/2018 03/12/1952 0 2
1 J18.0;E10.8;N39.0;I50.0 - - - None None None None J-4-
16-II None None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH
(SEDANG) 5077500 0 0 - 0 - 0 - 0 - 0
5077500 5489308 0 4 0 0 0 MUNIROH D378704
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144380
1#0##0#0#0.0#2018-02-21 08:16:29#0#12:00:00#12:00:00#12:00:00 1
c4354e2fe32f32e1aa58d688df72aedf 0 0 978983 0 0
3073211 0 0 0 0 1437114 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 08/02/2018 11/12/1948 0 1
1 N18.5;D63.8;K29.7;B34.9 99.04;39.95 - - None None None None
- 0 4958500 4813807 0 2 0 0 0 IR PAUL
RAUBUN, M.S.E D361946 69 25260 DR SRI KUNMARTINI, SPPD
0138R01702180003648 0001222739706 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 146705 1#0##0#0#0.0#2018-02-21
08:22:01#0#12:00:00#12:00:00#00:00:00 1 f2a726ae8302d7d0c7a8b55500359bd4
0 0 499265 0 0 1813420 0 0 0 0
2501122 0 0 0 0 0
3201126 B 1 BS 1 07/02/2018 08/02/2018 25/12/1959 0 2
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 57794310 0 2 0 0 0 IRMINA SRI
REJEKI,NY D383397 58 21229 DR AZRI NURIZAL SPPD KKV
0138R01702180002756 0000061174225 3;JKN DR RIZKI; 5.2.0.201712280730
4 145795 1#0##0#0#0.0#2018-02-28
08:53:33#0#12:00:00#12:00:00#12:00:00 2 f8280104718ebafc85024330a29a1873
0 18299120 0 0 0 29288190 0 0 0 0
2638000 0 0 0 69000 7500000
3201126 B 3 BS 1 07/02/2018 08/02/2018 10/06/1959 0 2
- 0 45079800 58285700 0 2 0 0 0 IYEM
0000511512794 3;JKN DR RIZKI; 5.2.0.201712280730 4 145868
1#0##0#0#0.0#2018-02-28 10:37:49#0#12:00:00#12:00:00#12:00:00 1
05bbbaaec24a387457977b5deb09aee9 0 14520800 0 0 0
34464900 0 0 0 0 9244000 0 0 0 56000 0
3201126 B 1 BS 1 06/02/2018 08/02/2018 23/03/1966 0 1
11257400 0 0 - 0 - 0 - 0 - 0
11257400 17444534 0 3 0 0 0 MANAHAN PANGGABEAN
D300361 51 18948 DR SIDDHI ANDIKA, SPU 0138R01702180002328
0000060498314 3;JKN DR RIZKI; 5.2.0.201712280730 4 145323
1#0##0#0#0.0#2018-02-28 16:07:13#0#12:00:00#12:00:00#00:00:00 1
91ed2569696d53604d075cb08d634f0e 0 5853688 0 0 0
2001615 0 0 0 0 3270231 0 0 0 69000
6250000
3201126 B 1 BS 1 07/02/2018 08/02/2018 17/11/2015 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3540824 0 2 0 0 0 RIZKY PUTRA DWIANDRA
0002425188137 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
146009 1#0##0#0#0.0#2018-03-01 14:16:12#0#12:00:00#12:00:00#12:00:00
1 c7c1a2cb46de552303984bd13c24a460 0 0 338858 0 0
1382323 0 0 0 0 1819643 0 0 0 0 0
3201126 B 3 BS 1 07/02/2018 08/02/2018 15/01/2007 0 2
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 3533161 0 2 0 0 0 RAHMA SEROJA
0001261517049 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
145923 1#0##0#0#0.0#2018-03-01 14:24:15#0#12:00:00#12:00:00#12:00:00
1 60ea4ffd5d101adf8c59263fb3057e2a 0 0 268830 0 0
2463190 0 0 0 0 801141 0 0 0 0 0
3201126 B 1 BS 1 06/02/2018 08/02/2018 16/02/2017 0 1
LAIN (RINGAN) 3917900 0 0 - 0 - 0 - 0 -
0 3917900 4614269 0 3 0 0 0 BY NY. RIZKA
FAUZIAH D358830 0 355 DR OTTY MITHA S, SPA 0138R01702180002636
0002224716153 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
145666 16#0##0#0#0.0#2018-03-01 14:48:56#0#12:00:00#12:00:00#00:00:00
1 efe6d4441fd078656b76533e5898e17f 0 0 269459 0 0
2019442 0 0 0 0 2325368 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 08/02/2018 15/09/1984 0 2
0 - 0 - 0 - 0 - 0 2783600 5932578
0 3 0 0 0 LIA SULIHATI D389060 33 12197 DR
5.2.0.201712280730 4 145671 1#0##0#0#0.0#2018-03-02
07:36:44#0#12:00:00#12:00:00#12:00:00 1 951a831a7c9d28700074b867af31ef19
0 1722500 832408 0 0 1283557 0 0 0 0
414113 0 0 0 1680000 0
3201126 B 2 BS 1 06/02/2018 08/02/2018 12/03/1977 0 1
1 N18.5;I73.8 88.40;39.50 - - None None None None I-1-20-II
(SEDANG) 23032500 0 0 - 0 - 0 - 0 - 0
23032500 24526570 0 3 0 0 0 SAMIDI D374603
0000042713741 3;JKN DR RIZKI; 5.2.0.201712280730 4 146704
1#0##0#0#0.0#2018-03-02 08:46:19#0#12:00:00#12:00:00#12:00:00 1
9d956c981e35797964076f445cae42c3 0 7331500 0 0 0
14931570 0 0 0 0 2263500 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 08/02/2018 19/07/1986 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10701977 0 3 0 0 0 SRI LESTARI D389425 31 11525
DR FERRI SABARUDDIN SPOG 0138R01702180002341 0001288276007 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 145370 1#0##0#0#0.0#2018-
03-02 08:48:05#0#12:00:00#12:00:00#12:00:00 1
01b1cd4165a7d26bacd0df63bb1bcb08 0 0 1974753 0 0
2605653 0 0 0 0 6045571 0 0 0 76000 0
3201126 B 3 BS 1 08/02/2018 08/02/2018 20/01/1966 0 2
2 D64.9;K92.0;K92.1;N18.5 - - - None None None None D-4-
13-II None None None None None None GANGGUAN SEL DARAH MERAH SELAIN KRISIS
0 - 0 4227600 870732 0 1 0 0 0
ROSMAWATI d376434 52 19012 DR NIKEN PRABHA 0138R01702180003476
0001859073311 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146347
1#0##0#0#0.0#2018-03-02 09:26:24#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 345964 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 08/02/2018 25/08/1998 0 2
1 B34.9;R11 - - - None None None None A-4-13-I None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2085852 0 2 0 0 0 JEIHAN AGUSTIAN
0002258437094 3;JKN DR RIZKI; 5.2.1.201804062320 4 146247
1#0##0#0#0.0#2018-05-05 11:50:28#0#12:00:00#12:00:00#12:00:00 2
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0 0 0 0 964958 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 08/02/2018 06/02/2018 2660 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437236 0 3 0 0 0 BAYI NY SRI LESTARI
d389706 0 0 DR SUPROHAITA SPA(K) 0138R01702180003602
0002419327203 3;JKN DR RIZKI; 5.2.1.201804062320 4 146630
1#0##0#0#0.0#2018-05-16 10:39:45#0#12:00:00#12:00:00#12:00:00 2
8eb21e43755e8a0074fd670092dbb644 0 0 433812 0 0 88899
0 0 0 0 914525 0 0 0 0 0
3201126 B 3 BS 1 02/02/2018 08/02/2018 01/11/1993 0 2
1 O90.3;E87.6;R57.0;J18.9 - - - None None None None W-4-
17-III None None None None None None GANGGUAN POSTPARTUM (BERAT)
4142800 0 0 - 0 - 0 - 0 - 0
4142800 9948352 0 7 1 2 0 JUWITA NOVITA SARI
0000512779961 3;JKN DR RIZKI; 5.2.2.201806040537 4 144079
1#0##0#0#0.0#2018-08-14 14:54:32#0#12:00:00#12:00:00#12:00:00 3
86d8df4aaf98ea216f788175abce2720 0 0 1218880 0 0
1770145 0 0 0 0 4889327 0 0 0 870000
1200000
3201126 B 3 BS 1 08/02/2018 08/02/2018 25/09/1959 0 1
1 I12.0;E87.7 - - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 786734 0 1 0 0 0 ROSID D389830 58
21321 DR LIDYA SANTALIA 0138R01702180003744 0001439442101 3;JKN DR
RIZKI; 5.2.0.201712280730 4 148930 1#0##0#0#0.0#2018-09-07
16:00:39#0#12:00:00#12:00:00#12:00:00 2 6920548a3ceeb6ca03147da7eead786c
0 0 446265 0 0 0 0 0 0 0 340469
0 0 0 0 0
3201126 B 1 BS 1 07/02/2018 08/02/2018 11/04/1949 0 2
1 K20;K29.7;A49.9 45.16 - - None None None None K-4-12-I
0 0 - 0 - 0 - 0 - 0 4136800
7018823 0 2 0 0 0 HANIFA MADIR D014391 68
25139 DR BETTY DWI L, SPPD 0138R01702180003305 0001455027974 3;JKN
DR RIZKI; 5.2.2.201806040537 4 146257 1#0##0#0#0.0#2018-09-29
14:33:45#0#12:00:00#12:00:00#12:00:00 3 e6bcd4ed903ce288e51e80f65aedc9c3
0 2791340 812536 0 0 558772 0 0 0 0
1176175 0 0 0 0 1680000
3201126 B 3 BS 1 07/02/2018 09/02/2018 29/12/1952 0 2
1 I63.9;G81.9;E14.4;I10 87.03 - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5248478 0 3 0 0 0 SARMIATI
d389732 65 23781 DR MAYSAMIRAWATI SPS 0138R01702180002847
0001209047815 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146003
1#0##0#0#0.0#2018-02-19 15:58:14#0#12:00:00#12:00:00#12:00:00 1
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3283170 0 0 0 0 1158358 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 09/02/2018 15/11/1967 0 2
1 I13.1;D63.8;A49.9 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 2749242 0 3 0 0 0 WARKINAH
0001311658389 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146244
1#0##0#0#0.0#2018-02-19 15:59:51#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1513357 0 0 0 0 0
3201126 B 3 BS 1 02/02/2018 09/02/2018 19/08/1948 0 2
6419700 0 0 - 0 - 0 - 0 - 0
6419700 7543381 0 8 0 0 0 SINAH BT.USIN
0000510376803 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144080
1#0##0#0#0.0#2018-02-19 16:06:24#0#12:00:00#12:00:00#12:00:00 1
7661a13dad86700e605d302fe303f27a 0 0 1046870 0 0
3959519 0 0 0 0 2536992 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 09/02/2018 06/02/2018 3325 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1844692 0 4 0 0 0 BAYI NY WENING WESTI
SUMINAR D389735 0 0 DR GUNAWAN S, SPA 0138R01702180002899
0002427726429 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145937
1#0##0#0#0.0#2018-02-19 16:09:11#0#12:00:00#12:00:00#12:00:00 1
783bb2cc9d19c075a3946732a79c4908 0 0 506812 0 0 396699
0 0 0 0 941181 0 0 0 0 0
3201126 B 2 BS 1 05/02/2018 09/02/2018 26/05/2017 0 1
1 N48.1;N39.0 64.0 - - None None None None V-1-15-II None
None None None None None SIRKUMSISI DENGAN KONDISI TERTENTU (SEDANG)
1943100 0 0 - 0 - 0 - 0 - 0
1943100 12635904 0 5 0 0 0 ARSENIO SAKHA WAHYUDI
0002253818057 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144456
1#1#vip#5#2023975#75.0#2018-02-19 16:24:09#0#12:00:00#12:00:00#12:00:00
1 7529e8c06b13fe85b6e35b0759cea4a5 0 2968119 422038 0
0 2415599 0 0 0 0 6757648 0 0 0 72500
0
3201126 B 2 BS 1 06/02/2018 09/02/2018 21/07/1991 0 2
0 0 - 0 - 0 - 0 - 0 5984100
11146142 0 4 0 0 0 WENING WESTI SUMINAR D211922
TANTIYO S;16137 5.2.0.201712280730 4 145670 1#0##0#0#0.0#2018-
02-19 16:31:48#0#12:00:00#12:00:00#00:00:00 1
99db948277cdf7f490eb041c585eba02 0 5682448 469205 0 0
2714302 0 0 0 0 2083187 0 0 0 69000 128000
3201126 B 3 BS 1 06/02/2018 09/02/2018 07/01/1963 0 1
1 I63.9;I10 87.03 - - None None None None G-4-14-I None
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 4842347 0 4 0 0 0 ASMAT d389727 55
TANTIYO S;16137 5.2.0.201712280730 4 145967 1#0##0#0#0.0#2018-
02-21 08:26:27#0#12:00:00#12:00:00#12:00:00 1
fc59d7c3f017ad233023a59ce73ba52f 0 0 557179 0 0
3153379 0 0 0 0 1131789 0 0 0 0 0
3201126 B 1 BS 1 05/02/2018 09/02/2018 14/11/1963 0 1
1 N18.5;I15.1;D63.8 99.04;39.27 - - None None None None N-1-
- 0 12472300 18937714 0 5 0 0 0 MASRU
0000023204417 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145030
1#0##0#0#0.0#2018-02-21 08:27:56#0#12:00:00#12:00:00#12:00:00 1
48beece2bcd95785a1634a08f87fa1af 0 0 4349967 0 0
3595297 0 0 0 0 10923450 0 0 0 69000 0
3201126 B 2 BS 1 04/02/2018 09/02/2018 14/03/2003 0 2
1 A01.0;J18.0 93.94 - - None None None None A-4-14-III None
(BERAT) 3965700 0 0 - 0 - 0 - 0 - 0
3965700 5288982 0 6 0 0 0 NADIRA RIZKA FEBRIYANI
0002233069367 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 144375
1#0##0#0#0.0#2018-02-21 09:33:13#0#12:00:00#12:00:00#12:00:00 1
e6611c7c896ed53bae63a12cf985a1ce 0 0 298025 0 0
2093949 0 0 0 0 2897008 0 0 0 0 0
3201126 B 1 BS 1 08/02/2018 09/02/2018 27/11/1979 0 1
1 E10.2;I10 99.17;39.27 - - None None None None N-1-12-I
- 0 6076700 13308766 0 2 0 0 0 DEDY
0000164837531 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146661
1#0##0#0#0.0#2018-02-21 09:45:25#0#12:00:00#12:00:00#12:00:00 1
1de56ee5206534813230d95ee39473cc 0 7580660 1175507 0 0
2233932 0 0 0 0 2318667 0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 09/02/2018 07/12/1962 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3245621 0 1 0 0 0 KASONO TN
0002223029204 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146870
1#0##0#0#0.0#2018-02-21 10:39:42#0#12:00:00#12:00:00#00:00:00 1
a2790c8c87b4c63fd844aa8cf6740639 0 0 424889 0 0
1163152 0 0 0 0 1657580 0 0 0 0 0
3201126 B 1 BS 1 08/02/2018 09/02/2018 09/06/1955 0 1
1 I20.0;I11.0;E14.8 - - - None None None None I-4-20-III
None None None None None None ANGINA PEKTORIS DAN NYERI DADA (BERAT)
9856000 0 0 - 0 - 0 - 0 - 0
9856000 5810556 0 2 0 0 0 SUGIYONO D173492
0000039003974 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146527
1#0##0#0#0.0#2018-02-21 10:47:10#0#12:00:00#12:00:00#12:00:00 1
2e5ee7d6d630fd4b677b5d48ecd31c3c 0 0 934424 0 0
2890002 0 0 0 0 1986130 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 09/02/2018 27/11/2015 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2640815 0 3 0 0 0 ARSY EFFARIS YYESHA
d389737 2 803 DR RASTRA, SPA 0138R01702180002809
0001719412402 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145998
1#0##0#0#0.0#2018-02-21 11:06:59#0#12:00:00#12:00:00#12:00:00 1
a00445a275e3a6ef44d46de2d8f2dafa 0 0 298025 0 0 629026
0 0 0 0 1713764 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 09/02/2018 10/05/1971 0 2
1 N39.0;A01.0 - - - None None None None N-4-12-III None
None None None None None INFEKSI GINJAL DAN SALURAN URIN (BERAT)
6075100 0 0 - 0 - 0 - 0 - 0
6075100 3137153 0 4 0 0 0 ITA ROSITA FITARIA
0002328121416 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145668
1#0##0#0#0.0#2018-02-21 12:07:17#0#12:00:00#12:00:00#12:00:00 1
2bd8b3a01d83d1cb7fa0bc22276a157b 0 0 599759 0 0 791160
0 0 0 0 1746234 0 0 0 0 0
3201126 B 2 BS 1 04/02/2018 09/02/2018 01/11/1950 0 2
1 I63.9;J18.0;E11.7;G81.9 87.03;90.59;87.49 - - None None None
None G-4-14-III None None None None None None KECEDERAAN PEMBULUH
DARAH OTAK DENGAN INFARK (BERAT) 10406600 0 0 - 0 - 0
- 0 - 0 10406600 6870518 0 6 0 0 0
RAHAYU D389523 67 24567 DR NURUL KOMARI SPS
0138R01702180001445 0001794703522 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 144377 1#0##0#0#0.0#2018-02-21
12:59:31#0#12:00:00#12:00:00#12:00:00 1 489ca4d630134e637ac424f3628e7773
0 0 882140 0 0 2987905 0 0 0 0
3000473 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 09/02/2018 26/02/1988 0 2
1 E10.8;K29.7;K92.0 - - - None None None None E-4-10-II
0 - 0 5873300 5616187 0 3 0 0 0
FARDIANY NAZAR d389725 29 10939 DR ARU, SPPD
0138R01702180002815 0001451231739 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 146006 1#0##0#0#0.0#2018-02-21
13:05:16#0#12:00:00#12:00:00#12:00:00 1 f25306a490600764bc914442bbe87c46
0 0 495728 0 0 3212045 0 0 0 0
1908414 0 0 0 0 0
3201126 B 1 BS 1 04/02/2018 09/02/2018 13/03/1953 0 1
1 I25.0;I08.9;I50.0;E11.9 90.59;89.52;88.55;36.07 - - YY02 None
None None I-1-40-II None None YY-02-III None None None PROSEDUR
0 - 0 - 0 46734600 62566930 0 6 0 0
0 RAMLI D310667 64 23704 DR AZRI NURIZAL SPPD KKV
0138R01702180001352 0000061034589 3;JKN DR RIZKI; 5.2.0.201712280730
4 144361 1#0##0#0#0.0#2018-02-28
09:05:58#0#12:00:00#12:00:00#00:00:00 1 641c831b3a858c5396d73ac65de7e3d1
0 11028540 53000 0 0 37997390 0 0 0 0
5422000 0 0 0 566000 7500000
3201126 B 1 BS 1 07/02/2018 09/02/2018 04/02/1952 0 1
- 0 58821400 61584710 0 3 0 0 0 YOPIE YUNUS
0001266323051 3;JKN DR RIZKI; 5.2.0.201712280730 4 145782
1#0##0#0#0.0#2018-02-28 09:32:28#0#12:00:00#12:00:00#00:00:00 1
9a77bda10d72eb921c0aadf3848ecb3e 0 18299120 0 0 0
32387590 0 0 0 0 3329000 0 0 0 69000
7500000
3201126 B 1 BS 1 08/02/2018 09/02/2018 14/12/1955 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4361721 0 2 0 0 0 TENDY LUMBAN TORUAN
0000060481574 3;JKN DR RIZKI; 5.2.0.201712280730 4 146862
1#0##0#0#0.0#2018-02-28 10:27:38#0#12:00:00#12:00:00#00:00:00 2
75876705fe425cefa9d3dabf2013729a 0 0 573641 0 0
1103984 0 0 0 0 2684096 0 0 0 0 0
3201126 B 3 BS 1 08/02/2018 09/02/2018 13/07/1950 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3478649 0 2 0 0 0 IGNATIUS ANTONO
ADJI d389824 67 24682 DR SRI KUNMARTINI, SPPD 0138R01702180003778
0001463354684 3;JKN DR RIZKI; 5.2.0.201712280730 4 146786
1#0##0#0#0.0#2018-02-28 10:50:23#0#12:00:00#12:00:00#12:00:00 1
cb69a6f3aacf90576dfb463ea4615e1a 0 0 424889 0 0
2274185 0 0 0 0 779575 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 09/02/2018 25/10/1978 0 2
1 O82.9;Z35.5;Z37.0 74.0;90.59 - - None None None None O-6-
10-I None None None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN)
5984100 0 0 - 0 - 0 - 0 - 0
5984100 20004235 0 3 0 0 0 ASIA HARIYATI
D258948 39 14350 DR NELWATI, SPOG 0138R01702180003274
0002049651606 3;JKN DR RIZKI; 5.2.0.201712280730 4 146250
1#1#vvip#3#14020135#0.0#2018-02-28 11:13:57#0#12:00:00#12:00:00#12:00:00
1 692eeb67483277489b2cb3451d46d353 0 10536400 942352 0
0 2906983 0 0 0 0 5421500 0 0 0 197000
0
3201126 B 3 BS 1 06/02/2018 09/02/2018 11/04/1992 0 2
1 O15.1;O82.9;Z37.0 74.0 - - None None None None O-6-10-III
None None None None None None OPERASI PEMBEDAHAN CAESAR (BERAT)
9052900 0 0 - 0 - 0 - 0 - 0
9052900 19612365 0 4 1 1 0 RATIH APRIYANI
0002311563396 3;JKN DR RIZKI; 5.2.0.201712280730 4 145623
1#0##0#0#0.0#2018-02-28 12:22:17#0#12:00:00#12:00:00#12:00:00 1
e2b643a9b8b19ad097733f26b1cf184a 0 4512076 439460 0 0
11257829 0 0 0 0 2686000 0 0 0 69000 648000
3201126 B 3 BS 1 08/02/2018 09/02/2018 01/01/1958 0 2
4199800 0 0 - 0 - 0 - 0 - 0
4199800 2207976 0 2 0 0 0 MARYAM D355261
0001739669668 3;JKN DR RIZKI; 5.2.0.201712280730 4 147990
1#0##0#0#0.0#2018-02-28 15:02:02#0#12:00:00#12:00:00#12:00:00 1
fc67988e22470ac57457ba07816b86c4 0 0 686537 0 0 824992
0 0 0 0 696447 0 0 0 0 0
3201126 B 1 BS 1 07/02/2018 09/02/2018 06/04/2001 0 2
0 0 - 0 - 0 - 0 - 0 3349800
3398937 0 3 0 0 0 FARISSA AZZAHRA SALSABILA
D389756 16 6151 DR RASTRA, SPA 0138R01702180003292
0001742584217 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146254
1#0##0#0#0.0#2018-03-14 08:26:23#0#12:00:00#12:00:00#12:00:00 1
3e8eae8aba5d8cf61851ab1ea80d96a4 0 0 354482 0 0 453095
0 0 0 0 2591360 0 0 0 0 0
3201126 B 3 BS 1 07/02/2018 09/02/2018 21/12/1942 0 1
1 E87.6;A09.9;K40.9;I11.9 - - - None None None None E-4-
11-I None None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (RINGAN)
2954900 0 0 - 0 - 0 - 0 - 0
2954900 4181172 0 3 0 0 0 JASIMIN KAMSO
0001014278196 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146253
1#0##0#0#0.0#2018-03-14 09:56:27#0#12:00:00#12:00:00#12:00:00 1
ed4f14eb5ad0a7156f15b05bc5079f95 0 0 1324303 0 0
2031334 0 0 0 0 825535 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 09/02/2018 10/05/1962 0 1
1 D43.2;G81.9;R57.2;A41.9 87.03 - - None None None None G-4-
LAIN-LAIN (BERAT) 8736200 0 0 - 0 - 0 - 0 -
0 8736200 4197666 0 1 0 0 0 DEDY MAIZAL
0000043446014 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147675
1#0##0#0#0.0#2018-03-14 10:37:03#0#12:00:00#12:00:00#00:00:00 1
61c18495eb88639acc32b7f1084b0feb 0 0 604998 0 0
2258054 0 0 0 0 0 1334614 0 0 0 0
3201126 B 3 BS 1 06/02/2018 09/02/2018 09/01/1972 0 1
20-II None None None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN
(SEDANG) 19193800 0 0 - 0 - 0 - 0 - 0
19193800 14294708 0 4 0 0 0 ARDIANSYAH D385096
0001335250721 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145669
1#0##0#0#0.0#2018-03-19 13:06:29#0#12:00:00#12:00:00#12:00:00 3
8a46e05aa5f318256a657fe38c75df2b 0 0 4606500 0 0
6046540 0 0 0 0 3615668 0 0 0 26000 0
3201126 B 2 BS 1 04/02/2018 09/02/2018 09/10/1970 0 2
1 I64;G81.9;I10;E75.6;E11.7 87.03 - - None None None None
0 0 - 0 - 0 - 0 - 0 5866300
7740285 0 6 0 0 0 SRI WAHYUNINGSIH D389514 47
DR RIZKI; 5.2.0.201712280730 4 144371 1#0##0#0#0.0#2018-03-28
16:13:18#0#12:00:00#12:00:00#12:00:00 2 4499e0aac86149eedc1b36784ed4e6af
0 0 965054 0 0 3420357 0 0 0 0
3354874 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 09/02/2018 17/03/1993 0 1
1 A09.9;R11 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2455464 0 3 0 0 0 FATRA RAMADHAN FAUSTER
0002140547725 3;JKN DR RIZKI; 5.2.1.201804062320 4 146255
1#0##0#0#0.0#2018-05-05 11:48:11#0#12:00:00#12:00:00#12:00:00 2
77fd6a4a555410e672b39203a9d867f6 0 0 303524 0 0 955302
0 0 0 0 1196638 0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 09/02/2018 01/09/1927 0 1
1 I64;K29.7 - - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 3588972 0 1 0
0 0 JENAL BETONG d389911 90 33034 DR ADITIA NATA KUSUMA
0138R01702180003905 0000510789947 3;JKN DR RIZKI; 5.2.1.201804062320
4 146872 1#0##0#0#0.0#2018-05-16
11:21:23#0#12:00:00#12:00:00#12:00:00 2 397c26f3636427c59c948062895c04b9
0 0 451179 0 0 2614000 0 0 0 0 523793
0 0 0 0 0
3201126 B 1 BS 1 31/01/2018 09/02/2018 27/06/2017 0 1
1 I27.0;J18.0;Q25.0;D64.9 99.04;93.94 - - None None None None
I-4-24-III None None None None None None GANGGUAN SISTEM PEMBULUH
- 0 11395800 17416156 0 10 0 0 0 ZHAVIER
SYAWAL SAKTI SETIAWAN D382364 0 218 DR AULIA TANGKARI, SPA
0138R01701180014683 0002249580655 3;JKN DR RIZKI; 5.2.1.201804062320
4 142838 1#0##0#0#0.0#2018-05-19
13:31:58#0#12:00:00#12:00:00#12:00:00 2 cfba47455e1f894484fa967af53c09b5
0 0 480175 0 0 6920106 0 0 0 0
8635875 0 0 0 0 1380000
3201126 B 3 BS 1 07/02/2018 09/02/2018 09/12/1977 0 1
1 S09.9;R57.1;R57.0;R00.1 90.59;89.52 - - None None None None
6333900 0 0 - 0 - 0 - 0 - 0
6333900 7469904 0 3 0 0 0 REZKY NOVAN D347612
40 14670 DR AHMAD HIBBAN A WRIYA 0138R01702180003260 0001603349717
3;JKN DR RIZKI; 5.2.2.201806040537 4 146249 1#0##0#0#0.0#2018-
08-14 16:10:30#0#12:00:00#12:00:00#00:00:00 3
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4860332 0 0 0 0 777685 0 0 0 0 0
3201126 B 2 BS 1 08/02/2018 09/02/2018 10/08/1947 0 2
SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0 -
0 3584400 3359587 0 2 0 0 0 LELY OSWANDI
d285147 70 25750 DR ZULFAN 0138R01702180003763 0002094308289
3;JKN DR RIZKI; 5.2.2.201806040537 4 146818 1#0##0#0#0.0#2018-
09-26 19:59:10#0#12:00:00#12:00:00#12:00:00 2
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1626540 0 0 0 0 1255786 0 0 0 0 0
3201126 B 2 BS 1 06/02/2018 10/02/2018 08/09/1976 0 2
1 D25.9;R33;K29.7 68.9 - - None None None None W-1-20-I
9917100 0 0 - 0 - 0 - 0 - 0
9917100 17419894 0 5 0 0 0 ANITA RATNA DEWI,SE
d221826 41 15126 DR FERRI SABARUDDIN SPOG 0138R01702180002689
0001625703491 3;JKN DR RIZKI; 5.2.0.201712280730 4 145667
1#0##0#0#0.0#2018-02-27 09:30:58#1#12:00:00#12:00:00#12:00:00 1
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5384582 0 0 0 0 2595219 0 0 0 69000 0
3201126 B 3 BS 1 08/02/2018 10/02/2018 03/03/1953 0 2
1 E14.9;I64 90.59;89.52 - - None None None None E-4-10-III
0 - 0 6262900 4403574 0 3 0 0 0 SITI
AISYAH D389805 64 23718 DR SOEGIONO, SPPD 0138R01702180003330
0000512218585 3;JKN DR RIZKI; 5.2.0.201712280730 4 146266
1#0##0#0#0.0#2018-02-28 09:44:02#0#12:00:00#12:00:00#12:00:00 1
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2758050 0 0 0 0 1103084 0 0 0 0 0
3201126 B 1 BS 1 07/02/2018 10/02/2018 03/07/1994 0 2
None None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN
(RINGAN) 10909500 0 0 - 0 - 0 - 0 - 0
10909500 16249134 0 4 0 0 0 CINDITIA d386508
3;JKN DR RIZKI; 5.2.0.201712280730 4 145941 1#0##0#0#0.0#2018-
02-28 09:50:21#0#12:00:00#12:00:00#12:00:00 1
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4484265 0 0 0 0 3907027 0 0 0 145000
0
3201126 B 1 BS 1 07/02/2018 10/02/2018 31/03/1978 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 12978522 0 4 0 0 0 TRI ARYANTI .
0002419752576 3;JKN DR RIZKI; 5.2.0.201712280730 4 146252
1#0##0#0#0.0#2018-02-28 10:08:25#0#12:00:00#12:00:00#12:00:00 1
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1953145 0 0 0 0 3023062 0 0 0 69000 0
3201126 B 2 BS 1 07/02/2018 10/02/2018 29/10/1983 0 2
1 O13;O63.1;O82.9;Z37.1 74.0 - - None None None None O-6-
6486300 0 0 - 0 - 0 - 0 - 0
6486300 12047649 0 4 0 0 0 SITI ZENAB D368627
34 12520 DR NELWATI, SPOG 0138R01702180002954 0001607783185 3;JKN
DR RIZKI; 5.2.0.201712280730 4 145961 1#0##0#0#0.0#2018-02-28
10:45:11#0#12:00:00#12:00:00#12:00:00 1 efe217b5412caed13a3af1edc68d078e
0 6161176 175841 0 0 3107468 0 0 0 0
2534164 0 0 0 69000 0
3201126 B 1 BS 1 08/02/2018 10/02/2018 07/05/1970 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 17548685 0 3 0 0 0 ROSMAWATI D389171
47 17444 DR RAY HENDRY, SPOT 0138R01702180003861 0001269740248
3;JKN DR RIZKI; 5.2.0.201712280730 4 146867 1#0##0#0#0.0#2018-
02-28 11:02:48#0#12:00:00#12:00:00#12:00:00 1
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3604708 0 0 0 0 2951545 0 0 0 145000
1875000
3201126 B 3 BS 1 06/02/2018 10/02/2018 13/10/2017 0 1
1 J18.0;A09.9 87.44;93.94 - - None None None None J-4-16-I
(RINGAN) 3613200 0 0 - 0 - 0 - 0 - 0
3613200 3687758 0 5 0 0 0 MUHAMMAD KAIFA ABQORY
0002272383088 3;JKN DR RIZKI; 5.2.0.201712280730 4 145672
1#0##0#0#0.0#2018-02-28 11:06:31#0#12:00:00#12:00:00#12:00:00 1
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1820315 0 0 0 0 1319255 0 0 0 170000
0
3201126 B 1 BS 1 08/02/2018 10/02/2018 08/02/2018 2323 2
(RINGAN) 7677000 0 0 - 0 - 0 - 0 - 0
7677000 2327174 0 3 0 0 0 BAYI NY TRI ARYANTI II
D389839 0 0 DR AWIDIYA, SPA 0138R01702180004176
0002420767596 3;JKN DR RIZKI; 5.2.0.201712280730 4 147301
1#0##0#0#0.0#2018-02-28 11:29:00#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1470745 0 0 0 0 0
3201126 B 1 BS 1 08/02/2018 10/02/2018 08/02/2018 2041 2
(RINGAN) 7677000 0 0 - 0 - 0 - 0 - 0
7677000 2327174 0 3 0 0 0 BAYI NY TRI ARYANTI I
D389838 0 0 DR AWIDIYA, SPA 0138R01702180004174
0002420765921 3;JKN DR RIZKI; 5.2.0.201712280730 4 147299
1#0##0#0#0.0#2018-02-28 11:31:27#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1470745 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 10/02/2018 03/03/1970 0 1
1 K80.0 51.22 - - None None None None B-1-12-I None None
None None None None CHOLESISTEKTOMI TANPA LAPAROSKOPIK (RINGAN)
8447200 0 0 - 0 - 0 - 0 - 0
8447200 14367788 0 4 0 0 0 ABDUL HALIM D387591
0002099400682 3;JKN DR RIZKI; 5.2.0.201712280730 4 145862
1#0##0#0#0.0#2018-02-28 11:36:17#0#12:00:00#12:00:00#12:00:00 1
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5088132 0 0 0 0 2710140 0 0 0 101000
0
3201126 B 3 BS 1 07/02/2018 10/02/2018 13/10/2003 0 1
- 0 - 0 - 0 - 0 3874400 8334566 0
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CATUR S, SPB 0138R01702180003112 0001849581606 3;JKN DR RIZKI;
5.2.0.201712280730 4 146703 1#0##0#0#0.0#2018-02-28
11:44:46#0#12:00:00#12:00:00#12:00:00 1 cdb82b38cd921f0c36edb2c75366323c
0 4183732 160000 0 0 2624582 0 0 0 0
1306252 0 0 0 60000 0
3201126 B 1 BS 1 09/02/2018 10/02/2018 10/11/1965 0 2
5176000 0 0 - 0 - 0 - 0 - 0
5176000 4763961 0 2 0 0 0 DWI ASTUTI D322571
3;JKN DR RIZKI; 5.2.0.201712280730 4 146889 1#0##0#0#0.0#2018-
02-28 11:53:30#0#12:00:00#12:00:00#00:00:00 1
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1829100 0 0 0 0 1899661 0 0 0 0 0
3201126 B 2 BS 1 05/02/2018 10/02/2018 28/01/2003 0 2
1 A09.9;R10.4;N83.2 88.76 - - None None None None K-4-17-I
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 4444449 0 6 0 0 0 JEANY CHAVIELDA P
0001174882713 3;JKN DR RIZKI; 5.2.0.201712280730 4 145038
1#0##0#0#0.0#2018-02-28 11:58:55#0#12:00:00#12:00:00#00:00:00 1
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1364156 0 0 0 0 2841758 0 0 0 0 0
3201126 B 2 BS 1 08/02/2018 10/02/2018 22/02/2017 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 3769975 0 3 0 0 0 NATHANIA ABYGAIL PUTRI
ZALUCHU D389803 0 351 DR KRISTON SILITONGA, SPA
0138R01702180003327 0002238543775 3;JKN DR RIZKI; 5.2.0.201712280730
4 146264 1#0##0#0#0.0#2018-02-28
12:02:26#0#12:00:00#12:00:00#12:00:00 1 2144b0d999f508342ff69d0980f91f2b
0 0 443231 0 0 1539110 0 0 0 0
1787634 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 10/02/2018 27/08/1967 0 2
1 J18.0;I11.9 89.52;90.59;87.44 - - None None None None J-4-
(RINGAN) 4335900 0 0 - 0 - 0 - 0 - 0
4335900 4404030 0 4 0 0 0 IDA FARIDA d389751
0001272499367 3;JKN DR RIZKI; 5.2.0.201712280730 4 146246
1#0##0#0#0.0#2018-02-28 12:05:13#0#12:00:00#12:00:00#12:00:00 1
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1335360 0 0 0 0 2126614 0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 10/02/2018 11/05/1970 0 2
1 D34 06.11 - - None None None None E-4-13-I None None
3697100 0 0 - 0 - 0 - 0 - 0
3697100 4518803 0 2 0 0 0 SULASTRI D388698
3;JKN DR RIZKI; 5.2.0.201712280730 4 146873 1#0##0#0#0.0#2018-
02-28 12:08:32#0#12:00:00#12:00:00#12:00:00 1
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2167900 0 0 0 0 847623 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 10/02/2018 11/09/2014 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3077445 0 4 0 0 0 KEISYA ATSA ALMEERA
D285331 3 1245 DR RASTRA, SPA 0138R01702180003163
0002099807919 3;JKN DR RIZKI; 5.2.0.201712280730 4 146243
1#0##0#0#0.0#2018-02-28 12:11:43#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 2247328 0 0 0 0 0
3201126 B 1 BS 1 07/02/2018 10/02/2018 16/05/2011 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 7707659 0 4 0 0 0 VITO AHMAR DANUTA
D208965 6 2459 DR HUDA, SPA 0138R01702180003858
0001266091863 3;JKN DR RIZKI; 5.2.0.201712280730 4 146864
1#1#vvip#4#4531459#0.0#2018-02-28 12:14:47#0#12:00:00#12:00:00#12:00:00
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1518169 0 0 0 0 5636239 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 10/02/2018 08/01/1986 0 2
1 G40.9;Z34.8 - - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 3718200 2636698
0 2 0 0 0 NILA DWI PRATIWI D001098 32 11720 DR
HARDI PRANATA SPS 0138R01702180004437 0001907525441 3;JKN DR RIZKI;
5.2.0.201712280730 4 147682 1#0##0#0#0.0#2018-02-28
14:33:09#0#12:00:00#12:00:00#12:00:00 1 07d3feb8d78a44704e183ecffb943d35
0 0 387638 0 0 834066 0 0 0 0
1414994 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 10/02/2018 11/01/1964 0 2
1 I20.9;I25.0;I11.9 88.55 - - None None None None I-1-15-I
None None None None None None KATETERISASI JANTUNG (RINGAN) 6357300
0 0 - 0 - 0 - 0 - 0 6357300
15328820 0 2 0 0 0 RITA HARIANI .N A017648 54
3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4 146886
1#0##0#0#0.0#2018-03-01 13:53:52#0#12:00:00#12:00:00#00:00:00 1
9f2b64b2cb12a87142ee98be66a226e8 0 7060040 0 0 0
4093960 0 0 0 0 2174820 0 0 0 0
2000000
3201126 B 2 BS 1 07/02/2018 10/02/2018 16/04/1965 0 1
1 K40.9;I13.1;D63.8 53.03;99.04;89.52 - - None None None None
K-1-14-II None None None None None None PROSEDUR HERNIA INGUINAL DAN
FEMORAL (SEDANG) 7719500 0 0 - 0 - 0 - 0 -
0 7719500 16537546 0 4 1 2 0 YAHYA D363282
52 19290 SRI KUNMARTINI.DR,SPPD 0138R01702180002737 0001155907473
3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4 145781
1#0##0#0#0.0#2018-03-01 16:36:10#0#12:00:00#12:00:00#00:00:00 1
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5252471 0 0 0 0 4550146 0 0 0 0
1089000
3201126 B 2 BS 1 09/02/2018 10/02/2018 21/07/1969 0 2
- 0 10690500 12572368 0 2 0 0 0 SAMSINI
d389939 48 17735 SRI KUNMARTINI.DR,SPPD 0138R01702180004364
0001189332786 3;JKN DR RIZKI; 5.2.0.201712280730 4 147685
1#0##0#0#0.0#2018-03-02 08:41:04#0#12:00:00#12:00:00#12:00:00 1
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4131532 0 0 0 0 1678491 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 10/02/2018 17/07/1978 0 1
- 0 58821400 76271635 0 2 0 0 0 ACHMAD
SYAHID D375843 39 14452 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180004096 0001338762881 3;JKN DR RIZKI; 5.2.0.201712280730
4 146999 1#0##0#0#0.0#2018-03-02
09:00:59#0#12:00:00#12:00:00#12:00:00 1 ec4e9d733be541f9e7492adbbe544fbe
0 18299120 0 0 0 47864515 0 0 0 0
2608000 0 0 0 0 7500000
3201126 B 2 BS 1 04/02/2018 10/02/2018 19/07/2017 0 1
1 K56.1;D64.9;A41.9 54.11;99.04 - - None None None None K-1-
40-III None None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-
LAIN (BERAT) 18011700 0 0 - 0 - 0 - 0 -
0 18011700 35180494 0 7 1 1 0 AIDAN KHALLEN
FIRDAUS D388921 0 200 DR CATUR SUZANTARA 0138R01702180001336
0002315902498 3;JKN DR RIZKI; 5.2.0.201712280730 4 144358
1#0##0#0#0.0#2018-03-02 09:36:37#0#12:00:00#12:00:00#12:00:00 1
84e50811dd169efdc570cadcc368d5a1 0 12445928 2309755 0 0
9617811 0 0 0 0 7226000 0 0 0 0
3581000
3201126 B 3 BS 1 01/02/2018 10/02/2018 08/12/1945 0 1
1 N13.1;E87.5;R31;N18.9;N39.0 56.0;58.5 - - None None None
None N-1-40-II None None None None None None PROSEDUR PADA URETRA DAN
TRANSURETRA (SEDANG) 10919500 0 0 - 0 - 0 - 0
- 0 10919500 26859789 0 10 0 0 0 AMIN SUWARDI
d387627 72 26353 DR SIDHI,SPU 0138R01702180000721
0001455361727 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 143610
1#0##0#0#0.0#2018-03-02 10:07:15#0#12:00:00#12:00:00#12:00:00 1
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10614779 0 0 0 0 8136300 0 0 0 657000
0
3201126 B 3 BS 1 09/02/2018 10/02/2018 01/01/1959 0 1
1 K65.9;K25.1;R57.1 - - - None None None None K-4-16-III
None None None None None None INFEKSI-INFEKSI GASTROINTESTINAL (BERAT)
5159600 0 0 - 0 - 0 - 0 - 0
5159600 4528169 0 2 0 0 0 ASMAWIH D389949
59 21589 DR DINI DANIATY 0138R01702180004439 0000511958452 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 147686 1#0##0#0#0.0#2018-
03-02 11:31:10#0#12:00:00#12:00:00#12:00:00 1
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3478570 0 0 0 0 585235 0 0 0 0 0
3201126 B 2 BS 1 07/02/2018 10/02/2018 12/08/2014 0 1
1 R50.9 - - - None None None None A-4-12-I None None
None None None None DEMAM YANG TIDAK DITENTUKAN (RINGAN) 3167100
0 0 - 0 - 0 - 0 - 0 3167100
2994123 0 4 0 0 0 FAKHRI ZHAFFRAN AL GHIFARI
D292819 3 1275 DR BENNY S, SPA 0138R01702180002875
0001653257395 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145993
1#0##0#0#0.0#2018-03-14 08:39:10#0#12:00:00#12:00:00#12:00:00 2
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0 0 0 0 2241877 0 0 0 0 0
3201126 B 2 BS 1 09/02/2018 10/02/2018 01/02/2018 0 2
0 - 0 - 0 - 0 - 0 5045200 3533925
0 2 0 0 0 FATHIYA KHAYRA d389284 0 8 DR TRI
LESTARI, SPA 0138R01702180004256 0002426510395 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 147424 1#0##0#0#0.0#2018-03-14
10:33:00#0#12:00:00#12:00:00#12:00:00 1 2f085e0c48fd00dfd506ab4ed206eb0c
0 0 454068 0 0 160666 0 0 0 0
1611191 0 0 0 0 1308000
3201126 B 2 BS 1 07/02/2018 10/02/2018 07/02/2018 3357 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3341058 0 4 0 0 0 BAYI NY ASIA HARIYATI
0002428039326 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146689
1#1#kelas_1#4#731200#0.0#2018-03-19 09:00:25#0#12:00:00#12:00:00#12:00:00
3 2616f016ff0d83e03fb06dcd450890ae 0 0 845085 0 0
88899 0 0 0 0 2407074 0 0 0 0 0
3201126 B 3 BS 1 10/02/2018 10/02/2018 04/03/1977 0 2
1 K21.9;A01.0 - - - None None None None K-4-12-III None
0 - 0 - 0 - 0 - 0 6781600 2905495
0 1 0 0 0 IVOLAI WALASI MARGRET DACHI D169512 40
14953 DR RENDRA RAMADYA 0138R01702180004504 0000201634356 3;JKN DR
RIZKI; 5.2.1.201804062320 4 147697 1#0##0#0#0.0#2018-05-05
11:36:34#0#04:25:00#11:47:00#00:00:00 2 c2711b05593d1d0899b9bd2f6f94f856
0 0 610344 0 0 1380072 0 0 0 0 497079
0 0 0 418000 0
3201126 B 3 BS 1 29/01/2018 10/02/2018 07/06/1967 0 1
4 A35;J18.9;J80;A41.9;N18.1 96.72 - - None None None None
J-1-02-III None None None None None None VENTILASI MEKANIKAL LONG TERM
TANPA TRAKEOSTOMI (BERAT) 66331600 0 0 - 0 - 0 -
0 - 0 66331600 78037137 0 13 1 6 4 HARUN
0001291961362 3;JKN DR RIZKI; 5.2.1.201804062320 4 141647
1#0##0#0#0.0#2018-05-16 10:32:45#0#12:00:00#12:00:00#12:00:00 2
7f89808a7748184fc00a6c033fc7e634 0 0 14645953 0 0
31716934 0 0 0 0 15368250 0 0 0 0
16306000
3201126 B 2 BS 1 06/02/2018 10/02/2018 30/07/1967 0 1
1 K35.2;D29.1 54.19;88.76;87.44 - - None None None None K-1-
40-I None None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN
(RINGAN) 9351000 0 0 - 0 - 0 - 0 - 0
9351000 13569794 0 5 0 0 0 HERI HUSAERI
0001453555989 3;JKN DR RIZKI; 5.2.1.201804062320 4 145940
1#0##0#0#0.0#2018-05-16 10:38:54#0#12:00:00#12:00:00#12:00:00 2
305b5f1f645676a4bc798bd6aba07bd6 0 6156100 1600976 0 0
4714974 0 0 0 0 1028744 0 0 0 0 69000
3201126 B 1 BS 1 04/02/2018 11/02/2018 03/10/2017 0 2
5058500 0 0 - 0 - 0 - 0 - 0
5058500 12706571 0 8 0 0 0 ZIVANA ANDHIRA MA'RUF
0002293328823 3;JKN DR RIZKI; 5.2.0.201712280730 4 144368
1#0##0#0#0.0#2018-02-28 13:41:29#0#12:00:00#12:00:00#12:00:00 1
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4468535 0 0 0 0 6759771 0 0 0 290000
680000
3201126 B 1 BS 1 07/02/2018 11/02/2018 10/10/1940 0 2
1 I11.0;I25.0;E14.9 87.44;89.52;99.17 - - None None None None
I-4-12-I None None None None None None KEGAGALAN JANTUNG (RINGAN)
5005900 0 0 - 0 - 0 - 0 - 0
5005900 8538752 0 5 0 0 0 HJ NAFISAH MUSTAQIM
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1#0##0#0#0.0#2018-02-28 13:45:33#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 09/02/2018 11/02/2018 19/05/1991 0 2
1 A01.0;Z34.9 - - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 1812027 0 3 0 0 0 MEINALISA PUTRI
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1#0##0#0#0.0#2018-02-28 13:48:06#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 11/02/2018 11/02/2018 12/04/1958 0 1
3 I64;I11.9 - - - None None None None G-4-15-I None
- 0 - 0 - 0 4915400 2734136 0 1 0
0 0 MUKRI D390094 59 21855 DR HARDI PRANATA SPS
0138R01702180004726 0001339122104 3;JKN DR RIZKI; 5.2.0.201712280730
4 147834 1#1#vvip#1#0#0.0#2018-02-28
14:04:59#0#00:13:00#13:00:00#12:00:00 1 c3ddaa2d54e6036e404525a43320ff63
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0 0 - 0 - 0 - 0 - 0 5005900
7523109 0 4 0 0 0 MUHAMMAD NUH NASUTION D389807
0001819580016 3;JKN DR RIZKI; 5.2.0.201712280730 4 146267
1#0##0#0#0.0#2018-02-28 14:10:50#0#12:00:00#12:00:00#12:00:00 1
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596000
3201126 B 1 BS 1 08/02/2018 11/02/2018 14/01/1954 0 2
1 I64;N18.5;J18.0;E87.8 87.03 - - None None None None G-4-
15-III None None None None None None KECEDERAAN PEMBULUH DARAH OTAK NON
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4 0 0 0 SRI HENDARJANI D389073 64 23401 DR
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14:16:35#0#12:00:00#12:00:00#12:00:00 1 e13d03337d951c880818126fc7908ec6
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2830500 0 0 0 0 0
3201126 B 1 BS 1 08/02/2018 11/02/2018 05/04/1998 0 1
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2925900 4444857 0 4 0 0 0 MAGA RAHA SAMA SIAGIAN
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1#0##0#0#0.0#2018-02-28 14:19:08#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 09/02/2018 11/02/2018 17/09/1961 0 2
- 0 8908800 8983414 0 3 0 0 0 BAMBANG
SETIAWAN D387941 56 20599 SRI KUNMARTINI.DR,SPPD 0138R01702180004403
0001740406904 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
147676 10#0##0#0#0.0#2018-03-01 15:07:40#0#12:00:00#12:00:00#12:00:00
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3201126 B 1 BS 1 09/02/2018 11/02/2018 12/10/1965 0 1
1 E11.9;J40;E78.4;K76.0;D29.1 87.44;88.76 - - None None None
None E-4-10-II None None None None None None PENYAKIT KENCING MANIS &
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15:15:23#0#12:00:00#12:00:00#12:00:00 2 ac6a73c0f48fe62d3a1801521dc6d2eb
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2752081 0 0 0 0 0
3201126 B 2 BS 1 09/02/2018 11/02/2018 27/06/1952 0 2
1 K74.6;I85.0;K26.3;K76.6 45.16;43.41 - - None None None None
(BERAT) 8096600 0 0 - 0 - 0 - 0 - 0
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3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4 147688
1#0##0#0#0.0#2018-03-01 15:29:22#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 10/02/2018 11/02/2018 15/04/1968 0 1
1 I12.0;I25.0 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 10638332 0 2 0 0 0 SLAMET SUSENO
0002139514817 3;JKN DR RIZKI; 5.2.0.201712280730 4 147825
1#0##0#0#0.0#2018-03-02 08:35:20#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 09/02/2018 11/02/2018 08/07/2016 0 2
1 A09.9;E86;J02.9 - - - None None None None K-4-17-I
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2502712 0 3 0 0 0 FATHIYYA ZAHIRA SATRIA
D338098 1 581 DR RASTRA, SPA 0138R01702180004608
0002069234807 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147795
1#0##0#0#0.0#2018-03-02 08:53:24#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 11/02/2018 11/02/2018 15/08/1967 0 1
1 N18.5;J18.9 93.94;99.21 - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 1085381 0 1 0 0 0 KUSROTO
0001869464845 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147986
1#0##0#0#0.0#2018-03-02 08:59:43#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 09/02/2018 11/02/2018 19/09/1977 0 1
INTERNAL (RINGAN) 5178700 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-03-02 09:04:50#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 06/02/2018 11/02/2018 29/08/1983 0 2
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None None None None N-4-10-III None None None None None None TUMOR
GINJAL & SALURAN URIN & GAGAL GINJAL (BERAT) 6077700 0 0 - 0
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3 0 KATINI D389637 34 12580 SRI KUNMARTINI.DR,SPPD
0138R01702180002501 0002062585901 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 145607 1#0##0#0#0.0#2018-03-19
10:17:47#0#12:00:00#12:00:00#12:00:00 2 ac89c417705901c9974bd986dc4f1ab7
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6020934 0 0 0 1516000 0
3201126 B 3 BS 1 10/02/2018 11/02/2018 10/10/1958 0 1
4 I20.0;I08.9;I25.0;I50.0 - - - None None None None I-4-
20-II None None None None None None ANGINA PEKTORIS DAN NYERI DADA (SEDANG)
4854000 0 0 - 0 - 0 - 0 - 0
4854000 1476709 0 2 0 0 0 SYARIFUDIN D359754
0001304564499 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147793
1#0##0#0#0.0#2018-03-19 10:26:29#0#12:00:00#12:00:00#00:00:00 2
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3201126 B 2 BS 1 08/02/2018 11/02/2018 04/10/2017 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 5485195 0 4 0 0 0 BAYI NY SHEREN DHORTY
LAURENS D378140 0 127 DR KRISTON SILITONGA, SPA
0138R01702180013105 0002294182056 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 146746 1#0##0#0#0.0#2018-03-19
10:51:31#0#12:00:00#12:00:00#12:00:00 2 93b70ba9ceb146c2ce3d26612459e38b
0 0 293399 0 0 2156951 0 0 0 0
2404845 0 0 0 0 630000
3201126 B 3 BS 1 07/02/2018 11/02/2018 26/12/1996 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 3501901 0 5 0 0 0 NATALIA DAMESARI GULTOM
0001858376902 3;JKN DR RIZKI; 5.2.1.201804062320 4 147243
1#0##0#0#0.0#2018-05-05 11:34:08#0#12:00:00#12:00:00#12:00:00 2
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1699364 0 0 0 0 1483596 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 11/02/2018 12/12/1947 0 2
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0 3 0 0 0 NASWARTI D358758 70 25627 DR. ARU
5.2.1.201804062320 4 147690 1#0##0#0#0.0#2018-05-16
10:40:12#0#12:00:00#12:00:00#12:00:00 2 528b96e7e36744d966454e4f62f0ab74
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1814945 0 0 0 0 0
3201126 B 3 BS 1 12/02/2018 12/02/2018 07/12/1950 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 255900 0 1 0 0 0 NAWANGSIH D340973
67 24539 DR AHMAD HIBBAN A WRIYA 0138R01702180005233 0001306656538
3;JKN VERA ARIESANDI; 5.2.0.201712280730 4 149300
24#0##0#0#0.0#2018-02-14 10:10:03#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 07/02/2018 12/02/2018 01/06/1955 0 1
1 I11.0;R57.0 87.44 - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 4973600 10807414
0 6 0 0 0 SUHERMAN D389779 62 22897 DR PRIYO
SUNARTO , SPJP 0138R01702180003295 0001014459895 3;JKN DR RIZKI;
5.2.0.201712280730 4 146260 1#0##0#0#0.0#2018-02-28
16:22:27#0#12:00:00#12:00:00#12:00:00 1 cef7f4aa7380be44d522273beb007bc1
0 0 936171 0 0 3430216 0 0 0 0
3878027 0 0 0 870000 1693000
3201126 B 3 BS 1 09/02/2018 12/02/2018 17/09/1961 0 1
1 I48;I11.9 89.52 - - None None None None I-4-19-I None
None None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG (RINGAN)
3914900 0 0 - 0 - 0 - 0 - 0
3914900 3619159 0 4 0 0 0 SUPARMAN D389944
0001208583707 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
147679 1#0##0#0#0.0#2018-03-01 13:32:23#0#12:00:00#12:00:00#12:00:00
1 9532d8d07ae98d7c91dd8071a5e2f115 0 0 709622 0 0
1681270 0 0 0 0 1228267 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 12/02/2018 13/11/1987 0 2
1 A91;K29.7 90.59 - - None None None None A-4-13-I None
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4738667 0 4 0 0 0 NOVITA WULANDARI
0001624407322 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
146871 1#0##0#0#0.0#2018-03-01 13:35:15#0#12:00:00#12:00:00#12:00:00
1 a8b208457095eaacccf37b5f9e77d381 0 0 316331 0 0
962330 0 0 0 0 3460006 0 0 0 0 0
3201126 B 2 BS 1 10/02/2018 12/02/2018 03/09/2012 0 1
1 K30;J02.9 93.94 - - None None None None K-4-18-I None
1743400 0 0 - 0 - 0 - 0 - 0
1743400 3326055 0 3 0 0 0 CHRISTOFFEL WIJAYA
0002293496019 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
147694 1#0##0#0#0.0#2018-03-01 13:40:25#0#12:00:00#12:00:00#12:00:00
2 ce6739563aba2388db51eba48d939610 0 0 209906 0 0
1187557 0 0 0 0 1758592 0 0 0 170000
0
3201126 B 1 BS 1 09/02/2018 12/02/2018 21/10/1960 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 8415021 0 4 0 0 0 LINDA LENGKEI BACAS
D104456 57 20930 DR ARU, SPPD 0138R01702180004417
0002321927019 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
147702 1#1#vvip#1#5489121#0.0#2018-03-01
13:44:17#0#12:00:00#12:00:00#12:00:00 1 4e3fe5465e9498c17cacb56eb7dec518
0 0 758804 0 0 2567202 0 0 0 0
5089015 0 0 0 0 0
3201126 B 1 BS 1 05/02/2018 12/02/2018 04/05/1943 0 2
1 J80;J44.9;K30 96.05;96.72 - - None None None None J-1-
- 0 56235600 45783696 0 8 1 5 0 SAIYAH
0002229758965 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
144990 1#0##0#0#0.0#2018-03-01 14:07:33#0#12:00:00#12:00:00#12:00:00
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15408808 0 0 0 0 10939000 0 0 0 0
5648000
3201126 B 1 BS 1 06/02/2018 12/02/2018 30/05/1965 0 2
1 I50.0;J18.0;E14.9 87.44 - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 6963100
10771320 0 7 0 0 0 ENDANG TRIASTUTI,NY D137753
3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4 145041
2#0##0#0#0.0#2018-03-01 14:44:48#0#12:00:00#12:00:00#00:00:00 1
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3300889 0 0 0 0 6197666 0 0 0 580000
0
3201126 B 3 BS 1 09/02/2018 12/02/2018 15/11/1985 0 2
1 O62.4;O36.8 - - - None None None None W-4-16-I None
None None None None None GANGGUAN ANTEPARTUM (RINGAN) 2168300 0
0 - 0 - 0 - 0 - 0 2168300 3032883
0 4 0 0 0 CITRA DEWI D389954 32 11774 DR FERRI
SABARUDDIN SPOG 0138R01702180004436 0001124571633 3;JKN YULIA N.
MAIWA;15092 5.2.0.201712280730 4 147684 1#0##0#0#0.0#2018-03-01
14:52:30#0#12:00:00#12:00:00#12:00:00 1 d089d6c702ff52686d45058219d8b9d9
0 0 498147 0 0 600323 0 0 0 0
1294413 0 0 0 0 640000
3201126 B 2 BS 1 10/02/2018 12/02/2018 14/12/1990 0 2
1 O62.4;O36.8 88.78 - - None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 2601900 2713230
0 3 0 0 0 DINA NURPITA SUPRAWOTO I107902 27 9920
DR. SITI AZIZAH SPOG 0138R01702180004721 0000100053009 3;JKN YULIA
N. MAIWA;15092 5.2.0.201712280730 4 147832 19#0##0#0#0.0#2018-03-01
14:53:52#0#12:00:00#12:00:00#12:00:00 1 4a8046d3ff7fb62ac0ae8f4d6be11aac
0 0 484171 0 0 759558 0 0 0 0
1213501 0 0 0 0 256000
3201126 B 1 BS 1 07/02/2018 12/02/2018 05/05/1975 0 1
- 0 - 0 - 0 - 0 4784600 9308410 0
6 0 0 0 RAMLIH D389638 42 15619 DR. ARU ARIADNO,
SPPD 0138R01702180002917 0001208382491 3;JKN YULIA N. MAIWA;15092
5.2.0.201712280730 4 145939 1#0##0#0#0.0#2018-03-01
14:58:56#0#12:00:00#12:00:00#12:00:00 1 2569c031b7e24df3b3b8b66a38670fe1
0 0 572372 0 0 3415077 0 0 0 0
5320961 0 0 0 0 0
3201126 B 1 BS 1 07/02/2018 12/02/2018 05/06/1949 0 2
1 M54.22;M47.82;M47.86 90.59;89.52;87.22;87.24 - - None None
None None M-4-17-I None None None None None None MASALAH BAGIAN
PUNGGUNG/PINGGANG BELAKANG (RINGAN) 5162900 0 0 - 0 - 0
- 0 - 0 5162900 8442999 0 6 0 0 0
RUKMINI D321874 68 25084 DR NURUL KOMARI SPS
5.2.0.201712280730 4 145974 5#0##0#0#0.0#2018-03-01
15:03:43#0#12:00:00#12:00:00#00:00:00 1 098ed419a898ee470af24d785e43f5a0
0 0 386918 0 0 2791735 0 0 0 0
5264346 0 0 0 0 0
3201126 B 3 BS 1 08/02/2018 12/02/2018 06/03/1947 0 2
1 I50.0;E87.6;I25.0;E87.1 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
4269996 0 5 0 0 0 JAENAH D389810 70 25907
YULIA N. MAIWA;15092 5.2.0.201712280730 4 146272
1#0##0#0#0.0#2018-03-01 15:05:25#0#12:00:00#12:00:00#12:00:00 2
06e42be7ed1ebcc2b1015c8b9a9e7a0b 0 0 777923 0 0
1581724 0 0 0 0 1620345 0 0 0 290004
0
3201126 B 2 BS 1 07/02/2018 12/02/2018 21/03/1969 0 1
1 I21.3 36.07;88.55 - - YY02 None None None I-1-40-I None
None YY-02-III None None None PROSEDUR KARDIOVASKULAR PERKUTAN (RINGAN)
12871000 0 0 PCI 10725800 - 0 - 0 - 0
23596800 49622496 0 6 0 0 0 MUSLIH d389731
0002035531552 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
145997 1#0##0#0#0.0#2018-03-01 16:18:16#0#12:00:00#12:00:00#12:00:00
1 f0c56a2af456179aee00443a37093a39 0 10730200 53000 0 0
27073296 0 0 0 0 3746000 0 0 0 0
8020000
3201126 B 3 BS 1 09/02/2018 12/02/2018 11/06/1964 0 1
1 K29.6;K92.0;K92.1 - - - None None None None K-4-11-II
3296400 0 0 - 0 - 0 - 0 - 0
3296400 3626811 0 4 0 0 0 DADANG MULYADI
0002290812401 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147691
1#0##0#0#0.0#2018-03-02 07:41:47#0#12:00:00#12:00:00#12:00:00 1
df763971f8d98b911416e66d2878b579 0 789000 349676 0 0
2224867 0 0 0 0 237268 0 0 0 26000 0
3201126 B 3 BS 1 08/02/2018 12/02/2018 22/06/1966 0 1
0 0 - 0 - 0 - 0 - 0 4204300
4371522 0 5 0 0 0 MURYADI D291220 51 18859
TANTIYO S;16137 5.2.0.201712280730 4 146261 1#0##0#0#0.0#2018-
03-02 07:44:32#0#12:00:00#12:00:00#12:00:00 1
61f9ff9ff28c61dcc2d5ce6c8ae1d915 0 0 431387 0 0
2313148 0 0 0 0 285987 0 0 0 1341000
0
3201126 B 2 BS 1 09/02/2018 12/02/2018 05/10/1961 0 1
- 0 51950600 60499865 0 4 0 0 0 KWAN KOK
LIONG D297726 56 20581 DR AGOES KOOSHARTORO SPPD-KKV 0138R01702180004099
0002241301858 3;JKN DR RIZKI; 5.2.0.201712280730 4 146997
1#0##0#0#0.0#2018-03-02 08:57:11#0#12:00:00#12:00:00#12:00:00 1
e2cb378830ce02d50c5024de30fde60c 0 16400960 0 0 0
34542905 0 0 0 0 2056000 0 0 0 0
7500000
3201126 B 3 BS 1 11/02/2018 12/02/2018 04/08/1954 0 2
1 D11.9 26.11 - - None None None None U-4-15-I None None
None None None None PENYAKIT TELINGA, HIDUNG, MULUT DAN TENGGOROKAN LAIN-
LAIN (RINGAN) 2961500 0 0 - 0 - 0 - 0 -
0 2961500 5013057 0 2 0 0 0 HJ. MASENAH
0001739620686 3;JKN DR RIZKI; 5.2.0.201712280730 4 147856
1#0##0#0#0.0#2018-03-02 09:20:03#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 613457 0 0 0 0 0
3201126 B 2 BS 1 11/02/2018 12/02/2018 23/04/1952 0 2
1 I12.0;E13.1;D63.8;A49.9 - - - None None None None N-4-
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 3745022 0 2 0 0 0 KUSMIYATI
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1#0##0#0#0.0#2018-03-02 09:29:14#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 09/02/2018 12/02/2018 04/06/1964 0 1
(RINGAN) 4639400 0 0 - 0 - 0 - 0 - 0
4639400 5608414 0 4 0 0 0 ZAENUDIN TN d375732
53 19608 DR ARU, SPPD 0138R01702180004448 0000061071581 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 147687 1#0##0#0#0.0#2018-
03-02 09:30:37#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 10/02/2018 12/02/2018 23/08/1973 0 1
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PARYANTO D266414 44 16242 DR AZRI NURIZAL SPPD KKV
0138R01702180004513 0001846286324 3;JKN DR RIZKI; 5.2.0.201712280730
4 147700 1#0##0#0#0.0#2018-03-02
09:46:28#0#12:00:00#12:00:00#00:00:00 1 efc8ba1c7b67a7fbb501fb0e9eea2984
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2521000 0 0 0 59000 7500000
3201126 B 2 BS 1 11/02/2018 12/02/2018 29/12/1991 0 1
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0 2 0 0 0 TRY JUNANTO D389573 26 9541 DR ZULFAN,
5.2.0.201712280730 4 147854 1#0##0#0#0.0#2018-03-02
10:30:40#0#12:00:00#12:00:00#12:00:00 1 9f4073d4c6e955445f69dab58bd51570
0 0 1108824 0 0 889752 0 0 0 0
2098970 0 0 0 0 1680000
3201126 B 3 BS 1 12/02/2018 12/02/2018 01/08/1992 0 2
1 K30;R51;M79.1 - - - None None None None K-4-18-I
(RINGAN) 1452800 0 0 - 0 - 0 - 0 - 0
1452800 605355 0 1 0 0 0 MIRNA RAHMANIA
0000512284544 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149758
1#0##0#0#0.0#2018-03-02 11:09:33#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 346603 0 0 0 0 0
3201126 B 1 BS 1 10/02/2018 12/02/2018 10/12/1980 0 2
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INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 10869508 0 3 0 0 0 ZULIYATIN
0001821841042 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147695
1#0##0#0#0.0#2018-03-14 10:40:16#0#12:00:00#12:00:00#12:00:00 1
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5767679 0 0 0 0 3356089 0 0 0 0 588000
3201126 B 3 BS 1 11/02/2018 12/02/2018 01/01/1966 0 2
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KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0 -
0 29135800 20041560 0 2 1 2 1 AMENIH
0000512360201 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 147846
1#0##0#0#0.0#2018-04-26 16:17:38#0#12:00:00#12:00:00#12:00:00 1
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7660400 0 0 0 0 3268000 0 0 0 2226000
0
3201126 B 2 BS 1 05/02/2018 12/02/2018 04/09/1957 0 2
1 E11.5 89.52;90.59;84.15 - - None None None None M-1-02-I
None None None None None None AMPUTASI (RINGAN) 11410700 0 0
- 0 - 0 - 0 - 0 11410700 39242017 0
8 0 0 0 RITA SARA LOEN D201094 60 22069 DR ARU, SPPD
0138R01702180002795 0001285207503 3;JKN DR RIZKI; 5.2.2.201806040537
4 145665 1#0##0#0#0.0#2018-08-14
16:06:11#0#12:00:00#12:00:00#12:00:00 3 df225ee695712891e0a48c63ba5367ef
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4061000 0 0 0 69000 0
3201126 B 1 BS 1 11/02/2018 12/02/2018 13/08/1966 0 1
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0 - 0 - 0 5576700 7448503 0 2 0 0
0 SUBIANTORO D389355 51 18810 DR ZULFAN, SPPD
0138R01702180004765 0001630809977 3;JKN DR RIZKI; 5.2.2.201806040537
4 148097 1#0##0#0#0.0#2018-09-05
18:17:33#0#12:00:00#12:00:00#12:00:00 3 88e349a1de34d1ba9ea01a48bd0fd4d1
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2967785 0 0 0 0 1680000
3201126 B 1 BS 1 07/02/2018 12/02/2018 16/10/1955 0 1
1 I63.3;G40.9;I60.9 90.59;88.41 - - None None None None G-1-
12-III None None None None None None PROSEDUR PEMBULUH DARAH EXTRA
KRANIAL (BERAT) 18195100 0 0 - 0 - 0 - 0 -
0 18195100 23366201 0 6 0 0 0 RYANDY Z MASDUKI
0000208839295 3;JKN DR RIZKI; 5.2.2.201806040537 4 145678
1#0##0#0#0.0#2018-09-10 16:03:45#0#12:00:00#12:00:00#12:00:00 4
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7511622 0 0 0 0 10456000 0 0 0 0 0
3201126 B 2 BS 1 09/02/2018 13/02/2018 11/08/2017 0 2
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4605327 0 5 0 0 0 BAYI NY RUT LEBERINA D373552
YULIA N. MAIWA;15092 5.2.0.201712280730 4 155883
1#0##0#0#0.0#2018-03-01 16:00:22#0#12:00:00#12:00:00#12:00:00 1
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1125885 0 0 0 0 2347283 0 0 0 680000
0
3201126 B 2 BS 1 11/02/2018 13/02/2018 11/02/2018 2550 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1591112 0 3 0 0 0 BY NY ARIANI
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148990 1#0##0#0#0.0#2018-03-01 16:01:32#0#12:00:00#12:00:00#12:00:00
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3201126 B 2 BS 1 11/02/2018 13/02/2018 06/05/1982 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10067766 0 3 0 0 0 ARIANI D390135
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3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147851
1#0##0#0#0.0#2018-03-02 07:39:51#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 08/02/2018 13/02/2018 21/06/1966 0 2
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- 0 6077700 4950325 0 6 0 0 0 ASTUTI
D389877 51 18860 DR SRI KUN, SPPD 0138R01702180003840
0000508736856 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146863
1#0##0#0#0.0#2018-03-02 08:43:35#0#12:00:00#12:00:00#12:00:00 1
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2643979 0 0 0 0 1578353 0 0 0 128000
0
3201126 B 3 BS 1 07/02/2018 13/02/2018 09/06/1965 0 1
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0 - 0 6262900 15297669 0 7 0 0 0 LILI
MUSTARI d389754 52 19236 DR AZRI NURIZAL SPPD KKV
0138R01702180003255 0001739658352 3;JKN TANTIYO S;16137
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08:46:45#0#12:00:00#12:00:00#12:00:00 1 324488063d7d42f173b4b19b4b27fbf9
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3201126 B 3 BS 1 09/02/2018 13/02/2018 10/05/1975 0 2
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KOOSHARTORO SPPD-KKV 0138R01702180004164 0001305707128 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 147231 1#0##0#0#0.0#2018-03-02
08:56:02#0#12:00:00#12:00:00#00:00:00 1 3c81e6e8205ec9ba5e588449d5d3a115
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1512735 0 0 0 153000 0
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09:17:17#0#12:00:00#12:00:00#12:00:00 1 c49fa67be89bd45e12a50998b0862c06
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3201126 B 3 BS 1 10/02/2018 13/02/2018 22/08/2013 0 1
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2268700 1992044 0 4 0 0 0 AKMAL YAZID NUR FITHRAH
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1#0##0#0#0.0#2018-03-02 09:19:04#0#20:44:34#20:44:34#12:00:00 1
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3201126 B 2 BS 1 12/02/2018 13/02/2018 24/10/1983 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 4760714 0 2 0 0 0 WINDU S. ANUGRAH TN
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1#0##0#0#0.0#2018-03-02 09:23:58#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 1 BS 1 11/02/2018 13/02/2018 05/10/1939 0 1
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10-I None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
0 - 0 4903800 5539219 0 3 0 0 0 SUBANA
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1#0##0#0#0.0#2018-03-02 09:34:15#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 08/02/2018 13/02/2018 14/09/1951 0 2
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11578700 20884195 0 6 0 0 0 ENDANG KUNTARI
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1#0##0#0#0.0#2018-03-02 09:36:17#0#12:00:00#12:00:00#12:00:00 1
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3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147689
1#0##0#0#0.0#2018-03-02 10:08:49#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 08/02/2018 13/02/2018 21/05/2003 0 1
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(SEDANG) 10628600 0 0 - 0 - 0 - 0 - 0
10628600 19070333 0 6 0 0 0 TEGUH RIZKY PRATAMA
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1#0##0#0#0.0#2018-03-02 10:11:14#0#12:00:00#12:00:00#12:00:00 1
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0
3201126 B 3 BS 1 11/02/2018 13/02/2018 18/01/2005 0 1
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(RINGAN) 15255300 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-03-02 10:13:36#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 11/02/2018 13/02/2018 14/12/1955 0 1
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HERRY JOGADINATA D288727 62 22705 DR SRI KUNMARTINI, SPPD
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5.2.0.201712280730 4 147857 1#0##0#0#0.0#2018-03-02
10:43:36#0#12:00:00#12:00:00#12:00:00 1 a23ddea3189d7ad734292317a61f588a
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18:23:03#0#12:00:00#12:00:00#12:00:00 1 7098775f0cb46c85d01369c5754694da
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8019717 0 0 0 0 0
3201126 B 3 BS 1 13/02/2018 13/02/2018 14/01/1954 0 2
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(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-03-02 18:44:29#0#12:00:00#12:00:00#12:00:00 1
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4 147923 1#0##0#0#0.0#2018-03-05
09:49:37#0#12:00:00#12:00:00#12:00:00 1 2d35766c8b344a895c7f3c4d8b417e45
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2056000 0 0 0 0 7500000
3201126 B 1 BS 1 11/02/2018 13/02/2018 12/05/1946 0 1
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0 - 0 - 0 58821400 68113039 0 3 0 0
0 NIAN DAIMAN,H,MBA. D370989 71 26208 DR AZRI NURIZAL SPPD KKV
0138R01702180004747 0000061030394 3;JKN TANTIYO S;16137
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09:34:08#0#12:00:00#12:00:00#00:00:00 1 cfccf942f90c53a9c388870a018d06df
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0 0 - 0 - 0 - 0 - 0 4204300
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TANTIYO S;16137 5.2.0.201712280730 4 144757 1#0##0#0#0.0#2018-
03-14 10:32:02#0#12:00:00#12:00:00#12:00:00 1
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3279327 0 0 0 0 2811776 0 0 0 0 0
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0 0 - 0 - 0 - 0 - 0 4888600
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DR RIZKI; 5.2.0.201712280730 4 147357 1#0##0#0#0.0#2018-03-29
12:00:35#0#12:00:00#12:00:00#12:00:00 3 d67e56c9a35716d73adc44703b4fef44
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1665398 0 0 0 0 0
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0001638965226 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147861
1#0##0#0#0.0#2018-03-29 15:30:18#0#12:00:00#12:00:00#00:00:00 2
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1547627 0 0 0 0 2503699 0 0 0 0 0
3201126 B 2 BS 1 10/02/2018 13/02/2018 22/06/1952 0 2
1 I10;R10.1;A01.0;M13.9;M24.41 88.21 - - None None None None
I-4-17-III None None None None None None HIPERTENSI (BERAT)
3196400 0 0 - 0 - 0 - 0 - 0
3196400 4849410 0 4 0 0 0 MARIA CHRISTINA DJUWATI
0001292964131 3;JKN DR RIZKI; 5.2.1.201804062320 4 147821
1#0##0#0#0.0#2018-05-05 11:52:42#0#12:00:00#12:00:00#12:00:00 2
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2390135 0 0 0 0 2155751 0 0 0 0 0
3201126 B 1 BS 1 12/02/2018 13/02/2018 17/02/1984 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6153100 0 2 0 0 0 WIDYA SETIYANTI
0001078199965 3;JKN DR RIZKI; 5.2.1.201804062320 4 148537
1#0##0#0#0.0#2018-05-16 10:31:51#0#12:00:00#12:00:00#12:00:00 2
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1276237 0 0 0 0 3481039 0 0 0 0 0
3201126 B 1 BS 1 06/02/2018 14/02/2018 10/02/1965 0 2
1 J18.9;E11.2;I11.9;K30 87.44;93.94 - - None None None None
J-4-16-II None None None None None None SIMPLE PNEUMONIA & WHOOPING
COUGH (SEDANG) 7108500 0 0 - 0 - 0 - 0 -
0 7108500 26160778 0 9 0 0 0 IGUSTI AYU MAS
DARYANI D389630 52 19354 DR AZRI NURIZAL SPPD KKV
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15:18:43#0#12:00:00#12:00:00#12:00:00 1 1728b0852f87c4dc408fee49cd7717e1
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12701000 0 0 0 290000 0
3201126 B 2 BS 1 10/02/2018 14/02/2018 10/07/2012 0 1
1 A49.9;J22 93.94 - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 5251405 0 5 0 0 0 ALFATIH RASHDAN D
0001204930822 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
147698 1#0##0#0#0.0#2018-03-01 15:42:56#0#12:00:00#12:00:00#12:00:00
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2017025 0 0 0 0 2894550 0 0 0 0 0
3201126 B 3 BS 1 13/02/2018 14/02/2018 21/08/1968 0 1
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GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
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D365591 49 18073 DR SRI KUN, SPPD 0138R01702180006136
0002209767625 3;JKN YULIA N. MAIWA;15092 5.2.0.201712280730 4
149212 1#0##0#0#0.0#2018-03-01 15:58:33#0#12:00:00#12:00:00#00:00:00
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1272460 0 0 0 0 428047 0 0 0 0 0
3201126 B 2 BS 1 11/02/2018 14/02/2018 29/09/1994 0 2
0 - 0 - 0 - 0 - 0 5984100 22984804
0 4 0 0 0 DINI CHAICER RIANTI D355648 23 8536
DR NINING H, SPOG 0138R01702180004801 0002291441286 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 147847 1#1#vvip#4#17000704#0.0#2018-
03-02 07:51:48#0#12:00:00#12:00:00#12:00:00 1
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4794404 0 0 0 0 1313000 0 0 0 743000
0
3201126 B 1 BS 1 12/02/2018 14/02/2018 08/09/1982 0 2
0 0 - 0 - 0 - 0 - 0 6981500
13327130 0 3 0 0 0 INDRY IKASEPTIA ANGGRENI
D222854 35 12941 DR MAMAN H, SPOG 0138R01702180004891
0001457317091 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147860
1#0##0#0#0.0#2018-03-02 08:01:36#0#12:00:00#12:00:00#12:00:00 1
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2318837 0 0 0 0 871868 0 0 0 406000
0
3201126 B 1 BS 1 10/02/2018 14/02/2018 01/02/2001 0 1
1 A91;A01.0 - - - None None None None A-4-13-III None
4481300 0 0 - 0 - 0 - 0 - 0
4481300 7284994 0 5 0 0 0 MUHAMMAD YAHYA AYYASY
D012697 17 6218 DR TRI LESTARI, SPA 0138R01702180004584
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1#0##0#0#0.0#2018-03-02 08:07:45#0#12:00:00#12:00:00#12:00:00 1
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2168075 0 0 0 0 476588 0 0 0 366000
0
3201126 B 1 BS 1 10/02/2018 14/02/2018 27/07/1947 0 2
1 E11.4;I11.0;G45.9 87.03 - - None None None None G-4-17-III
None None None None None None GANGUAN SARAF KRANIAL DAN PERIFER (BERAT)
10695200 0 0 - 0 - 0 - 0 - 0
10695200 7871880 0 5 0 0 0 ROCHYATI, NY
0000158329359 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147831
1#0##0#0#0.0#2018-03-02 08:16:01#0#12:00:00#12:00:00#12:00:00 1
54dd5fc829f58678754217c70271c1d9 0 0 738220 0 0
3468677 0 0 0 0 3124000 0 0 0 540983
0
3201126 B 1 BS 1 11/02/2018 14/02/2018 08/06/1960 0 2
1 I20.0;E11.6;I11.9;I47.1 - - - None None None None I-4-
6795600 0 0 - 0 - 0 - 0 - 0
6795600 5491572 0 4 0 0 0 SUPIYETI, NY
0000061119753 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147836
1#0##0#0#0.0#2018-03-02 08:19:55#0#12:00:00#12:00:00#12:00:00 1
3108bb0c1df4cc95de32c05162d1f020 0 0 669698 0 0
1312612 0 0 0 0 3483262 0 0 0 26000 0
3201126 B 3 BS 1 09/02/2018 14/02/2018 14/10/2011 0 1
None None None None GANGGUAN PEMBEKUAN DARAH (RINGAN) 4042800 0
0 - 0 - 0 - 0 - 0 4042800 3888899
0 6 0 0 0 AFANDY DWI RAYHAN D389903 6 2310 DR
RASTRA, SPA 0138R01702180004214 0002210086023 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 147353 1#0##0#0#0.0#2018-03-02
08:35:47#0#12:00:00#12:00:00#12:00:00 1 d4d1c668eb30a7bd8b89917df49970d6
0 0 469852 0 0 1542631 0 0 0 0
1596000 0 0 0 280416 0
3201126 B 2 BS 1 08/02/2018 14/02/2018 05/06/1955 0 1
1 I62.0;G81.9 87.03 - - None None None None G-4-13-II None
None None None None None PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK
(SEDANG) 6183900 0 0 - 0 - 0 - 0 - 0
6183900 10710168 0 7 0 0 0 IMAM SUBAGIJO
0002195430873 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 146861
1#0##0#0#0.0#2018-03-02 09:06:49#0#12:00:00#12:00:00#00:00:00 1
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5857822 0 0 0 0 4028165 0 0 0 26000 0
3201126 B 3 BS 1 13/02/2018 14/02/2018 01/05/1967 0 2
1 E14.2;D63.8;A41.9;I10 99.04;38.95;99.17 - - None None None
0 - 0 - 0 19332400 14280141 0 2 0 0
0 RINI D374283 50 18551 DR SRI KUN, SPPD 0138R01702180005641
0000510895899 3;JKN DR RIZKI; 5.2.0.201712280730 4 148584
30#0##0#0#0.0#2018-03-02 09:41:09#0#12:00:00#12:00:00#12:00:00 1
186a1ff3f448e94d7b8385f96df3f157 0 0 2000000 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 12/02/2018 14/02/2018 28/08/1978 0 2
0 0 - 0 - 0 - 0 - 0 11569900
13821774 0 3 0 0 0 DEWI RATNA YUNIAWATI D033647
TANTIYO S;16137 5.2.0.201712280730 4 147883 1#0##0#0#0.0#2018-
03-02 10:40:21#0#12:00:00#12:00:00#12:00:00 1
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2666886 0 0 0 0 8046228 0 0 0 0 0
3201126 B 1 BS 1 13/02/2018 14/02/2018 26/11/2013 0 1
None None None None PROSEDUR PADA SKROTUM DAN PROSTAT KOMPLEK-MODERAT
(RINGAN) 12096300 0 0 - 0 - 0 - 0 - 0
12096300 11960253 0 2 0 0 0 ASYAM ASH-SHIDDIQ
ABDILLAH D284298 4 1540 DR CATUR SUZANTARA 0138R01702180005709
0001969802987 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148782
1#0##0#0#0.0#2018-03-02 10:41:27#0#12:00:00#12:00:00#12:00:00 1
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1078680 0 0 0 0 7304646 0 0 0 69000 0
3201126 B 1 BS 1 13/02/2018 14/02/2018 27/07/2011 0 2
1 L92.3 27.43 - - None None None None U-1-30-I None None
None None None None PROSEDUR MULUT (RINGAN) 7431700 0 0 -
0 - 0 - 0 - 0 7431700 9151898 0 2
0 0 0 MALIKA KIREY ANINDITA D212267 6 2393 DR CATUR S,
SPB 0138R01702180005682 0000207473466 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 148731 1#0##0#0#0.0#2018-03-02
10:42:29#0#12:00:00#12:00:00#12:00:00 1 212bdd23d9b3b946ac5ddb1b7e5a45d1
0 0 2155193 0 0 494483 0 0 0 0
6467722 0 0 0 34500 0
3201126 B 1 BS 1 05/02/2018 14/02/2018 28/11/1938 0 2
1 I63.9;G81.9;A49.9;E87.1 87.03 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 12944263 0 10 0 0 0 TIMOUR BR ARUAN
0000061053265 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 145035
1#0##0#0#0.0#2018-03-02 10:44:53#0#12:00:00#12:00:00#00:00:00 1
2221724142e19a57fd00f6f910c24c64 0 0 1117062 0 0
3925380 0 0 0 0 7901821 0 0 0 0 0
3201126 B 1 BS 1 11/02/2018 14/02/2018 05/12/1967 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4465438 0 4 0 0 0 JUSMIARTI D390113
TANTIYO S;16137 5.2.0.201712280730 4 147843 1#0##0#0#0.0#2018-
03-02 11:05:04#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 3442131 0 0 0 0 0
3201126 B 1 BS 1 11/02/2018 14/02/2018 29/11/2012 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3376330 0 4 0 0 0 ALIFIANDRA AQILA PUTRA
D390136 5 1900 DR AWIDIYA, SPA 0138R01702180004846
0001606600012 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147855
1#0##0#0#0.0#2018-03-02 11:15:46#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 2589881 0 0 0 0 0
3201126 B 2 BS 1 10/02/2018 14/02/2018 18/10/2015 0 1
0 0 - 0 - 0 - 0 - 0 3167100
4133474 0 5 0 0 0 IMANUEL AFFERA SETIAWAN D313104
TANTIYO S;16137 5.2.0.201712280730 4 147828 1#0##0#0#0.0#2018-
03-02 11:17:36#0#12:00:00#12:00:00#12:00:00 1
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1519035 0 0 0 0 2316414 0 0 0 0 0
3201126 B 3 BS 1 12/02/2018 14/02/2018 17/01/1995 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2374946 0 3 0 0 0 AISYAH NURAZIZAH
0001194593714 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148534
1#0##0#0#0.0#2018-03-02 11:19:05#0#12:00:00#12:00:00#12:00:00 1
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1082063 0 0 0 0 883870 0 0 0 0 0
3201126 B 2 BS 1 11/02/2018 14/02/2018 06/02/1953 0 1
1 J15.9;Z03.0 90.59;89.52;87.49 - - None None None None J-4-
(RINGAN) 4335900 0 0 - 0 - 0 - 0 - 0
4335900 6867710 0 4 0 0 0 NAAN B.IMANG
0002298955241 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147839
1#0##0#0#0.0#2018-03-02 11:32:06#0#12:00:00#12:00:00#12:00:00 1
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2733190 0 0 0 0 3691289 0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 14/02/2018 25/12/1961 0 2
1 E16.2;A15.2;E10.6;K30 87.49;89.52;90.59 - - None None None
0 - 0 - 0 4894400 6479050 0 6 0 0
0 SRI HENDRANI D389928 56 20500 DR ARU, SPPD
0138R01702180004124 0002282991221 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 147339 1#0##0#0#0.0#2018-03-02
11:35:03#0#12:00:00#12:00:00#12:00:00 1 c3cad236624a13c74f8d247527d07a81
0 0 572281 0 0 3860906 0 0 0 0
2045863 0 0 0 0 0
3201126 B 1 BS 1 13/02/2018 14/02/2018 06/01/1953 0 2
1 S42.00;E10.6 79.39;90.59;87.49 - - None None None None
M-1-60-II None None None None None None PROSEDUR SISTEM
MUSKULOSKLETAL & JARINGAN PENGHUBUNG LAIN-LAIN (SEDANG) 14058300 0 0
- 0 - 0 - 0 - 0 14058300 19768551 0
2 0 0 0 SUDARSINAH D231851 65 23779 DR BENNY H
TUMBELAKA 0138R01702180006069 0000049151259 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149201 1#0##0#0#0.0#2018-03-02
11:38:42#0#12:00:00#12:00:00#12:00:00 1 d9da8df32a14443842a6137627871e24
0 0 6145490 0 0 2656261 0 0 0 0
10693800 0 0 0 273000 0
3201126 B 3 BS 1 13/02/2018 14/02/2018 02/02/1965 0 1
1 I63.9;K30;G81.9 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 2259793 0 2 0 0 0 FERI ENRI
0001719849205 3;JKN DR RIZKI; 5.2.0.201712280730 4 149210
1#0##0#0#0.0#2018-03-02 14:26:03#0#12:00:00#02:30:00#12:00:00 2
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1371777 0 0 0 0 436837 0 0 0 0 0
3201126 B 3 BS 1 12/02/2018 14/02/2018 01/09/1953 0 1
- 0 45079800 57891845 0 3 0 0 0 YADI SALEH
0000512763952 3;JKN DR RIZKI; 5.2.0.201712280730 4 147948
1#0##0#0#0.0#2018-03-02 15:05:41#0#12:00:00#12:00:00#12:00:00 1
d35b3a784e8ca1d156eb893004999b12 0 14520800 0 0 0
34126045 0 0 0 0 1745000 0 0 0 0
7500000
3201126 B 3 BS 1 12/02/2018 14/02/2018 01/02/1990 0 2
None None None None None GANGGUAN SISTEM PEMBULUH DARAH LAIN-LAIN
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 3249330 0 3 0 0 0 RATIH NURAINI
0001014228112 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147859
1#0##0#0#0.0#2018-03-02 18:16:55#0#12:00:00#12:00:00#00:00:00 1
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1501887 0 0 0 0 1027573 0 0 0 0 0
3201126 B 1 BS 1 12/02/2018 14/02/2018 12/02/2018 2870 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2520191 0 3 0 0 0 BAYI NY. INDRY IKASEPTIA
ANGGRENI d390173 0 0 DR DYAH HARINI, SPA 0138R01702180006264
0002429304006 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149246
1#0##0#0#0.0#2018-03-02 18:21:42#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1415872 0 0 0 0 0
3201126 B 2 BS 1 13/02/2018 14/02/2018 04/01/1973 0 1
0 0 - 0 - 0 - 0 - 0 2783600
5686705 0 2 0 0 0 ARISMAN D370277 45 16476
S;16137 5.2.0.201712280730 4 149202 1#0##0#0#0.0#2018-03-02
18:41:35#0#12:00:00#12:00:00#00:00:00 1 3091dab92a0f796bbdd114fd5012d374
0 0 842408 0 0 1161270 0 0 0 0
2003027 0 0 0 0 1680000
3201126 B 1 BS 1 13/02/2018 14/02/2018 15/10/1959 0 2
0 - 0 - 0 - 0 - 0 4136800 5930872
0 2 0 0 0 KARMINI D352349 58 21306 DR ZULFAN,
5.2.0.201712280730 4 149205 1#0##0#0#0.0#2018-03-02
18:48:46#0#12:00:00#12:00:00#00:00:00 1 2f975c8ef0035b500fd68592b5e25dbe
0 0 1274304 0 0 914567 0 0 0 0
2027501 0 0 0 34500 1680000
3201126 B 1 BS 1 12/02/2018 14/02/2018 03/10/1985 0 2
1 S72.40 79.35;78.75 - - None None None None M-1-20-I
None None None None None None PROSEDUR PAHA DAN SENDI PANGGUL (RINGAN)
17301400 0 0 - 0 - 0 - 0 - 0
17301400 21183446 0 3 0 0 0 NUR IKASARI D282086
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148533
27#0##0#0#0.0#2018-03-02 19:09:55#0#12:00:00#12:00:00#12:00:00 1
bf456eee7b11d872eeffe06a528031bf 0 0 8142406 0 0
4312540 0 0 0 0 8578500 0 0 0 149996
0
3201126 B 1 BS 1 13/02/2018 14/02/2018 03/04/2016 0 1
1 Q53.2 62.5 - - None None None None V-1-12-I None None
(RINGAN) 12096300 0 0 - 0 - 0 - 0 - 0
12096300 12178568 0 2 0 0 0 KHAIRY YUSUF AQLAN
0001733414837 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148851
1#0##0#0#0.0#2018-03-02 19:59:48#0#12:00:00#12:00:00#12:00:00 1
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1156712 0 0 0 0 7368929 0 0 0 145000
0
3201126 B 3 BS 1 11/02/2018 14/02/2018 12/06/2017 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3137455 0 4 0 0 0 ARKHAN WILDAN PRATAMA
d390116 0 244 DR AWIDIYA, SPA 0138R01702180005291
0002257867023 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148433
1#0##0#0#0.0#2018-03-02 20:11:05#0#12:00:00#12:00:00#12:00:00 1
3a78e6cb2c4a8393be54af8afb818b10 0 0 378188 0 0
1476013 0 0 0 0 1283254 0 0 0 0 0
3201126 B 2 BS 1 13/02/2018 14/02/2018 06/04/1980 0 2
- 0 - 0 - 0 - 0 2601900 3031097 0
2 0 0 0 PRIATMI PASKARINA D043658 37 13827 DR AFRA
FONDA SPOG 0138R01702180005695 0001623402999 3;JKN DR RIZKI;
5.2.0.201712280730 4 148757 1#0##0#0#0.0#2018-03-02
20:32:06#0#12:00:00#12:00:00#00:00:00 1 b2d61f8e1835766d16855325f8191967
0 0 537171 0 0 985630 0 0 0 0
1252296 0 0 0 256000 0
3201126 B 3 BS 1 13/02/2018 14/02/2018 14/04/1984 0 2
INTERNAL (RINGAN) 4315600 0 0 - 0 - 0 - 0 -
0 4315600 6368002 0 2 0 0 0 DWI ASTUTI
0138R01702180005780 0001739838093 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 148922 1#0##0#0#0.0#2018-03-02
21:09:45#0#12:00:00#12:00:00#12:00:00 1 c5418b52b0663d296ff0db0b71a047f0
0 0 1208368 0 0 1419655 0 0 0 0
3614979 0 0 0 125000 0
3201126 B 2 BS 1 13/02/2018 14/02/2018 04/03/1968 0 1
0 0 - 0 - 0 - 0 - 0 7609600
19331725 0 2 0 0 0 TUKIJO D389282 49 18243
DR RIZKI; 5.2.0.201712280730 4 148539 1#0##0#0#0.0#2018-03-05
09:53:24#0#12:00:00#12:00:00#12:00:00 1 116641ee11c9f95791137cbe2cbb3d87
0 10969960 0 0 0 4186765 0 0 0 0
2106000 0 0 0 69000 2000000
3201126 B 2 BS 1 13/02/2018 14/02/2018 05/06/1939 0 2
14653000 0 0 - 0 - 0 - 0 - 0
14653000 24961430 0 2 1 1 0 ARSYAH D390271
0000207108009 3;JKN DR RIZKI; 5.2.0.201712280730 4 149207
1#0##0#0#0.0#2018-03-06 09:37:17#0#12:00:00#12:00:00#12:00:00 1
035caed6e0177793372e27cb8fcda9d6 0 5362540 492590 0 0
7039300 0 0 0 0 7324000 0 0 0 2743000
2000000
3201126 B 1 BS 1 13/02/2018 14/02/2018 18/03/1967 0 2
1 E11.2;D63.8;I13.1 99.04 - - None None None None N-4-16-II
LAIN (SEDANG) 7385300 0 0 - 0 - 0 - 0 -
0 7385300 5725387 0 2 0 0 0 SITI NURAINI
0000061127302 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148689
1#0##0#0#0.0#2018-03-14 08:46:28#0#12:00:00#12:00:00#12:00:00 1
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2451339 0 0 0 0 1962558 0 0 0 0 0
3201126 B 2 BS 1 11/02/2018 14/02/2018 11/02/2018 3680 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2893827 0 4 0 0 0 BAYI NY DINI CHAICER
RIANTI D390149 0 0 DR DYAH HARINI, SPA 0138R01702180005298
0002428973458 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148446
1#0##0#0#0.0#2018-03-19 10:07:08#0#12:00:00#12:00:00#12:00:00 3
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0 0 0 0 1855316 0 0 0 0 0
3201126 B 3 BS 1 10/02/2018 14/02/2018 09/03/1961 0 1
1 I64;G81.9;E75.6 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 5321844 0
5 0 0 0 NAMAN D390004 56 20792 DR MAYSAM I., SPS
0138R01702180004572 0001284719218 3;JKN DR RIZKI; 5.2.0.201712280730
4 147751 1#0##0#0#0.0#2018-03-29
11:58:46#0#12:00:00#12:00:00#12:00:00 2 865cab6b9952a22d47b2b0abdae77691
0 0 743951 0 0 2888735 0 0 0 0
1689158 0 0 0 0 0
3201126 B 1 BS 1 13/02/2018 14/02/2018 03/03/2002 0 1
0 0 - 0 - 0 - 0 - 0 3978000
15 5826 DR NIA KURNIATI, SPA 0138R01702180006101 0001620848485
3;JKN DR RIZKI; 5.2.1.201804062320 4 149206 1#0##0#0#0.0#2018-
05-16 09:31:43#0#12:00:00#12:00:00#12:00:00 2
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14511979 0 0 0 0 1927395 0 0 0 0 0
3201126 B 2 BS 1 13/02/2018 14/02/2018 06/02/2018 0 2
0 - 0 - 0 - 0 - 0 5045200 2185832
0 2 0 0 0 BAYI NY SRI LESTARI d389706 0 7
DR SUPROHAITA SPA(K) 0138R01702180006030 0002419327203 3;JKN DR
RIZKI; 5.2.1.201804062320 4 149199 1#0##0#0#0.0#2018-05-16
10:01:59#0#12:00:00#12:00:00#12:00:00 2 35125ee5209d8f5c5f9d1d7595c4f874
0 0 454068 0 0 162266 0 0 0 0
1229498 0 0 0 0 340000
3201126 B 2 BS 1 12/02/2018 14/02/2018 25/07/1958 0 1
1 N18.5;D63.8;J90;J18.0 38.95;99.04 - - None None None None
- 0 - 0 23198900 15107999 0 3 0 0 0
ROKIB D348894 59 21752 DR SRI KUNMARTINI, SPPD 0138R01702180005221
0001125532642 3;JKN DR RIZKI; 5.2.1.201804062320 4 148336
1#0##0#0#0.0#2018-05-16 10:02:39#0#12:00:00#12:00:00#00:00:00 2
06c1e570607f2fe1889a22e98200e3bf 0 0 3153245 0 0
4750030 0 0 0 0 7204724 0 0 0 0 0
3201126 B 3 BS 1 13/02/2018 14/02/2018 19/05/1967 0 1
None None None None CARDIAC ARREST, TIDAK DIKETAHUI (RINGAN) 3333000
0 0 - 0 - 0 - 0 - 0 3333000
2157765 0 2 0 0 0 TABRONI d390334 50 18533
DR WIDHI DEWANTA K AJI 0138R01702180005980 0001153929879 3;JKN DR
RIZKI; 5.2.1.201804062320 4 149195 1#0##0#0#0.0#2018-05-16
10:06:21#0#12:00:00#12:00:00#12:00:00 2 30ed33af02223239fda5fa533e53e054
0 0 352341 0 0 1375262 0 0 0 0 430162
0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 14/02/2018 10/12/1970 0 2
1 N30.9;D63.8;R10.4 99.04;90.59;88.76;89.52;87.03 - - None None
None None N-4-12-II None None None None None None INFEKSI GINJAL DAN
SALURAN URIN (SEDANG) 4206000 0 0 - 0 - 0 - 0
- 0 4206000 5976375 0 6 0 0 0 LINDA
SITOMPUL D097316 47 17228 DR ARU, SPPD 0138R01702180004348
0001740115372 3;JKN DR RIZKI; 5.2.1.201804062320 4 147600
1#0##0#0#0.0#2018-05-16 10:27:13#0#12:00:00#12:00:00#00:00:00 4
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3464609 0 0 0 0 1994978 0 0 0 0 0
3201126 B 1 BS 1 10/02/2018 14/02/2018 17/02/1949 0 1
1 A49.9;E11.9;K29.7 90.59;87.49 - - None None None None A-4-
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 10661118 0 5 0 0 0 TIMAN
D330890 68 25195 DR ARU, SPPD 0138R01702180004487
0000060731605 3;JKN DR RIZKI; 5.2.1.201804062320 4 147696
1#1#vvip#5#7484918#0.0#2018-05-16 11:08:44#0#12:00:00#12:00:00#00:00:00
2 ae12d6b1a552f1c22c24b7f3d86292f4 0 6375000 825348 0
0 2737314 0 0 0 0 697456 0 0 0 26000
0
3201126 B 1 BS 1 08/02/2018 14/02/2018 12/11/1936 0 2
1 E10.1;I50.1;K29.6;A49.9;L40.8;M19.84;I51.7 90.59;89.52;87.49 -
- None None None None E-4-10-II None None None None None None
PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK (SEDANG) 6852200
0 0 - 0 - 0 - 0 - 0 6852200
11551939 0 7 0 0 0 TIERNA PANGGABEAN,NY D239920
81 29673 DR ARU, SPPD 0138R01702180003627 0000060558344 3;JKN
DR RIZKI; 5.2.2.201806040537 4 146702 1#0##0#0#0.0#2018-08-16
09:04:18#0#12:00:00#12:00:00#00:00:00 3 460b827a2b518a3eaf874a81ccc2a6b8
0 0 895120 0 0 4408085 0 0 0 0
6248734 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 14/02/2018 29/09/1955 0 2
1 K21.0;I49.3 - - - None None None None K-4-12-III None
0 - 0 - 0 - 0 - 0 6781600 1602456
0 1 0 0 0 LIE WINDY RAMLI D296125 62 22784 DR
DICKI PRATAMA 0138R01702180006152 0001797652124 3;JKN DR RIZKI;
5.2.1.201804062320 4 149218 1#0##0#0#0.0#2018-08-16
10:05:36#0#12:00:00#12:00:00#00:00:00 3 66eec040f4baac3e241ba8b4c2c43317
0 0 610344 0 0 598278 0 0 0 0 367834
0 0 0 26000 0
3201126 B 1 BS 1 13/02/2018 14/02/2018 08/09/1957 0 1
(RINGAN) 11257400 0 0 - 0 - 0 - 0 - 0
11257400 14971875 0 2 0 0 0 SUPARDIYONO D384163
3;JKN DR RIZKI; 5.2.2.201806040537 4 148541 1#0##0#0#0.0#2018-
09-06 17:17:07#0#12:00:00#12:00:00#12:00:00 3
9d9ec6400cdbf185f57bba5d4cd426e2 0 6580000 6392688 0 0
874719 0 0 0 0 1124468 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 14/02/2018 01/04/1954 0 1
1 N18.5;E87.7 - - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 1239714 0 1 0 0 0 AMBAR YANTO D387886
DR RIZKI; 5.2.2.201806040537 4 149215 1#0##0#0#0.0#2018-09-29
10:59:24#0#12:00:00#12:00:00#12:00:00 2 4891fb122a96a746f9358a0eeee5527c
0 0 251865 0 263000 617746 0 0 0 0
81103 0 0 26000 0 0
3201126 B 3 BS 1 13/02/2018 14/02/2018 02/05/2016 0 2
1 E87.6;K56.0 - - - None None None None E-4-11-II None
4504900 0 0 - 0 - 0 - 0 - 0
4504900 19902729 0 2 1 2 0 NADINA ILMI FADILAH
0002041116884 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 149213
1#0##0#0#0.0#2018-10-06 10:25:52#0#12:00:00#12:00:00#12:00:00 1
d4300846496a6017375a2680cd5d5b6b 0 0 1278528 0 1236000
9079201 0 0 0 0 5290000 0 0 0 3019000
0
3201126 B 2 BS 1 13/02/2018 15/02/2018 07/08/1991 0 2
1 L72.9 83.39 - - None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 6397900 13362067
0 3 0 0 0 SETIYANI D390222 26 9687 DR H. H
PUAR, SPB 0138R01702180006092 0001463981973 3;JKN DR RIZKI;
5.2.0.201712280730 4 149203 1#1#kelas_1#3#1066300#0.0#2018-02-
27 09:17:29#1#12:00:00#12:00:00#12:00:00 1 d9bdba061c183bedc7917d2e3560c38c
0 0 5306310 0 0 2025488 0 0 0 0
5995769 0 0 0 34500 0
3201126 B 3 BS 1 14/02/2018 15/02/2018 18/06/1952 0 2
4 I21.2;E11.9;I50.0 89.52;99.60 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 7219300
8107774 0 2 0 0 0 SITI ZAHARA, NY D390420 65
23982 DR RICO ADITYA 0138R01702180006710 0000060992302 3;JKN DR
RIZKI; 5.2.0.201712280730 4 149866 1#0##0#0#0.0#2018-03-02
11:07:50#0#14:15:00#03:15:00#12:00:00 1 c493057fea2f9c83c1ba238f694c971a
0 0 850737 0 0 5366622 0 0 0 0 851415
0 0 0 0 1039000
3201126 B 3 BS 1 14/02/2018 15/02/2018 02/03/1964 0 1
- 0 4132100 4467489 0 2 0 0 0 ROMLI TN
0001743644902 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149856
1#0##0#0#0.0#2018-03-02 12:38:32#0#12:00:00#12:00:00#00:00:00 1
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2163584 0 0 0 0 1932016 0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 15/02/2018 31/12/1965 0 2
1 K29.7;R07.4 - - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 2319600
2064650 0 1 0 0 0 SUMIRAH D351800 52 19039
DR NIKEN PRABHA DUHITA 0138R01702180006741 0001770808015 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 149954 1#0##0#0#0.0#2018-
03-02 12:56:08#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 442071 0 0 0 418000 0
3201126 B 3 BS 1 15/02/2018 15/02/2018 18/10/2017 0 1
1 J18.0;E45 87.44 - - None None None None J-4-16-III None
6419700 0 0 - 0 - 0 - 0 - 0
6419700 3429532 0 1 0 0 0 RIFKI ADITYA
0002328238236 3;JKN DR RIZKI; 5.2.0.201712280730 4 151119
1#0##0#0#0.0#2018-03-02 14:47:44#0#12:00:00#12:00:00#12:00:00 1
73f192ef08e52b9f064868e3363b2df2 0 0 577773 0 0
2338397 0 0 0 0 513362 0 0 0 0 0
3201126 B 3 BS 1 10/02/2018 15/02/2018 09/01/1966 0 1
- 0 36446400 65620412 0 6 1 3 0 JANUARIUS
TARIGAN D387062 52 19025 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180004605 0002058843071 3;JKN DR RIZKI; 5.2.0.201712280730
4 147794 1#0##0#0#0.0#2018-03-02
15:17:24#0#12:00:00#12:00:00#12:00:00 1 56164f716907882ddbd8de1e07fffd04
0 14520800 404900 0 0 35476712 0 0 0 0
4364000 0 0 0 870000 9984000
3201126 B 3 BS 1 15/02/2018 15/02/2018 05/03/1948 0 1
None None None None None INFARK MYOKARD AKUT (SEDANG) 7219300 0
0 - 0 - 0 - 0 - 0 7219300 2716444
0 1 0 0 0 ZABIDIN MUCHID d019649 69 25549 DR
NIKEN PRABHA DUHITA 0138R01702180006891 0001733260757 3;JKN DR RIZKI;
5.2.0.201712280730 4 150020 1#0##0#0#0.0#2018-03-02
17:57:29#0#12:00:00#12:00:00#12:00:00 1 035d975671023f97a2db2c96c6d94a14
0 0 936171 0 0 877562 0 0 0 0 484711
0 0 0 418000 0
3201126 B 3 BS 1 09/02/2018 15/02/2018 25/05/1933 0 2
1 I11.0;J18.0 - - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 4973600 5152924
0 7 0 0 0 OEY MEI HOA D364641 84 30941 DR BAMBANG
DWIPUTRA SPJP 0138R01702180004279 0001725624911 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 147455 1#0##0#0#0.0#2018-03-02
18:34:08#0#12:00:00#12:00:00#00:00:00 1 b8b03c312ebee4b9a6fe48427b482f79
0 0 866978 0 0 2081839 0 0 0 0
2204107 0 0 0 0 0
3201126 B 1 BS 1 13/02/2018 15/02/2018 09/11/1973 0 1
12140800 0 0 - 0 - 0 - 0 - 0
12140800 18967343 0 3 0 0 0 BUDI HARTONO
0002254297599 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149208
1#0##0#0#0.0#2018-03-02 18:40:20#0#12:00:00#12:00:00#12:00:00 1
52a9792647034d44d0f75089a88537ed 0 6833600 6645832 0 0
3726911 0 0 0 0 1286000 0 0 0 475000
0
3201126 B 2 BS 1 11/02/2018 15/02/2018 09/03/2015 0 1
1 A09.9;K56.1 - - - None None None None K-4-17-II None
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 4178468 0 5 0 0 0 CALON BAYI NY DIAN
RESTINOVIKA D390148 2 1070 DR RASTRA, SPA 0138R01702180004873
0001832742246 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147858
1#0##0#0#0.0#2018-03-02 18:47:46#0#12:00:00#12:00:00#12:00:00 1
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1567575 0 0 0 0 2319358 0 0 0 0 0
3201126 B 2 BS 1 11/02/2018 15/02/2018 21/09/2006 0 1
1 K30;A37.9 93.94 - - None None None None K-4-18-II None
None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
2941900 0 0 - 0 - 0 - 0 - 0
2941900 4418390 0 5 0 0 0 CEVIN JORDAN NENDISSA
D228432 11 4161 DR AWIDIYA, SPA 0138R01702180004735
0002327420992 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147837
1#0##0#0#0.0#2018-03-02 18:54:07#0#12:00:00#12:00:00#12:00:00 1
662b1ab86734e6dae752725755097755 0 0 238535 0 0
1339801 0 0 0 0 2840054 0 0 0 0 0
3201126 B 1 BS 1 12/02/2018 15/02/2018 11/07/1960 0 1
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 6551357 0 4 0 0 0 SUDIRJA D308581
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 148535
1#0##0#0#0.0#2018-03-02 19:11:08#0#12:00:00#12:00:00#12:00:00 1
4d2aa10605e9de7c512b1ec92fd5e07e 0 0 1020330 0 0
2297934 0 0 0 0 3233093 0 0 0 0 0
3201126 B 1 BS 1 14/02/2018 15/02/2018 03/12/1941 0 1
- 0 58821400 61018130 0 2 0 0 0 PETRUS PANDI
BENGKAL D383291 76 27832 DR AZRI NURIZAL SPPD KKV
0138R01702180006184 0001293050867 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149220 1#0##0#0#0.0#2018-03-02
19:37:44#0#12:00:00#12:00:00#12:00:00 1 e802e162a8388d3377d4823297392136
0 0 9619120 0 0 32492010 0 0 0 0
11338000 0 0 0 0 7569000
3201126 B 1 BS 1 14/02/2018 15/02/2018 03/07/1982 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 5779690 0 2 0 0 0 YULIANI D390350
35 13010 DR MAMAN HILMAN 0138R01702180006708 0001652418022 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 149865 1#0##0#0#0.0#2018-
03-02 19:53:39#0#12:00:00#12:00:00#12:00:00 1
cbd36c53e7d7f4461fc2733e7038f29e 0 0 1131824 0 0 993255
0 0 0 0 3504611 0 0 0 150000 0
3201126 B 2 BS 1 13/02/2018 15/02/2018 29/11/1999 0 2
1 M17.9 - - - None None None None M-4-18-I None None
None None None None PENYAKIT TULANG DAN SENDI LAIN-LAIN (RINGAN)
3344900 0 0 - 0 - 0 - 0 - 0
3344900 3124413 0 3 0 0 0 IRENE ANGLE HORHORUW
0001638585325 3;JKN DR RIZKI; 5.2.0.201712280730 4 149209
1#0##0#0#0.0#2018-03-02 19:56:48#0#12:00:00#12:00:00#00:00:00 1
c1f58b65587a243a7d8e43375508bcc1 0 0 412873 0 0
1471139 0 0 0 0 1240401 0 0 0 0 0
3201126 B 2 BS 1 12/02/2018 15/02/2018 25/08/1985 0 2
None None None None None CHOLESISTEKTOMI TANPA LAPAROSKOPIK (RINGAN)
8447200 0 0 - 0 - 0 - 0 - 0
8447200 12132396 0 4 0 0 0 INDRAWATI D388666
3;JKN DR RIZKI; 5.2.0.201712280730 4 147998 1#0##0#0#0.0#2018-
03-02 20:10:53#0#12:00:00#12:00:00#12:00:00 1
655ad5a23ad22d66ac86737fc46f9c0d 0 6446316 84471 0 0
3121900 0 0 0 0 2479709 0 0 0 0 0
3201126 B 2 BS 1 14/02/2018 15/02/2018 29/03/2011 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2363618 0 2 0 0 0 NANDYA NAFISHA YAHYA
0001633583283 3;JKN DR RIZKI; 5.2.0.201712280730 4 149214
1#0##0#0#0.0#2018-03-02 20:12:47#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 14/02/2018 15/02/2018 29/06/2012 0 1
LAIN (RINGAN) 3553800 0 0 - 0 - 0 - 0 -
0 3553800 7430049 0 2 0 0 0 ADRIANSYAH RIZAL P
0001187711021 3;JKN DR RIZKI; 5.2.0.201712280730 4 149864
1#0##0#0#0.0#2018-03-02 20:17:45#0#12:00:00#12:00:00#12:00:00 1
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1507694 0 0 0 0 1174391 0 0 0 0 0
3201126 B 3 BS 1 13/02/2018 15/02/2018 13/07/1950 0 1
1 I87.2;N18.5;D63.8 88.40;39.50 - - None None None None I-1-
(SEDANG) 19193800 0 0 - 0 - 0 - 0 - 0
19193800 26511963 0 3 0 0 0 IGNATIUS ANTONO ADJI
0138R01702180005795 0001463354684 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 148946 1#0##0#0#0.0#2018-03-02
20:21:55#0#12:00:00#12:00:00#12:00:00 1 ab2eb4d8af879ec71bad94a8adf5f5dd
0 3235501 4627536 0 0 0 0 0 0 0
1276000 0 0 17303926 69000 0
3201126 B 3 BS 1 14/02/2018 15/02/2018 15/07/1963 0 1
1 N18.5;J91;I50.1;D63.8 99.04;89.52;90.59;87.49;38.95 - - None
None None None N-1-12-III None None None None None None MEMBUAT
BARU, MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (BERAT) 19332400 0 0 -
0 - 0 - 0 - 0 19332400 14853034 0 2
0 0 0 DASUKI D390413 54 19938 SRI KUNMARTINI.DR,SPPD
0138R01702180006655 0001790812269 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149855 1#0##0#0#0.0#2018-03-02
20:31:49#0#12:00:00#12:00:00#12:00:00 1 cc967f122bcc5ef0eac5504e96861735
0 0 5659396 0 0 5100944 0 0 0 0
4023694 0 0 0 0 69000
3201126 B 3 BS 1 13/02/2018 15/02/2018 01/05/1966 0 2
1 I87.2;I73.8;N18.5;D63.8 88.40;39.50 - - None None None None
0 - 0 19193800 23761805 0 3 0 0 0 ENOK
SURYATI D390283 51 18916 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01702180005776 0000380012376 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 148902 1#0##0#0#0.0#2018-03-02
20:43:31#0#12:00:00#12:00:00#12:00:00 1 0cad3697ced2204c56891f229ecd4b7a
0 3235500 4030698 0 0 0 0 0 0 0
1226000 0 0 0 15269607 0
3201126 B 2 BS 1 14/02/2018 15/02/2018 21/10/1969 0 1
- 0 51950600 60747720 0 2 0 0 0 JABIR AL
FATAH D384400 48 17648 DR AGOES KOOSHARTORO SPPD-KKV 0138R01702180006362
0001639831408 3;JKN DR RIZKI; 5.2.0.201712280730 4 149635
1#0##0#0#0.0#2018-03-02 20:44:19#0#12:00:00#12:00:00#12:00:00 1
b3e3f63c9335735cf6db6fbe2217920a 0 16400960 0 0 0
34671760 0 0 0 0 2106000 0 0 0 69000
7500000
3201126 B 2 BS 1 14/02/2018 15/02/2018 24/04/1964 0 2
(RINGAN) 18436700 0 0 - 0 - 0 - 0 - 0
18436700 27650050 0 2 0 0 0 MIAH NAINGGOLAN
0138R01702180006155 0001383672172 3;JKN DR RIZKI; 5.2.0.201712280730
4 149219 1#0##0#0#0.0#2018-03-02
20:51:35#0#12:00:00#12:00:00#12:00:00 1 888dde1265f5916d9ecc382045a3a48d
0 8445925 0 0 0 16798125 0 0 0 0
2406000 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 15/02/2018 04/04/1959 0 1
1 N18.5;E10.2;D63.8 39.27;99.17;99.04 - - None None None None
- 0 - 0 8908800 11656648 0 2 1 0 0
NUROHIM D389257 58 21501 DR AZRI NURIZAL SPPD KKV
0138R01702180006579 0001740522418 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149840 1#0##0#0#0.0#2018-03-02
21:00:32#0#12:00:00#12:00:00#12:00:00 1 4033b009d4a5345daaf3cde95c42c93c
0 0 2636552 0 0 4493712 0 0 0 0
4381384 0 0 0 145000 0
3201126 B 3 BS 1 14/02/2018 15/02/2018 15/01/1959 0 1
- 0 8908800 10570338 0 2 0 0 0 SAIMAN
0001459059175 3;JKN irene; 5.2.0.201712280730 4 149860
1#0##0#0#0.0#2018-03-06 09:13:11#0#12:00:00#12:00:00#12:00:00 2
af67077e4788a50261eb9577bb5c7508 0 0 2636552 0 0
3941269 0 0 0 0 3847517 0 0 0 145000
0
3201126 B 1 BS 1 13/02/2018 15/02/2018 26/05/1989 0 2
10235200 0 0 - 0 - 0 - 0 - 0
10235200 17875063 0 3 0 0 0 IRMA PERMATA SARI
0002072645144 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149158
1#0##0#0#0.0#2018-03-08 08:40:23#0#12:00:00#12:00:00#12:00:00 1
f21f42b78cf0c5bfc707c1422e19f360 0 0 3593208 0 0
2422158 0 0 0 0 11709697 0 0 0 150000
0
3201126 B 1 BS 1 10/02/2018 15/02/2018 31/12/1938 0 2
None None None None None None PROSEDUR ANGGOTA TUBUH ATAS (BERAT)
32452500 0 0 - 0 - 0 - 0 - 0
32452500 23554770 0 6 0 0 0 SUHARTI,HJ D195978
79 28896 DR BENNY H T, SPOT 0138R01702180004703 0000060975584
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147829
1#0##0#0#0.0#2018-03-19 09:50:51#0#12:00:00#12:00:00#00:00:00 2
0ba1df4e74d80249ca393be8bfedbf70 0 0 5418548 0 908000
4115922 0 0 0 0 1200000 0 0 11836300 76000
0
3201126 B 1 BS 1 14/02/2018 15/02/2018 14/11/1963 0 1
- 0 - 0 12472300 19674450 0 2 0 0 0
MASRU D389549 54 19816 DR SRI KUNMARTINI, SPPD 0138R01702180006682
0000023204417 3;JKN DR RIZKI; 5.2.0.201712280730 4 149858
1#0##0#0#0.0#2018-03-28 13:38:24#0#12:00:00#12:00:00#12:00:00 2
87f481467f3b63798aca0788c8ffdc9f 0 0 8640643 0 0
3958307 0 0 0 0 7006500 0 0 0 0 69000
3201126 B 2 BS 1 14/02/2018 15/02/2018 14/04/1967 0 2
1 E11.2;I25.0;D63.8;J22 38.95;89.52;99.04;87.44 - - None None
None None N-1-12-II None None None None None None MEMBUAT BARU,
MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (SEDANG) 10690500 0 0 - 0
- 0 - 0 - 0 10690500 16168969 0 2 0
0 0 SUHAERSIH D390411 50 18569 DR SRI KUN, SPPD
0138R01702180006687 0001264059876 3;JKN DR RIZKI; 5.2.0.201712280730
4 149859 1#0##0#0#0.0#2018-03-28
13:46:51#0#12:00:00#12:00:00#12:00:00 2 1d832426324cfccc5559a9ebf8b44c3b
0 8248880 2140901 0 0 3953905 0 0 0 0
1756283 0 0 0 69000 0
3201126 B 1 BS 1 13/02/2018 15/02/2018 08/06/1971 0 2
1 I13.2;J40 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 25080841 0 3 1 0 0 SILVIA
H.C.TIMBULENG D110611 46 17052 SRI KUNMARTINI.DR,SPPD
0138R01702180005745 0001261925897 3;JKN DR RIZKI; 5.2.0.201712280730
4 148848 1#0##0#0#0.0#2018-03-28
14:14:40#0#12:00:00#12:00:00#12:00:00 3 3338038fb26ef5f740277e8439e79176
0 0 7901937 0 0 8627904 0 0 0 0
8115000 0 0 0 0 436000
3201126 B 3 BS 1 14/02/2018 15/02/2018 31/12/1945 0 1
1 N18.5;D63.8;A49.9;I50.0 89.52 - - None None None None N-4-
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3700811 0 2 0 0 0 MAR'IH
D355659 72 26343 DR RICO ADITYA 0138R01702180006728
0001961373993 3;JKN DR RIZKI; 5.2.0.201712280730 4 149870
1#0##0#0#0.0#2018-03-28 14:43:57#0#14:10:00#15:00:00#00:00:00 3
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2622709 0 0 0 0 531109 0 0 0 0 0
3201126 B 3 BS 1 13/02/2018 15/02/2018 05/05/2014 0 2
1 B34.9;B37.9 - - - None None None None A-4-13-II None
2667400 0 0 - 0 - 0 - 0 - 0
2667400 1604143 0 3 0 0 0 ASILA HUMAIRAH ACHMAD
D304446 3 1380 DR AWIDIYA, SPA 0138R01702180006002
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1#0##0#0#0.0#2018-03-28 16:36:56#0#12:00:00#12:00:00#12:00:00 2
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0 0 0 0 833444 0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 15/02/2018 23/03/1981 0 2
1 H81.3;R11 88.76;89.52;90.59 - - None None None None U-4-
0 - 0 - 0 - 0 - 0 1517500 5535160
0 7 0 0 0 IRMA SURYANI D389971 36 13472 DR
ARU, SPPD 0138R01702180004470 0002032086093 3;JKN DR RIZKI;
5.2.1.201804062320 4 147692 1#0##0#0#0.0#2018-05-05
11:29:19#0#12:00:00#12:00:00#12:00:00 2 d8f161b7fe5af9435c07bc9731aba330
0 0 261764 0 0 3307283 0 0 0 0
1966113 0 0 0 0 0
3201126 B 3 BS 1 10/02/2018 15/02/2018 19/07/1965 0 2
1 A01.0;R10.1;H81.1;I10 - - - None None None None A-4-
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 4553124 0 6 0 0 0 DERITA
SIMANULANG D376366 52 19199 DR BETTY DWI L, SPPD 0138R01702180004664
0001743642617 3;JKN DR RIZKI; 5.2.1.201804062320 4 147824
1#0##0#0#0.0#2018-05-05 11:32:21#0#16:38:45#16:38:45#12:00:00 2
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2475992 0 0 0 0 1815368 0 0 0 0 0
3201126 B 3 BS 1 12/02/2018 15/02/2018 09/04/2013 0 2
1 R10.4 88.76 - - None None None None K-4-17-I None None
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2405308 0 4 0 0 0 AULIA NUR SINTA
0001720505024 3;JKN DR RIZKI; 5.2.1.201804062320 4 148944
1#0##0#0#0.0#2018-05-16 09:21:53#0#12:00:00#12:00:00#12:00:00 2
511f64ea33b37c0959891b269cb30d50 0 0 401696 0 0
1031255 0 0 0 0 972357 0 0 0 0 0
3201126 B 2 BS 1 13/02/2018 15/02/2018 07/01/2014 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4867386 0 3 0 0 0 FAIZAN JABAR ABDALA
D265870 4 1498 DR CATUR S, SPB 0138R01702180005737
0001635174268 3;JKN DR RIZKI; 5.2.1.201804062320 4 148819
1#0##0#0#0.0#2018-05-16 09:38:20#0#12:00:00#12:00:00#00:00:00 2
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0 0 0 0 3605427 0 0 0 0 0
3201126 B 1 BS 1 11/02/2018 15/02/2018 15/03/1964 0 1
GINJAL (BERAT) 8508800 0 0 - 0 - 0 - 0 -
0 8508800 7935070 0 5 0 0 0 ISMAJAYA
D378634 53 19691 DR SRI KUN 0138R01702180004811 0000059574148
3;JKN DR RIZKI; 5.2.1.201804062320 4 147848 1#0##0#0#0.0#2018-
05-16 09:41:41#0#12:00:00#12:00:00#12:00:00 2
47644809cd6cfe0d92e21ecc3fdb8859 0 3905000 573641 0 0
1755062 0 0 0 0 519117 0 0 0 1182250
0
3201126 B 3 BS 1 15/02/2018 15/02/2018 22/11/1972 0 2
4 I21.9;I64;R57.0 99.60 - - None None None None I-4-10-III
0 0 - 0 - 0 - 0 - 0 10401900
3742953 0 1 0 0 0 UTAMI DEWI d390473 45 16521
DR WIDHI DEWANTA K AJI 0138R01702180013099 0001336522454 3;JKN DR
RIZKI; 5.2.1.201804062320 4 162205 1#0##0#0#0.0#2018-05-16
10:00:53#0#12:00:00#12:00:00#12:00:00 3 fac5e8e6007ba01361ac65893170465e
0 0 936171 0 0 2272916 0 0 0 0 507866
0 0 0 26000 0
3201126 B 3 BS 1 15/02/2018 15/02/2018 15/11/1967 0 2
1 N18.5;J20.9 93.94 - - None None None None N-4-10-I None
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 983352 0 1 0 0 0 WARKINAH D386344
50 18355 DR. SUKMARINI 0138R01702180007032 0001311658389 3;JKN
DR RIZKI; 5.2.1.201804062320 4 150114 1#0##0#0#0.0#2018-05-16
10:05:14#0#12:00:00#12:00:00#12:00:00 3 b275b86cca7831321425db0df43f5216
0 0 371889 0 0 258132 0 0 0 0 353331
0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 15/02/2018 06/12/1973 0 1
1 R07.4 - - - None None None None I-4-20-I None None
None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN) 4202600
0 0 - 0 - 0 - 0 - 0 4202600
1561634 0 1 0 0 0 DENI SOMANTRI D390466 44
TANTIYO S;16137 5.2.1.201804062320 4 149871 1#0##0#0#0.0#2018-
05-16 10:58:38#0#00:00:00#05:30:00#12:00:00 2
b295e43d139bbe8f01736b94bfda979c 0 0 1085931 0 0 84540
0 0 0 0 391163 0 0 0 0 0
3201126 B 3 BS 1 13/02/2018 15/02/2018 12/01/1963 0 1
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4495030 0 3 0 0 0 MUKIMIN
0001336191265 3;JKN DR RIZKI; 5.2.1.201804062320 4 148595
1#0##0#0#0.0#2018-05-16 11:25:16#0#12:00:00#12:00:00#12:00:00 2
c0d81e62aaa918833a8f69815b8946f0 0 0 557179 0 0
2828784 0 0 0 0 1109067 0 0 0 0 0
3201126 B 1 BS 1 12/02/2018 15/02/2018 29/06/1951 0 1
1 E11.5 86.22 - - None None None None I-4-15-I None None
None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN LAIN-LAIN
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 11794932 0 4 0 0 0 GATOT PRIYANTO
d055057 66 24335 DR HENDRIEK SP B 0138R01702180005477
0000041797934 3;JKN DR RIZKI; 5.2.2.201806040537 4 148536
1#0##0#0#0.0#2018-08-14 15:02:51#0#12:00:00#12:00:00#12:00:00 3
f8039a419baaf8c6d2f75029788020ce 0 0 1981056 0 0
2429245 0 0 0 0 7384631 0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 15/02/2018 30/12/1982 0 2
- 0 - 0 - 0 - 0 2168300 1044931 0
1 0 0 0 INDAH PERMATASARI D385469 35 12831 DR DINI
DANIATY 0138R01702180007166 0001645827208 3;JKN DR RIZKI;
5.2.0.201712280730 4 150289 1#0##0#0#0.0#2018-09-07
16:01:48#0#12:00:00#12:00:00#12:00:00 2 be480b672dc4ec4fbafdf1ea1855405b
0 0 328671 0 0 212900 0 0 0 0 375360
0 0 0 0 128000
3201126 B 3 BS 1 16/02/2018 16/02/2018 03/07/1954 0 1
1 J18.0;H81.1 87.03 - - None None None None J-4-16-I None
3613200 0 0 - 0 - 0 - 0 - 0
3613200 2325759 0 1 0 0 0 ICHLASUL AMAL
0000037725581 3;JKN DR RIZKI; 5.2.0.201712280730 4 150308
1#0##0#0#0.0#2018-03-02 16:09:21#0#00:00:00#04:00:00#12:00:00 1
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1559419 0 0 0 0 441152 0 0 0 0 0
3201126 B 1 BS 1 14/02/2018 16/02/2018 17/04/1965 0 2
1 E11.4;H81.3;M19.9 90.59;87.49 - - None None None None G-4-
17-I None None None None None None GANGUAN SARAF KRANIAL DAN PERIFER
(RINGAN) 6296600 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-03-02 19:15:11#0#12:00:00#12:00:00#12:00:00 2
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1895445 0 0 0 0 2702115 0 0 0 0 0
3201126 B 1 BS 1 15/02/2018 16/02/2018 27/09/2003 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 11080650 0 2 0 0 0 EGA WARDANA D388735
14 5255 DR ASRI RAHMAWATI SPB 0138R01702180006956 0001626392182
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1#0##0#0#0.0#2018-03-02 19:33:34#0#12:00:00#12:00:00#12:00:00 1
4e964bcddb5f07e13978f26755a23091 0 0 2151660 0 0
1486888 0 0 0 0 7297102 0 0 0 145000
0
3201126 B 1 BS 1 13/02/2018 16/02/2018 17/05/1954 0 2
- 0 4903800 4809834 0 4 0 0 0 SUKINI
EKOWATI D390268 63 23283 DR. ARU ARIADNO, SPPD 0138R01702180006091
0001771538861 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149204
1#0##0#0#0.0#2018-03-02 19:51:44#0#12:00:00#12:00:00#12:00:00 1
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1196330 0 0 0 0 3119162 0 0 0 0 0
3201126 B 2 BS 1 13/02/2018 16/02/2018 16/10/2002 0 2
1 A15.6 87.44;90.59;34.91 - - None None None None J-4-15-I
(RINGAN) 5203800 0 0 - 0 - 0 - 0 - 0
5203800 9748514 0 4 0 0 0 SALSA AULIA ELBANA
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1#0##0#0#0.0#2018-03-02 20:14:40#0#12:00:00#12:00:00#12:00:00 1
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3871330 0 0 0 0 3879753 0 0 0 0 0
3201126 B 3 BS 1 12/02/2018 16/02/2018 15/12/1956 0 1
1 I21.3;I25.0;I11.0;J18.9 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 6227192 0 5 0 0 0 HAMZAH SIMIN
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1#0##0#0#0.0#2018-03-02 20:23:56#0#12:00:00#12:00:00#12:00:00 1
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3553705 0 0 0 0 1748386 0 0 0 0 443000
3201126 B 3 BS 1 14/02/2018 16/02/2018 28/10/1993 0 2
None None None None PLEURAL EFUSI DAN PNEUMOTORAK (RINGAN) 4640500
0 0 - 0 - 0 - 0 - 0 4640500
3058986 0 3 0 0 0 HARTATIK PUTRI ISLAMIA D385982
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1#0##0#0#0.0#2018-03-02 20:40:57#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1015121 0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 16/02/2018 01/06/1954 0 2
1 E16.2;J18.0 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 6262900 0 0 - 0 - 0 - 0 -
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TANTIYO S;16137 5.2.0.201712280730 4 150076 1#0##0#0#0.0#2018-
03-02 20:46:51#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 15/02/2018 16/02/2018 23/07/1938 0 2
1 K30;I11.9;H81.3 - - - None None None None K-4-18-I
(RINGAN) 1743400 0 0 - 0 - 0 - 0 - 0
1743400 3270441 0 2 0 0 0 MARTHA PARURU
0001830582235 3;JKN DR RIZKI; 5.2.0.201712280730 4 149872
1#0##0#0#0.0#2018-03-02 20:46:58#0#12:00:00#12:00:00#00:00:00 1
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1803597 0 0 0 0 1249954 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 16/02/2018 04/06/1947 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 8969593 0 3 0 0 0 JUPRI d333812 70
25823 DR E SURYA POHAN DR SPB KBD 0138R01702180006325 0000512223772
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149478
1#0##0#0#0.0#2018-03-02 20:49:39#0#12:00:00#12:00:00#12:00:00 1
98d8776def79e09f972164ccaf3421d4 0 0 1536920 0 0
3089077 0 0 0 0 4198596 0 0 0 145000
0
3201126 B 3 BS 1 14/02/2018 16/02/2018 05/03/1996 0 2
5405200 0 0 - 0 - 0 - 0 - 0
5405200 7222022 0 3 0 0 0 SITI JUBAEDAH
0000511069735 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149815
1#0##0#0#0.0#2018-03-02 21:07:40#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 4588469 0 0 0 185000 0
3201126 B 2 BS 1 13/02/2018 16/02/2018 22/06/1960 0 1
1 K92.1;D64.9;K29.7;I10 99.04 - - None None None None K-4-
18-II None None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN
(SEDANG) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 5451487 0 4 0 0 0 SURYADINATA D390310
57 21055 DR ARU, SPPD 0138R01702180006031 0001815193067 3;JKN
DR RIZKI; 5.2.0.201712280730 4 149200 1#0##0#0#0.0#2018-03-05
10:22:28#0#12:00:00#12:00:00#12:00:00 1 35e2a5396b67f1d1a7af8f052f4056a5
0 0 375596 0 0 2673252 0 0 0 0
2402639 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 16/02/2018 15/06/1960 0 2
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3048598 0 2 0 0 0 SUNDARI HARTATI
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1#0##0#0#0.0#2018-03-05 11:52:14#0#12:00:00#12:00:00#00:00:00 2
ac80052985be500306d2c2bf642f42fe 0 0 499265 0 0
1313892 0 0 0 0 1235441 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 16/02/2018 09/09/1967 0 2
(SEDANG) 6023100 0 0 - 0 - 0 - 0 - 0
6023100 1839920 0 1 0 0 0 MULYANI, AMD
0001102994616 3;JKN DR RIZKI; 5.2.0.201712280730 4 150310
1#0##0#0#0.0#2018-03-08 14:39:31#0#12:00:00#12:00:00#12:00:00 1
8d30e6af635e01a27d2cb9d7fea1fde1 0 0 569114 0 0 343437
0 0 0 0 927369 0 0 0 0 0
3201126 B 1 BS 1 14/02/2018 16/02/2018 08/06/1998 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3790942 0 3 0 0 0 DIMAS FAJAR PRAKOSO
0001327635911 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 149770
1#0##0#0#0.0#2018-05-16 11:23:52#0#12:00:00#12:00:00#12:00:00 2
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0 0 0 0 2617006 0 0 0 0 0
3201126 B 3 BS 1 16/02/2018 16/02/2018 16/12/1947 0 2
1 J81;I21.2;J80 99.60 - - None None None None J-4-21-III
None None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM
0 - 0 6291000 4145010 0 1 0 0 0
MARKINAH D311040 70 25630 DR SUKMARINI 0138R01702180007329
0000060808691 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 151026
1#0##0#0#0.0#2018-05-17 11:43:41#0#00:00:00#12:00:00#12:00:00 3
338531e23be8728645b3305d84aa3763 0 0 679437 0 0
2905404 0 0 0 0 560169 0 0 0 0 0
3201126 B 3 BS 1 16/02/2018 16/02/2018 10/02/1941 0 2
4 J80;N39.0;N17.9;R57.2 99.60 - - None None None None J-4-
0 - 0 6291000 4126055 0 1 0 0 0 ROSITA
0000060811997 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 150330
1#0##0#0#0.0#2018-05-17 12:55:22#0#13:20:00#18:53:00#00:00:00 3
9fafbe18e170ec3f5638d7ac64801099 0 0 566190 0 0
3000936 0 0 0 0 558929 0 0 0 0 0
3201126 B 2 BS 1 13/02/2018 16/02/2018 27/06/1952 0 2
4 K74.6;R57.0 38.95 - - None None None None N-1-12-III None
DIALISIS (BERAT) 23198900 0 0 - 0 - 0 - 0 -
0 23198900 31369971 0 4 1 0 0 HADIJAH
0000060714281 3;JKN DR RIZKI; 5.2.2.201806040537 4 149197
1#0##0#0#0.0#2018-10-01 11:11:06#0#12:00:00#12:00:00#00:00:00 2
15f3da24740142b21a9bcfb9caa7255e 0 0 6780681 0 0
14783190 0 0 0 0 7609100 0 0 0 0
2197000
3201126 B 3 BS 1 16/02/2018 17/02/2018 27/07/1965 0 2
4 E87.6;D64.9;I63.9;E87.1 96.05;99.04 - - None None None None
ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 - 0 -
0 6293300 8684568 0 2 0 0 0 DIDIT DWI SUPRAPTI
0001263680965 3;JKN DR RIZKI; 5.2.0.201712280730 4 150316
1#0##0#0#0.0#2018-03-02 16:05:55#0#23:21:00#07:40:00#00:00:00 1
19b75bde039d3cd86fd01429f3680a24 0 0 566397 0 0
6204022 0 0 0 0 875149 0 0 0 0
1039000
3201126 B 1 BS 1 09/02/2018 17/02/2018 19/12/1983 0 2
1 A15.2;R04.2 90.59;87.49 - - None None None None J-4-15-I
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 20973869 0 9 0 0 0 HERA WATI D111795
0001456658019 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147680
1#1#vvip#9#14902769#0.0#2018-03-02 19:18:12#0#12:00:00#12:00:00#12:00:00
1 f828496f52c4eb4bd85b08f9e743ea54 0 0 1115442 0 0
6874927 0 0 0 0 12113500 0 0 0 0 870000
3201126 B 1 BS 1 15/02/2018 17/02/2018 12/05/1968 0 2
1 E11.9;A09.9 - - - None None None None E-4-10-I None
- 0 4903800 3449609 0 3 0 0 0 HERTI
HARTATI D351230 49 18176 DR SOEGIONO, SPPD 0138R01702180007212
0000036875812 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150300
1#0##0#0#0.0#2018-03-02 19:39:10#0#12:00:00#12:00:00#00:00:00 1
91835508cf782aaa7bd8a4fc6cd49d41 0 0 494342 0 0 706092
0 0 0 0 2249175 0 0 0 0 0
3201126 B 1 BS 1 09/02/2018 17/02/2018 25/03/1934 0 2
1 G20;E11.5;I44.0;E87.1;E87.6 89.52;90.59 - - None None None
None G-4-11-II None None None None None None TUMOR SISTEM SARAF &
GANGGUAN DEGENERATIF (SEDANG) 8501800 0 0 - 0 - 0 -
0 - 0 8501800 25295399 0 9 0 0 0 RUSTI
PURBA D150394 83 30637 DR. ARU ARIADNO, SPPD 0138R01702180004338
0001257557376 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 147618
1#1#vvip#9#16793599#0.0#2018-03-02 19:42:15#0#12:00:00#12:00:00#00:00:00
1 2cce7ba1a83450ed91652d1719e55776 0 0 2763000 0 0
6673899 0 0 0 0 13316500 0 0 0 512000
2030000
3201126 B 2 BS 1 10/02/2018 17/02/2018 06/07/1952 0 2
1 I11.0;J90 34.91 - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 5968400 10514903
0 8 0 0 0 HJ.MUJENAH D378196 65 23960 DR PRIYO
SUNARTO , SPJP 0138R01702180004663 0001338885022 3;JKN DR RIZKI;
5.2.0.201712280730 4 147822 1#0##0#0#0.0#2018-03-02
19:50:50#0#12:00:00#12:00:00#12:00:00 1 97461097722fb13cc8403546fcf897d8
0 0 3529780 0 0 2438732 0 0 0 0
4546391 0 0 0 0 0
3201126 B 1 BS 1 14/02/2018 17/02/2018 14/09/1979 0 2
0 - 0 - 0 - 0 - 0 6981500 13597363
0 4 0 0 0 LIS NUR INDAH D219551 38 14033 DR
NINING H, SPOG 0138R01702180006696 0001609492623 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149862 1#0##0#0#0.0#2018-03-02
20:04:21#0#12:00:00#12:00:00#12:00:00 1 f2507c780f57915ab54b0f6ac3a1e60a
0 0 2925415 0 0 2168001 0 0 0 0
8434947 0 0 0 0 69000
3201126 B 3 BS 1 15/02/2018 17/02/2018 16/02/1957 0 2
1 B49;E87.6;A01.0;I10 - - - None None None None A-4-
14-III None None None None None None PENYAKIT INFEKSI BAKTERI DAN
PARASIT LAIN-LAIN (BERAT) 3304700 0 0 - 0 - 0 -
0 - 0 3304700 2711974 0 3 0 0 0 SOPIAH
0001089726557 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150294
1#0##0#0#0.0#2018-03-02 20:29:22#0#12:00:00#12:00:00#12:00:00 1
51bafad1cb50389a1f2d47a75e787d97 0 0 350423 0 0
1455632 0 0 0 0 905919 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 17/02/2018 09/07/1961 0 2
1 G51.0;I10 - - - None None None None G-4-17-I None
None None None None None GANGUAN SARAF KRANIAL DAN PERIFER (RINGAN)
5397100 0 0 - 0 - 0 - 0 - 0
5397100 4464041 0 3 0 0 0 WENI ERLIN SISWATI
0001655703898 3;JKN DR RIZKI; 5.2.0.201712280730 4 150301
1#0##0#0#0.0#2018-03-02 20:34:42#0#12:00:00#12:00:00#12:00:00 1
dd852cbdbeef05c6843d177971b955d3 0 0 538739 0 0
2299762 0 0 0 0 1625540 0 0 0 0 0
3201126 B 3 BS 1 08/02/2018 17/02/2018 01/07/1952 0 1
1 I95.9;I11.0;E10.1;E16.2;R57.0;N18.2;I25.1 89.52;87.49 - - None
None None None I-4-24-III None None None None None None GANGGUAN
SISTEM PEMBULUH DARAH LAIN-LAIN (BERAT) 8139800 0 0 - 0 -
0 - 0 - 0 8139800 32298229 0 10 1 6
0 AKMAL D389876 65 23963 DR AZRI NURIZAL SPPD KKV
0138R01702180003857 0000510868945 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 146865 1#0##0#0#0.0#2018-03-02
20:35:38#0#12:00:00#12:00:00#12:00:00 1 830f03f8fcdca2ebd52c8614f5f54869
0 0 1137482 0 0 13802247 0 0 0 0
9282500 0 0 0 0 8076000
3201126 B 2 BS 1 15/02/2018 17/02/2018 23/10/1991 0 2
0 0 - 0 - 0 - 0 - 0 3479400
5838420 0 3 0 0 0 RINI ANGGRAINI d390526 26
RIZKI; 5.2.0.201712280730 4 150295 1#0##0#0#0.0#2018-03-02
20:39:19#0#12:00:00#12:00:00#12:00:00 1 67e1b7a86aab7f071e812dd2b4ef89fc
0 0 509579 0 0 3405888 0 0 0 0
1922953 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 17/02/2018 13/11/1982 0 2
None None None None PERSALINAN PALSU (RINGAN) 1896900 0 0
- 0 - 0 - 0 - 0 1896900 2903501 0
3 0 0 0 RACHTIA CHAERANI D232784 35 12878 ENDANG TRI
KURNIADEWI DR SPOG 0138R01702180006996 0002068119415 3;JKN DR RIZKI;
5.2.0.201712280730 4 150112 1#0##0#0#0.0#2018-03-02
20:40:56#0#12:00:00#12:00:00#12:00:00 1 d3e15fab2e6b29e73ed6354ad180283f
0 0 223721 0 0 886738 0 0 0 0
1793042 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 17/02/2018 20/05/2017 0 2
1 J06.9 - - - None None None None U-4-13-I None None
None None None None PERADANGAN EPIGLOTIS, TELINGA TENGAH, ISPA DAN
0 - 0 2376200 3234385 0 3 0 0 0
CLARRYSHA RYANTY PUTRY D390472 0 271 DR SONNY KUSUMA YULIARSO, SPA
0138R01702180006748 0002137035025 3;JKN DR RIZKI; 5.2.0.201712280730
4 149873 1#0##0#0#0.0#2018-03-05
10:24:49#0#12:00:00#12:00:00#12:00:00 1 3be2cd75dd9643213f11c13540a42cad
0 0 266858 0 0 874932 0 0 0 0
1752595 0 0 0 0 340000
3201126 B 3 BS 1 17/02/2018 17/02/2018 14/07/1957 0 1
1 A41.9;A15.3;E13.9;E87.8 - - - None None None None A-4-
0 - 0 - 0 - 0 - 0 4330300 3760751
0 1 0 0 0 RUSMANHADI D390635 60 22133 DR LIDYA
SANTALIA 0138R01702180007538 0000041383359 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150621 1#0##0#0#0.0#2018-03-06
09:09:59#0#12:00:00#12:00:00#12:00:00 1 904766d9d8bec47b13bd2ad51d50d53a
0 0 389727 0 0 2229994 0 0 0 0 553030
0 0 0 0 588000
3201126 B 3 BS 1 10/02/2018 17/02/2018 07/06/1958 0 1
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 9734425 0 8 0 0 0 RODJALI D390058
3;JKN irene; 5.2.0.201712280730 4 147830 1#0##0#0#0.0#2018-
03-06 09:20:38#0#12:00:00#12:00:00#12:00:00 2
5f38f5990c87a63b5e8fa724ca665d59 0 0 813045 0 0
6680548 0 0 0 0 2214832 0 0 0 26000 0
3201126 B 1 BS 1 15/02/2018 17/02/2018 26/06/1962 0 2
- 0 12472300 10325701 0 3 0 0 0 JUNIAR
SIHOTANG D389314 55 20323 DEDY PRATAMA,SPBV 0138R01702180007019
0000037682458 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150113
1#0##0#0#0.0#2018-03-07 09:25:38#0#12:00:00#12:00:00#12:00:00 1
97b0a7fa339f73df8e0559e2debb420a 0 6605000 1458408 0 0
1441780 0 0 0 0 751513 0 0 0 0 69000
3201126 B 1 BS 1 16/02/2018 17/02/2018 31/12/1968 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4337168 0 2 0 0 0 INDRAWAN RUSMAN
0001621275952 3;JKN DR RIZKI; 5.2.0.201712280730 4 150332
1#0##0#0#0.0#2018-03-08 14:26:45#0#12:00:00#12:00:00#00:00:00 2
34c3f3ce54b40619f256cfd7c79b1af3 0 0 573641 0 0
1081037 0 0 0 0 2682490 0 0 0 0 0
3201126 B 1 BS 1 15/02/2018 17/02/2018 15/02/2018 2482 2
(RINGAN) 7677000 0 0 - 0 - 0 - 0 - 0
7677000 2447870 0 3 0 0 0 BAYI NY LIS NUR INDAH
0002430484413 3;JKN DR RIZKI; 5.2.0.201712280730 4 150428
1#0##0#0#0.0#2018-03-08 14:28:25#0#12:00:00#12:00:00#12:00:00 1
033601afedaf840e376a4706f22d4923 0 0 729930 0 0 239299
0 0 0 0 1478641 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 17/02/2018 20/05/2017 0 2
0 - 0 2376200 3234385 0 3 0 0 0
CLARRYSHA RYANTY PUTRY D390472 0 271 DR SONNY KUSUMA YULIARSO, SPA
0138R01702180013102 0002137035025 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 149873 1#0##0#0#0.0#2018-03-19
10:34:29#0#12:00:00#12:00:00#12:00:00 2 b59237884eaab35b7251fe9b78c7de3f
0 0 266858 0 0 874932 0 0 0 0
1752595 0 0 0 0 340000
3201126 B 2 BS 1 14/02/2018 17/02/2018 22/12/2016 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3067164 0 4 0 0 0 ABYAN KURNIAWAN
0002210315859 3;JKN DR RIZKI; 5.2.0.201712280730 4 149869
1#0##0#0#0.0#2018-03-28 13:49:04#0#12:00:00#12:00:00#00:00:00 2
bf742ec1078ac7b92ba5e0459b7d697d 0 0 278711 0 0 858797
0 0 0 0 1759656 0 0 0 170000 0
3201126 B 1 BS 1 10/02/2018 17/02/2018 28/10/2014 0 2
1 J18.0;J45.9;Q21.0 - - - None None None None J-4-16-II
(SEDANG) 7108500 0 0 - 0 - 0 - 0 - 0
7108500 13058610 0 8 0 0 0 ASYIFA KEIZHA ANISA
0001798797633 3;JKN DR RIZKI; 5.2.1.201804062320 4 147699
1#0##0#0#0.0#2018-05-16 09:40:43#0#12:00:00#12:00:00#00:00:00 2
2dedc59d0c7be693e27299bca674e652 0 0 333467 0 0
4406841 0 0 0 0 7128302 0 0 0 0
1190000
3201126 B 2 BS 1 14/02/2018 17/02/2018 03/09/1988 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3238192 0 4 0 0 0 IRMA DARMAWANTI
0001788420328 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 149868
1#0##0#0#0.0#2018-05-16 11:32:21#0#12:00:00#12:00:00#12:00:00 2
f4aeaa05f8db3d8967627c1e67e72570 0 0 480212 0 0
1005136 0 0 0 0 1752844 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 18/02/2018 22/11/1954 0 2
1 I63.9;E14.9;G81.9;E78.5 87.44;87.03 - - None None None None
0 - 0 6909500 7227029 0 5 0 0 0
MARYATI D390392 63 23095 DR NURUL KOMARI SPS
0138R01702180006444 0001261990484 3;JKN DR RIZKI; 5.2.0.201712280730
4 149768 1#0##0#0#0.0#2018-03-02
15:23:57#0#12:00:00#12:00:00#12:00:00 1 3ef66ad9a1c690814063f4bfda8f663f
0 0 610179 0 0 4803054 0 0 0 0
1813796 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 18/02/2018 27/11/1961 0 1
0 - 0 - 0 - 0 - 0 5005900 2808883
0 3 0 0 0 ALEXANDER SINUHAJI D359234 56 20535
TANTIYO S;16137 5.2.0.201712280730 4 150333 1#0##0#0#0.0#2018-
03-02 19:19:32#0#12:00:00#12:00:00#00:00:00 1
14cba6b6190478ec8c13850dbe2ae5b2 0 0 503530 0 0
1569594 0 0 0 0 735759 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 18/02/2018 01/06/1952 0 1
1 D64.9;K92.1;K92.0 99.04 - - None None None None D-4-13-II
0 - 0 5918600 5105028 0 3 0 0 0
MUCHATON D378080 65 24001 DR ZULFAN, SPPD 0138R01702180007255
0000084577037 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150311
1#0##0#0#0.0#2018-03-02 19:20:53#0#12:00:00#12:00:00#12:00:00 1
e68e1fbb6b384559eca8bde4aba3585f 0 0 585674 0 0
1816380 0 0 0 0 2702970 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 18/02/2018 21/12/2007 0 1
- 0 5918600 6012321 0 3 0 0 0 IQBAL
MARLOPO PURNAMASIDI C240998 10 3710 DR VERA MUNA MANOE, SPA
0138R01702180007405 0001335363658 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150327 1#0##0#0#0.0#2018-03-02
19:22:25#0#12:00:00#12:00:00#12:00:00 1 2bed5cf94c16099c1605e84deb43c418
0 0 429362 0 0 2820630 0 0 0 0
2762329 0 0 0 0 0
3201126 B 1 BS 1 17/02/2018 18/02/2018 15/02/2017 0 1
0 - 0 2772200 3190338 0 2 0 0 0 ATHAR
RAFIF ABQARY D358892 1 367 DR OTTY MITHA S, SPA
0138R01702180007448 0002225309139 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150335 1#0##0#0#0.0#2018-03-02
19:25:15#0#12:00:00#12:00:00#00:00:00 1 d12921d17c1ef2dab0d7356bb8ef2679
0 0 269459 0 0 1124165 0 0 0 0
1796714 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 18/02/2018 08/07/2016 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3001114 0 3 0 0 0 MUHAMMAD REVAN SALIM
0002069229183 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150324
1#0##0#0#0.0#2018-03-02 19:31:55#0#12:00:00#12:00:00#12:00:00 1
5d05c603cf48cbfa7e5ff571f2282fda 0 0 269459 0 0 166320
0 0 0 0 2565334 0 0 0 0 0
3201126 B 1 BS 1 15/02/2018 18/02/2018 25/08/1964 0 2
None None None None None ANGINA PEKTORIS DAN NYERI DADA (BERAT)
9856000 0 0 - 0 - 0 - 0 - 0
9856000 5629626 0 4 0 0 0 BAYETA NURBAETI
0001462581652 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149875
1#0##0#0#0.0#2018-03-02 19:44:10#0#12:00:00#12:00:00#12:00:00 1
34b5d7780fc30fede3b57bede0a12627 0 0 582524 0 0
1400809 0 0 0 0 3518293 0 0 0 128000
0
3201126 B 1 BS 1 09/02/2018 18/02/2018 23/03/2017 0 1
1 J18.0;I50.9 - - - None None None None J-4-16-II None
7108500 0 0 - 0 - 0 - 0 - 0
7108500 14614307 0 10 0 0 0 BY NY MELINDA
KRISNAWATI/ ELVINO ZAVIER D369058 0 323 DR AWIDIYA, SPA
0138R01702180004104 0002236690034 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 147013 1#0##0#0#0.0#2018-03-02
19:55:51#0#12:00:00#12:00:00#12:00:00 1 8ac1c9ae86017c1247956989112056bb
0 0 763847 0 0 4019384 0 0 0 0
8792076 0 0 0 680000 359003
3201126 B 1 BS 1 14/02/2018 18/02/2018 14/01/1960 0 1
1 E14.5;N39.0;I87.2 86.22 - - None None None None I-4-15-II
LAIN (SEDANG) 8537100 0 0 - 0 - 0 - 0 -
0 8537100 15141453 0 5 0 0 0 IRADAT KIYAI
d377877 58 21216 DEDY PRATAMA,SPBV 0138R01702180006334
0001281634536 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 149771
1#0##0#0#0.0#2018-03-02 20:03:10#0#12:00:00#12:00:00#12:00:00 1
40d2db37b5e2ff738cc73a3280970a79 0 0 3051401 0 0
3021990 0 0 0 0 9033562 0 0 0 0 34500
3201126 B 3 BS 1 12/02/2018 18/02/2018 03/12/1970 0 2
1 H81.1 - - - None None None None U-4-11-I None None
None None None None DYSEQUILIBRIUM (RINGAN) 1517500 0 0 -
0 - 0 - 0 - 0 1517500 3857377 0 7
0 0 0 SAENAH D390211 47 17238 DR HARDI PRANATA SPS
0138R01702180005713 0001465380123 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 148777 1#0##0#0#0.0#2018-03-02
20:13:15#0#12:00:00#12:00:00#12:00:00 1 6500b3ab721e21de2fa34f4b6bfe8ef8
0 0 189575 0 0 1811450 0 0 0 0
1830352 0 0 0 26000 0
3201126 B 3 BS 1 16/02/2018 18/02/2018 01/02/1965 0 2
- 0 3502700 2593946 0 3 0 0 0 ASENIH
0001326075671 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150329
1#0##0#0#0.0#2018-03-02 20:16:30#0#12:00:00#12:00:00#12:00:00 1
bb5cf5461c4c7c61a47a90fd5a0062c3 0 0 493498 0 0
1203185 0 0 0 0 871263 0 0 0 26000 0
3201126 B 3 BS 1 16/02/2018 18/02/2018 29/08/1993 0 2
5405200 0 0 - 0 - 0 - 0 - 0
5405200 10202572 0 3 0 0 0 NINA RATNASARI
D389508 24 8937 DR MAMAN H, SPOG 0138R01702180007298
0001457556131 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150321
1#0##0#0#0.0#2018-03-02 20:18:31#0#12:00:00#12:00:00#12:00:00 1
9462b08a1d2fb61b71592a8651d595dd 0 3534500 1899716 0 0
3802898 0 0 0 0 768458 0 0 0 197000
0
3201126 B 2 BS 1 14/02/2018 18/02/2018 21/05/2010 0 1
1 A01.0;A90 - - - None None None None A-4-14-II None
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 3868451 0 5 0 0 0 MEISYA SAFIYAH Z
0001175537439 3;JKN DR RIZKI; 5.2.0.201712280730 4 149857
1#0##0#0#0.0#2018-03-02 20:20:02#0#12:00:00#12:00:00#00:00:00 1
621e50ce4f64384138dd15adbbf682de 0 0 298025 0 0 973850
0 0 0 0 2596576 0 0 0 0 0
3201126 B 2 BS 1 16/02/2018 18/02/2018 25/04/1952 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 4345006 0 3 0 0 0 DIDI SUHENDRI
D321683 65 24038 DR ARU, SPPD 0138R01702180007338
0001459026955 3;JKN DR RIZKI; 5.2.0.201712280730 4 150322
1#0##0#0#0.0#2018-03-02 20:21:50#0#12:00:00#12:00:00#00:00:00 1
97fea569b47110578237d7669edf4a34 0 0 622727 0 0
1897026 0 0 0 0 1825253 0 0 0 0 0
3201126 B 2 BS 1 14/02/2018 18/02/2018 10/11/1975 0 2
0 - 0 - 0 - 0 - 0 2783600 4275015
0 5 0 0 0 NENENG SUHERTI d372040 42 15437 DR.
ARU ARIADNO, SPPD 0138R01702180006713 0001167513546 3;JKN DR RIZKI;
5.2.0.201712280730 4 149867 1#0##0#0#0.0#2018-03-02
20:26:37#0#12:00:00#12:00:00#12:00:00 1 aadc355ad6f64b5674b2bedb5b4d5136
0 0 372122 0 0 1577219 0 0 0 0
2325674 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 18/02/2018 01/01/1950 0 2
1 J81;K29.7;I11.9 87.44 - - None None None None J-4-21-I
PERNAFASAN LAIN-LAIN (RINGAN) 3358200 0 0 - 0 - 0 -
0 - 0 3358200 3514919 0 4 0 0 0
SALBIYAH, HJ D373699 68 24882 DR ARU, SPPD
0138R01702180007181 0000976208883 3;JKN DR RIZKI; 5.2.0.201712280730
4 150296 1#0##0#0#0.0#2018-03-02
20:29:51#0#12:00:00#12:00:00#12:00:00 1 454a16f8eed112bda20a48123fe164f0
0 0 732437 0 0 506534 0 0 0 0
2275948 0 0 0 0 0
3201126 B 2 BS 1 16/02/2018 18/02/2018 28/08/1950 0 1
- 0 51950600 55661660 0 3 0 0 0 IDRIS
0000197980828 3;JKN DR RIZKI; 5.2.0.201712280730 4 150318
1#0##0#0#0.0#2018-03-05 10:28:40#0#12:00:00#12:00:00#12:00:00 1
59ca0fbe3e5405f2048fe3752b3acf73 0 14328940 0 0 0
31262720 0 0 0 0 2501000 0 0 0 69000
7500000
3201126 B 2 BS 1 16/02/2018 18/02/2018 19/06/1976 0 2
5043100 0 0 - 0 - 0 - 0 - 0
5043100 3460419 0 3 0 0 0 YUNIAR KAMAL
0002065506895 3;JKN DR RIZKI; 5.2.0.201712280730 4 150325
1#0##0#0#0.0#2018-03-07 08:34:13#0#12:00:00#12:00:00#00:00:00 1
c704300cce2829c6508435cb65d2e54b 0 0 506879 0 0
1186157 0 0 0 0 1767383 0 0 0 0 0
3201126 B 1 BS 1 17/02/2018 18/02/2018 23/03/1985 0 2
0 - 0 - 0 - 0 - 0 6981500 11858486
0 2 0 0 0 CHOLILAH ,NY D390306 32 12019 DR
MAMAN H, SPOG 0138R01702180007452 0000038206787 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150338 1#0##0#0#0.0#2018-03-07
09:28:49#0#12:00:00#12:00:00#12:00:00 1 e5f85f6dbe8b655b3506b9062c754dd8
0 6407900 2077635 0 0 2038162 0 0 0 0
861789 0 0 0 0 473000
3201126 B 1 BS 1 16/02/2018 18/02/2018 04/04/1944 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 66064320 0 3 0 0 0 MAMAN SUDIRMAN
0000060557477 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150319
1#0##0#0#0.0#2018-03-07 09:32:16#0#12:00:00#12:00:00#00:00:00 1
a7cfb7d339018f4e3515f127b7da6e15 0 10753000 9619120 0 0
36867200 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 16/02/2018 18/02/2018 18/12/1974 0 2
0 - 0 5399900 4963008 0 3 0 0 0
SRIMULYANI D388205 43 15766 DR SOEGIONO, SPPD 0138R01702180007266
0000057572684 3;JKN DR RIZKI; 5.2.0.201712280730 4 150314
1#0##0#0#0.0#2018-03-08 13:36:08#0#12:00:00#12:00:00#12:00:00 1
3214740504d9e9c6fc4e5882202f626a 0 0 538991 0 0
1730334 0 0 0 0 2693683 0 0 0 0 0
3201126 B 1 BS 1 17/02/2018 18/02/2018 30/03/1967 0 2
1 H81.1;K29.7;R55;I45.1 89.52 - - None None None None U-4-
0 - 0 - 0 - 0 - 0 2124500 3934320
0 2 0 0 0 DEWI D390600 50 18587 DR NURUL KOMARI
SPS 0138R01702180007449 0001257580113 3;JKN DR RIZKI; 5.2.0.201712280730
4 150336 1#0##0#0#0.0#2018-03-08
14:38:01#0#12:00:00#12:00:00#12:00:00 1 2e88c7a24d18eb8200d8f6d34a04a82c
0 0 244205 0 0 1844730 0 0 0 0
1845385 0 0 0 0 0
3201126 B 2 BS 1 17/02/2018 18/02/2018 05/07/1964 0 1
(RINGAN) 3976600 0 0 - 0 - 0 - 0 - 0
3976600 2307685 0 2 0 0 0 BANTA AYUSAN
0001874825436 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150617
1#0##0#0#0.0#2018-03-19 10:49:55#0#12:00:00#12:00:00#12:00:00 2
a43776e710a286fd19da8a61bd97e13d 0 0 499265 0 0 621450
0 0 0 0 1186970 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 18/02/2018 20/10/1986 0 2
1 R63.8 - - - None None None None E-4-10-I None None
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 4041743 0 3 0 0 0 SHOLEHATI D128796
31 11442 DR ARU, SPPD 0138R01702180007292 0001290978257 3;JKN
DR RIZKI; 5.2.1.201804062320 4 150320 1#0##0#0#0.0#2018-05-05
11:19:01#0#12:00:00#12:00:00#00:00:00 2 327e8e1804425cd042152310eb2e24b6
0 0 345274 0 0 1063056 0 0 0 0
2633413 0 0 0 0 0
3201126 B 1 BS 1 14/02/2018 18/02/2018 04/02/1962 0 1
1 K80.8;E10.9;D29.1;R10.4 90.59;89.52 - - None None None None
B-4-14-I None None None None None None GANGGUAN SALURAN EMPEDU LAIN-
LAIN (RINGAN) 5879800 0 0 - 0 - 0 - 0 -
0 5879800 11065763 0 5 0 0 0 ANDREAS HERDY
SARTONO D390404 56 20464 DR ARU, SPPD 0138R01702180006701
0000042215747 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 149863
1#1#vvip#5#5185963#0.0#2018-05-16 11:18:52#0#12:00:00#12:00:00#12:00:00
2 8df48d470271e99722264946ceffe9b8 0 0 825348 0 0
3944987 0 0 0 0 6295428 0 0 0 0 0
3201126 B 1 BS 1 15/02/2018 18/02/2018 16/07/1961 0 2
1 M54.52;R10.4 - - - None None None None M-4-17-I
None None None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG BELAKANG
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 5656922 0 4 0 0 0 KOMALASARI D390377
56 20668 DR ARU, SPPD 0138R01702180006886 0000031124856 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 150022 1#0##0#0#0.0#2018-
05-16 11:21:58#0#12:00:00#12:00:00#12:00:00 2
84525dadfbaa3dab26f43d8a4f15fb2f 0 0 345275 0 0
1791568 0 0 0 0 3520079 0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 19/02/2018 23/12/2001 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2021517 0 3 0 0 0 SALSABILA D370018
3;JKN DR RIZKI; 5.2.0.201712280730 4 150334 1#0##0#0#0.0#2018-
03-02 14:30:10#0#12:00:00#12:00:00#00:00:00 1
1666e1219103c3db03f8ad2238670929 0 0 257183 0 0 817085
0 0 0 0 947249 0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 19/02/2018 01/08/1955 0 2
1 I11.0 87.44;89.52 - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 3575600 2329090
0 5 0 0 0 LAMANIH D390484 62 22844 DR AGOES
5.2.0.201712280730 4 150111 1#0##0#0#0.0#2018-03-02
14:33:18#0#12:00:00#12:00:00#12:00:00 1 631603630efa3ef4d1ec2f0f2f359302
0 0 374804 0 0 460916 0 0 0 0
1493370 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 19/02/2018 01/02/1975 0 1
3697100 0 0 - 0 - 0 - 0 - 0
3697100 1863587 0 2 0 0 0 ADRIANUS D388950
3;JKN DR RIZKI; 5.2.0.201712280730 4 151038 1#0##0#0#0.0#2018-
03-02 14:35:41#0#12:00:00#12:00:00#12:00:00 1
e8158cab980a1980e0676dee5ecd2722 0 0 739420 0 0 536750
0 0 0 0 587417 0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 19/02/2018 10/05/1960 0 1
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 4245789 0 5 0 0 0 SIRIN D390533 57
DR RIZKI; 5.2.0.201712280730 4 150304 1#0##0#0#0.0#2018-03-02
14:38:30#0#12:00:00#12:00:00#12:00:00 1 52970ce4daf12f8e959ea583e1ce6170
0 0 451179 0 0 2262348 0 0 0 0
1532262 0 0 0 0 0
3201126 B 3 BS 1 15/02/2018 19/02/2018 01/04/1949 0 2
1 I21.3;I20.0;K29.7 89.52 - - None None None None I-4-10-II
0 0 - 0 - 0 - 0 - 0 7219300
5474303 0 5 0 0 0 SAAMAH D390369 68 25157
DR RIZKI; 5.2.0.201712280730 4 149876 1#0##0#0#0.0#2018-03-02
14:45:02#0#12:00:00#12:00:00#12:00:00 1 400f89e41bdae3b3bc0cf72bbefa19ae
0 0 702736 0 0 3072435 0 0 0 0
1699132 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 19/02/2018 03/10/1976 0 1
1 I13.1;N13.3 39.27 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 8762377 0 2 0 0 0 TAUPIK
0002249447962 3;JKN DR RIZKI; 5.2.0.201712280730 4 150758
1#0##0#0#0.0#2018-03-02 15:01:46#0#12:00:00#12:00:00#12:00:00 1
13f9b04d8e687ed8d76ad4898ec9171a 0 5676352 53000 0 0
2174285 0 0 0 0 858740 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 19/02/2018 22/11/1998 0 2
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 6214884 0 2 0 0 0 AULIA RISKY N
D390726 19 7028 DR. SITI AZIZAH SPOG 0138R01702180007723
0000511253008 3;JKN DR RIZKI; 5.2.0.201712280730 4 150747
1#0##0#0#0.0#2018-03-02 15:12:17#0#12:00:00#12:00:00#12:00:00 1
93c8bbc9c09f25733b1ba3e14078c797 0 2660168 106000 0 0
2265635 0 0 0 0 850581 0 0 0 332500
0
3201126 B 3 BS 1 17/02/2018 19/02/2018 18/06/1972 0 2
1 I10;H81.3 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 1906700 1642883 0
3 0 0 0 YUNI WIDARTINI D383873 45 16680 DR SOEGIONO,
4 150732 1#0##0#0#0.0#2018-03-02
15:19:15#0#12:00:00#12:00:00#12:00:00 2 79b0221f56c1a867e00ffc2e9204d1c9
0 0 224603 0 0 495802 0 0 0 0 922478
0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 19/02/2018 25/09/1941 0 1
1 I50.0;I48 89.52 - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 4144700 764433
0 1 0 0 0 MISAR D390790 76 27906 DR YOHANNES
DWINANDA 0138R01702180007897 0002061510254 3;JKN DR RIZKI;
5.2.0.201712280730 4 152011 1#0##0#0#0.0#2018-03-02
16:14:26#0#02:10:00#09:10:00#12:00:00 1 5507faf23dfeeb45030aacb06e030d79
0 0 373023 0 0 52400 0 0 0 0 339010
0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 19/02/2018 08/03/2011 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4150846 0 5 0 0 0 VIA GHAISANI ZAHRA
0001628417068 3;JKN DR RIZKI; 5.2.0.201712280730 4 150306
1#0##0#0#0.0#2018-03-05 08:57:33#0#12:00:00#12:00:00#12:00:00 1
0b27dddcd342033438fbc1cb0896a75b 0 0 278711 0 0
1214584 0 0 0 0 2317551 0 0 0 0 340000
3201126 B 2 BS 1 14/02/2018 19/02/2018 25/03/1941 0 2
1 F03;R63.0;I64 96.07 - - None None None None F-4-16-III
None None None None None None GANGGUAN OTAK ORGANIK LAIN-LAIN TERMASUK
KETERBELAKANGAN MENTAL (BERAT) 10525500 0 0 - 0 - 0
- 0 - 0 10525500 6504625 0 6 0 0 0
SEMIYEM D082868 76 28085 DR. ARU ARIADNO, SPPD
0138R01702180006695 0001903951899 3;JKN DR RIZKI; 5.2.0.201712280730
4 149861 1#0##0#0#0.0#2018-03-05
09:01:28#0#12:00:00#12:00:00#12:00:00 2 9f24a9f1d4f377ceecbf042c4700b5d5
0 0 278200 0 0 2952389 0 0 0 0
3274036 0 0 0 0 0
3201126 B 2 BS 1 17/02/2018 19/02/2018 15/02/1998 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2416840 0 3 0 0 0 ALVI ARIANI D077266
DR RIZKI; 5.2.0.201712280730 4 150734 1#0##0#0#0.0#2018-03-05
09:11:31#0#12:00:00#12:00:00#12:00:00 1 30a21d5b40808e57d2b90fee434b1864
0 0 298025 0 0 627204 0 0 0 0
1491611 0 0 0 0 0
3201126 B 2 BS 1 17/02/2018 19/02/2018 05/12/2016 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3317817 0 3 0 0 0 KEIHIN IVER RAYYANKA
0002263370128 3;JKN DR RIZKI; 5.2.0.201712280730 4 150518
1#0##0#0#0.0#2018-03-05 09:17:18#0#12:00:00#12:00:00#12:00:00 1
08957f6c32375b3d5678331bf509d649 0 0 278711 0 0 384053
0 0 0 0 2655053 0 0 0 0 0
3201126 B 2 BS 1 15/02/2018 19/02/2018 12/06/1960 0 1
5043100 0 0 - 0 - 0 - 0 - 0
5043100 3779582 0 5 0 0 0 M OTAY D390542
0000039408131 3;JKN DR RIZKI; 5.2.0.201712280730 4 150302
1#0##0#0#0.0#2018-03-05 10:18:57#0#12:00:00#12:00:00#12:00:00 1
5e9b58056e7112ab2cd6e642cca0c845 0 0 506879 0 0 681941
0 0 0 0 2590762 0 0 0 0 0
3201126 B 1 BS 1 18/02/2018 19/02/2018 07/05/1944 0 1
- 0 12472300 13643036 0 2 0 0 0 TJOK R
SUDARSANA D390476 73 26950 SRI KUNMARTINI.DR,SPPD 0138R01702180007785
0001842099311 3;JKN DR RIZKI; 5.2.0.201712280730 4 150757
1#0##0#0#0.0#2018-03-06 10:53:11#0#12:00:00#12:00:00#12:00:00 1
653426075f5210b04971ba5811dfe5b4 0 6468200 3669967 0 0
2487334 0 0 0 0 948535 0 0 0 0 69000
3201126 B 1 BS 1 17/02/2018 19/02/2018 14/11/1963 0 1
1 T82.4;N18.5 39.42 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 13043985 0 3 0 0 0 MASRU D389549
3;JKN DR RIZKI; 5.2.0.201712280730 4 150633 1#0##0#0#0.0#2018-
03-06 15:45:06#0#12:00:00#12:00:00#12:00:00 1
09195d17d628d71f4ed3cdab061066c9 0 6587000 1215340 0 0
4125300 0 0 0 0 909345 0 0 0 0 207000
3201126 B 1 BS 1 16/02/2018 19/02/2018 05/10/2016 0 2
1 A09.9;J06.9;B37.9 - - - None None None None K-4-17-II
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 4265259 0 4 0 0 0 KIARA HANNA HUMAIRA
D346382 1 499 DR. TRI LESTARI 0138R01702180007402
0002309360523 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150326
1#0##0#0#0.0#2018-03-07 08:10:49#0#12:00:00#12:00:00#12:00:00 1
3efe4c991181e2c6a660c797cdf37b1d 0 0 269459 0 0 566764
0 0 0 0 3429036 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 19/02/2018 16/08/2015 0 2
1 J18.0;D50.9 - - - None None None None J-4-16-II None
7108500 0 0 - 0 - 0 - 0 - 0
7108500 7401603 0 4 0 0 0 HANIFAH MADANI PUTASA
0002088896657 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150312
1#0##0#0#0.0#2018-03-07 08:52:59#0#12:00:00#12:00:00#12:00:00 1
47f0d08c50c0ff6e45e42bc91c99c5e4 0 0 692765 0 0
2784621 0 0 0 0 3634217 0 0 0 0 290000
3201126 B 1 BS 1 17/02/2018 19/02/2018 09/02/1941 0 1
1 E13.7;K25.3;N18.9;N39.0;D63.8 - - - None None None None
E-4-10-II None None None None None None PENYAKIT KENCING MANIS &
0 - 0 - 0 6852200 6012865 0 3 0 0
0 SUTEDJO d381834 77 28132 DR BETTY DWI L, SPPD
0138R01702180007620 0000060680283 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150735 1#0##0#0#0.0#2018-03-08
09:07:01#0#12:00:00#12:00:00#12:00:00 1 808bb8ef48f995fac0fcc27f18eab3e6
0 0 669698 0 0 2926302 0 0 0 0
2416865 0 0 0 0 0
3201126 B 1 BS 1 18/02/2018 19/02/2018 08/08/1965 0 1
1 I13.1;D63.8;N39.9 99.04;89.52;90.59 - - None None None None
- 0 5784900 3868063 0 2 0 0 0 SUMARSA
0000037514327 3;JKN DR RIZKI; 5.2.0.201712280730 4 150742
1#0##0#0#0.0#2018-03-08 14:25:13#0#12:00:00#12:00:00#12:00:00 1
e3cddcd96ea64a6cdca5818e34c9da90 0 0 818792 0 0
1208220 0 0 0 0 1841051 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 19/02/2018 22/01/1947 0 2
1 I63.9;I10;E14.9 - - - None None None None G-4-14-I
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 5746180 0 4 0 0 0 RICA LUKITO
0001258988984 3;JKN DR RIZKI; 5.2.0.201712280730 4 150313
1#0##0#0#0.0#2018-03-08 14:35:22#0#12:00:00#12:00:00#00:00:00 1
c9ce97939e09b4a38123d68300cf5fdd 0 0 1145699 0 0
1074563 0 0 0 0 3525918 0 0 0 0 0
3201126 B 2 BS 1 17/02/2018 19/02/2018 12/06/2004 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2769668 0 3 0 0 0 MUHAMMAD FATIH ZAHRAN
0000196442908 3;JKN DR RIZKI; 5.2.0.201712280730 4 150727
1#0##0#0#0.0#2018-03-28 13:52:08#0#12:00:00#12:00:00#00:00:00 2
a0038707552e0d1c094842e62b3d4a7b 0 0 238535 0 0 808940
0 0 0 0 1722193 0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 19/02/2018 19/08/1981 0 2
1 I21.2;I13.1;K29.7;D63.8 39.95;99.04 - - None None None None
7219300 0 0 - 0 - 0 - 0 - 0
7219300 6734436 0 3 0 0 0 IIN SUPRIATIN
0002282454371 3;JKN DR RIZKI; 5.2.0.201712280730 4 150729
1#0##0#0#0.0#2018-03-28 14:25:34#0#12:00:00#12:00:00#12:00:00 3
98b0357d9828c8c7f4b7543885ebd4cf 0 0 774930 0 0
3232685 0 0 0 0 1255571 0 0 0 0
1471250
3201126 B 3 BS 1 17/02/2018 19/02/2018 22/03/1985 0 2
1 A91;R10.1 - - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1648975 0 3 0 0 0 NUR ZUBAEDAH
0002036307633 3;JKN DR RIZKI; 5.2.0.201712280730 4 150737
1#0##0#0#0.0#2018-03-29 09:54:29#0#12:00:00#12:00:00#12:00:00 3
25eb0b33e1c6d76849d559357edede3e 0 0 409013 0 0 403585
0 0 0 0 836377 0 0 0 0 0
3201126 B 1 BS 1 17/02/2018 19/02/2018 25/08/1961 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3915090 0 3 0 0 0 AMIN D390686 56
20630 DR SOEGIONO, SPPD 0138R01702180007632 0000060518621 3;JKN DR
RIZKI; 5.2.1.201804062320 4 150736 1#0##0#0#0.0#2018-05-05
11:17:49#0#12:00:00#12:00:00#12:00:00 2 90a9216f78825a6d96b1cc1174d02183
0 0 345275 0 0 1290188 0 0 0 0
2279627 0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 19/02/2018 19/04/1976 0 1
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 1363587 0 3 0 0 0 ZAENAL MUTTAQIN
0000512019753 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 150731
1#0##0#0#0.0#2018-05-16 10:45:44#0#12:00:00#12:00:00#12:00:00 2
ba0e0a4190991efd642269654598d4f1 0 0 261764 0 0 284116
0 0 0 0 817707 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 20/02/2018 01/07/1979 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 1652282 0 2 0 0 0 ECIN D373173 38
14113 SRI KUNMARTINI.DR,SPPD 0138R01702180008577 0000511859002 3;JKN
DR RIZKI; 5.2.0.201712280730 4 151426 1#0##0#0#0.0#2018-03-02
11:03:01#0#12:00:00#12:00:00#12:00:00 1 e0bfb19807f759ba4383e4af31418935
0 0 371889 0 0 620300 0 0 0 0 660093
0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 20/02/2018 18/10/2016 0 2
0 - 0 - 0 - 0 - 0 2225900 2689061
0 3 0 0 0 KHALISA DIVANTI KURNIA D390735 1 488
DR RIANITA SYAMSU, SPA 0138R01702180007695 0002083715223 3;JKN DR
RIZKI; 5.2.0.201712280730 4 150745 1#0##0#0#0.0#2018-03-02
14:51:14#0#12:00:00#12:00:00#12:00:00 1 0a9b148516936324efb35ff433820244
0 0 253331 0 0 1444810 0 0 0 0 990920
0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 20/02/2018 01/02/1996 0 2
1 A49.9;K29.7;O08.8 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 2753900 0 0 - 0 - 0 - 0
- 0 2753900 2715955 0 4 0 0 0 SUCI SYAH
FITRI D390657 22 8052 DR SOEGIONO, SPPD 0138R01702180007598
0000512668866 3;JKN DR RIZKI; 5.2.0.201712280730 4 150730
1#0##0#0#0.0#2018-03-02 14:54:25#0#12:00:00#12:00:00#12:00:00 1
ef9824757bd6eaaf24407435282b4b25 0 0 402676 0 0
1057600 0 0 0 0 1255679 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 20/02/2018 07/08/1975 0 2
1 D64.9;K29.6;K92.1;A01.4 99.04 - - None None None None D-4-
- 0 - 0 5407200 3297617 0 2 0 0 0
NENGSIH D390787 42 15537 DR BETTY DWI L, SPPD
0138R01702180007883 0002085387186 3;JKN DR RIZKI; 5.2.0.201712280730
4 150771 1#0##0#0#0.0#2018-03-02
15:27:00#0#12:00:00#12:00:00#12:00:00 1 26ba8bab7eb2ba79c4449ffb67f2c00d
0 0 409013 0 0 2120872 0 0 0 0 767732
0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 20/02/2018 26/06/1953 0 2
1 G56.0 04.43 - - None None None None G-1-13-I None None
None None None None PROSEDUR CARPAL TUNNEL RELEASE (RINGAN) 1786400
0 0 - 0 - 0 - 0 - 0 1786400
8162204 0 2 0 0 0 ENNY DJUHAENI D372132 64
23614 DR RAY HENDRY, SPOT 0138R01702180008222 0001723042978 3;JKN
DR RIZKI; 5.2.0.201712280730 4 151122 1#0##0#0#0.0#2018-03-05
09:24:36#0#12:00:00#12:00:00#12:00:00 1 29b895431d71df6693a025c756ff304f
0 4850692 0 0 0 1862050 0 0 0 0
1449462 0 0 0 0 0
3201126 B 2 BS 1 17/02/2018 20/02/2018 12/04/1985 0 2
1 O48;O82.9;Z37.0 74.0 - - None None None None O-6-10-I
5984100 0 0 - 0 - 0 - 0 - 0
5984100 18644870 0 4 0 0 0 ENDANG JAYANTI
D027507 32 11999 DR ARJU A, SPOG 0138R01702180007667
0000205196534 3;JKN DR RIZKI; 5.2.0.201712280730 4 150739
1#1#vip#4#6233525#75.0#2018-03-05 09:31:23#0#12:00:00#12:00:00#12:00:00
2 a0b7f0f05950d1a7c98971c9c0b4046e 0 10536400 698000 0
0 2634470 0 0 0 0 4776000 0 0 0 0
0
3201126 B 2 BS 1 18/02/2018 20/02/2018 07/08/1979 0 1
1 B17.9 - - - None None None None B-4-13-I None None
0 - 0 - 0 - 0 - 0 5045200 2367594
0 3 0 0 0 MULYONO D390770 38 14075 DR SOEGIONO,
4 150762 1#0##0#0#0.0#2018-03-05
09:35:06#0#12:00:00#12:00:00#12:00:00 1 240d26a973177385c0a6d8401ea737dc
0 0 507068 0 0 372137 0 0 0 0
1488389 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 20/02/2018 04/05/1980 0 1
1 I87.2;L03.1;I88.8 88.77 - - None None None None I-4-15-I
LAIN (RINGAN) 5378800 0 0 - 0 - 0 - 0 -
0 5378800 2920484 0 3 0 0 0 MAMAN SUPARMAN
0138R01702180007858 0002249512727 3;JKN DR RIZKI; 5.2.0.201712280730
4 150768 1#0##0#0#0.0#2018-03-05
09:57:15#0#12:00:00#12:00:00#12:00:00 1 9a321d18227fffa65c598229749f3791
0 0 537092 0 0 1156332 0 0 0 0
1227060 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 20/02/2018 22/12/1989 0 2
1 O82.9;O99.0;Z37.0 74.0;99.04 - - None None None None O-6-
6486300 0 0 - 0 - 0 - 0 - 0
6486300 11647023 0 3 0 0 0 EKA TATIEK ULANSARI
0001627459997 3;JKN DR RIZKI; 5.2.0.201712280730 4 150754
1#0##0#0#0.0#2018-03-05 10:05:03#0#12:00:00#12:00:00#00:00:00 1
81720033bd7513a530cb7c1ae46e828d 0 5682448 415205 0 0
3423415 0 0 0 0 2125955 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 20/02/2018 18/02/2018 2848 1
1 P03.4;P83.8 - - - None None None None P-8-17-I None
(RINGAN) 4386800 0 0 - 0 - 0 - 0 - 0
4386800 1633367 0 3 0 0 0 BAYI NY EKA TATIEK
ULANSARI D390783 0 0 DR RIANITA SYAMSU, SPA 0138R01702180008765
0002431287167 3;JKN DR RIZKI; 5.2.0.201712280730 4 151537
1#0##0#0#0.0#2018-03-05 11:30:27#0#12:00:00#12:00:00#12:00:00 1
504f392b672fff0fc37d97b330c468d7 0 0 433812 0 0 396699
0 0 0 0 802856 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 20/02/2018 19/02/1957 0 2
1 I64;I11.0;R57.2;N18.5 - - - None None None None G-4-
- 0 - 0 - 0 - 0 6899800 3964008 0
1 0 0 0 AMINAH D390959 61 22281 DR VINSENSIA NOVI
KARTIKA 0138R01702180009174 0002087951095 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 152017 1#0##0#0#0.0#2018-03-06
09:06:44#0#12:00:00#12:00:00#12:00:00 1 564b78297d30d29d34a9c4f77a2b6e63
0 0 780498 0 0 2635182 0 0 0 0 548328
0 0 0 0 0
3201126 B 2 BS 1 11/02/2018 20/02/2018 10/08/1947 0 2
1 S72.00 81.51;93.19 - - YY01 RR04 None None M-1-04-I
None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI TUNGKAI
BAWAH (RINGAN) 13878100 0 0 HIP REPLACEMENT / KNEE REPLACEMENT
31225800 70404077 0 10 0 0 0 LELY OSWANDI
0002094308289 3;JKN DR RIZKI; 5.2.0.201712280730 4 147852
1#1#vip#10#14456325#75.0#2018-03-06 15:32:42#0#12:00:00#12:00:00#12:00:00
1 604ed1f6f79686dc01ff25c9b3e8678f 0 20843200 2851418 0
0 45015459 0 0 0 0 1226000 0 0 0 0
468000
3201126 B 1 BS 1 19/02/2018 20/02/2018 01/08/1953 0 2
1 N18.5;D63.8;I11.9 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 4069579 0 2 0 0 0 AUGUSTIEN A.
SUNDALANGI D319145 64 23578 DR. ARU ARIADNO, SPPD 0138R01702180008494
0001472918488 3;JKN DR RIZKI; 5.2.0.201712280730 4 151414
1#0##0#0#0.0#2018-03-06 15:35:29#0#12:00:00#12:00:00#00:00:00 1
39d4fafa440b6dd6b25458cd1a11435d 0 0 573641 0 0
1641704 0 0 0 0 1854234 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 20/02/2018 25/03/1959 0 2
1 J18.0;A41.9;E11.8;I10 - - - None None None None J-4-
(BERAT) 8987600 0 0 - 0 - 0 - 0 - 0
8987600 7220271 0 5 0 0 0 DEDE TATI HARTATI
D330629 58 21513 DR ZULFAN, SPPD 0138R01702180007415
0000041795515 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150331
1#0##0#0#0.0#2018-03-07 09:47:18#0#12:00:00#12:00:00#12:00:00 1
ba70500152e25d15a2709e1391b78232 0 0 842120 0 0
2320297 0 0 0 0 4057851 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 20/02/2018 26/06/1953 0 2
None None None None PROSEDUR CARPAL TUNNEL RELEASE (RINGAN) 1786400
0 0 - 0 - 0 - 0 - 0 1786400
8162204 0 2 0 0 0 ENNY DJUHAENI D372132 64
23614 DR RAY HENDRY, SPOT 0138R01702180013103 0001723042978 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 151122 1#0##0#0#0.0#2018-
03-19 10:28:39#0#12:00:00#12:00:00#12:00:00 2
0268a6f74444435a7e4b50e8c84766c0 0 4850692 0 0 0
1862050 0 0 0 0 1449462 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 20/02/2018 06/07/1998 0 2
1 D48.6 85.20;85.12 - - None None None None L-1-50-I None
0 0 - 0 - 0 - 0 - 0 7842900
10327409 0 3 0 0 0 RAHIMATUS SALWA d387617 19
TANTIYO S;16137 5.2.0.201712280730 4 151438 1#0##0#0#0.0#2018-
03-19 10:29:36#0#12:00:00#12:00:00#12:00:00 2
8035792a7085f93638dd15303e81592c 0 5805112 0 0 0
2588172 0 0 0 0 1789125 0 0 0 145000
0
3201126 B 2 BS 1 18/02/2018 20/02/2018 06/07/1998 0 2
1 D48.6 85.20;85.12 - - None None None None L-1-50-I None
0 0 - 0 - 0 - 0 - 0 7842900
10327409 0 3 0 0 0 RAHIMATUS SALWA d387617 19
TANTIYO S;16137 5.2.0.201712280730 4 151438 1#0##0#0#0.0#2018-
03-19 12:59:51#0#12:00:00#12:00:00#12:00:00 3
7b04c60039dffa75bc5f744219dbdd38 0 5805112 0 0 0
2588172 0 0 0 0 1789125 0 0 0 145000
0
3201126 B 2 BS 1 13/02/2018 20/02/2018 12/06/1943 0 2
1 I64;I11.0;I48;G81.9 90.59;87.49;89.52;93.19 - - None None
PEMBULUH DARAH OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (BERAT)
8279800 0 0 - 0 - 0 - 0 - 0
8279800 11332572 0 8 0 0 0 HAMDANAH D390302
74 27275 DR MAYSAM I., SPS 0138R01702180005989 0001263936126 3;JKN
DR RIZKI; 5.2.0.201712280730 4 149196 1#0##0#0#0.0#2018-03-28
13:51:09#0#12:00:00#12:00:00#12:00:00 2 c839e3cc1ff4bea499ba68d1b4af2577
0 0 1093660 0 0 5431529 0 0 0 0
4807383 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 20/02/2018 03/03/1947 0 1
1 I12.0;E14.9 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 14782693 0 2 0 0 0 SUKIMIN
D387487 70 25921 DR ARU, SPPD 0138R01702180008390
0000042653316 3;JKN DR RIZKI; 5.2.0.201712280730 4 151360
1#0##0#0#0.0#2018-03-28 14:22:48#0#12:00:00#12:00:00#12:00:00 2
1b724203ed88f521b0dc138f6657b942 0 0 3669967 0 0
4034634 0 0 0 0 7009092 0 0 0 0 69000
3201126 B 1 BS 1 19/02/2018 20/02/2018 14/02/1980 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6152247 0 2 0 0 0 SITI JURIAH D023921
38 13885 DR MAMAN HILMAN 0138R01702180008580 0001627033915 3;JKN
DR RIZKI; 5.2.1.201804062320 4 151427 1#0##0#0#0.0#2018-05-16
09:29:47#0#12:00:00#12:00:00#12:00:00 2 671e147d94fa9fd86a7e50d59d668ec6
0 0 945864 0 0 1262900 0 0 0 0
3874483 0 0 0 0 69000
3201126 B 1 BS 1 14/02/2018 20/02/2018 23/12/1964 0 1
4 I46.9;I25.1;I50.0;J18.8;I47.2;I10;E11.1 87.44;89.52;93.94;88.72 -
- None None None None I-4-14-III None None None None None None
CARDIAC ARREST, TIDAK DIKETAHUI (BERAT) 8461500 0 0 - 0
- 0 - 0 - 0 8461500 20525840 0 7 1
4 0 TINGKAS MANALU D102158 53 19411 DR AZRI NURIZAL SPPD KKV
0138R01702180006588 0002324524015 3;JKN DR RIZKI; 5.2.1.201804062320
4 149844 1#0##0#0#0.0#2018-05-16
09:54:07#0#12:00:00#12:00:00#12:00:00 2 1faf75e98b1d6e13c977321d46eb0744
0 0 985159 0 0 9644681 0 0 0 0
7061000 0 0 0 0 2835000
3201126 B 3 BS 1 14/02/2018 20/02/2018 08/09/2006 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 19003974 0 7 0 0 0 HASHFI QISTHAN SYUJA
d390383 11 4177 DR CATUR SUZANTARA 0138R01702180006381
0002096659506 3;JKN DR RIZKI; 5.2.1.201804062320 4 149702
1#0##0#0#0.0#2018-05-16 09:58:40#0#12:00:00#12:00:00#12:00:00 2
e34e747e68163d525cca833dffaf2fe5 0 0 2312825 0 0
11105249 0 0 0 0 5585899 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 20/02/2018 01/05/1968 0 2
None None None None DIVERTIKULITIS, DIVERTIKULOSIS DAN PENYAKIT
- 0 - 0 3983300 1929956 0 3 0 0 0
MAYA SHOFA D390744 49 18190 DR SOEGIONO, SPPD 0138R01702180007760
0001014464272 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 150752
1#0##0#0#0.0#2018-05-16 10:42:51#0#12:00:00#12:00:00#12:00:00 2
ac7f724447cc3f872f23eb8688fbe90d 0 0 261764 0 0 726933
0 0 0 0 941259 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 20/02/2018 01/07/1970 0 1
1 N18.9;R11;E14.9;I50.0 - - - None None None None N-4-
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 1071330 0 2 0 0 0 SUFIRMAN
0000512797623 3;JKN DR RIZKI; 5.2.2.201806040537 4 151412
1#0##0#0#0.0#2018-08-14 17:35:50#0#12:00:00#12:00:00#00:00:00 5
ae43606be5ec3d6673c70fc379fe1c5f 0 0 315243 0 0 397000
0 0 0 0 359087 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 20/02/2018 15/11/1967 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 11666387 0 2 0 0 0 WARKINAH D386344
3;JKN DR RIZKI; 5.2.2.201806040537 4 151020 1#0##0#0#0.0#2018-
10-01 12:07:58#0#12:00:00#12:00:00#12:00:00 2
268a05b31b78927ec18baf578bee49ff 0 5001100 3153245 0 0
2623820 0 0 0 0 819222 0 0 0 0 69000
3201126 B 3 BS 1 19/02/2018 21/02/2018 01/02/1998 0 2
(RINGAN) 3695900 0 0 - 0 - 0 - 0 - 0
3695900 1444787 0 3 0 0 0 CITRA PUSPASARI
INDESWATI D383574 20 7323 DR BETTY DWI L, SPPD 0138R01702180008592
0000510882489 3;JKN DR RIZKI; 5.2.0.201712280730 4 151430
1#0##0#0#0.0#2018-03-02 10:23:47#0#12:00:00#12:00:00#12:00:00 1
36fb52158e330f0cecf2ef4c75a36972 0 0 527768 0 0 270500
0 0 0 0 646519 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 21/02/2018 04/04/2017 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3488409 0 4 0 0 0 MUHAMMAD ALIF HIDAYAT
D390774 0 320 DR RASTRA, SPA 0138R01702180007820
0002239071399 3;JKN DR RIZKI; 5.2.0.201712280730 4 150761
1#0##0#0#0.0#2018-03-02 10:26:11#0#12:00:00#12:00:00#12:00:00 1
d67fb5aa291461dd511148efebfa02ac 0 0 378188 0 0
1550507 0 0 0 0 1219714 0 0 0 0 340000
3201126 B 3 BS 1 15/02/2018 21/02/2018 19/06/2010 0 2
1 J40;A16.1 87.44;93.94 - - None None None None J-4-21-II
0 - 0 4508300 7461661 0 7 0 0 0 AIKO
HASYANA PUTRI A254045 7 2798 DR AULIA TANGKARI, SPA
0138R01702180006750 0001816674568 3;JKN DR RIZKI; 5.2.0.201712280730
4 149874 1#0##0#0#0.0#2018-03-02
10:34:33#0#12:00:00#12:00:00#12:00:00 2 b1f78febb45cd4273477043095d7d20c
0 0 445985 0 0 4660530 0 0 0 0
2355146 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 21/02/2018 12/08/1971 0 2
1 D25.9;R33 69.09 - - None None None None W-1-11-I None
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 5228236 0 2 0 0 0 NURHASANAH D390416
46 16994 DR FERRI SABARUDDIN SPOG 0138R01702180009072
0002225964824 3;JKN DR RIZKI; 5.2.0.201712280730 4 151996
1#0##0#0#0.0#2018-03-02 10:38:45#0#12:00:00#12:00:00#12:00:00 1
58f0066c7a77f77e139f341cb9cf4e67 0 0 697168 0 0
1732034 0 0 0 0 2730034 0 0 0 69000 0
3201126 B 3 BS 1 19/02/2018 21/02/2018 02/06/1948 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 3628491 0 3 0 0 0 BUDI PURNAWAN
0002311066361 3;JKN DR RIZKI; 5.2.0.201712280730 4 151413
1#0##0#0#0.0#2018-03-02 15:28:41#0#12:00:00#12:00:00#12:00:00 1
ddc07e99808e498a4b07cf3b74d2de6c 0 0 688661 0 0
1887452 0 0 0 0 1052378 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 21/02/2018 12/09/1948 0 1
1 E11.2;E16.2;E87.1;I10 - - - None None None None N-4-
LAIN (SEDANG) 5275200 0 0 - 0 - 0 - 0 -
0 5275200 3595988 0 4 0 0 0 SYAFEI B NAMAN
D388858 69 25361 DR ARU, SPPD 0138R01702180007741
0001739716716 3;JKN DR RIZKI; 5.2.0.201712280730 4 150748
1#0##0#0#0.0#2018-03-02 15:33:02#0#12:00:00#12:00:00#12:00:00 1
2fd4d220e1054b3ff15b0eccfbd086d8 0 0 493496 0 0
1789240 0 0 0 0 1313252 0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 21/02/2018 12/08/1957 0 1
1 E87.6;R57.0;I50.0 89.52 - - None None None None E-4-11-III
6293300 0 0 - 0 - 0 - 0 - 0
6293300 11011421 0 5 0 0 0 AGUS D390602 60
3;JKN DR RIZKI; 5.2.0.201712280730 4 150400 1#0##0#0#0.0#2018-
03-02 15:46:40#0#12:00:00#12:00:00#12:00:00 1
cb52578ea3baced3a15ca1ed8b661023 0 0 619397 0 0
5742651 0 0 0 0 3891373 0 0 0 0 758000
3201126 B 3 BS 1 12/02/2018 21/02/2018 06/11/1967 0 1
1 E11.5;D63.8;N18.3 86.22 - - None None None None I-4-15-II
LAIN (SEDANG) 6097900 0 0 - 0 - 0 - 0 -
0 6097900 13732718 0 10 0 0 0 ERWIN IRAWAN
0001463679876 3;JKN DR RIZKI; 5.2.0.201712280730 4 148538
1#0##0#0#0.0#2018-03-02 15:54:53#0#12:00:00#12:00:00#00:00:00 1
bff96875932c4359e41e30e1733f1199 0 4862784 896183 0 0
4938349 0 0 0 0 2966402 0 0 0 69000 0
3201126 B 3 BS 1 17/02/2018 21/02/2018 01/11/1966 0 2
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 5318435 0 5 0 0 0 AISAH D390599 51
DR RIZKI; 5.2.0.201712280730 4 150337 1#0##0#0#0.0#2018-03-02
16:11:20#0#12:00:00#12:00:00#12:00:00 1 460004c54d43e032a550c71e1a02925b
0 0 557178 0 0 3072322 0 0 0 0
1688935 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 21/02/2018 28/11/1951 0 2
1 I25.0;I08.9 88.55;36.07 - - YY02 None None None I-1-40-II
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 55054995 0 2 0 0 0 THAI DJI KHIUN
0001388641331 3;JKN DR RIZKI; 5.2.0.201712280730 4 151535
1#0##0#0#0.0#2018-03-02 17:11:43#0#12:00:00#12:00:00#12:00:00 1
1fdad0549391ba9835dbd8b663b5f929 0 14520800 0 0 0
31363195 0 0 0 0 1602000 0 0 0 69000
7500000
3201126 B 3 BS 1 21/02/2018 21/02/2018 17/05/1955 0 1
10401900 0 0 - 0 - 0 - 0 - 0
10401900 2175921 0 1 0 0 0 LIM TJOEI HIN
0001319273673 3;JKN DR RIZKI; 5.2.0.201712280730 4 152354
1#0##0#0#0.0#2018-03-02 19:38:24#0#07:32:00#14:00:00#00:00:00 1
f6162ce8fc3dba46e4291bd49e5aee68 0 0 936171 0 0 808400
0 0 0 0 431350 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 21/02/2018 04/06/1958 0 2
1 C18.9;D63.0;E14.9 99.04 - - None None None None K-4-10-II
None None None None None None TUMOR PENCERNAAN (SEDANG) 8475400
0 0 - 0 - 0 - 0 - 0 8475400
3652534 0 2 0 0 0 ELISABETH ELLEN.T. LH D363093
3;JKN DR RIZKI; 5.2.0.201712280730 4 151433 1#0##0#0#0.0#2018-
03-05 10:34:26#0#12:00:00#12:00:00#00:00:00 1
b950f473e18c5675275ca12004187abf 0 0 317771 0 0
2059812 0 0 0 0 1274951 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 21/02/2018 05/07/1964 0 1
1 N18.5 39.27 - - None None None None N-1-12-I None None
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8196750 0 2 0 0 0 BANTA AYUSAN
d389649 53 19588 DR DEDY PRATAMA SPBV 0138R01702180008862
0001874825436 3;JKN DR RIZKI; 5.2.0.201712280730 4 151774
1#0##0#0#0.0#2018-03-05 11:07:45#0#12:00:00#12:00:00#12:00:00 1
8260fecff71f72538279ba2bd57e2bef 0 5122820 0 0 0
1647180 0 0 0 0 1426750 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 21/02/2018 16/09/1995 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4093026 0 4 0 0 0 MUHAMMAD ARIF
d382646 22 8191 DR HERY TIERA, SPU 0138R01702180007819
0000198750903 3;JKN DR RIZKI; 5.2.0.201712280730 4 150760
1#0##0#0#0.0#2018-03-05 11:50:56#0#12:00:00#12:00:00#12:00:00 1
4710017b993a3e7675141452f20932e5 0 0 238535 0 0
1748184 0 0 0 0 2106307 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 21/02/2018 20/03/2010 0 1
1 A49.9;N39.9 - - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3819095 0 4 0 0 0 FIRAS AZURA HABIBI
D189244 7 2892 DR HUDA, SPA 0138R01702180007697
0001188201328 3;JKN DR RIZKI; 5.2.0.201712280730 4 150744
1#0##0#0#0.0#2018-03-05 11:53:50#0#12:00:00#12:00:00#12:00:00 1
41200fb1d44a11bdb6a91f471287e061 0 0 298025 0 0
1225223 0 0 0 0 2295847 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 21/02/2018 23/03/1955 0 2
1 I13.2;D63.8 39.95;99.04 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4973600
7120819 0 3 0 0 0 ASTUTI D365706 62 22979
RIZKI; 5.2.0.201712280730 4 150836 1#0##0#0#0.0#2018-03-05
11:55:16#0#12:00:00#12:00:00#00:00:00 1 cc8648db682fc4a3e2d6505fbb7a2708
0 0 709388 0 0 3248333 0 0 0 0
3163098 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 21/02/2018 17/12/2015 0 2
SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0 -
0 3584400 5176052 0 3 0 0 0 ADEEVA AFSHEEN
MYESHA D339916 2 795 DR VERA MUNA MANOE, SPA 0138R01702180008564
0001898497269 3;JKN DR RIZKI; 5.2.0.201712280730 4 151421
1#0##0#0#0.0#2018-03-05 11:57:28#0#12:00:00#12:00:00#00:00:00 1
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2891552 0 0 0 0 1567616 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 21/02/2018 23/04/1952 0 2
1 N18.5;E87.1;J81 87.44 - - None None None None N-4-10-III
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 10076012 0 4 1 3 0 KUSMIYATI
0001423720596 3;JKN DR RIZKI; 5.2.0.201712280730 4 150743
1#0##0#0#0.0#2018-03-05 12:14:28#0#12:00:00#12:00:00#12:00:00 1
dc49eead2f3af347a72a209e71f76380 0 0 732680 0 0
2911904 0 0 0 0 4965428 0 0 0 0
1466000
3201126 B 1 BS 1 18/02/2018 21/02/2018 05/05/2010 0 2
0 0 - 0 - 0 - 0 - 0 3349800
3502706 0 4 0 0 0 SYARIFAH NAJMA BAHJATI D217088
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150763
1#0##0#0#0.0#2018-03-06 09:20:43#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 2598149 0 0 0 0 0
3201126 B 1 BS 1 12/02/2018 21/02/2018 14/05/1947 0 1
1 I63.9;G81.9;I25.0;I11.0;E13.7 87.03 - - None None None None
0 - 0 12141100 17827885 0 10 0 0 0 H.
BAMBANG SULISTIYO ADIWIJOYO D390156 70 25842 DR MAYSAMIRAWATI SPS
0138R01702180004899 0001295103194 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 147862 1#0##0#0#0.0#2018-03-06
09:22:31#0#12:00:00#12:00:00#12:00:00 1 a2c996eb96baf0a30abd701925e369cf
0 0 1388519 0 0 5203056 0 0 0 0
9370310 0 0 0 0 1865997
3201126 B 1 BS 1 18/02/2018 21/02/2018 04/09/1955 0 2
1 K80.1;N39.0 - - - None None None None B-4-14-II None
None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (SEDANG)
6859500 0 0 - 0 - 0 - 0 - 0
6859500 4536765 0 4 0 0 0 ERMIWATI D390775
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150767
1#0##0#0#0.0#2018-03-06 09:30:14#0#12:00:00#12:00:00#12:00:00 1
50d0e74617f9de504f60bd5d59314967 0 0 670355 0 0
1200612 0 0 0 0 2665798 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 21/02/2018 05/04/1971 0 1
1 I20.0;I10 - - - None None None None I-4-20-I None
5883600 0 0 - 0 - 0 - 0 - 0
5883600 3957262 0 3 0 0 0 HENGKI SOVIAN
0001466437689 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 151417
1#0##0#0#0.0#2018-03-06 09:31:14#0#12:00:00#12:00:00#12:00:00 1
c6c441bd258fb157d8fafdb31d791d56 0 0 582524 0 0 746852
0 0 0 0 2627886 0 0 0 0 0
3201126 B 1 BS 1 18/02/2018 21/02/2018 29/04/1954 0 1
1 I63.8;G41.8;G81.9 87.49;89.52;90.59;87.03 - - None None None
- 0 - 0 12141100 12574742 0 4 0 0 0
UJANG ISHAK D390739 63 23306 DR NURUL KOMARI SPS
0138R01702180007711 0001259008773 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150746 1#0##0#0#0.0#2018-03-06
09:40:32#0#12:00:00#12:00:00#12:00:00 1 1fb85f9d177ca63f6241559c7f5d6792
0 0 1145699 0 0 5776396 0 0 0 0
4248647 0 0 0 0 1404000
3201126 B 1 BS 1 18/02/2018 21/02/2018 27/05/1986 0 2
0 - 0 - 0 - 0 - 0 6981500 27531980
0 4 0 0 0 EDKE RAMADHITA D385454 31 11590 DR
ARJU A, SPOG 0138R01702180007847 0001639047699 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 150764 1#1#vvip#4#20550480#0.0#2018-03-06
09:49:20#0#12:00:00#12:00:00#12:00:00 2 1b38de4eb1049fa0fa84a97be0876de1
0 8973200 9305000 0 0 7765780 0 0 0 0
1291000 0 0 0 0 197000
3201126 B 1 BS 1 19/02/2018 21/02/2018 25/10/2017 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 5273559 0 3 0 0 0 AQILA DWI WIBISANA
0002302004981 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 151372
1#0##0#0#0.0#2018-03-06 10:08:00#0#12:00:00#12:00:00#12:00:00 1
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1237395 0 0 0 0 2713999 0 0 0 0 409000
3201126 B 1 BS 1 19/02/2018 21/02/2018 17/09/2014 0 2
1 A49.9;A09.9;J06.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 4003853 0 3 0 0 0 KHALISHA
HABIBA YASMIN AN d346578 3 1251 DR RIANITA SYAMSU, SPA
0138R01702180008006 0001969668876 3;JKN DR RIZKI; 5.2.0.201712280730
4 150772 1#0##0#0#0.0#2018-03-06
16:33:37#0#12:00:00#12:00:00#00:00:00 1 fa583cb93ea361e677ae55471f1dede9
0 0 338858 0 0 1034061 0 0 0 0
2630934 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 21/02/2018 12/01/1967 0 2
1 N18.5;R31;A49.9;K80.2 - - - None None None None N-4-
10-I None None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL
GINJAL (RINGAN) 4639400 0 0 - 0 - 0 - 0 -
0 4639400 3130957 0 3 0 0 0 JAINI D378822
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 151512
1#0##0#0#0.0#2018-03-08 08:29:21#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1792829 0 0 0 0 0
3201126 B 1 BS 1 14/02/2018 21/02/2018 19/10/1957 0 1
1 I64;K74.6;K27.9;G81.9 90.59;87.03;87.49 - - None None None
DARAH OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (SEDANG)
6844000 0 0 - 0 - 0 - 0 - 0
6844000 18562689 0 8 1 1 0 SUTOMO d343226
TANTIYO S;16137 5.2.0.201712280730 4 149216 1#0##0#0#0.0#2018-
03-08 09:15:21#0#12:00:00#12:00:00#00:00:00 1
40c1f3ce3ca32dbbcc793d39a02b501b 0 0 1186532 0 0
6616157 0 0 0 0 8486000 0 0 0 0
2274000
3201126 B 1 BS 1 20/02/2018 21/02/2018 12/04/1996 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 17258761 0 2 0 0 0 GURUH ARISTANTYO
PANDU WIBOWO D381904 21 7984 DEDY PRATAMA,SPBV 0138R01702180009078
0001827910754 3;JKN DR RIZKI; 5.2.0.201712280730 4 151989
1#0##0#0#0.0#2018-03-08 14:22:27#0#12:00:00#12:00:00#12:00:00 1
ec88ddd46a30663ac23c93353e7e7168 0 5896000 1762243 0 0
8311940 0 0 0 0 1185078 0 0 0 0 103500
3201126 B 1 BS 1 18/02/2018 21/02/2018 13/03/1952 0 2
1 H81.1;I10;K29.7;G44.2 - - - None None None None U-4-
0 - 0 - 0 - 0 - 0 2124500 4947896
0 4 0 0 0 MAMAH, NY D390747 65 24083 DR NURUL
5.2.0.201712280730 4 150755 1#0##0#0#0.0#2018-03-08
14:52:30#0#12:00:00#12:00:00#12:00:00 1 e8876bbed31b833ce7b009b61547966c
0 0 244204 0 0 1229998 0 0 0 0
3473694 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 21/02/2018 29/01/1944 0 1
1 I25.0;I08.9;E11.9;I11.9 88.55;36.07 - - YY02 None None None
- 0 46734600 57776322 0 2 0 0 0 SOEWARSO
0000060978508 3;JKN DR RIZKI; 5.2.0.201712280730 4 151549
1#0##0#0#0.0#2018-03-08 15:38:30#0#12:00:00#12:00:00#12:00:00 1
eda4335b19aefc094db40f3d0624a4fa 0 10062000 5374260 0 0
33515062 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 18/02/2018 21/02/2018 01/05/1964 0 2
1 I50.0;E11.9;I69.4;I25.0 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 3575600
2190035 0 4 1 0 0 IMI ALIS d376409 53 19651
DR BAMBANG DWIPUTRA SPJP 0138R01702180007798 0000512651665 3;JKN
DR RIZKI; 5.2.0.201712280730 4 150759 1#0##0#0#0.0#2018-03-28
16:05:53#0#12:00:00#12:00:00#12:00:00 2 eaaff94b36cd78b58c5e6581432d49cd
0 0 807893 0 0 423869 0 0 0 0 958273
0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 21/02/2018 15/08/1960 0 2
1 I84.2;E14.9;K29.7 - - - None None None None K-4-18-I
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 4367178 0 2 0 0 0 SUPARMI D251074
3;JKN DR RIZKI; 5.2.0.201712280730 4 151693 1#0##0#0#0.0#2018-
03-29 11:42:09#0#12:00:00#12:00:00#12:00:00 3
bcee84002bc0d19482cf3f18d391ce97 0 0 468350 0 0
2025125 0 0 0 0 1873703 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 21/02/2018 18/03/1967 0 2
1 E14.2;I11.9 - - - None None None None N-4-16-I None
(RINGAN) 5174200 0 0 - 0 - 0 - 0 - 0
5174200 3418544 0 2 0 0 0 SITI NURAINI
0000061127302 3;JKN DR RIZKI; 5.2.0.201712280730 4 151625
1#0##0#0#0.0#2018-03-29 11:47:13#0#12:00:00#12:00:00#12:00:00 2
aacd6bfb417501d0e5e2f2f4d65a2e0b 0 0 573641 0 0
1033260 0 0 0 0 1811643 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 21/02/2018 14/11/1974 0 2
1 M79.1;R10.1 90.59;89.52 - - None None None None M-4-20-I
None None None None None None TANDA, GEJALA & PERADANGAN
MUSKULOSKELETAL (RINGAN) 4105100 0 0 - 0 - 0 -
0 - 0 4105100 3856986 0 3 0 0 0
ELFINUR ZETHA RAHMAN D121118 43 15803 DR SOEGIONO, SPPD
0138R01702180007874 0001462949008 3;JKN DR RIZKI; 5.2.1.201804062320
4 150770 1#0##0#0#0.0#2018-05-05
11:27:42#0#12:00:00#12:00:00#00:00:00 2 65749a9b36fc7b2c626cbfaa0a8f1707
0 0 345275 0 0 890385 0 0 0 0
2621327 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 21/02/2018 07/02/1971 0 1
1 I13.1;D63.8;E13.9 99.04;38.95 - - None None None None N-1-
- 0 10690500 13610821 0 2 0 0 0 JOKO
MURYANTO d390929 47 17180 SRI KUNMARTINI.DR,SPPD 0138R01702180009108
0001268747559 3;JKN DR RIZKI; 5.2.1.201804062320 4 152014
1#0##0#0#0.0#2018-05-16 09:17:17#0#12:00:00#12:00:00#12:00:00 3
5ee23485725a61a31cdbe0d563b8d088 0 0 3153245 0 0
5037548 0 0 0 0 5385528 0 0 0 0 34500
3201126 B 2 BS 1 26/01/2018 21/02/2018 23/04/2016 0 1
4 G04.2;A17.8;A41.9 96.04;96.72 - - None None None None J-1-
02-III None None None None None None VENTILASI MEKANIKAL LONG TERM TANPA
TRAKEOSTOMI (BERAT) 79597900 0 0 - 0 - 0 - 0
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YASLAN D388660 1 643 DR NOVIK BUDIWARDHANA, SPA
0138R01701180012145 0002054585709 3;JKN DR RIZKI; 5.2.1.201804062320
4 140518 1#0##0#0#0.0#2018-05-16
09:47:46#0#12:00:00#12:00:00#12:00:00 2 69880f0b4bab81d0440287388841b72d
0 0 12112716 0 0 84526699 0 0 0 0
29907500 0 0 0 0 37989000
3201126 B 1 BS 1 20/02/2018 21/02/2018 19/02/2018 3564 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3034947 0 2 0 0 0 BAYI NY EDKE RAMADHITA
0002431496665 3;JKN DR RIZKI; 5.2.1.201804062320 4 152015
1#0##0#0#0.0#2018-05-16 09:51:22#0#12:00:00#12:00:00#12:00:00 2
802d3fa70ae4573232c2b59bfa36532d 0 0 310000 0 0 88899
0 0 0 0 2636048 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 21/02/2018 28/07/2017 0 2
0 0 - 0 - 0 - 0 - 0 3695000
2198474 0 2 0 0 0 TALITA SYAKIRA d390926 0
207 DR AWIDIYA, SPA 0138R01702180008990 0002250386471 3;JKN DR
RIZKI; 5.2.1.201804062320 4 151897 1#0##0#0#0.0#2018-05-16
09:53:22#0#12:00:00#12:00:00#12:00:00 2 d57a3cfee83c238c477e956ab1f2c203
0 0 385550 0 0 81099 0 0 0 0 1731825
0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 21/02/2018 10/08/1968 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2259696 0 4 0 0 0 HENTIA PRIHANTINA
0001740591314 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 150753
1#0##0#0#0.0#2018-05-16 10:52:55#0#12:00:00#12:00:00#12:00:00 2
4d786b70bf20d826bd8f22095b1293b7 0 0 409013 0 0 624852
0 0 0 0 1225831 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 21/02/2018 27/03/1940 0 1
1 E87.1;L89.9;R10.4;I69.4 - - - None None None None E-4-
3545800 0 0 - 0 - 0 - 0 - 0
3545800 4204929 0 4 0 0 0 DJUMARI D365719
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 150740
1#0##0#0#0.0#2018-05-16 11:26:39#0#12:00:00#12:00:00#00:00:00 2
1c54c92a7044dc49322c5954f7567a8b 0 0 515013 0 0
1328827 0 0 0 0 2361089 0 0 0 0 0
3201126 B 1 BS 1 17/02/2018 22/02/2018 06/10/1969 0 2
(RINGAN) 7018400 0 0 - 0 - 0 - 0 - 0
7018400 12925162 0 6 0 0 0 SUKMAWATI D390709
3;JKN DR RIZKI; 5.2.0.201712280730 4 150738
1#1#vvip#6#5906762#0.0#2018-02-27 08:56:16#1#12:00:00#12:00:00#12:00:00
1 7676ab80ae7fcf5d4741979a0b53b41e 0 0 819720 0 0
5513246 0 0 0 0 6592196 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 22/02/2018 01/10/2004 0 2
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 5968536 0 4 0 0 0 OKTARIAS ANANDA R
0001014393644 3;JKN DR RIZKI; 5.2.0.201712280730 4 151415
1#0##0#0#0.0#2018-03-02 10:09:02#0#12:00:00#12:00:00#12:00:00 1
3c905db56fed783b7ebebaa97a962607 0 0 268830 0 0
4231241 0 0 0 0 1468465 0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 22/02/2018 05/11/2014 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 5200316 0 6 0 0 0 AISYAH AQILAH
0001828371958 3;JKN DR RIZKI; 5.2.0.201712280730 4 150403
1#0##0#0#0.0#2018-03-02 10:11:37#0#12:00:00#12:00:00#12:00:00 1
a2f89409573012204276514d8d26b0ed 0 0 834794 0 0
2421314 0 0 0 0 1944208 0 0 0 0 0
3201126 B 3 BS 1 17/02/2018 22/02/2018 20/06/2011 0 1
1 L04.9 - - - None None None None D-4-14-I None None
None None None None GANGGUAN PADA DARAH & ORGAN PEMBENTUK DARAH LAIN-LAIN
(RINGAN) 3203700 0 0 - 0 - 0 - 0 - 0
3203700 4366332 0 6 0 0 0 TENGKU MUHAMMAD RASYA
SYAPUTRA D390720 6 2434 DR CATUR S, SPB 0138R01702180008039
0001339283733 3;JKN DR RIZKI; 5.2.0.201712280730 4 150799
1#0##0#0#0.0#2018-03-02 10:13:57#0#12:00:00#12:00:00#12:00:00 1
d2a2facd34ce5d635390b1490b1ffa82 0 0 341333 0 0
2398351 0 0 0 0 1626648 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 22/02/2018 16/06/1996 0 2
1 A01.0;N39.0 - - - None None None None A-4-14-II None
(SEDANG) 2753900 0 0 - 0 - 0 - 0 - 0
2753900 1748682 0 3 0 0 0 DINA HILDA YANTI
0002233175545 3;JKN DR RIZKI; 5.2.0.201712280730 4 151435
1#0##0#0#0.0#2018-03-02 10:41:54#0#12:00:00#12:00:00#12:00:00 1
676c8706b7ce25d6da8732efad82cf0f 0 0 257183 0 0 562099
0 0 0 0 929400 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 22/02/2018 22/01/1954 0 1
1 I64;E14.9;J98.5;R13;E78.5;M10.99 87.44 - - None None None
6844000 0 0 - 0 - 0 - 0 - 0
6844000 14677759 0 7 0 0 0 R A MUSTADJAB
0000061125164 3;JKN DR RIZKI; 5.2.0.201712280730 4 150328
1#1#vvip#7#7833759#0.0#2018-03-02 10:51:25#0#12:00:00#12:00:00#00:00:00
1 f64501c4ad7f3b10b00d505c763c3df8 0 0 1915109 0 0
4126423 0 0 0 0 8636227 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 22/02/2018 26/09/1976 0 1
1 N18.5;D63.8 87.44;99.04;39.95 - - None None None None N-4-
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 4753040 0 3 0 0 0 DORMAN LIBRANDO P
S TN D239322 41 15122 DR ARU, SPPD 0138R01702180008669
0001743628138 3;JKN DR RIZKI; 5.2.0.201712280730 4 151437
1#0##0#0#0.0#2018-03-02 10:55:01#0#12:00:00#12:00:00#00:00:00 1
2eb17683240a68763c756a4bf99f394e 0 0 599993 0 0
1870850 0 0 0 0 1125947 0 0 0 0
1156250
3201126 B 3 BS 1 14/02/2018 22/02/2018 10/08/1956 0 2
1 A15.6;J18.9;I11.0;K21.9 90.59;87.49;34.91 - - None None None
None J-4-15-III None None None None None None PERADANGAN DAN INFEKSI
- 0 6970400 10456846 0 9 0 0 0 REMIYATI
D378158 61 22468 DR BOBBY DRASTYAWAN SPPA 0138R01702180006150
0001458641362 3;JKN DR RIZKI; 5.2.0.201712280730 4 149217
1#0##0#0#0.0#2018-03-02 11:01:05#0#12:00:00#12:00:00#12:00:00 1
890bef8d7f7440d2d9a9edf1a7f7885d 0 0 2080100 0 0
5299653 0 0 0 0 3077093 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 22/02/2018 06/09/2017 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4307346 0 4 0 0 0 SARAH ALFATUNISA
0002271876309 3;JKN DR RIZKI; 5.2.0.201712280730 4 151690
1#0##0#0#0.0#2018-03-02 11:09:48#0#12:00:00#12:00:00#12:00:00 1
57bf58c497196b6312ae3cf639308698 0 0 378188 0 0
2229369 0 0 0 0 1359789 0 0 0 340000
0
3201126 B 2 BS 1 18/02/2018 22/02/2018 28/07/2016 0 2
- 0 - 0 - 0 - 0 3187000 3604957 0
5 0 0 0 KANAYA JULIANI ILHAM D390752 1 570 DR
AWIDIYA, SPA 0138R01702180008053 0002073904604 3;JKN DR RIZKI;
5.2.0.201712280730 4 150828 1#0##0#0#0.0#2018-03-05
08:43:54#0#12:00:00#12:00:00#12:00:00 1 c6d230130bbdd254d69cd32e0d56ff3d
0 0 392830 0 0 425289 0 0 0 0
2786838 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 22/02/2018 17/06/2017 0 1
0 - 0 - 0 - 0 - 0 2671100 3218824
0 4 0 0 0 AZMYA RAESHA RAMADHANI D390886 0 247
DR KRISTON SILITONGA, SPA 0138R01702180008602 0002275267904 3;JKN
DR RIZKI; 5.2.0.201712280730 4 151432 1#0##0#0#0.0#2018-03-05
08:45:11#0#12:00:00#12:00:00#12:00:00 1 bd17632cfdac70f01596b0e032d4f093
0 0 293399 0 0 1003848 0 0 0 0
1751577 0 0 0 170000 0
3201126 B 2 BS 1 17/02/2018 22/02/2018 04/08/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4226357 0 6 0 0 0 KHALIFAH AMMAR AR RASHAD
AFRYAND D390653 1 562 DR AULIA TANGKARI, SPA 0138R01702180007605
0002069933152 3;JKN DR RIZKI; 5.2.0.201712280730 4 150733
1#0##0#0#0.0#2018-03-05 08:49:47#0#12:00:00#12:00:00#12:00:00 1
6455472098e99750b26edd1d2211d075 0 0 238535 0 0 862831
0 0 0 0 3124991 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 22/02/2018 16/10/2012 0 2
0 - 0 - 0 - 0 - 0 2671100 3679286
0 4 0 0 0 ZAZKI ROFIFAH SUNGKAR D274207 5 1952
DR AWIDIYA, SPA 0138R01702180008210 0002136901408 3;JKN DR RIZKI;
5.2.0.201712280730 4 151120 1#0##0#0#0.0#2018-03-05
08:52:48#0#12:00:00#12:00:00#12:00:00 1 4bcb15866659b24e9f43c220cff486b9
0 0 293399 0 0 1099186 0 0 0 0
2286701 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 22/02/2018 28/08/1992 0 2
1 N39.0;A01.0;R55 89.14 - - None None None None N-4-12-III
None None None None None None INFEKSI GINJAL DAN SALURAN URIN (BERAT)
6075100 0 0 - 0 - 0 - 0 - 0
6075100 4551865 0 4 0 0 0 AULIA ROSMALINDA
0001632579254 3;JKN DR RIZKI; 5.2.0.201712280730 4 151431
1#0##0#0#0.0#2018-03-05 08:55:43#0#12:00:00#12:00:00#00:00:00 1
fafb9d6cf654653fd5b3a573961b762d 0 0 921660 0 0
1091419 0 0 0 0 1838786 0 0 0 0 700000
3201126 B 2 BS 1 16/02/2018 22/02/2018 05/09/1948 0 1
1 N13.6;R33;R42;D63.8 99.04;88.76;88.01;57.94 - - None None
None None N-4-12-II None None None None None None INFEKSI GINJAL DAN
SALURAN URIN (SEDANG) 5047200 0 0 - 0 - 0 - 0
- 0 5047200 11386984 0 7 0 0 0 MANAP
D389801 69 25366 DR ARU, SPPD 0138R01702180008742
0001336358193 3;JKN DR RIZKI; 5.2.0.201712280730 4 151550
1#0##0#0#0.0#2018-03-05 11:03:23#0#12:00:00#12:00:00#12:00:00 1
43e54782a773936c5b8ebd8c46dee1cc 0 0 615264 0 0
6465777 0 0 0 0 4305943 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 22/02/2018 25/07/1958 0 1
1 I97.9;I12.0 88.40;39.50 - - None None None None I-1-20-II
(SEDANG) 23032500 0 0 - 0 - 0 - 0 - 0
23032500 15469964 0 3 0 0 0 ROKIB D348894 59
21760 DR IRFIANSYAH LESMANA DR SPBTKV 0138R01702180009163
0001125532642 3;JKN DR RIZKI; 5.2.0.201712280730 4 152016
1#0##0#0#0.0#2018-03-05 11:17:34#0#12:00:00#12:00:00#00:00:00 1
0b0031c7a4e48bef55f0c50a82d17bda 0 8687600 921300 0 0
2530260 0 0 0 0 3261804 0 0 0 69000 0
3201126 B 2 BS 1 16/02/2018 22/02/2018 11/09/1981 0 1
None None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN LAIN-LAIN
(RINGAN) 5378800 0 0 - 0 - 0 - 0 - 0
5378800 14914924 0 7 0 0 0 IMAM KASKARAPATI
D390559 36 13307 DR ARU, SPPD 0138R01702180007267
0001627278873 3;JKN DR RIZKI; 5.2.0.201712280730 4 150315
1#0##0#0#0.0#2018-03-05 11:28:34#0#12:00:00#12:00:00#12:00:00 1
97eba5cd01a7de7add122c0df7643b28 0 5253624 644595 0 0
5155962 0 0 0 0 3791743 0 0 0 69000 0
3201126 B 2 BS 1 21/02/2018 22/02/2018 13/04/1984 0 1
- 0 10690500 11768563 0 2 0 0 0 HEZRON
PANDIANGAN D388984 33 12367 DR SRI KUN, SPPD 0138R01702180009647
0001336724368 3;JKN DR RIZKI; 5.2.0.201712280730 4 152556
1#0##0#0#0.0#2018-03-05 11:35:43#0#12:00:00#12:00:00#12:00:00 1
56fae903d0f7f6817ede168384ee2c52 0 6219200 1015145 0 0
3016812 0 0 0 0 1448406 0 0 0 69000 0
3201126 B 1 BS 1 20/02/2018 22/02/2018 08/06/2012 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3101492 0 3 0 0 0 SARAH AFIQAH SALSABILA
D231524 5 2083 DR AWIDIYA, SPA 0138R01702180008931
0001460563209 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 152139
1#0##0#0#0.0#2018-03-06 09:16:34#0#09:33:25#09:33:25#00:00:00 1
6781913864eb31761d0f6edafe52d674 0 0 241100 0 0 288491
0 0 0 0 2571901 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 22/02/2018 25/02/2015 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3633218 0 3 0 0 0 CALON BAYI NY SRI
NURHIDAYATI.K D390940 2 1091 DR AWIDIYA, SPA 0138R01702180009034
0001829060368 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 151974
1#0##0#0#0.0#2018-03-06 09:17:48#0#12:00:00#12:00:00#12:00:00 1
19706aa16c21be42ff62d51f1ee9220d 0 0 338858 0 0 687673
0 0 0 0 2606687 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 22/02/2018 17/12/1939 0 1
1 J91;E11.6;I69.4;D29.1 - - - None None None None J-4-
20-II None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (SEDANG)
9001900 0 0 - 0 - 0 - 0 - 0
9001900 6287467 0 4 0 0 0 DJAMALUDDIN IBRAHIM
0000060949102 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 151418
1#0##0#0#0.0#2018-03-06 09:19:10#0#12:00:00#12:00:00#12:00:00 1
60a5c2ab2bcbb90e1b99f527886362c3 0 0 863171 0 0
1862966 0 0 0 0 3561329 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 22/02/2018 20/02/2018 3350 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437236 0 3 0 0 0 BAYI NY RAHMAWATI AS
d390903 0 0 DR DYAH HARINI, SPA 0138R01702180008982
0002424724198 3;JKN DR RIZKI; 5.2.0.201712280730 4 151877
1#0##0#0#0.0#2018-03-06 09:23:19#0#12:00:00#12:00:00#12:00:00 1
53b2be638d70ff9c8a7b4af5937f485c 0 0 433812 0 0 88899
0 0 0 0 914525 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 22/02/2018 19/01/1952 0 2
1 M67.4 05.29 - - None None None None G-1-20-I None None
None None None None PROSEDUR SARAF KRANIAL DAN PERIFER (RINGAN)
12332900 0 0 - 0 - 0 - 0 - 0
12332900 14693747 0 3 0 0 0 MEGA ASMARA DAMIR,SE.
0000061013373 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 152018
1#0##0#0#0.0#2018-03-06 09:52:20#0#12:00:00#12:00:00#12:00:00 1
111dfdddb4fb243f0846d4384a9194bd 0 7179100 3399424 0 0
2932950 0 0 0 0 1037273 0 0 0 145000
0
3201126 B 1 BS 1 21/02/2018 22/02/2018 31/03/1950 0 2
1 E14.2;I25.0 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 14194386 0 2 0 0 0 NURLAELA
D388786 67 24799 DR SRI KUN, SPPD 0138R01702180009659
0001845558246 3;JKN DR RIZKI; 5.2.0.201712280730 4 152482
1#0##0#0#0.0#2018-03-06 16:06:45#0#12:00:00#12:00:00#12:00:00 1
ceebbd777327f3d45a23421e19a25b87 0 0 3669967 0 0
3604814 0 0 0 0 6850605 0 0 0 0 69000
3201126 B 2 BS 1 21/02/2018 22/02/2018 24/10/1983 0 1
1 I12.0;A49.9 - - - None None None None N-4-10-I None
(RINGAN) 3976600 0 0 - 0 - 0 - 0 - 0
0001638965226 3;JKN DR RIZKI; 5.2.0.201712280730 4 152166
1#0##0#0#0.0#2018-03-07 08:38:39#0#12:00:00#12:00:00#00:00:00 1
98dd6b341804dbc56c2619b5d22e553b 0 0 410894 0 0
1219681 0 0 0 0 1222660 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 22/02/2018 13/05/2016 0 1
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 4531264 0 4 0 0 0 SABRINA AYU ANNISA
0002288137162 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 151422
1#0##0#0#0.0#2018-03-08 08:19:25#0#12:00:00#12:00:00#12:00:00 1
e7eabacf56e3584d98957a85fc8f99b5 0 0 269459 0 0 815367
0 0 0 0 3446438 0 0 0 0 0
3201126 B 1 BS 1 16/02/2018 22/02/2018 27/09/2017 0 2
1 A09.9;E73.9;E87.6 - - - None None None None K-4-17-II
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 7882460 0 7 0 0 0 BAYI NY WIRINA PANGKEY
0002314866644 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150323
1#0##0#0#0.0#2018-03-08 09:26:05#0#12:00:00#12:00:00#12:00:00 1
2bf641a33b2624a3fed13550e6a6fe70 0 0 269459 0 0
1264326 0 0 0 0 6008675 0 0 0 0 340000
3201126 B 1 BS 1 19/02/2018 22/02/2018 10/03/1997 0 2
1 O21.1;E86 - - - None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 3035600 5489220
0 4 0 0 0 RETNO TRI WAHYUNINGSIH D388101 20 7651
DR ARIS WAHJU, SPOG 0138R01702180008088 0001731214901 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 150882 1#0##0#0#0.0#2018-
03-08 09:30:30#0#12:00:00#12:00:00#12:00:00 1
912ab4895cafa2f548349180e8ad3f74 1000000 0 576204 0 0
469329 0 0 0 0 3443684 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 22/02/2018 28/07/1974 0 2
9855000 0 0 - 0 - 0 - 0 - 0
9855000 16625470 0 4 0 0 0 YULIANINGSIH
d020699 43 15912 DR E SURYA POHAN DR SPB KBD 0138R01702180008138
0001827093925 3;JKN DR RIZKI; 5.2.0.201712280730 4 150999
1#0##0#0#0.0#2018-03-28 13:56:14#0#12:00:00#12:00:00#12:00:00 2
720e13e2e22b0ab017cc68e5affcb0e2 0 0 3068968 0 0
3980154 0 0 0 0 9213847 0 0 0 362500
0
3201126 B 1 BS 1 16/02/2018 22/02/2018 01/11/1948 0 1
1 J44.0;I50.0;K29.7;R33 87.44;93.94 - - None None None None
J-4-17-II None None None None None None PENYAKIT PARU OBSTRUKTIF
KRONIS (SEDANG) 6184400 0 0 - 0 - 0 - 0 -
0 6184400 14211903 0 7 0 0 0 MAKDIN SIMANJUNTAK
0000061022834 3;JKN DR RIZKI; 5.2.0.201712280730 4 150309
1#0##0#0#0.0#2018-03-28 13:58:20#0#12:00:00#12:00:00#00:00:00 2
b4e74793bb0b329248a0da6413e56e8b 0 0 945737 0 0
6843415 0 0 0 0 6422751 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 22/02/2018 01/05/1947 0 1
1 N13.6;D29.1;J18.0;I11.9 57.32;57.0 - - None None None None
N-1-40-III None None None None None None PROSEDUR PADA URETRA DAN
TRANSURETRA (BERAT) 12708900 0 0 - 0 - 0 - 0
- 0 12708900 19700443 0 4 0 0 0 HASAN BASRI
D387803 70 25862 DR SIDHI,SPU 0138R01702180008572
0000511890287 3;JKN DR RIZKI; 5.2.0.201712280730 4 151423
1#0##0#0#0.0#2018-03-28 14:40:48#0#12:00:00#12:00:00#12:00:00 3
675b628a836b1a61a957caea3effba11 0 7174912 353516 0 0
5427015 0 0 0 0 1745000 0 0 0 0
5000000
3201126 B 2 BS 1 21/02/2018 22/02/2018 13/09/1988 0 2
0 0 - 0 - 0 - 0 - 0 2009900
4352781 0 2 0 0 0 SEPTIA ANGGRAINI D222919 29
10753 DR ARI KUSUMA JANUARTO, DR. SPOG 0138R01702180009717
0002320916297 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 152555
1#0##0#0#0.0#2018-03-28 16:45:24#0#12:00:00#12:00:00#12:00:00 2
49067a64c9298337c0c4f525b532c98c 2199680 0 53000 0 0 860340
0 0 0 0 1239761 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 22/02/2018 22/08/1985 0 2
1 O82.9;Z37.0;O99.5 74.0 - - None None None None O-6-10-II
6486300 0 0 - 0 - 0 - 0 - 0
6486300 12619534 0 4 0 0 0 RAHMAWATI AS
0138R01702180008584 0001877102278 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 151428 1#0##0#0#0.0#2018-03-28
16:56:36#0#12:00:00#12:00:00#12:00:00 3 961cefdee72fa060bbc66196e9adaf66
0 5682448 475046 0 0 3516463 0 0 0 0
2586577 0 0 0 359000 0
3201126 B 1 BS 1 20/02/2018 22/02/2018 12/02/1976 0 2
1 A01.0;R10.1 99.21 - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4170879 0 3 0 0 0 RENI D249224 42
DR RIZKI; 5.2.1.201804062320 4 151434 1#0##0#0#0.0#2018-05-05
11:16:30#0#12:00:00#12:00:00#12:00:00 2 b3dc14258d244878b7e3ead6219e3231
0 0 338858 0 0 1190160 0 0 0 0
2641861 0 0 0 0 0
3201126 B 2 BS 1 21/02/2018 22/02/2018 21/02/2018 956 1
1 P03.9;P07.0;P36.8 - - - None None None None P-8-03-II
None None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-1 TANPA
- 0 20817900 3596856 0 2 0 0 0 BY NY SEPTIA
ANGGRAINI d391108 0 0 DR AULIA TANGKARI, SPA 0138R01702180010289
0002432673854 3;JKN DR RIZKI; 5.2.1.201804062320 4 153192
1#0##0#0#0.0#2018-05-16 09:49:42#0#12:00:00#12:00:00#12:00:00 2
faeebe3fe556cf3f63f6619caf8a36aa 0 0 1326888 0 0 792160
0 0 0 0 1477808 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 22/02/2018 07/10/1940 0 2
None None None None PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK (RINGAN)
2955200 0 0 - 0 - 0 - 0 - 0
2955200 2917195 0 1 0 0 0 EMAN SULAEMAN
D391105 77 28262 DR NIKEN PRABHA DUHITA 0138R01702180010007
0001740379937 3;JKN DR RIZKI; 5.2.1.201804062320 4 152696
1#0##0#0#0.0#2018-05-16 09:57:26#0#00:00:00#11:15:00#12:00:00 2
33d78099165d765ad09bcac32194b011 0 0 368658 0 0
2068692 0 0 0 0 479845 0 0 0 0 0
3201126 B 3 BS 1 21/02/2018 22/02/2018 21/03/1955 0 2
1 I95.9;R40.1;E87.1;E87.2 96.07 - - None None None None I-4-
24-II None None None None None None GANGGUAN SISTEM PEMBULUH DARAH LAIN-LAIN
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 6112118 0 2 0 0 0 ASMAH WATI D391046
62 22983 DR MUHAMMAD RIZKI YUWANA 0138R01702180009683
0001770657658 3;JKN DR RIZKI; 5.2.1.201804062320 4 152559
1#0##0#0#0.0#2018-05-16 09:58:11#0#13:31:00#08:40:00#12:00:00 2
d4117e4862431b8890aef2a3fe9fd44b 0 0 1698156 0 0
3725104 0 0 0 0 688858 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 22/02/2018 17/03/2010 0 1
- 0 - 0 - 0 - 0 4649300 10180315 0
4 0 0 0 RAFAN AS SAKHA SYAMIL ABDILLAH D324008 7
2896 DR CATUR S, SPB 0138R01702180008116 0001172352791 3;JKN DR
RIZKI; 5.2.1.201804062320 4 150935 1#0##0#0#0.0#2018-05-16
10:06:01#0#12:00:00#12:00:00#00:00:00 2 164f51ae27c1e718d47a48dc6ce9beba
0 5763300 1354804 0 0 2237709 0 0 0 0
752002 0 0 0 0 72500
3201126 B 3 BS 1 21/02/2018 22/02/2018 04/10/1967 0 2
1 I61.9;K21.9 87.03 - - None None None None G-4-13-I None
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 2778959 0 2 0 0 0 TARWIYAH D371653
TANTIYO S;16137 5.2.1.201804062320 4 152025 1#0##0#0#0.0#2018-
05-17 12:56:18#0#05:40:00#01:10:00#12:00:00 2
c6e05a3844ad271e31a1f0af5008b96b 0 0 368658 0 0
1939500 0 0 0 0 470801 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 23/02/2018 01/04/1963 0 2
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 7786123 0 6 0 0 0 SITI ASIYAH D390749
54 20047 DR MAYSAM I., SPS 0138R01702180007776 0000511372754 3;JKN
DR RIZKI; 5.2.0.201712280730 4 150756 1#0##0#0#0.0#2018-03-02
16:16:50#0#12:00:00#12:00:00#12:00:00 2 193d3c508d9f77396c022fc3c4812973
0 0 946759 0 0 4725991 0 0 0 0
2113373 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 23/02/2018 01/06/1957 0 2
1 I13.2;D63.8 99.04;39.95 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4144700
12116352 0 5 1 2 0 PONIAH d373295 60 22178
RIZKI; 5.2.0.201712280730 4 151123 1#0##0#0#0.0#2018-03-02
16:27:19#0#12:00:00#12:00:00#12:00:00 1 c726b1e7c0e74d0dbd33136591da8ae4
0 0 599993 0 0 4794200 0 0 0 0
5981159 0 0 0 741000 0
3201126 B 3 BS 1 20/02/2018 23/02/2018 21/12/1942 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 10232950 0 4 0 0 0 JASIMIN KAMSO
0001014278196 3;JKN DR RIZKI; 5.2.0.201712280730 4 151436
1#0##0#0#0.0#2018-03-02 16:31:04#0#12:00:00#12:00:00#12:00:00 1
2523558c5e75605670816bfea2d0a561 0 4629720 0 0 0
4086785 0 0 0 0 1447445 0 0 0 69000 0
3201126 B 3 BS 1 21/02/2018 23/02/2018 18/07/1958 0 2
1 I12.0;D63.8;J18.0;E79.0 38.95;99.04;87.44 - - None None None
0 - 0 - 0 19332400 13383974 0 3 0 0
0 SUWARNI D391032 59 21768 SRI KUNMARTINI.DR,SPPD
0138R01702180009650 0001481969856 3;JKN DR RIZKI; 5.2.0.201712280730
4 152472 1#0##0#0#0.0#2018-03-02
16:43:13#0#12:00:00#12:00:00#12:00:00 1 0bc07ef1d5c359287e4732a780f760b9
0 4498260 801792 0 0 5289585 0 0 0 0
2606837 0 0 0 187500 0
3201126 B 3 BS 1 19/02/2018 23/02/2018 10/12/1997 0 2
5062600 0 0 - 0 - 0 - 0 - 0
5062600 3178310 0 5 0 0 0 LINA SEPTIANA
PERMATASARI D390849 20 7376 DR BETTY DWI L, SPPD 0138R01702180008556
0001740059054 3;JKN DR RIZKI; 5.2.0.201712280730 4 151425
1#0##0#0#0.0#2018-03-02 16:58:00#0#12:00:00#12:00:00#12:00:00 1
aa15be8d5e75b858a6a38e42304483f2 0 0 508634 0 0
1207249 0 0 0 0 1462427 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 23/02/2018 17/11/2017 0 1
1 N48.1;N47 64.0 - - None None None None V-1-15-I None
1467400 0 0 - 0 - 0 - 0 - 0
1467400 3609816 0 2 0 0 0 BAYI NY EKA PURWANINGSIH
d382186 0 97 DR CATUR S, SPB 0138R01702180009979
0002310698709 3;JKN DR RIZKI; 5.2.0.201712280730 4 152632
1#0##0#0#0.0#2018-03-02 18:14:49#0#12:00:00#12:00:00#12:00:00 1
53ca679b1c6f8bf313c30d3be3880e04 0 2426872 0 0 0 540045
0 0 0 0 642899 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 23/02/2018 02/03/1964 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 4206886 0 2 0 0 0 ROMLI TN D325831
3;JKN DR RIZKI; 5.2.0.201712280730 4 152569 1#0##0#0#0.0#2018-
03-02 18:43:58#0#12:00:00#12:00:00#00:00:00 1
e421af40f8a25ad3fd6c93339e260f12 0 0 424889 0 0
1798530 0 0 0 0 827217 0 0 0 0
1156250
3201126 B 3 BS 1 21/02/2018 23/02/2018 26/05/1961 0 2
1 K80.8;K29.7;N19 - - - None None None None B-4-14-II
(SEDANG) 4899600 0 0 - 0 - 0 - 0 - 0
4899600 1937587 0 3 0 0 0 TUTI N. D387345
3;JKN DR RIZKI; 5.2.0.201712280730 4 152562 1#0##0#0#0.0#2018-
03-02 19:36:21#0#12:00:00#12:00:00#12:00:00 1
393804f5a68b95b0cdc76f8cf5f19a43 0 0 493964 0 0 763930
0 0 0 0 679693 0 0 0 0 0
3201126 B 2 BS 1 22/02/2018 23/02/2018 20/07/2012 0 1
0 - 0 - 0 - 0 - 0 4851400 3916940
0 2 0 0 0 MUHAMMAD FACHREEL RAMADHAN D232807 5
2043 DR VERA MUNA MANOE, SPA 0138R01702180010101 0001642022987 3;JKN
DR RIZKI; 5.2.0.201712280730 4 152892 1#0##0#0#0.0#2018-03-05
11:59:56#0#12:00:00#12:00:00#00:00:00 1 093b92389239cf96d8760a442bde5d16
0 0 489626 0 0 2135066 0 0 0 0
1292248 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 23/02/2018 15/09/1958 0 2
0 - 0 8291400 4123410 0 4 0 0 0 MYRNA
LOPPIES D048681 59 21708 DR NURUL KOMARI SPS 0138R01702180009207
0001627021326 3;JKN DR RIZKI; 5.2.0.201712280730 4 152019
1#0##0#0#0.0#2018-03-05 12:09:17#0#12:00:00#12:00:00#12:00:00 1
5229d7bb5aba364d5a44fe7935da1f6a 0 0 882140 0 0
1430514 0 0 0 0 1810756 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 23/02/2018 28/10/1997 0 2
1 A41.9;K29.7;E87.1;A92.0;D63.8 90.59 - - None None None None
A-4-10-III None None None None None None SEPTIKEMIA (BERAT)
7006300 0 0 - 0 - 0 - 0 - 0
7006300 6157963 0 6 0 0 0 DIAN PERMATA SARI
0002059151049 3;JKN DR RIZKI; 5.2.0.201712280730 4 150741
1#0##0#0#0.0#2018-03-05 12:16:17#0#12:00:00#12:00:00#12:00:00 1
251fb8c39b6380cf6da9fa94e2c341df 0 0 683567 0 0
2015540 0 0 0 0 3458853 0 0 0 0 0
3201126 B 1 BS 1 22/02/2018 23/02/2018 13/10/1986 0 1
1 N18.5;K30 - - - None None None None N-4-10-I None
(RINGAN) 4639400 0 0 - 0 - 0 - 0 - 0
4639400 2465153 0 2 0 0 0 MOCH ROCHLY WAHYUDI TN
0001744160815 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 152820
1#0##0#0#0.0#2018-03-06 09:55:51#0#12:00:00#12:00:00#00:00:00 1
2461ccb091f07dca7ff7287d379ba75c 0 0 470546 0 0 245335
0 0 0 0 1749272 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 23/02/2018 01/12/1957 0 1
1 T82.4;N18.5 88.60;39.50 - - None None None None I-1-20-I
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
15363900 20968430 0 2 0 0 0 MURTOWO D389563
DR RIZKI; 5.2.0.201712280730 4 152884 1#0##0#0#0.0#2018-03-06
15:21:25#0#12:00:00#12:00:00#12:00:00 1 41bc5551f86362a92538339586c081e7
0 6751820 0 0 0 12545610 0 0 0 0
1602000 0 0 0 69000 0
3201126 B 1 BS 1 15/02/2018 23/02/2018 10/08/1960 0 1
0 - 0 - 0 - 0 - 0 14562700 17500642
0 9 1 4 0 JUNAEDI D354658 57 21008 DR AGOES
5.2.0.201712280730 4 150303 1#0##0#0#0.0#2018-03-06
15:48:09#0#12:00:00#12:00:00#00:00:00 1 c93b66b4a714944dc0f6ede2476a30a3
0 0 579536 0 0 5864204 0 0 0 0
7786902 0 0 0 0 3270000
3201126 B 1 BS 1 21/02/2018 23/02/2018 12/08/1955 0 1
- 0 58821400 59707910 0 3 0 0 0 IR. H.
ACHRAR KARIM d390212 62 22839 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180009508 0001637055696 3;JKN DR RIZKI; 5.2.0.201712280730
4 152303 1#0##0#0#0.0#2018-03-06
15:49:53#0#12:00:00#12:00:00#12:00:00 1 e822159583bddbaa513d49777969d148
0 10753000 3419040 0 0 36582870 0 0 0 0
1256000 0 0 0 0 7697000
3201126 B 1 BS 1 19/02/2018 23/02/2018 23/06/2017 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 9890142 0 5 0 0 0 AN. ANTONIUS ARKANANTA
D376027 0 241 DR HUDA, SPA 0138R01702180008168
0002260863652 3;JKN DR RIZKI; 5.2.0.201712280730 4 151051
1#1#vvip#5#6713942#0.0#2018-03-06 15:57:10#0#12:00:00#12:00:00#12:00:00
1 d9f4ce9507baa1faadcbeb8f190eb345 0 0 849714 0 0
1992409 0 0 0 0 7048019 0 0 0 0 0
3201126 B 1 BS 1 21/02/2018 23/02/2018 17/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 17095200
16290461 0 3 0 0 0 MIEKE IRAWATI KUSUMA ASTUTI
0001292678403 3;JKN DR RIZKI; 5.2.0.201712280730 4 152033
1#0##0#0#0.0#2018-03-08 13:48:14#0#12:00:00#12:00:00#00:00:00 1
5591e6e1359ee974632e652720d7dfa2 0 5023000 3419040 0 0
4212690 0 0 0 0 1566731 0 0 0 0
2069000
3201126 B 2 BS 1 11/02/2018 23/02/2018 25/07/2017 0 1
1 D64.9;R56.0 99.04 - - None None None None D-4-13-II None
- 0 5073100 29513110 0 13 1 7 0 GIBRAN
WIBISANA PUTRA D390127 0 201 DR NOVIK BUDIWARDHANA, SPA
0138R01702180004814 0002268918551 3;JKN DR RIZKI; 5.2.0.201712280730
4 147850 1#0##0#0#0.0#2018-03-13
08:53:47#1#12:00:00#12:00:00#12:00:00 3 2d6431a5abb1c4fb516d8a8928953e04
0 0 2886030 0 0 12839035 0 0 0 0
8756045 0 0 0 1740000 3292000
3201126 B 2 BS 1 18/02/2018 23/02/2018 28/10/1997 0 2
1 A41.9;K29.7;E87.1;A92.0;D63.8 90.59 - - None None None None
7006300 0 0 - 0 - 0 - 0 - 0
7006300 6157963 0 6 0 0 0 DIAN PERMATA SARI
0002059151049 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150741
1#0##0#0#0.0#2018-03-19 10:31:50#0#12:00:00#12:00:00#12:00:00 2
07b5961cfd919ad352e589d148a1c402 0 0 683567 0 0
2015540 0 0 0 0 3458853 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 23/02/2018 02/05/1952 0 1
1 D29.1;I10;N39.9 60.29 - - None None None None V-1-14-I
None None None None None None PENGANGKATAN PROSTAT MELALUI URETRA
(RINGAN) 8837900 0 0 - 0 - 0 - 0 - 0
8837900 18887411 0 4 0 0 0 IRWAN DARWIS
0001729198192 3;JKN DR RIZKI; 5.2.0.201712280730 4 151755
1#0##0#0#0.0#2018-03-28 14:49:43#0#12:00:00#12:00:00#12:00:00 2
c51ddca8381b89bb2ca387387b309ba8 0 7174912 116000 0 0
4667499 0 0 0 0 1948000 0 0 0 606000
4375000
3201126 B 3 BS 1 19/02/2018 23/02/2018 09/11/1942 0 1
1 D29.1;R33;N39.9 60.29 - - None None None None V-1-14-I
(RINGAN) 8837900 0 0 - 0 - 0 - 0 - 0
8837900 19079667 0 5 0 0 0 DYANAH D387793
75 27496 DR SIDHI,SPU 0138R01702180008548 0001739815075 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 151419 1#0##0#0#0.0#2018-
03-28 16:40:32#0#12:00:00#12:00:00#12:00:00 3
21af38b7c1f76e4dd3ec68097a59b94a 0 5567412 0 0 0
6024255 0 0 0 0 2121000 0 0 0 367000
5000000
3201126 B 1 BS 1 22/02/2018 23/02/2018 05/03/1963 0 1
1 T82.4;N18.5;D63.8 99.04;38.95 - - None None None None N-1-
- 0 12472300 24253322 0 2 0 0 0 YASIR
0000040677963 3;JKN DR RIZKI; 5.2.0.201712280730 4 152941
1#0##0#0#0.0#2018-03-29 11:51:10#0#12:00:00#12:00:00#12:00:00 2
b02e4479b05e91831bb6191292e03c08 0 0 5413060 0 0
8413662 0 0 0 0 10357600 0 0 0 0 69000
3201126 B 1 BS 1 21/02/2018 23/02/2018 12/02/1963 0 1
1 I25.0;I08.9;I50.0;E11.9 36.07 - - YY02 None None None I-1-
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 64898888 0 3 0 0 0 ARIF WIDODO
0001337976382 3;JKN DR RIZKI; 5.2.0.201712280730 4 152094
1#0##0#0#0.0#2018-03-29 11:56:46#0#12:00:00#12:00:00#12:00:00 3
a658a7a7cc6733826f8394fac0af3627 0 10753000 9619120 0 0
35701768 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 20/02/2018 23/02/2018 24/04/1980 0 2
1 N30.9;R10.1 - - - None None None None N-4-12-I None
2871200 0 0 - 0 - 0 - 0 - 0
2871200 4541659 0 4 0 0 0 LILLY PANGESTUTI
D095244 37 13816 DR ARU, SPPD 0138R01702180008915
0001301994988 3;JKN DR RIZKI; 5.2.1.201804062320 4 151786
1#0##0#0#0.0#2018-05-05 11:13:24#0#12:00:00#12:00:00#00:00:00 2
91e356c4407ee84666b90b36a819ee2d 0 0 409013 0 0
1789528 0 0 0 0 2343118 0 0 0 0 0
3201126 B 1 BS 1 21/02/2018 23/02/2018 15/04/1983 0 1
1 J02.9;R10.1;R50.9 87.44 - - None None None None U-4-13-I
ISPA DAN LARINGOTRAKEITIS (RINGAN) 2772200 0 0 - 0 - 0
- 0 - 0 2772200 8282546 0 3 0 0 0
MUHITH AFIF SYAM HARAHAP D391014 34 12731 DR BETTY DWI L, SPPD
0138R01702180009594 0000198471284 3;JKN DR RIZKI; 5.2.1.201804062320
4 152381 1#0##0#0#0.0#2018-05-05
11:25:14#0#12:00:00#12:00:00#12:00:00 2 7de9594be8d37ca7030e04d76dd4af54
0 0 866000 0 0 2609697 0 0 0 0
4806849 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 23/02/2018 22/03/1955 0 2
4 A41.9;N18.5;J18.8 87.44;99.60 - - None None None None A-4-
0 0 - 0 - 0 - 0 - 0 8174100
7176203 0 4 1 1 0 HJ. NURUL A. ARIFIN D381660
3;JKN DR RIZKI; 5.2.1.201804062320 4 152023 1#0##0#0#0.0#2018-
05-16 08:20:58#0#12:00:00#12:00:00#12:00:00 1
ee5dee34548f13da2dbda586b037e5ac 0 0 470546 0 0
3775186 0 0 0 0 2930471 0 0 0 0 0
3201126 B 1 BS 1 20/02/2018 23/02/2018 09/05/2013 0 2
1 D21.4 54.11 - - None None None None K-1-40-I None None
10909500 0 0 - 0 - 0 - 0 - 0
10909500 9409242 0 4 0 0 0 LIDYA SHOPYA W BOMA
D388776 4 1748 DR CATUR S, SPB 0138R01702180008873
0001109843831 3;JKN DR RIZKI; 5.2.1.201804062320 4 151782
1#0##0#0#0.0#2018-05-16 09:40:06#0#12:00:00#12:00:00#12:00:00 2
594dc4723d1d3c4b6df93619882cc425 0 6202100 569492 0 0
1873592 0 0 0 0 691558 0 0 0 0 72500
3201126 B 3 BS 1 20/02/2018 23/02/2018 21/06/1966 0 2
1 I95.9;A41.9;I48;N18.5;I11.0;D63.8 99.61;99.04 - - None None
None None I-4-24-III None None None None None None GANGGUAN SISTEM
PEMBULUH DARAH LAIN-LAIN (BERAT) 8139800 0 0 - 0 - 0
- 0 - 0 8139800 27307534 0 4 1 2 0
ASTUTI D389877 51 18872 DR. ARU ARIADNO, SPPD
0138R01702180008715 0000508736856 3;JKN DR RIZKI; 5.2.1.201804062320
4 151439 1#0##0#0#0.0#2018-05-16
09:42:09#0#12:00:00#12:00:00#12:00:00 2 1ea9647dc58df3cd83596985e12a38c8
0 0 1029776 0 0 17762758 0 0 0 0
4718000 0 0 0 0 3797000
3201126 B 3 BS 1 23/02/2018 23/02/2018 15/08/1962 0 1
1 I50.0;R57.0;R16.0 - - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 4973600
1974820 0 1 0 0 0 ARKIYANTO D384905 55 20281
DR YOHANES DWINANDA R P 0138R01702180010423 0001469267561 3;JKN DR
RIZKI; 5.2.1.201804062320 4 153202 1#0##0#0#0.0#2018-05-16
09:46:11#0#12:00:00#12:00:00#12:00:00 2 92acb2df1638aeaafb15e9241420770c
0 0 447624 0 0 1109002 0 0 0 0 418194
0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 23/02/2018 01/12/1937 0 2
4 I50.0;J18.9;K92.1 87.44 - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 4973600
9775203 0 2 0 0 0 MURSITI D391107 80 29303
DR RIZKI; 5.2.1.201804062320 4 152571 1#0##0#0#0.0#2018-05-16
09:54:47#0#12:00:00#12:00:00#12:00:00 2 3ca7c59483a9e704115a7c7ea4748e0b
0 0 779480 0 0 5996224 0 0 0 0
2411499 0 0 0 0 588000
3201126 B 3 BS 1 22/02/2018 23/02/2018 12/01/1967 0 2
1 D62;C56;N18.5 99.03 - - None None None None D-4-13-I
ANEMIA SEL SICKLE (RINGAN) 2987000 0 0 - 0 - 0 -
0 - 0 2987000 4800195 0 2 0 0 0 JAINI
0002282122809 3;JKN DR RIZKI; 5.2.1.201804062320 4 153999
1#0##0#0#0.0#2018-05-16 09:56:52#0#00:35:00#03:00:00#12:00:00 2
d84280e7ce3a254efc570fa8e0676d1f 0 0 463788 0 0
3733376 0 0 0 0 603031 0 0 0 0 0
3201126 B 2 BS 1 18/02/2018 23/02/2018 18/11/2004 0 1
9924600 0 0 - 0 - 0 - 0 - 0
9924600 14612308 0 6 0 0 0 FAJAR HARAPAN T
D390773 13 4840 DR CATUR S, SPB 0138R01702180007869
0001278522494 3;JKN DR RIZKI; 5.2.1.201804062320 4 150769
1#0##0#0#0.0#2018-05-16 10:03:58#0#12:00:00#12:00:00#12:00:00 2
638b26cadad6c58e512f615516802473 0 6178300 2818790 0 0
4573273 0 0 0 0 1041945 0 0 0 0 0
3201126 B 3 BS 1 19/02/2018 23/02/2018 22/04/1999 0 1
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 4779548 0 5 0 0 0 TOMY HASIHOLAN
0001739678038 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 151370
1#0##0#0#0.0#2018-05-16 10:49:18#0#12:00:00#12:00:00#12:00:00 2
592574ffd173ce9c1c66bb3763ea2005 0 0 261764 0 0
2864103 0 0 0 0 1653681 0 0 0 0 0
3201126 B 3 BS 1 16/02/2018 23/02/2018 28/02/1982 0 1
1 E87.6;E87.1;A41.9 - - - None None None None E-4-11-III
6293300 0 0 - 0 - 0 - 0 - 0
6293300 3028697 0 8 0 0 0 NIK KURNIA HADIANZAH
0000042060418 3;JKN DR RIZKI; 5.2.2.201806040537 4 155848
1#0##0#0#0.0#2018-08-14 14:52:24#0#12:00:00#12:00:00#12:00:00 3
8d810e66068cef253a6a9f4ad3b2c1d7 0 0 763470 0 0
1778088 0 0 0 0 487139 0 0 0 0 0
3201126 B 2 BS 1 22/02/2018 23/02/2018 14/04/1962 0 1
- 0 - 0 23198900 12736929 0 2 0 0 0
WAGIYO D385922 55 20403 SRI KUNMARTINI.DR,SPPD
0138R01702180010234 0002062603258 3;JKN DR RIZKI; 5.2.2.201806040537
4 153166 1#0##0#0#0.0#2018-08-14
16:57:35#0#12:00:00#12:00:00#12:00:00 3 6a551a3efbcd766d3f23041202ba831e
0 0 3153245 0 0 4285327 0 0 0 0
5298357 0 0 0 0 0
3201126 B 1 BS 1 22/02/2018 23/02/2018 25/04/1982 0 2
1 E04.9;E83.5 06.11;88.79 - - None None None None E-4-13-II
(SEDANG) 7581900 0 0 - 0 - 0 - 0 - 0
7581900 4395453 0 2 0 0 0 NENY MUKHLISANI
d157009 35 13087 RACHMAWATI DR,SPB(K)ONK 0138R01702180010341
0001256855692 3;JKN DR RIZKI; 5.2.2.201806040537 4 153195
1#0##0#0#0.0#2018-09-06 12:11:40#0#12:00:00#12:00:00#00:00:00 2
ed7f2dd5914c277aa81da22d083ec252 0 0 1035200 0 0
1484700 0 0 0 0 1875553 0 0 0 0 0
3201126 B 3 BS 1 21/02/2018 24/02/2018 25/06/1955 0 2
7039300 0 0 - 0 - 0 - 0 - 0
7039300 10045199 0 4 0 0 0 NAMIH d384337 62
22887 DR E SURYA POHAN DR SPB KBD 0138R01702180009452 0001740228671
3;JKN DR RIZKI; 5.2.0.201712280730 4 152183 1#0##0#0#0.0#2018-
03-02 17:18:49#0#12:00:00#12:00:00#12:00:00 1
c96d03e40948ef1c7af374af2997d88b 0 5063804 70393 0 0
3170839 0 0 0 0 1450163 0 0 0 290000
0
3201126 B 3 BS 1 23/02/2018 24/02/2018 07/12/1962 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3995023 0 2 0 0 0 KASONO TN
0002223029204 3;JKN DR RIZKI; 5.2.0.201712280730 4 153199
1#0##0#0#0.0#2018-03-02 17:21:12#0#12:00:00#12:00:00#00:00:00 1
b3fc205ea736fcfa9cc9683aa28942a9 0 0 424889 0 0
1582527 0 0 0 0 1987607 0 0 0 0 0
3201126 B 3 BS 1 21/02/2018 24/02/2018 22/07/2017 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2034759 0 4 0 0 0 ABBYAN NANDANA WIJAYANTO
D391059 0 214 DR RASTRA, SPA 0138R01702180009657
0002268054549 3;JKN DR RIZKI; 5.2.0.201712280730 4 152550
1#0##0#0#0.0#2018-03-02 18:17:20#0#12:00:00#12:00:00#12:00:00 1
f635c1cd8def5fd84eaa44258a124028 0 0 207620 0 0 616024
0 0 0 0 1211115 0 0 0 0 0
3201126 B 3 BS 1 23/02/2018 24/02/2018 02/10/1970 0 2
1 K51.8;I84.2;I84.5 45.23 - - None None None None K-4-13-I
0 - 0 - 0 3983300 4175385 0 2 0 0
0 TONDA SARI d389922 47 17311 DR BETTY DWI L, SPPD
0138R01702180010619 0001336485723 3;JKN DR RIZKI; 5.2.0.201712280730
4 153647 1#0##0#0#0.0#2018-03-02
18:21:51#0#12:00:00#12:00:00#12:00:00 1 0b1de9c503cf7ff3d0d82f3ebef7ef20
0 2007824 53000 0 0 1120012 0 0 0 0 994549
0 0 0 0 0
3201126 B 3 BS 1 21/02/2018 24/02/2018 01/09/1973 0 1
0 - 0 - 0 - 0 3417600 4533058 0 4
0 0 0 YOGI WIJANAKA D383806 44 16244 DR HENDRIEK S, SPB
0138R01702180009795 0000510421026 3;JKN DR RIZKI; 5.2.0.201712280730
4 152561 1#0##0#0#0.0#2018-03-02
18:29:37#0#12:00:00#12:00:00#12:00:00 2 91fbc8b3b441f09a4ba46e9bda35c7d9
0 0 413584 0 0 2859456 0 0 0 0
1260018 0 0 0 0 0
3201126 B 3 BS 1 18/02/2018 24/02/2018 05/02/1960 0 2
1 H81.1;E14.9 - - - None None None None U-4-11-I None
- 0 - 0 - 0 - 0 1517500 4239403 0
7 0 0 0 MUANAH D390776 58 21198 DR HARDI PRANATA
SPS 0138R01702180007855 0001739783801 3;JKN DR RIZKI; 5.2.0.201712280730
4 150766 1#0##0#0#0.0#2018-03-02
19:33:18#0#12:00:00#12:00:00#12:00:00 1 bc357d0eebf9f94adb83d343e859eb0d
0 0 242575 0 0 2102157 0 0 0 0
1894671 0 0 0 0 0
3201126 B 2 BS 1 23/02/2018 24/02/2018 17/08/1971 0 2
- 0 10690500 12664596 0 2 0 0 0 MURNITI
D391231 46 16992 DR SRI KUN, SPPD 0138R01702180010918
0002328341027 3;JKN DR RIZKI; 5.2.0.201712280730 4 153661
1#0##0#0#0.0#2018-03-05 11:38:36#0#12:00:00#12:00:00#12:00:00 1
78be13e3be125f3e1e33d06bb4a6b8c2 0 5747200 1015145 0 0
4370712 0 0 0 0 1531539 0 0 0 0 0
3201126 B 2 BS 1 21/02/2018 24/02/2018 16/11/1971 0 2
1 I10;A49.9;J01.9 87.44;87.03 - - None None None None I-4-
17-I None None None None None None HIPERTENSI (RINGAN) 2288000 0
0 - 0 - 0 - 0 - 0 2288000 4961721
0 4 0 0 0 DIAN MURTIYATI d391062 46 16899 DR.
5.2.0.201712280730 4 152531 1#0##0#0#0.0#2018-03-05
12:22:27#0#12:00:00#12:00:00#12:00:00 1 ba51b42aab9884fa3bcfe73d55089167
0 0 564272 0 0 2531850 0 0 0 0
1865599 0 0 0 0 0
3201126 B 2 BS 1 21/02/2018 24/02/2018 08/07/1986 0 2
1 K80.1;A41.9 87.44 - - None None None None B-4-14-III None
None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (BERAT)
7875800 0 0 - 0 - 0 - 0 - 0
7875800 4947976 0 4 0 0 0 AYU ANNISA D391063
3;JKN DR RIZKI; 5.2.0.201712280730 4 152558 1#0##0#0#0.0#2018-
03-05 12:23:45#0#12:00:00#12:00:00#12:00:00 1
a82139345f166a02ca5b103932830619 0 0 761822 0 0
2023955 0 0 0 0 2162199 0 0 0 0 0
3201126 B 2 BS 1 22/02/2018 24/02/2018 06/11/2011 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2733799 0 3 0 0 0 NOVALDI ARYA PRATAMA
D217590 6 2300 DR RASTRA, SPA 0138R01702180010089
0001639973665 3;JKN DR RIZKI; 5.2.0.201712280730 4 152879
1#0##0#0#0.0#2018-03-05 12:24:28#0#12:00:00#12:00:00#00:00:00 1
40f7ce97573455758f4d9cec88b58d1a 0 0 298025 0 0 715927
0 0 0 0 1719847 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 24/02/2018 31/07/1936 0 2
1 I63.9;G81.9 87.03;87.44 - - None None None None G-4-14-II
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 7934004 0 6 0 0 0 SARNI, NY
0000060970882 3;JKN DR RIZKI; 5.2.0.201712280730 4 151411
1#0##0#0#0.0#2018-03-05 12:26:57#0#12:00:00#12:00:00#12:00:00 1
bcbc74ed83fd9ab9ad9fd1ee9433a0b2 0 0 654580 0 0
3704377 0 0 0 0 3575047 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 24/02/2018 02/06/1995 0 1
1 A18.0;M49.06;K29.7 - - - None None None None M-4-
15-I None None None None None None ARTRITIS SEPSIS (RINGAN) 3421500
0 0 - 0 - 0 - 0 - 0 3421500
3832287 0 3 0 0 0 PAIYAN PANDIANGAN D352168 22
TANTIYO S;16137 5.2.0.201712280730 4 153864 1#0##0#0#0.0#2018-
03-06 08:34:40#0#12:00:00#12:00:00#12:00:00 1
fdba947a36be3d6fc84b8c58324bf4b5 0 0 313620 0 0
2452957 0 0 0 0 1065710 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 24/02/2018 21/08/1973 0 1
4 I67.9;M54.59;E87.6;K29.7;R07.4 99.60 - - None None None
None G-4-26-II None None None None None None GANGGUAN - PENYAKIT
SISTEM SARAF LAIN-LAIN (SEDANG) 4302200 0 0 - 0 - 0
- 0 - 0 4302200 2646012 0 1 0 0 0
JHONNI P. NAINGGOLAN D342973 44 16258 DR MUHAMMAD RIZKI YUWANA
0138R01702180010945 0001856288553 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 153672 1#0##0#0#0.0#2018-03-06
08:36:48#0#12:00:00#12:00:00#12:00:00 1 9cde5264994ed5e992dc0fca4b8109fe
0 0 588198 0 0 861710 0 0 0 0 480104
0 0 0 128000 588000
3201126 B 3 BS 1 23/02/2018 24/02/2018 03/04/1934 0 1
5013100 0 0 - 0 - 0 - 0 - 0
5013100 2188074 0 2 0 0 0 ENGKING D391266
83 30642 DR ADRIAN HANDARU 0138R01702180010941 0000065320187 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 153670 1#0##0#0#0.0#2018-
03-06 09:01:06#0#12:00:00#12:00:00#12:00:00 1
a908c004bcdcd19d7509c12bb6701f6a 0 0 451179 0 0
1304750 0 0 0 0 432145 0 0 0 0 0
3201126 B 3 BS 1 23/02/2018 24/02/2018 14/12/1960 0 2
1 A01.0;K30 - - - None None None None A-4-14-I None
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 706612 0 2 0 0 0 DEMOLITA KATILI
0000037537571 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153663
1#0##0#0#0.0#2018-03-06 09:02:51#0#12:00:00#12:00:00#00:00:00 1
b3fee9e5006de4ca09b003628dba4044 0 0 204183 0 0 167202
0 0 0 0 335227 0 0 0 0 0
3201126 B 2 BS 1 21/02/2018 24/02/2018 14/08/2014 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4005796 0 4 0 0 0 ALVIN AGUSTINO PRATAMA
D391048 3 1287 DR RASTRA, SPA 0138R01702180009987
0002044793698 3;JKN DR RIZKI; 5.2.0.201712280730 4 152647
1#0##0#0#0.0#2018-03-06 09:25:16#0#12:00:00#12:00:00#12:00:00 1
04aed723633b1e7dfca606e617467a14 0 0 443231 0 0
1759504 0 0 0 0 1803061 0 0 0 0 0
3201126 B 1 BS 1 15/02/2018 24/02/2018 29/01/2018 0 1
1 P59.9;P07.3;P07.1;Z38.3 99.82 - - None None None None B-4-
5886000 0 0 - 0 - 0 - 0 - 0
5886000 10872027 0 10 0 0 0 BAYI NY THIA IRMAYA 1
0002430163462 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 150298
1#0##0#0#0.0#2018-03-06 10:06:29#0#12:00:00#12:00:00#12:00:00 1
94abbc41642a31c61d5728796d05cf0b 0 0 342457 0 0 288816
0 0 0 0 8201754 0 0 0 0 2039000
3201126 B 1 BS 1 22/02/2018 24/02/2018 22/02/2018 3170 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3341058 0 3 0 0 0 ARFA RAFASYA KHAIDI
0002144217993 3;JKN DR RIZKI; 5.2.0.201712280730 4 153680
1#0##0#0#0.0#2018-03-06 10:36:05#0#12:00:00#12:00:00#12:00:00 1
a99747a80ebe803aced6b0a7e024f3ce 0 0 845085 0 0 88899
0 0 0 0 2407074 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 24/02/2018 17/05/1964 0 2
1 I64;G81.9;I10;E14.9 - - - None None None None G-4-
- 0 - 0 - 0 - 0 6844000 6158954 0
6 0 0 0 NASSIYAM, NY D370627 53 19636 DR AL RASYID
SPS 0138R01702180008590 0000061030629 3;JKN DR RIZKI; 5.2.0.201712280730
4 151429 1#0##0#0#0.0#2018-03-06
10:55:22#0#12:00:00#12:00:00#00:00:00 1 14fcf86a1545b435f3565059e02e58d8
0 0 737400 0 0 1087632 0 0 0 0
4333922 0 0 0 0 0
3201126 B 1 BS 1 21/02/2018 24/02/2018 16/09/1992 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 19752672 0 4 0 0 0 KHAIRISA D382585
25 9289 DR NINING H, SPOG 0138R01702180009817 0000007420228 3;JKN
DR RIZKI; 5.2.0.201712280730 4 152564 1#0##0#0#0.0#2018-03-06
10:58:09#0#12:00:00#12:00:00#12:00:00 1 b145d3f202115b9c2880baf0f5309ae8
0 8289400 6435000 0 0 3392272 0 0 0 0
1311000 0 0 0 0 325000
3201126 B 3 BS 1 23/02/2018 24/02/2018 03/06/1970 0 1
1 I50.0;K30;I39.0 93.96 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 3575600 653560
0 2 0 0 0 MOH. ARIFIN D380192 47 17432 DR MUHAMMAD
RIZKI YUWANA 0138R01702180010873 0000045323019 3;JKN DR RIZKI;
5.2.0.201712280730 4 153653 1#0##0#0#0.0#2018-03-06
15:08:11#0#12:00:00#12:00:00#12:00:00 2 e3c7ec3a29f39bc7e75ffcd28df0efbb
0 0 321804 0 0 0 0 0 0 0 331756
0 0 0 0 0
3201126 B 1 BS 1 22/02/2018 24/02/2018 05/06/1977 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4725454 0 3 0 0 0 JUNITA SAVITRI DEWI,S.PD
0000168207129 3;JKN DR RIZKI; 5.2.0.201712280730 4 152570
1#0##0#0#0.0#2018-03-06 15:41:01#0#12:00:00#12:00:00#00:00:00 1
8b606bee2638094774c30db568351682 0 0 551420 0 0
1495892 0 0 0 0 2678142 0 0 0 0 0
3201126 B 1 BS 1 19/02/2018 24/02/2018 07/06/1953 0 1
1 E14.5 84.15 - - None None None None M-1-02-I None None
None None None None AMPUTASI (RINGAN) 13312500 0 0 - 0
- 0 - 0 - 0 13312500 20939528 0 6 0
0 0 MUHAJIR D338732 64 23633 DR HENDRIEK S, SPB
0138R01702180008540 0001261197742 3;JKN DR RIZKI; 5.2.0.201712280730
4 151416 1#0##0#0#0.0#2018-03-06
16:01:44#0#12:00:00#12:00:00#00:00:00 1 67f16f8704ace458386966cbb8d36f43
0 8886700 6114836 0 0 4503492 0 0 0 0
1331000 0 0 0 0 103500
3201126 B 2 BS 1 13/02/2018 24/02/2018 03/08/1980 0 1
1 D01.0;K56.7 54.19 - - None None None None K-1-40-II None
None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
10628600 0 0 - 0 - 0 - 0 - 0
10628600 28430244 0 12 0 0 0 AGUS D390328 37
RIZKI; 5.2.0.201712280730 4 149211 1#0##0#0#0.0#2018-03-07
12:06:03#0#12:00:00#12:00:00#12:00:00 1 c473e45e92c6834825c8f117f045332c
0 4565000 4358440 0 0 11059304 0 0 0 0
8157500 0 0 0 290000 0
3201126 B 1 BS 1 20/02/2018 24/02/2018 08/09/1949 0 1
0 0 - 0 - 0 - 0 - 0 5802600
7209584 0 5 0 0 0 ACHMAD RUCHIYAT D235779 68
3;JKN DR RIZKI; 5.2.0.201712280730 4 152013 1#0##0#0#0.0#2018-
03-08 13:40:05#0#12:00:00#12:00:00#12:00:00 2
cf634beef099444ef3f4aeba0238533c 0 0 426023 0 0
2726406 0 0 0 0 4057155 0 0 0 0 0
3201126 B 1 BS 1 22/02/2018 24/02/2018 05/09/2014 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3590053 0 3 0 0 0 DAFFIN NICKELTON NUGROHO
d373507 3 1266 DR RASTRA, SPA 0138R01702180010017
0002034031961 3;JKN DR RIZKI; 5.2.0.201712280730 4 152724
1#0##0#0#0.0#2018-03-08 14:40:46#0#12:00:00#12:00:00#12:00:00 1
32d026b1cc8f1afc0670f3ed044ec5cb 0 0 338858 0 0 647332
0 0 0 0 2603863 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 24/02/2018 17/02/1942 0 2
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 617675 0 1 0 0 0 ANIH SUHAENIH
D391306 76 27766 DR LIDYA SANTALIA 0138R01702180011041
0002232533687 3;JKN DR RIZKI; 5.2.0.201712280730 4 153745
1#0##0#0#0.0#2018-03-29 09:49:34#0#12:00:00#12:00:00#12:00:00 2
7d65d2163505839d4d45eba9815d0a28 0 0 208764 0 0 79502
0 0 0 0 329409 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 24/02/2018 17/01/1942 0 1
0 0 - 0 - 0 - 0 - 0 4202600 890571
0 1 0 0 0 SJAMSUDIN D370698 76 27797 DR LIDYA
SANTALIA 0138R01702180011018 0000060724012 3;JKN DR RIZKI;
5.2.1.201804062320 4 154013 1#0##0#0#0.0#2018-05-16
09:15:05#0#12:00:00#12:00:00#00:00:00 2 08f30190e1b4c75efa6d447b440bb682
0 0 321804 0 0 221505 0 0 0 0 347257
0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 24/02/2018 10/11/1960 0 2
None None None None KOMA & STUPOR NON TRAUMA (RINGAN) 2692100 0
0 - 0 - 0 - 0 - 0 2692100 1734833
0 1 0 0 0 NANI MARDIYANTI D391261 57 20925 DR
ADRIAN HANDARU 0138R01702180011001 0001730363848 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 153682 1#0##0#0#0.0#2018-05-16
09:47:19#0#00:00:00#12:00:00#12:00:00 2 4ca22989f503715dbe4459b05fd808a9
0 0 242289 0 0 1090050 0 0 0 0 402494
0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 24/02/2018 21/05/1974 0 2
0 - 0 - 0 - 0 - 0 3247500 5999818
0 2 0 0 0 TRIANI RAHMAWATI D058830 43 15984 DR.
5.2.1.201804062320 4 153664 1#0##0#0#0.0#2018-05-16
09:50:54#0#12:00:00#12:00:00#12:00:00 2 bdc47d6769805758f38c7a145fd7addc
0 0 962300 0 0 1355507 0 0 0 0
2002011 0 0 0 0 1680000
3201126 B 1 BS 1 23/02/2018 24/02/2018 06/11/2011 0 2
1 K11.1 26.29 - - None None None None U-1-13-I None None
None None None None PROSEDUR KELENJAR LUDAH (RINGAN) 9213600 0
0 - 0 - 0 - 0 - 0 9213600 11283507
0 2 0 0 0 AIRIN FAIRUZ BAIHAQI d389791 6 2301
DR CATUR S, SPB 0138R01702180010599 0001968502274 3;JKN DR RIZKI;
5.2.1.201804062320 4 153639 1#0##0#0#0.0#2018-05-16
10:01:22#0#12:00:00#12:00:00#12:00:00 2 6bc6cd1f587067da87c4ef967678d046
0 5896000 2579808 0 0 1944526 0 0 0 0
794173 0 0 0 0 69000
3201126 B 3 BS 1 24/02/2018 24/02/2018 05/03/1953 0 1
2 A15.3 - - - None None None None J-4-15-I None None
4336500 0 0 - 0 - 0 - 0 - 0
4336500 1787419 0 1 0 0 0 M SOLEH D391271
DR RIZKI; 5.2.1.201804062320 4 153675 1#0##0#0#0.0#2018-05-16
10:07:23#0#12:00:00#12:00:00#12:00:00 3 0e7555698d110924232ddd146f7695ca
0 0 390285 0 0 991200 0 0 0 0 405934
0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 24/02/2018 17/03/1979 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3191804 0 2 0 0 0 SURYADI d330714
3;JKN DR RIZKI; 5.2.1.201804062320 4 153635 1#0##0#0#0.0#2018-
05-16 10:20:05#0#12:00:00#12:00:00#12:00:00 3
1d3470a684852f2062381ec1b8a484c3 0 0 269459 0 0
1125535 0 0 0 0 1796810 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 24/02/2018 13/03/1953 0 1
4 I21.2;I50.0;R57.0 89.52 - - None None None None I-4-10-III
0 0 - 0 - 0 - 0 - 0 14562700
3761691 0 2 0 0 0 RAMLI D310667 64 23723 DR
AZRI NURIZAL SPPD KKV 0138R01702180010677 0000061034589 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 153638 1#0##0#0#0.0#2018-05-17
12:58:40#0#12:00:00#12:00:00#00:00:00 2 fbfa5e650262921dc7fdb30f3b783c5f
0 0 503531 0 0 1424068 0 0 0 0
1834092 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 24/02/2018 12/11/1968 0 2
1 K51.2;I84.1;K62.6 45.23 - - None None None None K-4-13-I
0 - 0 - 0 5576700 7607595 0 2 0 0
0 TITI WOELANDARI PRIHATINI d390219 49 18000 DR. ARU ARIADNO,
4 153643 1#0##0#0#0.0#2018-09-05
18:13:14#0#12:00:00#12:00:00#12:00:00 3 fa2489d5e357fe6fee6770e93e696b09
0 0 1670243 0 0 1360159 0 0 0 0
2828193 0 0 0 0 1749000
3201126 B 1 BS 1 23/02/2018 24/02/2018 21/05/1956 0 2
1 K51.9;K51.2;I84.5 45.23 - - None None None None K-4-13-I
0 - 0 - 0 5576700 7984536 0 2 0 0
0 NY MASYITOH D201433 61 22558 DR ARU, SPPD
0138R01702180010666 0001719918562 3;JKN DR RIZKI; 5.2.2.201806040537
4 153637 1#0##0#0#0.0#2018-09-05
18:13:56#0#12:00:00#12:00:00#12:00:00 3 942ea075119aa447c678aaa61ae35399
0 0 1670243 0 0 1636440 0 0 0 0
2852853 0 0 0 0 1825000
3201126 B 3 BS 1 23/02/2018 24/02/2018 30/06/2001 0 2
1 K51.8;N39.0;I84.2 45.23;90.59 - - None None None None K-4-
0 - 0 - 0 5152700 4870940 0 2 0 0
0 YUNITA NUR HALIZAH D390381 16 6082 DR BETTY DWI L, SPPD
0138R01702180010614 0001739769693 3;JKN DR RIZKI; 5.2.2.201806040537
4 153648 1#0##0#0#0.0#2018-09-05
18:15:22#0#12:00:00#12:00:00#12:00:00 2 c971713d58fadc1105d26def0f3b712b
0 2007824 53000 0 0 0 0 0 0 0 985116
0 0 0 145000 1680000
3201126 B 3 BS 1 23/02/2018 25/02/2018 12/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 12210800
11130509 0 3 0 0 0 FAUZIE LETRICK SADAR D389702
0002277791774 3;JKN DR RIZKI; 5.2.0.201712280730 4 153659
1#0##0#0#0.0#2018-03-02 17:02:28#0#12:00:00#12:00:00#12:00:00 1
053313cd985ff297c24a2f43feed4f2d 0 4517160 0 0 0
3357685 0 0 0 0 1186664 0 0 0 69000
2000000
3201126 B 3 BS 1 23/02/2018 25/02/2018 31/12/1959 0 1
0 - 0 - 0 - 0 - 0 12210800 10038152
0 3 0 0 0 H. HADI MUSTOFA D390421 58 21239 DR
5.2.0.201712280730 4 153652 1#0##0#0#0.0#2018-03-02
17:05:32#0#12:00:00#12:00:00#12:00:00 1 85e63e848792099beeb8bfcfa9f49b65
0 2908180 0 0 0 3945770 0 0 0 0
1115202 0 0 0 69000 2000000
3201126 B 3 BS 1 23/02/2018 25/02/2018 14/05/1962 0 1
12210800 0 0 - 0 - 0 - 0 - 0
12210800 10756849 0 3 0 0 0 SYARIFULLAH d387918
0001727137102 3;JKN DR RIZKI; 5.2.0.201712280730 4 153658
1#0##0#0#0.0#2018-03-02 17:15:11#0#12:00:00#12:00:00#12:00:00 1
72eb9a818f56d746659888f13b2e5bf5 0 3624680 0 0 0
3900950 0 0 0 0 1162219 0 0 0 69000
2000000
3201126 B 3 BS 1 23/02/2018 25/02/2018 10/12/2012 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 9295226 0 3 0 0 0 MUHAMMAD RASYID
D389088 5 1901 DR CATUR S, SPB 0138R01702180010448
0002267292879 3;JKN DR RIZKI; 5.2.0.201712280730 4 153203
1#0##0#0#0.0#2018-03-02 17:25:32#0#12:00:00#12:00:00#12:00:00 1
634fd94412b6438748179cccd4a2f20f 0 4540284 205316 0 0
3221527 0 0 0 0 1183099 0 0 0 145000
0
3201126 B 3 BS 1 21/02/2018 25/02/2018 29/06/2007 0 2
1 A01.0;A91;J06.9 - - - None None None None A-4-14-III
LAIN-LAIN (BERAT) 3304700 0 0 - 0 - 0 - 0 -
0 3304700 2410762 0 5 0 0 0 FIFI PERMATA SARI
0001469267605 3;JKN DR RIZKI; 5.2.0.201712280730 4 152563
1#0##0#0#0.0#2018-03-02 19:34:51#0#12:00:00#12:00:00#12:00:00 1
e25d8192e3136db917f101668685b18d 0 0 341081 0 0 833968
0 0 0 0 1235713 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 25/02/2018 01/04/1944 0 2
1 I21.2;I50.0;I48;J18.9 93.94 - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 5667393 0 4 0 0 0 MAIMUNAH d391112
0000511776639 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 152874
1#0##0#0#0.0#2018-03-05 08:20:35#0#12:00:00#12:00:00#12:00:00 1
79c8632d18d52ceaed06e7882f3e3d83 0 0 1054637 0 0
3163992 0 0 0 0 1448764 0 0 0 0 0
3201126 B 2 BS 1 20/02/2018 25/02/2018 18/08/1945 0 1
0 0 - 0 - 0 - 0 - 0 4290800
7764278 0 6 0 0 0 S MIHARDJA D321000 72 26484
DR SUPONO SPJP 0138R01702180008808 0000060968935 3;JKN DR RIZKI;
5.2.0.201712280730 4 151649 1#0##0#0#0.0#2018-03-05
12:19:00#0#12:00:00#12:00:00#12:00:00 1 470e4cdcb205c4b4f265c2f2501317a3
0 0 804540 0 0 2525795 0 0 0 0
3563943 0 0 0 0 870000
3201126 B 2 BS 1 22/02/2018 25/02/2018 19/12/2016 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2896289 0 4 0 0 0 AN. QUEENSHA QURROTA AIN
D353318 1 430 DR RASTRA, SPA 0138R01702180010111
0002209226916 3;JKN DR RIZKI; 5.2.0.201712280730 4 152913
1#0##0#0#0.0#2018-03-05 12:19:56#0#12:00:00#12:00:00#00:00:00 1
16b6d1c37055cf851365efdfbd3efadd 0 0 278711 0 0 382101
0 0 0 0 2235477 0 0 0 0 0
3201126 B 2 BS 1 21/02/2018 25/02/2018 15/06/1993 0 2
1 N20.2;K29.7 - - - None None None None N-4-13-I None
- 0 - 0 - 0 - 0 4101100 7036660 0
5 0 0 0 HERLINA ANGRAENI D391002 24 9017 DR. ARU
5.2.0.201712280730 4 152280 1#0##0#0#0.0#2018-03-05
12:20:52#0#12:00:00#12:00:00#12:00:00 1 ef4f0af31e15e6b9bc6a3abc81abc2af
0 0 560248 0 0 3455070 0 0 0 0
3021342 0 0 0 0 0
3201126 B 3 BS 1 25/02/2018 25/02/2018 04/12/1957 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1910770 0 1 0 0 0 KAHARUDDIN SAID DRH
D221749 60 21998 DR RICO ADITYA 0138R01702180011205
0001259190865 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153887
1#0##0#0#0.0#2018-03-06 09:04:10#0#12:00:00#12:00:00#12:00:00 1
497452ea67700e6ab7303ea58e477b96 0 0 378234 0 0
1118532 0 0 0 0 414004 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 25/02/2018 23/11/1964 0 1
1 I12.0;I70.2;E14.2;D63.8 39.27;99.04 - - None None None None
- 0 - 0 8908800 10312367 0 2 0 0 0
BERESMAN HUTAGAOL D389168 53 19451 SRI KUNMARTINI.DR,SPPD
0138R01702180011148 0001217892396 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 153901 1#0##0#0#0.0#2018-03-06
09:12:46#0#12:00:00#12:00:00#12:00:00 1 c0afab036d74f3883129987b078de4b9
0 2889000 2636552 0 0 3500374 0 0 0 0
1217441 0 0 0 0 69000
3201126 B 1 BS 1 22/02/2018 25/02/2018 02/06/1981 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 20465286 0 4 0 0 0 HERLINA HARMASTUTI
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1#1#vvip#4#13483786#0.0#2018-03-06 10:28:03#0#12:00:00#12:00:00#12:00:00
1 bafbec8dfcb2388f20dba243581079e5 0 9484400 1750000 0
0 2886886 0 0 0 0 6019000 0 0 0 325000
0
3201126 B 1 BS 1 22/02/2018 25/02/2018 22/02/2018 3016 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3718233 0 4 0 0 0 BAYI NY. NIA ANDRIYANI
0002433072194 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153893
1#1#vip#4#0#0.0#2018-03-06 10:28:17#0#12:00:00#12:00:00#12:00:00 1
041f5d866af30d19af8d180bd97872aa 0 0 845085 0 0 88899
0 0 0 0 2784249 0 0 0 0 0
3201126 B 2 BS 1 22/02/2018 25/02/2018 20/11/1994 0 2
- 0 3584400 4956434 0 4 0 0 0 AJENG
NOVIANTI D146917 23 8495 DR SOEGIONO, SPPD 0138R01702180009837
0001800823342 3;JKN DR RIZKI; 5.2.0.201712280730 4 152568
1#0##0#0#0.0#2018-03-06 15:01:25#0#12:00:00#12:00:00#12:00:00 1
1eb9a202a6eac26077f2664ed803d0c1 0 0 375596 0 0
2210585 0 0 0 0 2370253 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 25/02/2018 17/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 1982500
4108527 0 2 0 0 0 WINTI DAMAYANTI D391295 49
18088 DR RM DHENI DANARDHONO SPOG 0138R01702180010947 0001853099054
3;JKN DR RIZKI; 5.2.0.201712280730 4 153673 1#0##0#0#0.0#2018-
03-06 15:24:20#0#12:00:00#12:00:00#12:00:00 1
c805f67e6ae42ebb5f65febf0ee4001b 0 1833600 528800 0 0
1027345 0 0 0 0 383782 0 0 0 0 335000
3201126 B 1 BS 1 22/02/2018 25/02/2018 22/02/2018 3540 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 4095408 0 4 0 0 0 BAYI NY HERLINA
HARMASTUTI D391162 0 0 DR AULIA TANGKARI, SPA 0138R01702180010649
0002432938724 3;JKN DR RIZKI; 5.2.0.201712280730 4 153644
1#0##0#0#0.0#2018-03-06 16:25:13#0#12:00:00#12:00:00#12:00:00 1
66df2beb72413bdad0f753fa3295a3c9 0 0 845085 0 0 88899
0 0 0 0 3161424 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 25/02/2018 31/12/1957 0 2
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 6630321 0 3 0 0 0 YETTIMAR
D391234 60 21969 DR ARU, SPPD 0138R01702180010932
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1#0##0#0#0.0#2018-03-06 16:26:37#0#12:00:00#12:00:00#12:00:00 1
294f7a16bea73bbaab165df66ac1d0ee 0 0 595000 0 0
2749562 0 0 0 0 3285759 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 25/02/2018 22/10/1950 0 1
1 I25.0;I08.9;I50.0;E14.2;D29.1 88.55;36.07 - - YY02 None None
0 - 0 - 0 46734600 62132156 0 3 0 0
0 ACHMAD SAIDUN ALI, SH D286409 67 24596 DR AGOES KOOSHARTORO
5.2.0.201712280730 4 153209 1#0##0#0#0.0#2018-03-06
16:28:42#0#12:00:00#12:00:00#00:00:00 1 5cb7227f2a3c1b3e8cd8c5eda060a1c4
0 10753000 7201760 0 0 35451396 0 0 0 0
1226000 0 0 0 0 7500000
3201126 B 1 BS 1 23/02/2018 25/02/2018 01/10/1956 0 1
0 0 - 0 - 0 - 0 - 0 17095200
13784971 0 3 0 0 0 KASNO D389698 61 22425 DR
5.2.0.201712280730 4 153662 1#0##0#0#0.0#2018-03-06
16:31:29#0#12:00:00#12:00:00#12:00:00 1 6450762ea80efb0bb052955b06a4c14d
0 0 1775560 0 0 3880090 0 0 0 0
6060321 0 0 0 0 2069000
3201126 B 1 BS 1 21/02/2018 25/02/2018 29/04/2003 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 7907868 0 5 0 0 0 ADITYA JONATHAN P
SIREGAR D128111 14 5412 DR RASTRA, SPA 0138R01702180009499
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1#1#vvip#5#4981968#0.0#2018-03-06 16:32:32#0#12:00:00#12:00:00#12:00:00
1 48a630c6da6f94bba6545c46b7417d88 0 0 431803 0 0
557728 0 0 0 0 6918337 0 0 0 0 0
3201126 B 2 BS 1 22/02/2018 25/02/2018 19/01/1992 0 1
9351000 0 0 - 0 - 0 - 0 - 0
9351000 13061479 0 4 0 0 0 FERI OKYAWAN
0002251421346 3;JKN DR RIZKI; 5.2.0.201712280730 4 153196
1#0##0#0#0.0#2018-03-07 11:55:06#0#12:00:00#12:00:00#12:00:00 1
ae672627e595853803931b6150df851b 0 3247245 2671280 0 0
4460610 0 0 0 0 2537344 0 0 0 0 145000
3201126 B 1 BS 1 22/02/2018 25/02/2018 17/07/1940 0 2
None None None None LUKA BAKAR (RINGAN) 7227500 0 0 -
0 - 0 - 0 - 0 7227500 4797181 0 4
0 0 0 SUSANAH D342238 77 28344 DR TEDDY DJUNAEDI, SPB
0138R01702180010529 0001473665062 3;JKN DR RIZKI; 5.2.0.201712280730
4 153641 1#0##0#0#0.0#2018-03-08
10:49:47#0#12:00:00#12:00:00#12:00:00 1 1c7028b8db41a158674a30d153be785a
0 0 703475 0 0 1380872 0 0 0 0
2712834 0 0 0 0 0
3201126 B 1 BS 1 21/02/2018 25/02/2018 11/07/1945 0 2
1 J18.0;A01.0;K12.1;A91 87.44 - - None None None None J-4-
(BERAT) 8987600 0 0 - 0 - 0 - 0 - 0
8987600 6017809 0 5 0 0 0 PINTA NAPITUPULU
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1#0##0#0#0.0#2018-03-08 10:55:00#0#12:00:00#12:00:00#12:00:00 1
3fd24f0dbecd297c4b3a8c1741664b0f 0 0 316331 0 0
1722290 0 0 0 0 3979188 0 0 0 0 0
3201126 B 1 BS 1 25/02/2018 25/02/2018 30/08/1964 0 2
17095200 0 0 - 0 - 0 - 0 - 0
17095200 14415547 0 1 0 0 0 A DARYATI D389316
0000042074436 3;JKN DR RIZKI; 5.2.0.201712280730 4 153889
1#0##0#0#0.0#2018-03-08 13:13:48#0#12:00:00#12:00:00#12:00:00 1
dd8294e538706e7d078afbf914ad6b37 0 986000 3419040 0 0
3832434 0 0 0 0 4109073 0 0 0 0
2069000
3201126 B 1 BS 1 24/02/2018 25/02/2018 05/06/1945 0 1
- 0 46734600 46884241 0 2 0 0 0 MUHAMMAD NUH
NASUTION D389807 72 26562 DR AZRI NURIZAL SPPD KKV
0138R01702180011010 0001819580016 3;JKN DR RIZKI; 5.2.0.201712280730
4 153684 1#0##0#0#0.0#2018-03-08
13:28:21#0#12:00:00#12:00:00#12:00:00 1 295e3f0985f633dbdf379367e684769c
0 9182000 7201760 0 0 20757481 0 0 0 0
2174000 0 0 0 0 7569000
3201126 B 1 BS 1 22/02/2018 25/02/2018 14/03/1993 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 20400032 0 4 0 0 0 NIA ANDRIYANI
0001632201827 3;JKN DR RIZKI; 5.2.0.201712280730 4 152716
1#0##0#0#0.0#2018-03-08 13:33:18#0#12:00:00#12:00:00#12:00:00 1
2bf356647ac95b98e984cb1273405c2d 0 8666400 6610176 0 0
2835456 0 0 0 0 2091000 0 0 0 0 197000
3201126 B 3 BS 1 24/02/2018 25/02/2018 19/09/1967 0 2
1 I63.9;E14.9 - - - None None None None G-4-14-I None
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 2195645 0 2 0 0 0 SUDARSINI D100101
DR RIZKI; 5.2.0.201712280730 4 153880 1#0##0#0#0.0#2018-03-28
16:03:47#0#12:00:00#12:00:00#00:00:00 2 2651028714dbacdac598e6e3184dab6e
0 0 621855 0 0 1141150 0 0 0 0 432640
0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 25/02/2018 10/12/1953 0 1
- 0 12472300 18307641 0 2 0 0 0 HARDIMAN
0001822536652 3;JKN DR RIZKI; 5.2.1.201804062320 4 153674
1#0##0#0#0.0#2018-05-16 08:23:40#0#12:00:00#12:00:00#12:00:00 1
ad04a89e217afb57e159f5ca6bd3ead7 0 0 3669967 0 0
6242728 0 0 0 0 8325946 0 0 0 0 69000
3201126 B 1 BS 1 23/02/2018 25/02/2018 29/09/1969 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
0001273353625 3;JKN DR RIZKI; 5.2.1.201804062320 4 153656
1#0##0#0#0.0#2018-05-16 09:16:17#0#12:00:00#12:00:00#00:00:00 2
86e5d329ca001943e8690347dc253c77 0 0 520640 0 0
1325300 0 0 0 0 3531548 0 0 0 0 0
3201126 B 2 BS 1 22/02/2018 25/02/2018 11/01/2009 0 2
1 A49.9;A01.0 - - - None None None None A-4-14-III None
(BERAT) 3965700 0 0 - 0 - 0 - 0 - 0
3965700 3993411 0 4 0 0 0 KEYZHA ATIKAH ZAHRA
D161367 9 3329 DR RASTRA, SPA 0138R01702180010144
0001168437993 3;JKN DR RIZKI; 5.2.1.201804062320 4 152947
1#0##0#0#0.0#2018-05-16 09:32:55#0#12:00:00#12:00:00#12:00:00 2
742c7982b3bccdfb82061647f02d1485 0 0 298025 0 0
1388135 0 0 0 0 2307251 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 25/02/2018 07/07/1947 0 2
1 I25.0;I05.9;I11.0;K30 88.55;36.07 - - YY02 None None None
- 0 58821400 59950040 0 3 0 0 0 HANDARU
PURNOMO DEWI D313592 70 25799 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180010495 0000042827264 3;JKN DR RIZKI; 5.2.1.201804062320
4 153298 1#0##0#0#0.0#2018-05-16
09:36:38#0#12:00:00#12:00:00#00:00:00 2 1592fbd68b958319eefb29ef16ace1b0
0 10753000 3419040 0 0 37052000 0 0 0 0
1226000 0 0 0 0 7500000
3201126 B 3 BS 1 24/02/2018 25/02/2018 11/05/1963 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 899693 0 2 0 0 0 BELMAN SILABAN
D339006 54 20013 DR. SUKMARINI 0138R01702180011175
0002038174244 3;JKN DR RIZKI; 5.2.1.201804062320 4 153878
1#0##0#0#0.0#2018-05-16 09:42:57#0#12:00:00#12:00:00#12:00:00 2
5af3562054801904706cf002f27395c5 0 0 390285 0 0 161550
0 0 0 0 347858 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 25/02/2018 16/03/1972 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 68382966 0 3 0 0 0 ABDUL MUIN
0001796998533 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 153484
1#0##0#0#0.0#2018-05-16 09:48:30#0#12:00:00#12:00:00#12:00:00 2
c19638762f8de40758aef30e3da976bd 0 10753000 9619120 0 0
39284846 0 0 0 0 1226000 0 0 0 0
7500000
3201126 B 1 BS 1 23/02/2018 25/02/2018 15/06/1957 0 1
1 I20.0;I25.0;I08.9;I11.0;E14.9 88.55 - - None None None None
I-1-15-III None None None None None None KATETERISASI JANTUNG (BERAT)
17095200 0 0 - 0 - 0 - 0 - 0
17095200 15533260 0 3 0 0 0 MOHAMMAD SOLEH
0001286314132 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 153649
1#0##0#0#0.0#2018-05-16 09:49:37#0#12:00:00#12:00:00#12:00:00 2
b42a94d11b25a67014e6059db20c55d6 0 5122500 3419040 0 0
3880525 0 0 0 0 1042195 0 0 0 0
2069000
3201126 B 1 BS 1 20/02/2018 25/02/2018 11/03/1965 0 1
1 N18.5;R57.0;E87.7;A16.1 87.44 - - None None None None N-4-
GINJAL (BERAT) 8508800 0 0 - 0 - 0 - 0 -
0 8508800 13608792 0 6 1 3 0 BAYU WIDODO
0002250437703 3;JKN DR RIZKI; 5.2.1.201804062320 4 152020
1#0##0#0#0.0#2018-05-16 09:50:18#0#12:00:00#12:00:00#12:00:00 2
8595408b28e4035365263e58137a161e 0 0 988968 0 0
5683029 0 0 0 0 5131795 0 0 0 0
1805000
3201126 B 3 BS 1 23/02/2018 25/02/2018 10/07/1958 0 2
0 - 0 - 0 - 0 - 0 12210800 10642504
0 3 0 0 0 WADJEM D387849 59 21778 DR BAMBANG
DWIPUTRA SPJP 0138R01702180010917 0002084598617 3;JKN DR RIZKI;
5.2.1.201804062320 4 153657 1#0##0#0#0.0#2018-05-16
09:56:08#0#12:00:00#12:00:00#12:00:00 2 75035df7b97046932b06994c709b7c68
0 2432500 908180 0 0 4510585 0 0 0 0
722239 0 0 0 0 2069000
3201126 B 2 BS 1 24/02/2018 25/02/2018 11/11/1958 0 2
1 I49.3;E87.6;K30 - - - None None None None I-4-19-II
(SEDANG) 7333600 0 0 - 0 - 0 - 0 - 0
7333600 3132390 0 2 0 0 0 NENENG SUMIATI
0000168509351 3;JKN DR RIZKI; 5.2.1.201804062320 4 153676
1#0##0#0#0.0#2018-05-16 10:03:19#0#12:00:00#12:00:00#12:00:00 2
dafcbee562dd201905ee92146a9ed7c4 0 0 209906 0 0
1681561 0 0 0 0 1240916 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 25/02/2018 19/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 17095200
22270590 0 3 0 0 0 ENDANG TJAHYANINGSIH D390339
0000036883102 3;JKN DR RIZKI; 5.2.1.201804062320 4 153660
1#0##0#0#0.0#2018-05-16 10:21:11#0#12:00:00#12:00:00#12:00:00 2
214bb0944ce2ce90d44ad82d98e176ce 0 5122500 9619120 0 0
4302970 0 0 0 0 1226000 0 0 0 0
2000000
3201126 B 3 BS 1 25/02/2018 25/02/2018 01/11/1948 0 1
2 K92.1;R57.2;A41.9 89.52 - - None None None None K-4-18-III
(BERAT) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 2058747 0 1 0 0 0 MAKDIN SIMANJUNTAK
D173231 69 25318 DR SUKMARINI 0138R01702180011196
0000061022834 3;JKN irene; 5.2.0.201712280730 4 153885
1#0##0#0#0.0#2018-08-11 13:12:36#0#12:00:00#12:00:00#00:00:00 2
0128e127309d3a9de4da49c55c6fe667 0 0 264771 0 0
1370292 0 0 0 0 423684 0 0 0 0 0
3201126 B 1 BS 1 22/02/2018 25/02/2018 27/03/1953 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 22077520 0 4 0 0 0 DOLOROSA MAWARTININGSIH
0001482008815 3;JKN DR RIZKI; 5.2.1.201804062320 4 152736
1#0##0#0#0.0#2018-08-16 10:10:11#0#12:00:00#12:00:00#12:00:00 3
39265962a1bec734556ed90cf8aab0da 0 0 6547140 0 0
5893780 0 0 0 0 9491600 0 0 0 145000
0
3201126 B 2 BS 1 24/02/2018 25/02/2018 29/08/1957 0 2
(SEDANG) 30864700 0 0 PCI 10725800 - 0 - 0 -
0 41590500 53560780 0 2 0 0 0 SRI LESTARI
0002035928169 3;JKN DR RIZKI; 5.2.0.201712280730 4 153872
1#0##0#0#0.0#2018-09-05 16:10:13#0#12:00:00#12:00:00#12:00:00 2
ef39355ca9051a63cb313d0e5099c9af 0 7815000 6172940 0 0
29971840 0 0 0 0 2032000 0 0 0 0
7569000
3201126 B 3 BS 1 21/02/2018 25/02/2018 29/06/2007 0 2
1 A01.0;A91;J06.9 - - - None None None None A-4-14-III
LAIN-LAIN (BERAT) 3304700 0 0 - 0 - 0 - 0 -
0 3304700 2410762 0 5 0 0 0 FIFI PERMATA SARI
D390255 10 3890 DR DYAH HARINI, SPA 0138R0170218V000010
0001469267605 3;JKN DR RIZKI; 5.2.2.201806040537 4 228511
1#0##0#0#0.0#2018-09-29 10:27:40#0#00:00:00#00:00:00#12:00:00 1
096072070e9d4bac6ec8faa23bc14258 0 0 341081 0 0 833968
0 0 0 0 1052000 0 0 157713 26000 0
3201126 B 3 BS 1 24/02/2018 26/02/2018 17/08/1970 0 1
1 E11.2;D63.8;I25.0 39.27;99.04 - - None None None None N-1-
- 0 8908800 9699798 0 3 0 0 0 AGUS SANTOSA
D391385 47 17358 DR SRI KUN, SPPD 0138R01702180011147
0001338345729 3;JKN DR RIZKI; 5.2.0.201712280730 4 153867
1#0##0#0#0.0#2018-03-02 17:35:19#0#12:00:00#12:00:00#12:00:00 1
5cdf9e446ac88552ce7b907f646da201 0 4874560 854792 0 0
2758380 0 0 0 0 1143066 0 0 0 69000 0
3201126 B 3 BS 1 20/02/2018 26/02/2018 10/12/1970 0 2
1 E14.9;K56.7;C56;E87.6 90.59;89.52 - - None None None None
0 - 0 - 0 4894400 6788137 0 7 0 0
0 LINDA SITOMPUL D097316 47 17239 DR ARU, SPPD
0138R01702180009223 0001740115372 3;JKN DR RIZKI; 5.2.0.201712280730
4 152022 1#0##0#0#0.0#2018-03-02
17:38:03#0#12:00:00#12:00:00#00:00:00 1 1e71e6534e828633aa25c5f6d1c659df
0 0 599496 0 0 4122557 0 0 0 0
2066084 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 26/02/2018 01/03/1957 0 2
1 E14.5 86.63 - - None None None None L-1-30-I None None
None None None None PEMINDAHAN KULIT TANPA LUKA BAKAR (RINGAN)
8883500 0 0 - 0 - 0 - 0 - 0
8883500 8517671 0 5 0 0 0 SUMINTEN d384950
3;JKN DR RIZKI; 5.2.0.201712280730 4 152572 1#0##0#0#0.0#2018-
03-02 17:46:45#0#12:00:00#12:00:00#12:00:00 1
b6e00783b441a3b2297104cf60914489 0 5764333 220149 0 0
965958 0 0 0 0 1498231 0 0 0 69000 0
3201126 B 3 BS 1 22/02/2018 26/02/2018 16/10/2017 0 2
1 J18.0;D47.3 87.44 - - None None None None J-4-16-II None
5077500 0 0 - 0 - 0 - 0 - 0
5077500 3672843 0 5 0 0 0 SYAHIRAH AQILAH MARWAH
0002425337234 3;JKN DR RIZKI; 5.2.0.201712280730 4 152567
1#0##0#0#0.0#2018-03-02 18:05:03#0#12:00:00#12:00:00#12:00:00 2
88657b3bd2094aead64220b26f92ad53 0 0 414320 0 0
1507244 0 0 0 0 1581279 0 0 0 170000
0
3201126 B 3 BS 1 20/02/2018 26/02/2018 28/09/1960 0 2
1 I63.9;E14.9;E16.2 87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 5013100 0 0 - 0 - 0 - 0 -
0 5013100 6004208 0 7 0 0 0 ASMANI
0001810641352 3;JKN DR RIZKI; 5.2.0.201712280730 4 152021
1#0##0#0#0.0#2018-03-02 18:08:11#0#12:00:00#12:00:00#12:00:00 1
24fcc7c58d299bf56ad26f055a85c6eb 0 0 813045 0 0
3017864 0 0 0 0 2173299 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 26/02/2018 01/03/1960 0 2
1 I64;G81.9;I25.0;R47.0;R13;E78.5 87.03 - - None None None
4888600 0 0 - 0 - 0 - 0 - 0
4888600 5293317 0 5 0 0 0 SAINAH D391154
3;JKN DR RIZKI; 5.2.0.201712280730 4 153189 1#0##0#0#0.0#2018-
03-02 18:11:56#0#12:00:00#12:00:00#12:00:00 2
d47fc2ddf597d438bb30ecbee9bb92dd 0 0 813045 0 0
2879480 0 0 0 0 1600792 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 26/02/2018 20/08/1953 0 2
1 D69.3;A09.9 - - - None None None None D-4-11-I None
None None None None None GANGGUAN PEMBEKUAN DARAH (RINGAN) 4042800
0 0 - 0 - 0 - 0 - 0 4042800
4764251 0 5 0 0 0 NANIH D391097 64 23562 DR
5.2.0.201712280730 4 152566 1#0##0#0#0.0#2018-03-02
19:39:44#0#12:00:00#12:00:00#12:00:00 1 32a2d5a60ff20a6115277773b605de7f
0 0 416852 0 0 2694719 0 0 0 0
1652680 0 0 0 0 0
3201126 B 3 BS 1 26/02/2018 26/02/2018 21/04/1978 0 1
1 N18.5;J81 - - - None None None None N-4-10-III None
(BERAT) 6077700 0 0 - 0 - 0 - 0 - 0
6077700 2223371 0 1 0 0 0 MUHAMAD SOLEH TN
0001455588617 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153911
1#0##0#0#0.0#2018-03-05 08:57:30#0#12:00:00#12:00:00#00:00:00 1
f51868d065802f009fea4a0ffa129325 0 0 351242 0 0 281425
0 0 0 0 1590704 0 0 0 0 0
3201126 B 2 BS 1 19/02/2018 26/02/2018 22/03/1943 0 2
1 I63.9;R56.8;L89.2 87.44;87.03 - - None None None None G-4-
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 15811613 0 8 1 2 0 LATIFAH
0000060592151 3;JKN DR RIZKI; 5.2.0.201712280730 4 151420
1#0##0#0#0.0#2018-03-05 12:29:39#0#12:00:00#12:00:00#00:00:00 1
55365d9d08ea9df0405f1b784915bb7b 0 0 963778 0 0
5748430 0 0 0 0 6067405 0 0 0 0
3032000
3201126 B 2 BS 1 23/02/2018 26/02/2018 21/12/2016 0 2
1 J06.9;N39.9;B37.9 93.94 - - None None None None U-4-13-II
- 0 - 0 2801300 4242671 0 4 0 0 0
GENDIS FELLAH JONKA UTAMA D390983 1 429 DR HUDA, SPA
0138R01702180010357 0002088844389 3;JKN DR RIZKI; 5.2.0.201712280730
4 153198 1#0##0#0#0.0#2018-03-06
08:54:34#0#12:00:00#12:00:00#12:00:00 1 3105a2f333d9a607715db9673b2d8a62
0 0 338039 0 0 1241074 0 0 0 0
2323558 0 0 0 340000 0
3201126 B 2 BS 1 21/02/2018 26/02/2018 23/07/1948 0 1
1 I67.9;G81.9;M25.59 87.03 - - None None None None G-4-
LAIN (SEDANG) 5162700 0 0 - 0 - 0 - 0 -
0 5162700 7433082 0 6 0 0 0 ARNA D390963
DR RIZKI; 5.2.0.201712280730 4 152024 1#0##0#0#0.0#2018-03-06
09:21:48#0#12:00:00#12:00:00#12:00:00 1 a48d897b79045f488636704c6b76a665
0 0 594422 0 0 3296384 0 0 0 0
3542276 0 0 0 0 0
3201126 B 2 BS 1 24/02/2018 26/02/2018 28/11/1998 0 2
0 0 - 0 - 0 - 0 - 0 2871200
3161547 0 3 0 0 0 NIA PRIHATINI D391297 19
DR RIZKI; 5.2.0.201712280730 4 153678 1#0##0#0#0.0#2018-03-06
09:27:40#0#12:00:00#12:00:00#12:00:00 1 19f00645d070fcdc5cb66300ab83150a
0 0 452159 0 0 961558 0 0 0 0
1747830 0 0 0 0 0
3201126 B 2 BS 1 21/02/2018 26/02/2018 03/05/1965 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 17049117 0 6 0 0 0 RINI APSARI D391068
52 19287 DR HENDRIEK SP B 0138R01702180009785 0001082080912 3;JKN
DR RIZKI; 5.2.0.201712280730 4 152560 1#0##0#0#0.0#2018-03-06
09:44:48#0#12:00:00#12:00:00#12:00:00 1 49eb703bcd3e2fb0d6f205894af94f2f
0 6320890 303020 0 0 6608844 0 0 0 0
3681363 0 0 0 135000 0
3201126 B 2 BS 1 25/02/2018 26/02/2018 06/08/1935 0 2
- 0 10690500 19246457 0 2 0 0 0 SAJIYEM
0000208719393 3;JKN DR RIZKI; 5.2.0.201712280730 4 153896
1#1#vip#2#11136025#75.0#2018-03-06 09:52:47#0#12:00:00#12:00:00#12:00:00
1 c2eb22d8a04d38fcfe822cd4ee696e75 0 10213205 2017387 0
0 3322865 0 0 0 0 3624000 0 0 0 69000
0
3201126 B 1 BS 1 25/02/2018 26/02/2018 11/09/2012 0 1
1 R11 - - - None None None None K-4-17-I None None
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2346347 0 2 0 0 0 ARKANA ADHYASTAVEDA
SARTONO D391461 5 1993 DR AWIDIYA, SPA 0138R01702180011251
0000977234174 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153894
1#0##0#0#0.0#2018-03-06 09:54:34#0#12:00:00#12:00:00#12:00:00 1
55c8c7d88a57c8bd740cff4b6704cfde 0 0 269459 0 0 335389
0 0 0 0 1741499 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 26/02/2018 27/07/1954 0 2
1 I11.0;K29.7;R06.0 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 5005900
2833167 0 3 0 0 0 YANA YULIANA D318664 63
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153877
1#0##0#0#0.0#2018-03-06 10:00:10#0#12:00:00#12:00:00#12:00:00 1
fe6a113c08ecd00369ed9e0077346b52 0 0 345275 0 0 279045
0 0 0 0 2208847 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 26/02/2018 14/06/1992 0 2
0 - 0 - 0 - 0 - 0 6981500 22789895
0 4 0 0 0 GABRIELLA JUNIKE MARIA AZALIA SIMANJUNTAK
0001897151534 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153654
1#1#vvip#4#15808395#0.0#2018-03-06 10:18:09#0#12:00:00#12:00:00#12:00:00
1 77068d5bfad35abc822fcf5d15559351 0 9464400 6557176 0
0 4669319 0 0 0 0 1311000 0 0 0 0
788000
3201126 B 1 BS 1 24/02/2018 26/02/2018 02/12/1982 0 2
None None None None None None PROSEDUR KAKI (RINGAN) 12236300 0
0 - 0 - 0 - 0 - 0 12236300 24039231
0 3 0 0 0 DYAN ANDRIATY D390035 35 12868 DR
BENNY H T, SPOT 0138R01702180011007 0001137673181 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 153683 1#1#vip#3#9177225#75.0#2018-03-06
10:23:55#0#12:00:00#12:00:00#12:00:00 2 b5ef70f076f156b2bcd33c632d281746
0 12048700 7298787 0 0 3270744 0 0 0 0
1276000 0 0 0 0 145000
3201126 B 1 BS 1 22/02/2018 26/02/2018 03/12/1983 0 2
0 - 0 - 0 - 0 - 0 6981500 30789038
0 5 0 0 0 SANIAH d205077 34 12500 DR NELWATI,
5.2.0.201712280730 4 153193 1#1#vvip#5#23807538#0.0#2018-03-06
10:26:56#0#12:00:00#12:00:00#12:00:00 1 ce840c4908c3d37514c01085955dab46
0 11938700 11309600 0 0 6042738 0 0 0 0
1301000 0 0 0 0 197000
3201126 B 1 BS 1 23/02/2018 26/02/2018 23/02/2018 3072 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3690430 0 4 0 0 0 BAYI NY SANIAH
D391203 0 0 DR AWIDIYA, SPA 0138R01702180010645
0002324312627 3;JKN DR RIZKI; 5.2.0.201712280730 4 153646
1#0##0#0#0.0#2018-03-06 10:50:36#0#12:00:00#12:00:00#12:00:00 1
b2c8dcf753cc9c2db84d3650c3115a19 0 0 271000 0 0 0
0 0 0 0 3419430 0 0 0 0 0
3201126 B 3 BS 1 25/02/2018 26/02/2018 17/02/1953 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 892737 0 2 0 0 0 YUSPI D298708 65
23749 DR DICKI PRATAMA 0138R01702180011345 0001268943658 3;JKN DR
RIZKI; 5.2.0.201712280730 4 153908 1#0##0#0#0.0#2018-03-06
15:12:33#0#21:30:00#05:00:00#00:00:00 1 63d39bd13433659e528b8e8d2ad07757
0 0 378234 0 0 167100 0 0 0 0 347403
0 0 0 0 0
3201126 B 3 BS 1 26/02/2018 26/02/2018 21/06/1960 0 1
4 I24.9;J96.0;I10 99.60 - - None None None None I-4-20-III
7040000 0 0 - 0 - 0 - 0 - 0
7040000 3338549 0 1 0 0 0 PARDOMUAN SAHAT MARULI
S. D298225 57 21069 DR DICKI PRATAMA 0138R01702180011355
0001305441134 3;JKN DR RIZKI; 5.2.0.201712280730 4 153913
1#0##0#0#0.0#2018-03-06 15:15:43#0#00:00:00#01:45:00#00:00:00 1
b333d133c27fd7d7b66d354390a7581c 0 0 363870 0 0
1733269 0 0 0 0 525410 0 0 0 0 716000
3201126 B 3 BS 1 24/02/2018 26/02/2018 07/10/1967 0 2
- 0 45079800 46475440 0 3 0 0 0 DERAHIDRIS
0001740378644 3;JKN DR RIZKI; 5.2.0.201712280730 4 153870
1#0##0#0#0.0#2018-03-06 15:25:49#0#12:00:00#12:00:00#12:00:00 1
b7eaf7b5db5359ea63efdcbc54cb2989 0 7996000 6870800 0 0
22783640 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 25/02/2018 26/02/2018 20/07/1983 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 7257743 0 2 0 0 0 DANI HERYADI
0002318621815 3;JKN DR RIZKI; 5.2.0.201712280730 4 153903
1#0##0#0#0.0#2018-03-06 15:28:07#0#12:00:00#12:00:00#12:00:00 1
7cd728cba372040538f0044bf186a80e 0 3442300 1311745 0 0
1903892 0 0 0 0 530806 0 0 0 0 69000
3201126 B 2 BS 1 24/02/2018 26/02/2018 25/03/1950 0 2
2783600 0 0 - 0 - 0 - 0 - 0
2783600 4438640 0 3 0 0 0 KUSTINAH D383640
67 24808 DR ARU, SPPD 0138R01702180011117 0001457465117 3;JKN
DR RIZKI; 5.2.0.201712280730 4 153883 1#0##0#0#0.0#2018-03-07
09:28:04#0#12:00:00#12:00:00#12:00:00 1 00b69e4db60fd89d0ab6e0fc5deba485
0 0 761822 0 0 2350440 0 0 0 0
1326378 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 26/02/2018 06/11/1970 0 2
- 0 58821400 53264285 0 3 0 0 0 PRITA
NOVIANTI D277925 47 17277 DR BAMBANG DWIPUTRA SPJP
0138R01702180011126 0001650441104 3;JKN DR RIZKI; 5.2.0.201712280730
4 153865 1#0##0#0#0.0#2018-03-08
13:21:41#0#12:00:00#12:00:00#12:00:00 1 f127603f366d87f0d747fc65d317b694
0 9873000 9619120 0 0 24047165 0 0 0 0
2156000 0 0 0 0 7569000
3201126 B 1 BS 1 24/02/2018 26/02/2018 01/02/1951 0 1
- 0 58821400 53196535 0 3 0 0 0 IRWADY
AGOESTIAN ALIM D337353 67 24495 DR SUPONO SPJP 0138R01702180011152
0000061017309 3;JKN DR RIZKI; 5.2.0.201712280730 4 153871
1#0##0#0#0.0#2018-03-08 15:27:41#0#12:00:00#12:00:00#00:00:00 1
1369bea3314465ba469adafe618434f1 0 7801382 9619120 0 0
24670415 0 0 0 0 3536618 0 0 0 0
7569000
3201126 B 1 BS 1 24/02/2018 26/02/2018 14/09/1966 0 1
- 0 58821400 60118385 0 3 0 0 0 ERSON EFANDY
MAMPUK D334560 51 18791 DR BAMBANG DWIPUTRA SPJP
0138R01702180011153 0001643388996 3;JKN DR RIZKI; 5.2.0.201712280730
4 153869 1#0##0#0#0.0#2018-03-08
15:36:34#0#12:00:00#12:00:00#12:00:00 1 98143efae91e5763b99ed3a025178dd4
0 9182000 9619120 0 0 31592265 0 0 0 0
2156000 0 0 0 0 7569000
3201126 B 3 BS 1 12/02/2018 26/02/2018 04/06/1968 0 2
1 N18.5;E16.2;D63.8;A49.9;G93.4 99.04 - - None None None None
- 0 6077700 30840806 0 15 0 0 0 TRI BUDI
PERMANASARI D384969 49 18150 DR SRI KUNMARTINI, SPPD 0138R01702180005237
0001396519661 3;JKN DR RIZKI; 5.2.0.201712280730 4 148360
1#0##0#0#0.0#2018-03-08 15:48:32#0#12:00:00#12:00:00#12:00:00 1
5317c5c1632714c91109a3b9dd1e1a38 0 0 721547 0 0
8973009 0 0 0 0 10635000 0 0 0 5807250
4704000
3201126 B 3 BS 1 11/02/2018 26/02/2018 26/11/1965 0 1
1 I21.3;J18.9;R57.0;I13.2 96.05;96.72;38.95;87.44 - - None None
None None J-1-02-III None None None None None None VENTILASI
MEKANIKAL LONG TERM TANPA TRAKEOSTOMI (BERAT) 66331600 0 0 - 0
- 0 - 0 - 0 66331600 95235694 0 16 1
11 96 DARSONO D373005 52 19070 DR AZRI NURIZAL SPPD KKV
0138R01702180004766 0001729632069 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 147841 1#0##0#0#0.0#2018-05-16
09:50:42#0#12:00:00#12:00:00#12:00:00 2 a29093b7f2820e52b9b695ae28ad5cdd
0 18265000 29386904 0 0 28752090 0 0 0 0
5743700 0 0 0 0 13088000
3201126 B 3 BS 1 25/02/2018 26/02/2018 04/01/1970 0 2
0 0 - 0 - 0 - 0 - 0 12210800
10034528 0 2 0 0 0 LUSIYANI D389704 48 17584
TANTIYO S;16137 5.2.1.201804062320 4 153890 1#0##0#0#0.0#2018-
05-16 09:54:40#0#12:00:00#12:00:00#12:00:00 3
ffa5e3b0b8e1177ec1d1343b799748ba 0 2421000 908180 0 0
3923884 0 0 0 0 712464 0 0 0 0
2069000
3201126 B 3 BS 1 22/02/2018 26/02/2018 28/12/1942 0 1
1 I24.9;I10;R10.4 89.52 - - None None None None I-4-20-I
4202600 0 0 - 0 - 0 - 0 - 0
4202600 5020981 0 5 0 0 0 MACHRUDIE D390486
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 152565
1#0##0#0#0.0#2018-05-16 11:00:48#0#12:00:00#12:00:00#12:00:00 2
4df0e45fb330b75da796a46940773ceb 0 0 725190 0 0
2114316 0 0 0 0 1669475 0 0 0 512000
0
3201126 B 1 BS 1 24/02/2018 26/02/2018 25/07/1955 0 2
1 K21.9;E87.6 - - - None None None None K-4-12-II None
None None None None None GANGGUAN ESOFAGUS (SEDANG) 5739000 0
0 - 0 - 0 - 0 - 0 5739000 5130912
0 3 0 0 0 YULI SETIAWATI D391287 62 22860 SRI
KUNMARTINI.DR,SPPD 0138R01702180011563 0001310949876 3;JKN DR RIZKI;
5.2.1.201804062320 4 154147 1#0##0#0#0.0#2018-08-16
10:27:00#0#12:00:00#12:00:00#12:00:00 4 72ea4322165f08bcea4d2e966f25c665
0 0 569510 0 0 1856735 0 0 0 0
2704667 0 0 0 0 0
3201126 B 3 BS 1 20/02/2018 27/02/2018 21/08/1957 0 1
0 0 - 0 - 0 - 0 - 0 7219300
12706506 0 8 0 0 0 SUKAMTO D385798 60 22098
TANTIYO S;16137 5.2.0.201712280730 4 152279 1#0##0#0#0.0#2018-
03-05 08:41:43#0#12:00:00#12:00:00#12:00:00 1
fc49d1d0838616f921551f89ac7e5b1c 0 0 702737 0 0
3217502 0 0 0 0 6563267 0 0 0 0
2223000
3201126 B 3 BS 1 24/02/2018 27/02/2018 23/01/1962 0 2
None None None None None INFEKSI GINJAL DAN SALURAN URIN (SEDANG)
4206000 0 0 - 0 - 0 - 0 - 0
4206000 3598814 0 4 0 0 0 ULIANA SIAHAAN
0001717778575 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153882
1#0##0#0#0.0#2018-03-06 08:28:34#0#12:00:00#12:00:00#12:00:00 1
155126ffe84d936bd7282f3201aeed10 0 0 368243 0 0
2180135 0 0 0 0 1050436 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 27/02/2018 18/12/1961 0 1
1 I63.9;I10;G81.9 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 2776386 0 6 0 0 0 BAHRUDIN
0001208826459 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153194
1#0##0#0#0.0#2018-03-06 08:38:13#0#12:00:00#12:00:00#12:00:00 1
715099616ed9c956e63ee92c118e25a7 0 0 504179 0 0 749574
0 0 0 0 1522633 0 0 0 0 0
3201126 B 3 BS 1 22/02/2018 27/02/2018 03/06/1970 0 2
1 Z03.0;J15.9 90.59;87.49;89.52 - - None None None None J-4-
15-III None None None None None None PERADANGAN DAN INFEKSI PERNAFASAN
(BERAT) 6970400 0 0 - 0 - 0 - 0 - 0
6970400 7097934 0 6 0 0 0 MAESAROH D391113
47 17431 DR BOBBY SP.P 0138R01702180010203 0000511361076 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 153104 1#0##0#0#0.0#2018-
03-06 08:39:48#0#12:00:00#12:00:00#12:00:00 1
ab16d7c087e1b8884a66c8401adc7613 0 0 378188 0 0
1405395 0 0 0 0 5314351 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 27/02/2018 19/08/2016 0 1
- 0 - 0 - 0 - 0 2655900 2771253 0
4 0 0 0 MUHAMMAD ALWI D391309 1 554 DR RASTRA,
SPA 0138R01702180011053 0002316514994 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 153759 1#0##0#0#0.0#2018-03-06
08:43:15#0#12:00:00#12:00:00#12:00:00 1 4a653194ca6cf0c427570c8a587faea4
0 0 292031 0 0 1219925 0 0 0 0
1259297 0 0 0 0 0
3201126 B 3 BS 1 23/02/2018 27/02/2018 29/11/1958 0 1
1 E13.2;E87.6;I50.0;J18.0 39.95;39.27 - - None None None None
- 0 - 0 19332400 14721437 0 5 0 0 0
M.YAZIK D382063 59 21636 DR AZRI NURIZAL SPPD KKV
0138R01702180010710 0001422847664 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156495 1#0##0#0#0.0#2018-03-06
08:55:16#0#12:00:00#12:00:00#12:00:00 1 7c85b4160399b07e1e01a632ef0d52f7
0 0 2818614 0 0 4320738 0 0 0 0
7513085 0 0 0 69000 0
3201126 B 3 BS 1 26/02/2018 27/02/2018 18/07/2015 0 1
1467400 0 0 - 0 - 0 - 0 - 0
1467400 4350343 0 2 0 0 0 MUHAMMAD ARSYAH
DARMANSYAH D391069 2 954 DR CATUR SUZANTARA 0138R01702180011643
0002048539252 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154200
1#0##0#0#0.0#2018-03-06 09:11:15#0#12:00:00#12:00:00#12:00:00 1
9c9aba12f9561fadd67cbbc078994e3e 0 346000 410872 0 0
1091869 0 0 0 0 2356602 0 0 0 145000
0
3201126 B 1 BS 1 26/02/2018 27/02/2018 24/04/1964 0 2
- 0 58821400 64089434 0 2 0 0 0 MARYAM
0000037067984 3;JKN DR RIZKI; 5.2.0.201712280730 4 154178
1#0##0#0#0.0#2018-03-06 10:19:04#0#12:00:00#12:00:00#12:00:00 1
96c5e3bc3833004f36cc1432a9a59d3d 0 18299120 0 0 0
35455314 0 0 0 0 2638000 0 0 0 0
7697000
3201126 B 1 BS 1 26/02/2018 27/02/2018 07/10/1962 0 1
- 0 58821400 60192854 0 2 0 0 0 AHMAD
SURYAWAN D356460 55 20231 DR AGOES KOOSHARTORO SPPD
0138R01702180011512 0000038137656 3;JKN DR RIZKI; 5.2.0.201712280730
4 154011 1#0##0#0#0.0#2018-03-06
10:33:21#0#12:00:00#12:00:00#00:00:00 1 fddda6de3f9f163bbeea591eba111887
0 18299120 0 0 0 31686734 0 0 0 0
2638000 0 0 0 69000 7500000
3201126 B 1 BS 1 26/02/2018 27/02/2018 15/10/1982 0 2
1 O80.8;O60.1;O73.0;Z37.0 73.59;69.09 - - None None None None
O-6-11-II None None None None None None PERSALINAN VAGINAL DENGAN
STERILISASI &/ DILATASI & KURET (SEDANG) 5345400 0 0 - 0 -
0 - 0 - 0 5345400 6240566 0 2 0 0
0 NOVIDAWATI D052265 35 12918 DR ERDIYAN, SPOG
0138R01702180011877 0001308782812 3;JKN DR RIZKI; 5.2.0.201712280730
4 154444 1#0##0#0#0.0#2018-03-06
11:01:49#0#12:00:00#12:00:00#12:00:00 1 f6e99c4facf8270163badff6deae9439
0 3116000 1264940 0 0 1316165 0 0 0 0
543461 0 0 0 0 0
3201126 B 2 BS 1 23/02/2018 27/02/2018 06/12/1942 0 2
1 I50.0;E87.6;J44.9 90.59 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4973600
5108689 0 5 0 0 0 SUMARNI,NY d391206 75 27473
DR RIZKI; 5.2.0.201712280730 4 153636 1#0##0#0#0.0#2018-03-07
09:54:23#0#12:00:00#12:00:00#12:00:00 1 567e021f17c3f95973260f0f47a5aa79
0 0 500624 0 0 1722852 0 0 0 0
2885213 0 0 0 0 0
3201126 B 2 BS 1 23/02/2018 27/02/2018 21/02/1958 0 2
1 A41.9;E87.2;E11.2 87.44;87.03 - - None None None None A-4-
0 - 0 - 0 - 0 - 0 5196400 10044257
0 5 1 1 0 ASNAWATI D391199 60 21917 DR BETTY DWI
L, SPPD 0138R01702180010565 0002074469231 3;JKN DR RIZKI;
5.2.0.201712280730 4 153457 1#0##0#0#0.0#2018-03-07
09:58:48#0#12:00:00#12:00:00#12:00:00 1 a839efa028ac40e2a898bfef7b92d5f1
0 0 808200 0 0 6164956 0 0 0 0
3071101 0 0 0 0 0
3201126 B 2 BS 1 25/02/2018 27/02/2018 08/07/2013 0 2
1 A49.9;J06.9;G40.9 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3304700 0 0 - 0 - 0 - 0
- 0 3304700 2570665 0 3 0 0 0 ALYCIA
NAMIRA D357480 4 1693 DR AULIA TANGKARI, SPA 0138R01702180011589
0001201712117 3;JKN DR RIZKI; 5.2.0.201712280730 4 154149
1#0##0#0#0.0#2018-03-07 10:01:06#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 24/02/2018 27/02/2018 19/05/1992 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2956903 0 4 0 0 0 LISDA WATI BUTAR BUTAR
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1#0##0#0#0.0#2018-03-07 10:03:24#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 24/02/2018 27/02/2018 18/01/2017 0 2
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0138R01702180011104 0002201497424 3;JKN DR RIZKI; 5.2.0.201712280730
4 157948 1#0##0#0#0.0#2018-03-07
10:11:16#0#12:00:00#12:00:00#00:00:00 2 f007cc30b86ddcc384d60ee99ffa6f96
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2303843 0 0 0 340000 0
3201126 B 2 BS 1 25/02/2018 27/02/2018 22/10/2013 0 1
1 B34.9;K12.2 - - - None None None None A-4-13-II None
3200900 0 0 - 0 - 0 - 0 - 0
3200900 2780229 0 3 0 0 0 ALDEBARAN AJI RACHMAN
D391446 4 1587 DR RASTRA, SPA 0138R01702180011204
0001310325579 3;JKN DR RIZKI; 5.2.0.201712280730 4 153886
1#0##0#0#0.0#2018-03-07 10:14:32#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 20/02/2018 27/02/2018 14/06/2006 0 1
1 K35.2;A41.9 54.19;54.59 - - None None None None K-1-40-III
(BERAT) 18011700 0 0 - 0 - 0 - 0 - 0
18011700 20319478 0 8 0 0 0 MUHAMMAD ARIFIN ILHAM
0001635947785 3;JKN DR RIZKI; 5.2.0.201712280730 4 151983
1#0##0#0#0.0#2018-03-07 10:19:14#0#12:00:00#12:00:00#12:00:00 1
65a17d0473a472dc85dcc0551125b891 0 7356000 3108320 0 0
8099358 0 0 0 0 1368300 0 0 0 387500
0
3201126 B 2 BS 1 26/02/2018 27/02/2018 19/12/2016 0 2
5598300 0 0 - 0 - 0 - 0 - 0
5598300 5413034 0 2 0 0 0 ADIA RAFA SHALIHA PUTRI
AKBAR D389657 1 434 DR CATUR SUZANTARA 0138R01702180011564
0002241597699 3;JKN DR RIZKI; 5.2.0.201712280730 4 154095
1#0##0#0#0.0#2018-03-07 11:47:46#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 25/02/2018 27/02/2018 17/09/1997 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10659214 0 3 0 0 0 MUTHIA RIZQI LARASATI
WIBOWO D389599 20 7466 DR RACHMADSYAH, SPOG 0138R01702180011268
0001737054775 3;JKN DR RIZKI; 5.2.0.201712280730 4 153897
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2249229 0 0 0 0 1202232 0 0 0 0 197000
3201126 B 2 BS 1 23/02/2018 27/02/2018 03/03/1953 0 1
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12:00:14#0#12:00:00#12:00:00#00:00:00 1 65e15b2a1295c610d0d81827860bef12
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3201126 B 1 BS 1 25/02/2018 27/02/2018 14/01/2015 0 1
1 A49.9;J06.9 93.94 - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4317910 0 3 0 0 0 FAIST AL GHAISAN SYATHIR
d312348 3 1138 DR AULIA TANGKARI, SPA 0138R01702180011529
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1#0##0#0#0.0#2018-03-08 10:33:02#0#12:00:00#12:00:00#12:00:00 1
229b00619b75bfa8ca8e3e199089c6e4 0 0 333467 0 0
1332963 0 0 0 0 2651480 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 27/02/2018 03/09/2005 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 5762861 0 5 0 0 0 IRSYAD MUHAMMAD ARIF
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1#0##0#0#0.0#2018-03-08 10:36:15#0#12:00:00#12:00:00#12:00:00 1
6da6b8e65bc6aef6159c30b374592655 0 0 561264 0 0 893587
0 0 0 0 4308010 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 27/02/2018 08/09/1942 0 1
5480800 0 0 - 0 - 0 - 0 - 0
5480800 4814168 0 4 0 0 0 H ROBANI D134984
0001338490765 3;JKN DR RIZKI; 5.2.0.201712280730 4 153677
1#0##0#0#0.0#2018-03-08 10:38:33#0#12:00:00#12:00:00#12:00:00 1
3877c2f7582bc71f85d5400aa732cd04 0 0 546272 0 0
1235950 0 0 0 0 2775946 0 0 0 256000
0
3201126 B 1 BS 1 21/02/2018 27/02/2018 13/04/1951 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 8104009 0 7 0 0 0 DJADOTI SINURAT
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1#0##0#0#0.0#2018-03-08 11:04:17#0#12:00:00#12:00:00#12:00:00 1
8ff0ed011dcdd3179d3934688321dd18 0 0 684656 0 0
1741684 0 0 0 0 5677669 0 0 0 0 0
3201126 B 2 BS 1 25/02/2018 27/02/2018 07/04/1993 0 2
1 E07.9;R10.1 88.71 - - None None None None E-4-13-I None
4436500 0 0 - 0 - 0 - 0 - 0
4436500 2995160 0 3 0 0 0 TETI NURWANTI
0001637277309 3;JKN DR RIZKI; 5.2.1.201804062320 4 153902
1#0##0#0#0.0#2018-05-05 11:11:04#0#12:00:00#12:00:00#12:00:00 2
140e6afbd46c9455f8695b3ef16031fe 0 0 452285 0 0
1310930 0 0 0 0 1231945 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 27/02/2018 06/07/1978 0 1
1 E75.5;R10.1 - - - None None None None E-4-12-I None
None None None None None GANGGUAN METABOLIK BAWAAN (RINGAN) 4753100
0 0 - 0 - 0 - 0 - 0 4753100
10421942 0 4 0 0 0 ROSDAN RAWANDI D326426 39
RIZKI; 5.2.1.201804062320 4 153866 1#1#vvip#4#5668842#0.0#2018-
05-05 11:23:11#0#12:00:00#12:00:00#12:00:00 2
9bfff630c85595748b9427f27c6bf677 0 0 564481 0 0
4637152 0 0 0 0 5220305 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 27/02/2018 23/05/2016 0 1
1 A41.9;E86 99.60 - - None None None None A-4-10-I None
None None None None None SEPTIKEMIA (RINGAN) 2534700 0 0
- 0 - 0 - 0 - 0 2534700 4182905 0
1 0 0 0 MUHAMAD BILLAL D391591 1 645 DR AHMAD
HIBBAN A WRIYA 0138R01702180011908 0002061190405 3;JKN DR RIZKI;
5.2.1.201804062320 4 154452 1#0##0#0#0.0#2018-05-16
08:35:17#0#12:00:00#12:00:00#12:00:00 1 f02a71f1708db9950b4b4c2143934cf1
0 0 525474 0 0 3094783 0 0 0 0 562648
0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 27/02/2018 22/09/1954 0 1
0 0 - 0 - 0 - 0 - 0 4202600 850900
0 1 0 0 0 SUMI HARTANTO D268600 63 23169 DR
VINSENSIA NOVI KARTIKA 0138R01702180012365 0001298861177 3;JKN DR RIZKI;
5.2.1.201804062320 4 154917 1#0##0#0#0.0#2018-05-16
09:14:30#0#12:00:00#12:00:00#00:00:00 2 7e4017636bbc08ec3d320bd7d2c9530e
0 0 378234 0 0 0 0 0 0 0 344666
0 0 0 0 128000
3201126 B 3 BS 1 21/02/2018 27/02/2018 02/06/1948 0 1
1 I21.3;E11.8;J44.0 93.94 - - None None None None I-4-10-II
0 0 - 0 - 0 - 0 - 0 7219300
21035700 0 7 1 2 0 ATENG SUTISNA d391007 69
3;JKN DR RIZKI; 5.2.1.201804062320 4 152367 1#0##0#0#0.0#2018-
05-16 09:46:54#0#12:00:00#12:00:00#12:00:00 2
c2bb47a2ce1ee458d9b74b65df9700ec 0 0 1093191 0 0
12365509 0 0 0 0 5507000 0 0 0 0
2070000
3201126 B 2 BS 1 25/02/2018 27/02/2018 25/02/2018 2850 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1364963 0 3 0 0 0 BAYI NY MUTHIA RIZQI
LARASATI WIBOWO D391479 0 0 DR DYAH HARINI, SPA
0138R01702180011740 0002424549407 3;JKN DR RIZKI; 5.2.1.201804062320
4 154338 1#0##0#0#0.0#2018-05-16
09:48:43#0#12:00:00#12:00:00#12:00:00 3 9c0d3ab24c2dfb035a5da8d9d3060a2e
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0 0 0 0 0
3201126 B 2 BS 1 25/02/2018 27/02/2018 12/01/2014 0 1
(BERAT) 3965700 0 0 - 0 - 0 - 0 - 0
3965700 2019981 0 3 0 0 0 ARIMBI GRACIA UNDJUNG
D266315 4 1505 DR RASTRA, SPA 0138R01702180011339
0001833713897 3;JKN DR RIZKI; 5.2.1.201804062320 4 153907
1#0##0#0#0.0#2018-05-16 09:49:15#0#22:50:28#22:50:28#00:00:00 2
d131f208bbe6a0881f87d79ac69850a5 0 0 298025 0 0 553808
0 0 0 0 1168148 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 27/02/2018 01/04/1963 0 2
1 J81;N18.5;E16.2;E87.5 38.95 - - None None None None N-1-
- 0 8908800 20493258 0 4 1 3 0 MASAMAH
0000368760791 3;JKN DR RIZKI; 5.2.1.201804062320 4 153790
1#0##0#0#0.0#2018-05-16 09:55:28#0#12:00:00#12:00:00#12:00:00 2
761e3febce2ca2e8b33c2d0e2fc04fb0 0 0 2636552 0 0
8300956 0 0 0 0 7920750 0 0 0 0
1635000
3201126 B 1 BS 1 21/02/2018 27/02/2018 17/03/1951 0 1
- 0 58821400 70973761 0 7 1 2 0 EKA UTOYO
0001809227406 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 152355
1#0##0#0#0.0#2018-05-16 10:06:40#0#12:00:00#12:00:00#12:00:00 2
d6c8bff070fc3309928785ef28f0f866 0 0 2332160 0 0
44394601 0 0 0 0 14524000 0 0 0 0
9723000
3201126 B 3 BS 1 18/02/2018 27/02/2018 18/04/1964 0 2
- 0 45079800 66382270 0 10 0 0 0 LINA
0001613401018 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 150765
1#0##0#0#0.0#2018-05-16 10:08:56#0#12:00:00#12:00:00#12:00:00 2
b9cb500f22e9df4cb618679812281529 0 12707000 6923800 0 0
33905470 0 0 0 0 1226000 0 0 0 0
11619996
3201126 B 3 BS 1 27/02/2018 27/02/2018 22/06/2016 0 1
1 J22;A41.9 - - - None None None None J-4-21-III None
LAIN-LAIN (BERAT) 6291000 0 0 - 0 - 0 - 0 -
0 6291000 2232130 0 1 0 0 0 KENNY AN'NUR
RAMADHAN D391489 1 615 DR VINSENSIA NOVI KARTIKA
0138R01702180012164 0002429585335 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 154816 1#0##0#0#0.0#2018-05-16
10:09:40#0#12:00:00#12:00:00#12:00:00 2 c75d59fdc550bcdf9da5714d056a6a10
0 0 577773 0 0 1219330 0 0 0 0 435027
0 0 0 0 0
3201126 B 2 BS 1 26/02/2018 27/02/2018 27/08/2012 0 1
0 - 0 2376200 2126307 0 2 0 0 0 PRABU
SAELENDRA SASTRA AL FIRDAUS D391556 5 2009 DR VERA MUNA MANOE, SPA
0138R01702180011850 0001789345877 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 154440 1#0##0#0#0.0#2018-05-16
10:10:32#0#12:00:00#12:00:00#12:00:00 2 a291e29c46f42a650d1ed0d8601c5d4d
0 0 390231 0 0 768472 0 0 0 0 967604
0 0 0 0 0
3201126 B 3 BS 1 26/02/2018 27/02/2018 01/06/1957 0 2
4 E14.1;E87.1;A41.9;I46.9 - - - None None None None E-4-
0 - 0 6262900 5823169 0 2 0 0 0 NENIH
0000512347173 3;JKN DR RIZKI; 5.2.1.201804062320 4 154199
1#0##0#0#0.0#2018-05-16 10:12:51#0#12:00:00#12:00:00#12:00:00 2
9e55d207d2b3291d8ce0b3e00f77c0eb 0 0 493496 0 0
3158714 0 0 0 0 2170955 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 27/02/2018 12/07/1967 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7607437 0 1 0 0 0 SUMARNI D391159
3;JKN DR RIZKI; 5.2.2.201806040537 4 154907 1#0##0#0#0.0#2018-
08-14 17:01:28#0#12:00:00#12:00:00#12:00:00 3
93a6469c21a02a024003d0b7830bc482 0 3062500 1907320 0 0
2014934 0 0 0 0 553683 0 0 0 0 69000
3201126 B 3 BS 1 27/02/2018 28/02/2018 13/10/1991 0 2
1 O06.9;N39.0 69.02 - - None None None None W-1-11-II None
(SEDANG) 2538700 0 0 - 0 - 0 - 0 - 0
2538700 4611132 0 2 0 0 0 DWI OKTARINA ASRI
D375026 26 9634 DR MAMAN H, SPOG 0138R01702180011923
0001770807655 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154456
1#0##0#0#0.0#2018-03-05 09:10:02#0#12:00:00#12:00:00#12:00:00 1
50896ee72a6f759b8d934bfc7b43ce2f 0 0 1010168 0 0 812301
0 0 0 0 2719663 0 0 0 0 69000
3201126 B 3 BS 1 24/02/2018 28/02/2018 23/12/2017 0 2
1 D64.9;R50.9;N39.0 99.04 - - None None None None D-4-13-II
0 - 0 4227600 5348909 0 5 0 0 0 BAYI
NY MELI PUSPITASARI D391435 0 63 DR RASTRA, SPA
0138R01702180011161 0002325684699 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 153874 1#0##0#0#0.0#2018-03-05
12:23:03#0#12:00:00#12:00:00#12:00:00 1 eb766828446be1d98aa0f288cf1bed1d
0 0 321830 0 0 3037150 0 0 0 0
1427929 0 0 0 493000 69000
3201126 B 3 BS 1 26/02/2018 28/02/2018 16/08/1982 0 1
1 E87.6;M13.86 - - - None None None None E-4-11-I
2954900 0 0 - 0 - 0 - 0 - 0
2954900 2014158 0 3 0 0 0 SUHARDI D350221
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154277
1#0##0#0#0.0#2018-03-05 12:33:27#0#12:00:00#12:00:00#00:00:00 1
813dda197afbce2f2f80e6515fd61011 0 0 318941 0 0 748450
0 0 0 0 946767 0 0 0 0 0
3201126 B 2 BS 1 27/02/2018 28/02/2018 07/05/1974 0 2
INTERNAL (RINGAN) 5178700 0 0 - 0 - 0 - 0 -
0 5178700 11871844 0 2 0 0 0 SYARIFAH
0001608801794 3;JKN DR RIZKI; 5.2.0.201712280730 4 154905
1#0##0#0#0.0#2018-03-07 08:31:06#0#12:00:00#12:00:00#12:00:00 1
f64f5eefb8e6a99467b34d0796e4f233 0 0 2138036 0 0
1271145 0 0 0 0 8390163 0 0 0 0 72500
3201126 B 2 BS 1 24/02/2018 28/02/2018 30/05/2017 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 6032855 0 5 0 0 0 ANNASYA NUR SAILA
d391383 0 270 DR KRISTON SILITONGA, SPA 0138R01702180011123
0002241569362 3;JKN DR RIZKI; 5.2.0.201712280730 4 153863
1#0##0#0#0.0#2018-03-07 08:32:18#0#12:00:00#12:00:00#12:00:00 1
23125afc502c75a869042ca2c9cd5971 0 0 443231 0 0
2272451 0 0 0 0 2738173 0 0 0 510000
69000
3201126 B 2 BS 1 23/02/2018 28/02/2018 01/07/1952 0 2
1 I64;G81.9;E78.5;I10;R47.0 87.03 - - None None None None
0 0 - 0 - 0 - 0 - 0 5866300
6134224 0 6 0 0 0 ONENG D391291 65 23978 DR
5.2.0.201712280730 4 153666 1#0##0#0#0.0#2018-03-07
09:23:49#0#12:00:00#12:00:00#12:00:00 1 e69546aa7801270d6cf397d0957c0466
0 0 882140 0 0 2299780 0 0 0 0
2952304 0 0 0 0 0
3201126 B 1 BS 1 25/02/2018 28/02/2018 31/12/1951 0 2
1 I63.9;G81.9;N18.3 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 8876886 0 4 0 0 0 NANIK CHAERONY
0000089875866 3;JKN DR RIZKI; 5.2.0.201712280730 4 153895
1#0##0#0#0.0#2018-03-08 10:44:16#0#12:00:00#12:00:00#12:00:00 1
47eb7bb564fd145c5509e78fa8d5c9bc 0 0 1117063 0 0
4029092 0 0 0 0 3730731 0 0 0 0 0
3201126 B 1 BS 1 25/02/2018 28/02/2018 28/09/2010 0 1
1 A09.9;A49.9 - - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4295930 0 4 0 0 0 ZAKI NOOR HUDAYAH
D391456 7 2707 DR AWIDIYA, SPA 0138R01702180011222
0001785744988 3;JKN DR RIZKI; 5.2.0.201712280730 4 153891
1#0##0#0#0.0#2018-03-08 10:58:10#0#12:00:00#12:00:00#12:00:00 1
1225e6ca326b1faf2c4eba54893198f9 0 0 269459 0 0 595429
0 0 0 0 3431042 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 28/02/2018 03/01/1960 0 2
- 0 58821400 66937414 0 5 0 0 0 IR ROSAIDAR
ARIF D390734 58 21237 DR AZRI NURIZAL SPPD KKV 0138R01702180011061
0001880736851 3;JKN DR RIZKI; 5.2.0.201712280730 4 153773
1#0##0#0#0.0#2018-03-08 11:09:12#0#12:00:00#12:00:00#12:00:00 1
0d5500c5a84e48f509e656e8b9b26627 0 10564000 9672120 0 0
36305294 0 0 0 0 2827000 0 0 0 0
7569000
3201126 B 1 BS 1 25/02/2018 28/02/2018 25/05/1968 0 1
0 - 0 11182000 26821022 0 4 0 0 0
HERNIST NAIBAHO D391477 49 18173 DR MOHAMMAD AULIA HERDIYANA,SPOT
0138R01702180011333 0000205885743 3;JKN DR RIZKI; 5.2.0.201712280730
4 153905 1#0##0#0#0.0#2018-03-08
11:22:09#0#12:00:00#12:00:00#12:00:00 1 e1c61bff6b38f1065e66c9a9d8db22b8
0 2530000 3225912 0 0 14649510 0 0 0 0
6270600 0 0 0 145000 0
3201126 B 1 BS 1 23/02/2018 28/02/2018 17/12/1939 0 1
1 K29.6;K92.0;J18.0;E11.2;D29.1;K56.7 93.94;88.16 - - None None
None None K-4-11-III None None None None None None GASTRITIS & ULKUS
PEPTIKUM (BERAT) 5538000 0 0 - 0 - 0 - 0 -
0 5538000 11013332 0 6 0 0 0 DJAMALUDDIN
IBRAHIM D390844 78 28558 DR BETTY DWI L, SPPD 0138R01702180010784
0000060949102 3;JKN DR RIZKI; 5.2.0.201712280730 4 153650
1#1#vvip#6#5475332#0.0#2018-03-08 13:44:56#0#12:00:00#12:00:00#12:00:00
1 3a5145ef7337bcf748afdfbf3b8d46c6 0 0 701679 0 0
1915155 0 0 0 0 8396498 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 28/02/2018 14/06/1960 0 1
1 Z53.0;D29.1;R33;N39.0;I10 99.21 - - None None None None
Z-4-12-II None None None None None None FAKTOR-FAKTOR YANG
MEMPENGARUHI STATUS KESEHATAN LAIN-LAIN (SEDANG) 3938000 0 0 -
0 - 0 - 0 - 0 3938000 2753090 0 2
0 0 0 ROHIMIN D388527 57 21077 DR SIDDHI ANDIKA, SPU
0138R01702180012051 0001014130113 3;JKN DR RIZKI; 5.2.0.201712280730
4 154499 1#0##0#0#0.0#2018-03-28
14:34:54#0#12:00:00#12:00:00#12:00:00 2 294da60ae09b98467114b57b394e70f6
0 0 445941 0 0 1575040 0 0 0 0 732109
0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 28/02/2018 31/08/1967 0 2
1 M93.28;M89.42 80.92 - - None None None None M-1-80-I
8672000 0 0 - 0 - 0 - 0 - 0
8672000 10256140 0 2 0 0 0 IDA ROHAIDA D378636
50 18443 DR BENNY H T, SPOT 0138R01702180012246 0001125271517
3;JKN DR RIZKI; 5.2.0.201712280730 4 154896 1#0##0#0#0.0#2018-
03-28 15:39:19#0#12:00:00#12:00:00#12:00:00 2
072641efb295a57cd837be546ae15225 0 0 1833368 0 0
1876810 0 0 0 0 6400962 0 0 0 145000
0
3201126 B 1 BS 1 27/02/2018 28/02/2018 27/04/1950 0 1
1 Z53.0;D29.1;I10 - - - None None None None Z-4-12-I
0 - 0 2627300 4124673 0 2 0 0 0 TODUNG
PANABOR LUMBANTORUAN D205795 67 24778 DR HERY TIERA, SPU
0138R01702180011922 0000061053772 3;JKN DR RIZKI; 5.2.0.201712280730
4 154455 1#0##0#0#0.0#2018-03-29
11:09:37#0#12:00:00#12:00:00#00:00:00 2 68629338d3da49cdc05fba124cec3e63
0 0 571300 0 0 1596535 0 0 0 0
1887838 0 0 0 0 69000
3201126 B 2 BS 1 25/02/2018 28/02/2018 28/09/1993 0 2
- 0 - 0 - 0 - 0 3545800 3715854 0
4 0 0 0 PUTRI SEPTIANI INDRIA D386729 24 8916 DR.
5.2.1.201804062320 4 153900 1#0##0#0#0.0#2018-05-05
11:08:16#0#12:00:00#12:00:00#12:00:00 2 c3b264700b65fa88fc34af748fc69d07
0 0 209906 0 0 1424355 0 0 0 0
2081593 0 0 0 0 0
3201126 B 1 BS 1 26/02/2018 28/02/2018 10/10/1953 0 2
1 A01.0;E11.9;I11.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 3968857 0 3 0 0 0 EUIS NANI
NURJANI D106422 64 23515 DR BETTY DWI L, SPPD 0138R01702180011361
0001267825792 3;JKN DR RIZKI; 5.2.1.201804062320 4 153915
1#0##0#0#0.0#2018-05-05 11:21:31#0#12:00:00#12:00:00#00:00:00 2
a5a189f5e67b2fcfe77d2733036b0f10 0 0 372887 0 0 967325
0 0 0 0 2628644 0 0 0 0 0
3201126 B 1 BS 1 28/02/2018 28/02/2018 30/10/1954 0 1
1 S66.6 - - - None None None None M-4-21-I None None
None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
0 - 0 4133500 2267250 0 1 0 0 0 M R
ANTHONY B D383958 63 23132 DR BENNY H T, SPOT 0138R01702180012686
0000041693837 3;JKN DR RIZKI; 5.2.1.201804062320 4 155107
1#0##0#0#0.0#2018-05-16 09:44:01#0#12:00:00#12:00:00#12:00:00 2
34635b7b586ed064622e4b99386be49a 0 0 425015 0 0 886910
0 0 0 0 955325 0 0 0 0 0
3201126 B 1 BS 1 28/02/2018 28/02/2018 24/11/1961 0 1
1 I13.1;R18 54.91 - - None None None None N-4-10-II None
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 2823988 0 1 0 0 0 NOVIANDRIE POERBOSOESILO
TN D324836 56 20550 DR. ARU ARIADNO, SPPD 0138R01702180012712
0001484943434 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 155281
1#0##0#0#0.0#2018-05-16 10:11:28#0#12:00:00#12:00:00#00:00:00 2
8c4ef6cca4e42eff8cbbc7da78881baf 0 0 424889 0 0
1407352 0 0 0 0 991747 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 28/02/2018 02/05/2016 0 2
0 0 - 0 - 0 - 0 - 0 2639300
1245380 0 2 0 0 0 NADINA ILMI FADILAH D390376
0002041116884 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 154918
1#0##0#0#0.0#2018-05-16 10:12:14#0#12:00:00#12:00:00#12:00:00 2
76a57ebde851a07563b3c8a95fec2116 0 0 237537 0 0 637370
0 0 0 0 370473 0 0 0 0 0
3201126 B 1 BS 1 27/02/2018 28/02/2018 18/05/2001 0 2
1 I12.0;D63.8;J90 99.04;38.95 - - None None None None N-1-
- 0 - 0 27065300 19506467 0 2 0 0 0
DHENISWARI H PUTRI d391599 16 6129 DR SOEGIONO, SPPD
0138R01702180012058 0001421988772 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 154572 1#0##0#0#0.0#2018-05-16
10:13:04#0#12:00:00#12:00:00#12:00:00 2 d16bd70f0f377156d8b1326a6490f2e1
0 5896000 7901937 0 0 4418030 0 0 0 0
1256000 0 0 0 0 34500
3201126 B 3 BS 1 28/02/2018 28/02/2018 01/04/1975 0 2
1 N83.2;R10.4 - - - None None None None W-4-12-I None
LAIN-LAIN (RINGAN) 2809400 0 0 - 0 - 0 - 0
- 0 2809400 897283 0 1 0 0 0 HERYANTI
0001014214151 3;JKN DR RIZKI; 5.2.1.201804062320 4 155380
1#0##0#0#0.0#2018-05-16 10:13:37#0#12:00:00#12:00:00#12:00:00 2
6758edb318b44c025187a0b6a48102b8 0 0 406080 0 0 143502
0 0 0 0 347701 0 0 0 0 0
3201126 B 1 BS 1 27/02/2018 28/02/2018 25/12/1988 0 2
INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 - 0 -
0 6041900 14887477 0 2 0 0 0 YUDIT NATALYA
TOMASOA D158018 29 10656 DR BENNY H T, SPOT 0138R01702180012336
0001283865153 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 154914
1#0##0#0#0.0#2018-05-16 10:13:49#0#12:00:00#12:00:00#12:00:00 2
7bd88775d0f08675a4ee70186695e9b6 0 0 2379732 0 0
1894998 0 0 0 0 10467747 0 0 0 0 145000
3201126 B 3 BS 1 27/02/2018 28/02/2018 02/03/1964 0 1
1 T82.4;I12.0 38.95 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 16436174 0 2 0 0 0 ROMLI TN
0001743644902 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154908
1#0##0#0#0.0#2018-05-16 10:14:39#0#12:00:00#12:00:00#00:00:00 3
57e8e26bff623fc308432dbcefb13f21 0 3062500 1781760 0 0
10391650 0 0 0 0 1131264 0 0 0 0 69000
3201126 B 3 BS 1 27/02/2018 28/02/2018 06/09/1970 0 2
1 N18.5;J18.8;D63.8 39.27;99.04;87.44 - - None None None None
- 0 - 0 19332400 9070722 0 2 0 0 0
NY ANI D389064 47 17341 DR SRI KUN, SPPD 0138R01702180012447
0000369054044 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 154926
1#0##0#0#0.0#2018-05-16 10:15:28#0#12:00:00#12:00:00#12:00:00 2
e621524a1026bf9e7b73e5b5f0f083df 0 3352300 2743560 0 0
2256450 0 0 0 0 649412 0 0 0 0 69000
3201126 B 1 BS 1 27/02/2018 28/02/2018 14/05/1954 0 1
1 N21.1;N39.8;I10 57.32;57.0 - - None None None None N-1-
(RINGAN) 11257400 0 0 - 0 - 0 - 0 - 0
11257400 18345009 0 2 0 0 0 MION TARIGAN,DRS,MM
d388513 63 23300 DR SIDHI,SPU 0138R01702180012092
0000125692931 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 154646
1#0##0#0#0.0#2018-05-16 10:16:27#0#12:00:00#12:00:00#12:00:00 2
42e6c21f60031da5a5d31c672d982712 0 9101600 6402688 0 0
1387721 0 0 0 0 1256000 0 0 0 0 197000
3201126 B 3 BS 1 27/02/2018 28/02/2018 06/02/1951 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 2105799 0 2 0 0 0 NADIH LIYAS D391668
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 155377
1#0##0#0#0.0#2018-05-16 10:18:54#0#12:00:00#12:00:00#12:00:00 2
46bf4a6927a59079372b27999f8e3a2c 0 0 130752 0 0 814284
0 0 0 0 444763 0 716000 0 0 0
3201126 B 2 BS 1 26/02/2018 28/02/2018 12/09/1967 0 1
1 K56.7;A49.9;E83.5 87.44 - - None None None None K-4-15-II
None None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL
(SEDANG) 4895400 0 0 - 0 - 0 - 0 - 0
4895400 5256079 0 3 0 0 0 GUNAWAN MAHMUD
0001605725076 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 153912
1#0##0#0#0.0#2018-05-16 10:20:31#0#12:00:00#12:00:00#12:00:00 3
c22daf24917ea963533de76d4bcf1722 0 0 391831 0 0
2979392 0 0 0 0 1884856 0 0 0 0 0
3201126 B 2 BS 1 27/02/2018 28/02/2018 18/03/1962 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 10334360 0 2 0 0 0 NGADIMIN D391594
TANTIYO S;16137 5.2.1.201804062320 4 154913 1#0##0#0#0.0#2018-
05-16 10:21:18#0#12:00:00#12:00:00#12:00:00 2
534047ff8af1dacb660ddd63b978cfc4 0 4439100 1563494 0 0
3565186 0 0 0 0 732080 0 0 0 0 34500
3201126 B 2 BS 1 27/02/2018 28/02/2018 07/03/1974 0 2
1 K21.0;K31.0;A49.9 45.16 - - None None None None K-4-12-I
0 0 - 0 - 0 - 0 - 0 3545800
6059855 0 2 0 0 0 NENENG HASANAH D385247 43
TANTIYO S;16137 5.2.1.201804062320 4 154923 1#0##0#0#0.0#2018-
05-16 10:28:57#0#12:00:00#12:00:00#12:00:00 2
12aacfebe12c741d656ad767b73f2ca1 0 1605000 992824 0 0
1260592 0 0 0 0 452439 0 0 0 0
1749000
3201126 B 3 BS 1 25/02/2018 28/02/2018 26/12/1945 0 1
1 G44.2;R11 - - - None None None None G-4-23-I None
2650100 0 0 - 0 - 0 - 0 - 0
2650100 2562698 0 4 0 0 0 DASTA SASMITA
0001208191454 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 153904
1#0##0#0#0.0#2018-05-16 11:10:08#0#12:00:00#12:00:00#12:00:00 2
61ac155c761650d33651db0128a00282 0 0 291509 0 0
1288536 0 0 0 0 982653 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 28/02/2018 12/12/1950 0 2
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 15024416 0 5 0 0 0 WIWIK d093541 67
24546 DR DHARMAWAN, SPPD 0138R01702180011591 0001716514514 3;JKN
DR RIZKI; 5.2.2.201806040537 4 154154 1#0##0#0#0.0#2018-08-14
15:19:37#0#12:00:00#12:00:00#12:00:00 3 35c555189022422b45a6b01caaed1e22
0 0 3447840 0 0 2845170 0 0 0 0
8662406 0 0 0 0 69000
3201126 B 1 BS 1 27/02/2018 28/02/2018 04/06/1964 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 8335914 0 2 0 0 0 ZAENUDIN TN d375732
DR RIZKI; 5.2.2.201806040537 4 154884 1#0##0#0#0.0#2018-08-14
17:19:39#0#12:00:00#12:00:00#00:00:00 3 a84eba8b927f36e6f004a04a187cb2fc
0 5896000 1215340 0 0 554234 0 0 0 0
601339 0 0 0 0 69000
3201126 B 2 BS 1 28/02/2018 28/02/2018 05/08/1981 0 2
0 0 - 0 - 0 - 0 - 0 3479400
3829459 0 1 0 0 0 MARIAULFA D387299 36 13356
DR MAMAN HILMAN 0138R01702180012455 0001183640332 3;JKN DR RIZKI;
5.2.2.201806040537 4 154928 1#0##0#0#0.0#2018-09-29
11:09:42#0#12:00:00#12:00:00#12:00:00 1 d22447c79a2747430caef0d1dc3aab90
0 0 519146 0 0 2047788 0 0 0 0 799525
0 0 0 0 463000
3201126 B 1 BS 1 18/02/2018 01/03/2018 20/06/1952 0 1
1 I64;E11.5;G81.9;I48;A41.9 87.03;86.22 - - None None None
DARAH OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (BERAT)
9659700 0 0 - 0 - 0 - 0 - 0
9659700 35791922 0 12 1 5 0 DAYAT RUKAYAT
0000040018432 3;JKN DR RIZKI; 5.2.0.201712280730 4 150750
1#0##0#0#0.0#2018-03-12 12:47:18#0#12:33:16#12:33:16#12:00:00 1
1a1cc1b1167febabe4b6752eb3d70897 0 0 4854618 0 0
13461304 0 0 0 0 15602000 0 0 0 0
1874000
3201126 B 1 BS 1 25/02/2018 01/03/2018 29/10/1968 0 1
- 0 58821400 60525744 0 5 0 0 0 JEFFRY
LENGKONG D128834 49 18016 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180011209 0001856457483 3;JKN DR RIZKI; 5.2.0.201712280730
4 153888 1#0##0#0#0.0#2018-03-12
13:02:35#0#12:00:00#12:00:00#00:00:00 1 2010640fe862f6ea0b4578b8f4350866
0 12135000 9619120 0 0 29946624 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 2 BS 1 26/02/2018 01/03/2018 31/12/1954 0 1
- 0 51950600 83567160 0 4 0 0 0 AGUS SALIM
TN D369674 63 23068 DR AZRI NURIZAL SPPD KKV 0138R01702180011883
0000060983357 3;JKN DR RIZKI; 5.2.0.201712280730 4 154445
1#0##0#0#0.0#2018-03-12 13:06:19#0#12:00:00#12:00:00#00:00:00 1
d18d4e67ef32a63b08c0e43d59f032f1 0 9193500 8244960 0 0
57244700 0 0 0 0 1256000 0 0 0 0
7628000
3201126 B 3 BS 1 26/02/2018 01/03/2018 03/03/1976 0 2
1 D39.1;D63.0 65.39;99.04 - - None None None None W-1-20-II
10326200 0 0 - 0 - 0 - 0 - 0
10326200 10170222 0 4 0 0 0 HANI WAHYUNI
d388241 41 15335 DR ATJANG S, SPOG 0138R01702180011886
0001740408197 3;JKN DR RIZKI; 5.2.0.201712280730 4 154446
1#0##0#0#0.0#2018-03-12 13:10:39#0#12:00:00#12:00:00#12:00:00 1
65cb27519c238d56f68f7a8a8814b419 0 3701500 2181900 0 0
3441480 0 0 0 0 776342 0 0 0 0 69000
3201126 B 2 BS 1 27/02/2018 01/03/2018 28/07/1980 0 2
1 L04.0 86.22;83.21 - - None None None None D-4-14-I None
None None None None None GANGGUAN PADA DARAH & ORGAN PEMBENTUK DARAH
LAIN-LAIN (RINGAN) 3844400 0 0 - 0 - 0 - 0
- 0 3844400 9096548 0 3 0 0 0 YULIA
SOPHIANITA D390994 37 13728 DR HENDRIEK S, SPB 0138R01702180012445
0001154531248 3;JKN DR RIZKI; 5.2.0.201712280730 4 154927
1#0##0#0#0.0#2018-03-12 13:34:07#0#12:00:00#12:00:00#12:00:00 1
dccc356fc59ec93ce28477129187d001 0 4439100 1791412 0 0
2145935 0 0 0 0 651101 0 0 0 0 69000
3201126 B 2 BS 1 28/02/2018 01/03/2018 28/02/2018 2858 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 941910 0 2 0 0 0 BAYI NY DINA NURPITA
SUPRAWOTO D391681 0 0 DR SRI SAPARNI, SPA 0138R01702180012844
0002327138019 3;JKN DR RIZKI; 5.2.0.201712280730 4 155361
1#0##0#0#0.0#2018-03-12 13:35:31#0#12:00:00#12:00:00#12:00:00 1
eadcfaf57ec8f050f9f350ba9e3d16d7 0 0 219891 0 0 88899
0 0 0 0 633120 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 01/03/2018 19/02/2014 0 1
1 G40.9;A49.9 - - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 2655900 2829092
0 3 0 0 0 M AGAM ABDILLAH PRATAMA D292851 4 1469
DR RIANITA SYAMSU, SPA 0138R01702180012283 0001810948465 3;JKN DR
RIZKI; 5.2.0.201712280730 4 154921 1#0##0#0#0.0#2018-03-12
13:50:36#0#12:00:00#12:00:00#12:00:00 1 b718392395c9bd4a7b1d529225c89bee
0 0 292031 0 0 1623480 0 0 0 0 913581
0 0 0 0 0
3201126 B 2 BS 1 26/02/2018 01/03/2018 04/05/1964 0 2
1 I64;I48;H81.4;K29.7 87.03;87.44 - - None None None None
0 0 - 0 - 0 - 0 - 0 5866300
7176330 0 4 0 0 0 TRI RAHAYU D332578 53 19656
DR NURUL KOMARI SPS 0138R01702180011635 0002051453643 3;JKN DR
RIZKI; 5.2.0.201712280730 4 154349 1#0##0#0#0.0#2018-03-12
14:03:13#0#12:00:00#12:00:00#00:00:00 1 42c9d369723cd2c3695f9ec157dbc390
0 0 882140 0 0 3778710 0 0 0 0
2515480 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 01/03/2018 09/06/1947 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 12271775 0 7 0 0 0 DODO JUNAR
SUDIGDO,IR D312910 70 25827 DR NURUL KOMARI SPS 0138R01702180010569
0000061007804 3;JKN DR RIZKI; 5.2.0.201712280730 4 153469
1#0##0#0#0.0#2018-03-12 14:05:06#0#12:00:00#12:00:00#12:00:00 1
99d252f38b66abcdd0524e647517b8c9 0 0 1388521 0 0
4587428 0 0 0 0 6295826 0 0 0 0 0
3201126 B 1 BS 1 26/02/2018 01/03/2018 03/10/2012 0 1
- 0 - 0 - 0 - 0 5424200 13679322 0
4 0 0 0 VARICK GANENDRA PUTRA MARANTHA D390453 5
1972 DR CATUR SUZANTARA 0138R01702180011646 0002050011562 3;JKN
DR RIZKI; 5.2.0.201712280730 4 154292 1#0##0#0#0.0#2018-03-12
14:45:55#0#12:00:00#12:00:00#12:00:00 1 f0b31ffcd55e3777cc1295311f1e817a
0 7878200 1635776 0 0 3039437 0 0 0 0
980909 0 0 0 0 145000
3201126 B 3 BS 1 28/02/2018 01/03/2018 25/06/2015 0 2
(SEDANG) 2753900 0 0 - 0 - 0 - 0 - 0
2753900 1872256 0 2 0 0 0 PUTRI RAHMA FAUDZIAH
D391678 2 979 DR RASTRA, SPA 0138R01702180012477
0001852612683 3;JKN DR RIZKI; 5.2.0.201712280730 4 154929
1#0##0#0#0.0#2018-03-12 15:11:10#0#12:00:00#12:00:00#12:00:00 1
8f3d6c34d5d6da8e2a3312d3ce3e3aef 0 0 442727 0 0 755045
0 0 0 0 674484 0 0 0 0 0
3201126 B 2 BS 1 26/02/2018 01/03/2018 14/01/2017 0 1
- 0 - 0 - 0 - 0 3187000 3686756 0
4 0 0 0 AHMAD ADHIYA ULLAMI D391550 1 408 DR
RASTRA, SPA 0138R01702180011852 0002248731865 3;JKN DR RIZKI;
5.2.0.201712280730 4 154442 1#0##0#0#0.0#2018-03-12
16:35:28#0#12:00:00#12:00:00#12:00:00 1 03f1ab8b5779df13b251d784aa4b7c22
0 0 339830 0 0 1267236 0 0 0 0
2079690 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 01/03/2018 23/01/1963 0 2
1 D64.9;I10;D46.9 99.04 - - None None None None D-4-13-I
0 - 0 2987000 3117754 0 3 0 0 0 SUHAYA
0001263423341 3;JKN DR RIZKI; 5.2.0.201712280730 4 154885
1#0##0#0#0.0#2018-03-12 16:46:43#0#12:00:00#12:00:00#12:00:00 1
d4bf3881bbaa31933467119f990dc0b2 0 0 321830 0 0
1776959 0 0 0 0 1018965 0 0 0 0 0
3201126 B 1 BS 1 27/02/2018 01/03/2018 16/08/1929 0 1
(RINGAN) 11257400 0 0 - 0 - 0 - 0 - 0
11257400 20166010 0 3 0 0 0 BOIN D389598 88
32337 DR SIDHI,SPU 0138R01702180012140 0001718108886 3;JKN DR
RIZKI; 5.2.0.201712280730 4 154741 1#0##0#0#0.0#2018-03-13
09:20:12#0#12:00:00#12:00:00#12:00:00 1 39041b0ce7efd3b04fed8aa572759640
0 6587000 8264646 0 0 3691364 0 0 0 0
1256000 0 0 0 0 367000
3201126 B 2 BS 1 27/02/2018 01/03/2018 05/04/1931 0 2
1 I73.9;I10 88.40;39.50 - - None None None None I-1-20-I
(RINGAN) 18436700 0 0 - 0 - 0 - 0 - 0
18436700 18204060 0 3 0 0 0 SAINAH D389822
0001466840092 3;JKN DR RIZKI; 5.2.0.201712280730 4 154924
1#0##0#0#0.0#2018-03-13 14:30:48#0#12:00:00#12:00:00#12:00:00 1
62bc40a4d85e58cae265d4de016aa06c 0 5326100 4606500 0 0
6955540 0 0 0 0 1246920 0 0 0 0 68996
3201126 B 2 BS 1 28/02/2018 01/03/2018 29/09/1955 0 2
14653000 0 0 - 0 - 0 - 0 - 0
14653000 13212503 0 2 0 0 0 LIE WINDY RAMLI
0001797652124 3;JKN DR RIZKI; 5.2.0.201712280730 4 154930
1#0##0#0#0.0#2018-03-13 14:33:04#0#12:00:00#12:00:00#00:00:00 1
5ef5e002d31428d391c229a3656fd964 0 3555000 2930600 0 0
3516034 0 0 0 0 920369 0 0 0 0
2290500
3201126 B 3 BS 1 28/02/2018 01/03/2018 18/03/1965 0 2
1 I25.0;I11.0;I05.9;J22 88.55;36.07 - - YY02 None None None
- 0 45079800 58399884 0 2 0 0 0 SUDARTI
0001740574179 3;JKN DR RIZKI; 5.2.0.201712280730 4 154950
1#0##0#0#0.0#2018-03-13 15:55:13#0#12:00:00#12:00:00#12:00:00 1
e825f0ecdbf8d3c42385816d616dad71 0 8480000 6870800 0 0
34224084 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 27/02/2018 01/03/2018 10/08/2008 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1459408 0 3 0 0 0 SAVIRA AGUSTINA
d391595 9 3488 DR RASTRA, SPA 0138R01702180012012
0000511429432 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154858
1#0##0#0#0.0#2018-03-14 10:45:55#0#12:00:00#12:00:00#12:00:00 1
a130499df3f51f32ed40264d7df35af5 0 0 257183 0 0 291750
0 0 0 0 910471 0 0 0 0 0
3201126 B 2 BS 1 27/02/2018 01/03/2018 06/10/1982 0 2
0 - 0 - 0 - 0 - 0 5984100 10258099
0 3 0 0 0 YENNI PURBA SINAGA D391648 35 12928
DR MAMAN H, SPOG 0138R01702180012314 0001888819492 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 154912 1#0##0#0#0.0#2018-03-14
10:47:36#0#12:00:00#12:00:00#12:00:00 1 5bfab1370a1d2178538e1a0b438c99f7
0 5062400 2153753 0 0 2082855 0 0 0 0
762091 0 0 0 0 197000
3201126 B 2 BS 1 27/02/2018 01/03/2018 27/02/2018 3935 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1344253 0 3 0 0 0 BAYI NY YENNI PURBA
SINAGA D391663 0 0 DR VERA MUNA MANOE, SPA 0138R01702180013019
0002434846847 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155386
1#0##0#0#0.0#2018-03-14 10:48:34#0#12:00:00#12:00:00#12:00:00 1
a4ede4d4fa7f0dc40a44f314903373c3 0 0 433812 0 0 126499
0 0 0 0 783942 0 0 0 0 0
3201126 B 1 BS 1 27/02/2018 01/03/2018 01/07/2011 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3792030 0 3 0 0 0 GIBRAN PRADI ALFARITSI
D367533 6 2433 DR RASTRA, SPA 0138R01702180011910
0001626003303 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154453
1#0##0#0#0.0#2018-03-14 10:49:48#0#12:00:00#12:00:00#12:00:00 1
797292e8de94d666f7a110ee6412e153 0 0 338858 0 0 836095
0 0 0 0 2617077 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 01/03/2018 02/07/1957 0 2
1 E11.2;L03.9;D63.8 99.04 - - None None None None N-4-16-II
LAIN (SEDANG) 6330300 0 0 - 0 - 0 - 0 -
0 6330300 4241496 0 2 0 0 0 MUHAYATI NY
0001293884651 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155392
1#0##0#0#0.0#2018-03-14 10:53:24#0#12:00:00#12:00:00#00:00:00 1
47957bc93c910ddc862b20148457ebb5 0 0 446265 0 0
1533000 0 0 0 0 2262231 0 0 0 0 0
3201126 B 2 BS 1 26/02/2018 01/03/2018 12/07/1962 0 1
1 Z93.2;E87.1;E87.5;A49.9 - - - None None None None Z-4-
12-II None None None None None None FAKTOR-FAKTOR YANG MEMPENGARUHI STATUS
KESEHATAN LAIN-LAIN (SEDANG) 4725600 0 0 - 0 - 0 -
0 - 0 4725600 4378412 0 4 0 0 0 DJOLI
ISKANDAR D387317 55 20318 DR E SURYA POHAN DR SPB KBD
0138R01702180011843 0001647246677 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 154438 1#0##0#0#0.0#2018-03-14
10:56:48#0#12:00:00#12:00:00#12:00:00 1 c6f8d0ae8315c507b755e6331ea7020c
0 0 425122 0 0 1828352 0 0 0 0
2124938 0 0 0 0 0
3201126 B 1 BS 1 23/02/2018 01/03/2018 02/12/1959 0 2
1 E14.5;L03.1;R02;A41.9 86.22 - - None None None None I-4-
LAIN-LAIN (BERAT) 10244500 0 0 - 0 - 0 - 0 -
0 10244500 22213198 0 7 0 0 0 BAHRIAH
0001449626523 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153201
1#0##0#0#0.0#2018-03-14 11:04:28#0#12:00:00#12:00:00#12:00:00 1
8ca91b09649cbcb125b2b6df696d7696 0 8750000 2897514 0 0
9198684 0 0 0 0 1298000 0 0 0 0 69000
3201126 B 2 BS 1 27/02/2018 01/03/2018 20/11/1994 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3915090 0 3 0 0 0 AJENG NOVIANTI
0001800823342 3;JKN DR RIZKI; 5.2.0.201712280730 4 154454
1#0##0#0#0.0#2018-03-15 11:14:08#0#12:00:00#12:00:00#12:00:00 1
cbd4abdc5d4c68e02e67f8f18cbd5eef 0 0 371870 0 0
1746093 0 0 0 0 1797127 0 0 0 0 0
3201126 B 3 BS 1 24/02/2018 01/03/2018 09/11/1953 0 2
1 I64;E14.9;G81.9 87.03;87.44 - - None None None None G-4-
- 0 - 0 - 0 - 0 4888600 7084648 0
6 0 0 0 MARIYAH D370937 64 23483 DR NURUL KOMARI
SPS 0138R01702180011154 0001740429314 3;JKN DR RIZKI; 5.2.0.201712280730
4 153868 1#0##0#0#0.0#2018-03-15
11:23:42#0#12:00:00#12:00:00#00:00:00 1 5c48b4fd84ea47f412ce66618b038bc7
0 0 813045 0 0 4467121 0 0 0 0
1804483 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 01/03/2018 19/03/1977 0 1
1 A49.9;I11.0;I25.0 87.44;89.52 - - None None None None A-4-
0 - 0 3304700 3857047 0 3 0 0 0 MARULI
SUKARNO D386501 40 14955 DR AZRI NURIZAL SPPD KKV
0138R01702180011907 0001731212436 3;JKN DR RIZKI; 5.2.0.201712280730
4 154451 1#0##0#0#0.0#2018-03-15
14:33:32#0#12:00:00#12:00:00#12:00:00 1 b283e5e0296f5d52db415ea3994f9ff9
0 0 686600 0 0 2103117 0 0 0 0
1067330 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 01/03/2018 14/12/1990 0 2
0 0 - 0 - 0 - 0 - 0 2009900
4474119 0 2 0 0 0 DINA NURPITA SUPRAWOTO I107902
27 9938 DR. SITI AZIZAH SPOG 0138R01702180012667 0000100053009
3;JKN DR RIZKI; 5.2.0.201712280730 4 155195 1#0##0#0#0.0#2018-
03-15 14:55:01#0#12:00:00#12:00:00#12:00:00 1
fe2c8ba63c869d001f86e76c25d46a11 0 2645700 454980 0 0
827740 0 0 0 0 417699 0 0 0 0 128000
3201126 B 3 BS 1 27/02/2018 01/03/2018 08/06/1990 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1562149 0 3 0 0 0 HENDI IRAWAN
0000512024073 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154919
1#0##0#0#0.0#2018-03-19 11:42:28#0#12:00:00#12:00:00#12:00:00 1
6afe7759ba8bf5a785d42baa591ce3df 0 0 241100 0 0 490352
0 0 0 0 830697 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 01/03/2018 09/09/1976 0 2
0 0 - 0 - 0 - 0 - 0 2009900
8549403 0 2 0 0 0 RATNA MULARSIH D039915 41
15147 DR AFRA FONDA SPOG 0138R01702180012717 0001732008666 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 155306 1#0##0#0#0.0#2018-
03-19 12:44:01#0#12:00:00#12:00:00#12:00:00 1
c50311daf56ded2f460f44ff7b27bf39 0 2645700 401980 0 0
4537416 0 0 0 0 674307 0 0 0 0 290000
3201126 B 3 BS 1 28/02/2018 01/03/2018 08/02/2018 0 1
1 Q43.1 - - - None None None None K-4-18-I None None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1129511 0 2 0 0 0 BAYI NY PINTA LUSINDA
SIREGAR D391634 0 20 DR MUHAMMAD RIZKI YUWANA
0138R01702180013082 0002317537675 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 155399 1#0##0#0#0.0#2018-03-24
10:10:19#0#16:30:00#01:30:00#12:00:00 1 a57537fc96a22815726a341cca94d3d9
0 0 140168 0 0 626450 0 0 0 0 362893
0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 01/03/2018 22/02/2018 3000 1
1 E80.7 99.82 - - None None None None P-8-14-I None None
None None None None NEONATAL, BBL > 2499 GR DENGAN ANOMALI MAYOR ATAU
KONDISI HEREDITER (RINGAN) 3654700 0 0 - 0 - 0 -
0 - 0 3654700 2831315 0 3 0 0 0 BAYI
NY RAHMAWATI SIREGAR D391645 0 5 DR DYAH HARINI, SPA
0138R01702180012346 0002305303558 3;JKN DR RIZKI; 5.2.0.201712280730
4 154916 1#0##0#0#0.0#2018-03-29
15:16:09#0#12:00:00#12:00:00#12:00:00 1 812655000090db1c654ba52a13acaac5
0 0 381923 0 0 160666 0 0 0 0
1948726 0 0 0 0 340000
3201126 B 2 BS 1 26/02/2018 01/03/2018 05/07/2015 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4623330 0 4 0 0 0 KHANZA AULIA RAHMA
D330327 2 967 DR RASTRA, SPA 0138R01702180011352
0001655273553 3;JKN ECHI; 5.2.0.201712280730 4 153910
1#0##0#0#0.0#2018-04-24 12:18:32#0#12:00:00#12:00:00#12:00:00 2
38a67e0c88cadd1797abf5b7ba085023 0 0 266858 0 0
2008011 0 0 0 0 2348461 0 0 0 0 0
3201126 B 2 BS 1 27/02/2018 01/03/2018 08/01/2016 0 2
1 K12.0 - - - None None None None U-4-14-I None None
0 - 0 - 0 - 0 - 0 4425900 2989381
0 3 0 0 0 GHAZIYA HAFIZA SAFITRI D320271 2 781
DR AULIA TANGKARI, SPA 0138R01702180012190 0001966830658 3;JKN DR
RIZKI; 5.2.2.201806040537 4 154881 1#0##0#0#0.0#2018-08-09
11:17:21#0#12:00:00#12:00:00#00:00:00 2 9312b41f256538a3dcc34ce253cf98ad
0 0 278711 0 0 804103 0 0 0 0
1736567 0 0 0 0 170000
3201126 B 1 BS 1 28/02/2018 01/03/2018 30/11/1958 0 2
- 0 58821400 67917514 0 2 0 0 0 GIRGIR
MARPAUNG, NY D333310 59 21640 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180012655 0000061015915 3;JKN DR RIZKI; 5.2.2.201806040537
4 155078 1#0##0#0#0.0#2018-08-09
11:26:29#0#12:00:00#12:00:00#00:00:00 2 3262f9f5724f25434d1dc1fe73df0758
0 10062000 7201760 0 0 41863254 0 0 0 0
1256000 0 0 0 0 7534500
3201126 B 1 BS 1 27/02/2018 01/03/2018 06/10/1963 0 2
1 I12.0;D29.1 39.95;38.95 - - None None None None N-1-12-I
- 0 6076700 15153778 0 3 0 0 0 ARI GALIH
BASTARI D374340 54 19868 DR. ARU ARIADNO, SPPD 0138R01702180012439
0001369145665 3;JKN DR RIZKI; 5.2.0.201712280730 4 154922
1#0##0#0#0.0#2018-08-10 08:26:47#0#12:00:00#12:00:00#12:00:00 2
d2a4bcf3a1dd4c62c030984ebd018b31 0 6241500 1336874 0 0
3703535 0 0 0 0 3674869 0 0 0 0 197000
3201126 B 1 BS 1 27/02/2018 01/03/2018 15/08/1942 0 1
1 K80.2;R10.1;I10 88.76 - - None None None None B-4-14-I
(RINGAN) 5879800 0 0 - 0 - 0 - 0 - 0
5879800 6774347 0 3 0 0 0 OENG RUMADJI,H.SH
0000042601713 3;JKN DR RIZKI; 5.2.2.201806040537 4 154915
1#1#vvip#3#894547#0.0#2018-09-06 11:31:06#0#12:00:00#12:00:00#12:00:00 2
4e1637c242f555343f1033b1797eb93e 0 0 866000 0 0
1856665 0 0 0 0 4051682 0 0 0 0 0
3201126 B 1 BS 1 26/02/2018 01/03/2018 17/08/1955 0 2
1 I10;R10.1;N13.6 87.44;88.76 - - None None None None I-4-
17-II None None None None None None HIPERTENSI (SEDANG) 3107600 0
0 - 0 - 0 - 0 - 0 3107600 4985751
0 4 0 0 0 WIWIN NURAINI D328160 62 22839 DR
BETTY DWI L, SPPD 0138R01702180011351 0000060718544 3;JKN DR RIZKI;
5.2.2.201806040537 4 153909 1#0##0#0#0.0#2018-09-06
11:36:13#0#12:00:00#12:00:00#12:00:00 3 07e654fdf0ce31455651d3765ac2cc8b
0 0 409013 0 0 1881567 0 0 0 0
2695171 0 0 0 0 0
3201126 B 1 BS 1 28/02/2018 01/03/2018 09/11/1959 0 2
1 I12.0;J90;I51.7 39.27 - - None None None None N-1-12-III
- 0 27065300 17053248 0 2 0 0 0 RUSMIATI
0001212480202 3;JKN DR RIZKI; 5.2.2.201806040537 4 155394
1#0##0#0#0.0#2018-09-06 12:05:13#0#12:00:00#12:00:00#12:00:00 3
ae214931234f6846df99151391bfd852 0 6302700 7901937 0 0
1607978 0 0 0 0 1171633 0 0 0 0 69000
3201126 B 1 BS 1 28/02/2018 01/03/2018 12/12/1952 0 1
1 I12.0;E11.2 39.27;87.44 - - None None None None N-1-12-II
- 0 12472300 12704109 0 2 0 0 0 FRANS
MARTINUS SAMUEL D111772 65 23819 DR. ARU ARIADNO, SPPD
0138R01702180013041 0001318423162 3;JKN DR RIZKI; 5.2.2.201806040537
4 155393 1#0##0#0#0.0#2018-09-06
12:12:57#0#12:00:00#12:00:00#00:00:00 2 52ddf7648334a96e9470bae76c7146a0
0 6302700 3669967 0 0 1775332 0 0 0 0
887110 0 0 0 0 68999
3201126 B 2 BS 1 23/02/2018 01/03/2018 22/12/1955 0 1
1 E10.8;I11.0;I25.1 - - - None None None None E-4-10-III
0 - 0 7515400 5075523 0 7 0 0 0
MASLIHAN SANJAYA D305228 62 22709 DR AGOES KOOSHARTORO SPPD-KKV
0138R01702180010937 0001864751771 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 153669 1#0##0#0#0.0#2018-09-28
12:02:31#0#12:00:00#12:00:00#00:00:00 2 295bd0d5332f13ed253632d57c74c7ed
0 0 832679 0 0 1359800 0 0 0 0
2883044 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 02/03/2018 26/02/1966 0 2
None None None None TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL (RINGAN)
3313800 0 0 - 0 - 0 - 0 - 0
3313800 13242452 0 4 1 3 0 EKA SUHANINGSIH
0002205688072 3;JKN DR RIZKI; 5.2.0.201712280730 4 154920
1#0##0#0#0.0#2018-03-12 14:52:34#0#12:00:00#12:00:00#00:00:00 1
0ac5625c116b7af5c9da60241b871b7e 0 0 527768 0 0
8131855 0 0 0 0 3100829 0 0 0 0
1482000
3201126 B 1 BS 1 26/02/2018 02/03/2018 28/10/1960 0 1
(RINGAN) 7018400 0 0 - 0 - 0 - 0 - 0
7018400 6292354 0 5 0 0 0 DEDDY SUPRIATNA SH
0002287895714 3;JKN DR RIZKI; 5.2.0.201712280730 4 154449
1#0##0#0#0.0#2018-03-12 15:06:54#0#12:00:00#12:00:00#12:00:00 1
e6d6991b6364fa2244ac8481c5b67381 0 0 1020330 0 0
1710375 0 0 0 0 3561649 0 0 0 0 0
3201126 B 3 BS 1 28/02/2018 02/03/2018 09/04/1972 0 2
1 D64.9;K80.2;D39.1 90.59;99.04;87.49;89.52 - - None None None
0 - 0 - 0 2987000 4903887 0 3 0 0
0 YENNY AFRIYANTI D354601 45 16761 DR ARU, SPPD
0138R01702180012915 0002204986307 3;JKN DR RIZKI; 5.2.0.201712280730
4 155381 1#0##0#0#0.0#2018-03-12
16:15:55#0#12:00:00#12:00:00#00:00:00 1 6af7111319df3c10c3e43a448fefc5a4
0 0 493496 0 0 3361076 0 0 0 0
1049315 0 0 0 0 0
3201126 B 1 BS 1 28/02/2018 02/03/2018 12/08/1944 0 2
1 I10;R11 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 2669400 4547564 0
3 0 0 0 RUSMINI SUSILO D197906 73 26863 DR. ARU
5.2.0.201712280730 4 155385 1#0##0#0#0.0#2018-03-12
16:33:35#0#12:00:00#12:00:00#12:00:00 1 e0223d8c6b9c3a3380112c89adf12f4d
0 0 345275 0 0 1881285 0 0 0 0
2321004 0 0 0 0 0
3201126 B 1 BS 1 28/02/2018 02/03/2018 25/07/1968 0 1
1 D64.9;A49.9;K92.1;I84.2 99.04 - - None None None None D-4-
13-I None None None None None None GANGGUAN SEL DARAH MERAH SELAIN KRISIS
0 - 0 4181800 5864028 0 3 0 0 0 RUSYDI
ADDIBANI d347486 49 18115 DR BETTY DWI L, SPPD 0138R01702180012818
0001628236203 3;JKN DR RIZKI; 5.2.0.201712280730 4 155351
1#0##0#0#0.0#2018-03-12 16:36:58#0#12:00:00#12:00:00#12:00:00 1
c251e6a53fcdedf46eb89e69a95da369 0 0 429362 0 0
2682038 0 0 0 0 2752628 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 02/03/2018 04/03/1998 0 2
0 - 0 - 0 - 0 - 0 7842900 9537392
0 3 0 0 0 WIDIA TIA NURAJIZAH D390856 19 7301
YASMIN SURYANDARI BACHTIAR. DR. SPB 0138R01702180013064 0001296806613
3;JKN DR RIZKI; 5.2.0.201712280730 4 155396 1#0##0#0#0.0#2018-
03-12 16:42:17#0#12:00:00#12:00:00#12:00:00 1
65135fbb752a916af5b0109cd3c985d2 0 4439100 2913792 0 0
1412058 0 0 0 0 699942 0 0 0 0 72500
3201126 B 3 BS 1 27/02/2018 02/03/2018 09/04/1991 0 1
(SEDANG) 19193800 0 0 - 0 - 0 - 0 - 0
19193800 30924302 0 4 0 0 0 M.MUHAMMAD TAUPIK
0002222493761 3;JKN DR RIZKI; 5.2.0.201712280730 4 155379
1#0##0#0#0.0#2018-03-13 08:08:36#0#12:00:00#12:00:00#12:00:00 2
8b344886b5341c0f1da379c26bc6151d 0 0 5619202 0 0
20454800 0 0 0 0 4781300 0 0 0 0 69000
3201126 B 3 BS 1 01/03/2018 02/03/2018 01/06/2002 0 2
0 0 - 0 - 0 - 0 - 0 1982500
3740808 0 2 0 0 0 NUR INTAN AMLIA D391787 15
5752 DR. SITI AZIZAH SPOG 0138R01703180000078 0000511484725 3;JKN
DR RIZKI; 5.2.0.201712280730 4 155406 1#0##0#0#0.0#2018-03-13
08:38:04#0#12:00:00#12:00:00#12:00:00 1 7ededb6f756432a68d38150c939f3cbe
0 0 387980 0 0 1046502 0 0 0 0
2178326 0 0 0 0 128000
3201126 B 3 BS 1 01/03/2018 02/03/2018 13/12/1963 0 2
1 E04.9;E83.5 06.11 - - None None None None E-4-13-II None
None None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN (SEDANG)
5415600 0 0 - 0 - 0 - 0 - 0
5415600 2791223 0 2 0 0 0 MARYANI D390133
3;JKN DR RIZKI; 5.2.0.201712280730 4 155920 1#0##0#0#0.0#2018-
03-13 13:57:36#0#12:00:00#12:00:00#12:00:00 1
5c24c65d08a7adf216c3b96e46c218c4 0 0 739420 0 0
1403700 0 0 0 0 648103 0 0 0 0 0
3201126 B 3 BS 1 28/02/2018 02/03/2018 06/03/1947 0 2
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 62462820 0 3 0 0 0 JAENAH
0000511736624 3;JKN DR RIZKI; 5.2.0.201712280730 4 155388
1#0##0#0#0.0#2018-03-13 14:17:45#0#12:00:00#12:00:00#12:00:00 1
5eceaf1ef8753028caa4b819f7634b69 0 8172500 5144120 0 0
40321200 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 28/02/2018 02/03/2018 01/02/1969 0 2
7039300 0 0 - 0 - 0 - 0 - 0
7039300 9789726 0 3 0 0 0 MINTARSIH D374549
0000511568414 3;JKN DR RIZKI; 5.2.0.201712280730 4 154931
1#0##0#0#0.0#2018-03-13 14:22:51#0#12:00:00#12:00:00#12:00:00 1
d735bb829d0e8eee1d940c9ed6991308 0 3611800 2034004 0 0
3184973 0 0 0 0 741449 0 0 0 0 217500
3201126 B 1 BS 1 28/02/2018 02/03/2018 05/10/1957 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 18173686 0 3 0 0 0 LENNY ZAKHRONI
0002294946516 3;JKN DR RIZKI; 5.2.0.201712280730 4 155397
1#0##0#0#0.0#2018-03-13 14:28:00#0#12:00:00#12:00:00#12:00:00 1
e37746a3acd8de5235ccf13c1820ffb8 0 9763300 5390424 0 0
1630029 0 0 0 0 1244933 0 0 0 0 145000
3201126 B 2 BS 1 01/03/2018 02/03/2018 01/09/1984 0 1
INTERNAL (RINGAN) 5178700 0 0 - 0 - 0 - 0 -
0 5178700 7746437 0 2 0 0 0 SHANDY HALIM
SUSANTO D388608 33 12234 DR MOHAMMAD AULIA HERDIYANA,SPOT
0138R01703180000277 0001452166536 3;JKN DR RIZKI; 5.2.0.201712280730
4 155691 1#0##0#0#0.0#2018-03-13
15:51:02#0#12:00:00#12:00:00#12:00:00 1 ad81726708b47786d77f9c4e5217f905
0 4407900 1450036 0 0 1180725 0 0 0 0
562776 0 0 0 0 145000
3201126 B 1 BS 1 01/03/2018 02/03/2018 03/06/1969 0 1
LAIN (SEDANG) 7385300 0 0 - 0 - 0 - 0 -
0 7385300 3592542 0 2 0 0 0 SUIMAN SUTIYO
0002294997445 3;JKN DR RIZKI; 5.2.0.201712280730 4 155917
1#0##0#0#0.0#2018-03-16 10:02:38#0#12:00:00#12:00:00#12:00:00 1
094ee947a1dc1fe6ad345655534762d8 0 0 573641 0 0
1195875 0 0 0 0 1823026 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 02/03/2018 17/02/1953 0 1
1 A49.9;I50.0;K29.7 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3304700 0 0 - 0 - 0 - 0
- 0 3304700 3419293 0 3 0 0 0 YUSPI
0001268943658 3;JKN DR RIZKI; 5.2.0.201712280730 4 155384
1#0##0#0#0.0#2018-03-16 10:44:58#0#12:00:00#12:00:00#00:00:00 1
dd317747ba7d3e851db42cb2043d4f9e 0 0 492172 0 0
1369929 0 0 0 0 1557192 0 0 0 0 0
3201126 B 3 BS 1 01/03/2018 02/03/2018 12/09/1954 0 2
1 E14.2;J18.0;D63.8 99.04;39.27;87.03;87.44 - - None None None
0 - 0 - 0 19332400 8862759 0 2 0 0
0 SURATI D391827 63 23181 SRI KUNMARTINI.DR,SPPD
0138R01703180000398 0002258651439 3;JKN DR RIZKI; 5.2.0.201712280730
4 155851 1#0##0#0#0.0#2018-03-16
15:10:36#0#12:00:00#12:00:00#12:00:00 1 a139f8aa927ac7f0f1b92187efc52c03
0 3438800 2636552 0 0 2082600 0 0 0 0
635807 0 0 0 0 69000
3201126 B 2 BS 1 01/03/2018 02/03/2018 04/05/1980 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3461142 0 2 0 0 0 MAMAN SUPARMAN
0002249512727 3;JKN DR RIZKI; 5.2.0.201712280730 4 155401
1#0##0#0#0.0#2018-03-29 15:27:06#0#12:00:00#12:00:00#12:00:00 1
54f83dd41b2bf54ea9561a531fecb32b 0 0 499265 0 0
1699447 0 0 0 0 1262430 0 0 0 0 0
3201126 B 2 BS 1 01/03/2018 02/03/2018 04/08/2016 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2345408 0 2 0 0 0 NAIRA SYAFA FATHIYYA
D391770 1 574 DR RASTRA, SPA 0138R01703180000005
0002070214716 3;JKN DR RIZKI; 5.2.0.201712280730 4 155403
1#0##0#0#0.0#2018-03-29 15:35:16#0#12:00:00#12:00:00#12:00:00 1
685ba92edc19e7c372ba5e214920bf16 0 0 298025 0 0 687945
0 0 0 0 1189438 0 0 0 0 170000
3201126 B 3 BS 1 01/03/2018 02/03/2018 01/06/1952 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3582830 0 2 0 0 0 SATAR TN D350156
3;JKN DR RIZKI; 5.2.0.201712280730 4 155921 1#0##0#0#0.0#2018-
03-29 15:36:11#0#12:00:00#12:00:00#00:00:00 1
a9adf337f5bff65483651e91e5f21ea2 0 0 424889 0 0
1301800 0 0 0 0 1856141 0 0 0 0 0
3201126 B 1 BS 1 15/02/2018 02/03/2018 29/01/2018 0 2
1 P59.9;P07.3;P07.1 99.82 - - None None None None B-4-13-I
None None None None None None GANGGUAN HATI LAIN-LAIN (RINGAN)
5886000 0 0 - 0 - 0 - 0 - 0
5886000 18274073 0 16 0 0 0 BAYI NY THIA IRMAYA 2 /
ADYATAMA BIRU D390541 0 17 DR AULIA TANGKARI, SPA
0138R01702180007199 0002430164182 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 150299 1#0##0#0#0.0#2018-04-26
16:04:28#0#12:00:00#12:00:00#12:00:00 1 2c1b2f2a7d0e644a810d49ba68a4e883
0 0 342457 0 0 312616 0 0 0 0
13382000 0 0 0 0 4237000
3201126 B 3 BS 1 26/02/2018 02/03/2018 31/12/1968 0 1
1 I50.0;E10.9;I25.0 89.52 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 3575600
5343314 0 5 0 0 0 TOTONG SUPRIATNA D391529 49
3;JKN DR RIZKI; 5.2.2.201806040537 4 154441 1#0##0#0#0.0#2018-
08-09 11:05:54#0#12:00:00#12:00:00#12:00:00 2
57e9f293aba0bb70812c9cc5a20b3163 0 0 845396 0 0
2893855 0 0 0 0 1604063 0 0 0 0 0
3201126 B 2 BS 1 26/02/2018 02/03/2018 20/12/1964 0 2
1 I63.9;I25.0;E14.9 87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 6015800 0 0 - 0 - 0 - 0 -
0 6015800 7778547 0 5 0 0 0 SINAH D391552
3;JKN DR RIZKI; 5.2.2.201806040537 4 154439 1#0##0#0#0.0#2018-
08-09 11:13:17#0#12:00:00#12:00:00#12:00:00 2
2000c2580f0c1841e951a1f6c11502e7 0 0 1006480 0 0
2745890 0 0 0 0 4026177 0 0 0 0 0
3201126 B 3 BS 1 27/02/2018 02/03/2018 18/08/1973 0 1
1 K92.1;D64.9;M19.99 99.04 - - None None None None K-4-
(SEDANG) 2451500 0 0 - 0 - 0 - 0 - 0
2451500 5037984 0 4 0 0 0 DIDIK SAPRUDIN
0001211082658 3;JKN DR RIZKI; 5.2.2.201806040537 4 155153
1#0##0#0#0.0#2018-09-06 11:29:58#0#12:00:00#12:00:00#12:00:00 2
b5ea5323140bb18f493791e6a1aeee24 0 0 349676 0 0
3367220 0 0 0 0 1321088 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 03/03/2018 15/06/1960 0 2
1 I13.2;L97;K21.9 87.44 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4973600
6990744 0 4 0 0 0 SUNDARI HARTATI D068054 57
DR RIZKI; 5.2.0.201712280730 4 155398 1#0##0#0#0.0#2018-03-15
15:13:35#0#12:00:00#12:00:00#00:00:00 1 0e73e2563d3128596b4cf928b5976c48
0 0 782320 0 0 3053836 0 0 0 0
3154588 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 03/03/2018 02/10/1996 0 2
- 0 - 0 - 0 - 0 4101100 4644643 0
4 0 0 0 BUNGA YOISCHA CHRISKA PAATH D383737 21 7819
RIZKI; 5.2.0.201712280730 4 155309 1#0##0#0#0.0#2018-03-15
15:19:58#0#12:00:00#12:00:00#12:00:00 1 3595ed1454544596e5bce956d0421866
0 0 507248 0 0 2085040 0 0 0 0
2052355 0 0 0 0 0
3201126 B 3 BS 1 28/02/2018 03/03/2018 19/03/1954 0 2
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 3409083 0 4 0 0 0 NUNUNG HASANAH
D391682 63 23357 DR ARU, SPPD 0138R01702180013025
0002096527768 3;JKN DR RIZKI; 5.2.0.201712280730 4 155387
1#0##0#0#0.0#2018-03-15 15:24:40#0#12:00:00#12:00:00#12:00:00 1
1dce5a03c19b22f51b9bff2b5ad55323 0 0 207620 0 0
1986939 0 0 0 0 1214524 0 0 0 0 0
3201126 B 3 BS 1 01/03/2018 03/03/2018 23/06/1986 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2171922 0 3 0 0 0 IRA FITRIANA
0000511161535 3;JKN DR RIZKI; 5.2.0.201712280730 4 155918
1#0##0#0#0.0#2018-03-15 15:26:55#0#12:00:00#12:00:00#12:00:00 1
23d20cbf9284d9b92d6e25985833729c 0 0 508634 0 0 706200
0 0 0 0 957088 0 0 0 0 0
3201126 B 2 BS 1 02/03/2018 03/03/2018 02/03/2002 0 1
None None None None PROSEDUR MASTOID DAN SINUS (RINGAN) 7892000 0
0 - 0 - 0 - 0 - 0 7892000 8417454
0 2 0 0 0 AQILA RAIHANI D332983 16 5844 DR
ASNOMINANDA, SPHT 0138R01703180000642 0001796468321 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 155938 1#0##0#0#0.0#2018-03-15
16:53:04#0#12:00:00#12:00:00#00:00:00 1 595f23ac6d74869bc81e47ab88cb6bd3
0 4389100 2209792 0 0 1139387 0 0 0 0
606675 0 0 0 0 72500
3201126 B 3 BS 1 02/03/2018 03/03/2018 29/11/1948 0 2
0 0 - 0 - 0 - 0 - 0 4202600
1294736 0 2 0 0 0 HARTININGSIH D379921 69
25295 DR ELISABETH DYAH NOVIANI 0138R01703180001142 0001446387489
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156443
1#0##0#0#0.0#2018-03-15 17:45:02#0#12:00:00#12:00:00#12:00:00 1
6ba257ad81cd637b3546e99d3c4b14aa 0 0 378234 0 0 542800
0 0 0 0 373702 0 0 0 0 0
3201126 B 2 BS 1 28/02/2018 03/03/2018 31/08/1978 0 1
0 0 - 0 - 0 - 0 - 0 8663100
8894572 0 4 0 0 0 NIKO HARI WIBOWO d374482 39
3;JKN DR RIZKI; 5.2.0.201712280730 4 155390 1#0##0#0#0.0#2018-
03-16 09:17:22#0#12:00:00#12:00:00#12:00:00 1
e1d5fdc5aa7354f03c80fa8c74f8df16 0 0 1176406 0 0
4271278 0 0 0 0 2858888 0 0 0 0 588000
3201126 B 1 BS 1 02/03/2018 03/03/2018 26/06/1962 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3061263 0 2 0 0 0 JUNIAR SIHOTANG
0000037682458 3;JKN DR RIZKI; 5.2.0.201712280730 4 156425
1#0##0#0#0.0#2018-03-16 09:20:14#0#12:00:00#12:00:00#12:00:00 1
e5f6200c20a09878822ef21a7878b15d 0 0 573641 0 0 699352
0 0 0 0 1788275 0 0 0 0 0
3201126 B 2 BS 1 01/03/2018 03/03/2018 16/06/1958 0 2
1 M51.1;E11.9;I10 87.44;87.24 - - None None None None M-4-
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 4171765 0 3 0 0 0 MARSIAH D391810
3;JKN DR RIZKI; 5.2.0.201712280730 4 155847 1#0##0#0#0.0#2018-
03-16 09:55:05#0#12:00:00#12:00:00#12:00:00 1
5f5b5b1a0ed5b7d2772a4f7f46460d7c 0 0 671940 0 0
1685906 0 0 0 0 1813919 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 03/03/2018 21/11/1946 0 1
1 M54.57;M16.9;K30;I10 88.26 - - None None None None M-4-
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 10913280 0 8 0 0 0 BAMBANG IRAWAN
BUDIHARDJO D366076 71 26028 DR CATUR BANUAJI SPS 0138R01702180010999
0000061002494 3;JKN DR RIZKI; 5.2.0.201712280730 4 153681
1#0##0#0#0.0#2018-03-16 10:39:42#0#12:00:00#12:00:00#00:00:00 1
c2edfb966a20c3daf46e658c3f9b7e0d 0 0 570661 0 0
3336666 0 0 0 0 7005953 0 0 0 0 0
3201126 B 1 BS 1 26/02/2018 03/03/2018 17/07/2017 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 14394309 0 6 1 4 0 BAYI NY. DIANE LEANDER
D371160 0 224 DR RASTRA, SPA 0138R01702180011863
0002265768865 3;JKN DR RIZKI; 5.2.0.201712280730 4 154443
1#0##0#0#0.0#2018-03-16 10:42:37#0#12:00:00#12:00:00#00:00:00 1
afcf5554ebb5686005fb4844bfbee4c1 0 0 508264 0 0
5412361 0 0 0 0 6216684 0 0 0 0
2257000
3201126 B 3 BS 1 01/03/2018 03/03/2018 13/01/1977 0 2
1 J18.0;K30;I10 90.59;87.49 - - None None None None J-4-
(RINGAN) 3613200 0 0 - 0 - 0 - 0 - 0
3613200 2531727 0 3 0 0 0 BETSI D391776 41
RIZKI; 5.2.0.201712280730 4 155404 1#0##0#0#0.0#2018-03-16
10:46:41#0#12:00:00#12:00:00#12:00:00 1 39ba9bfc21efa83422bfd81f190095f8
0 0 680336 0 0 870764 0 0 0 0 980627
0 0 0 0 0
3201126 B 2 BS 1 01/03/2018 03/03/2018 12/05/1997 0 2
1 A01.0;K30 88.76;90.59 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 4015087 0 3 0 0 0 MEGA SILVIA
ANGGRAINI D363592 20 7598 DR BETTY DWI L, SPPD 0138R01703180000019
0000000540066 3;JKN DR RIZKI; 5.2.0.201712280730 4 155405
1#0##0#0#0.0#2018-03-16 10:49:23#0#12:00:00#12:00:00#00:00:00 1
f59c6f1d17a2df2ab5bbfe5442ed5e39 0 0 480212 0 0
1731206 0 0 0 0 1803669 0 0 0 0 0
3201126 B 3 BS 1 01/03/2018 03/03/2018 01/11/2000 0 1
1 R14;R10.1 - - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2257765 0 3 0 0 0 AFUNWA EROTE ANNA CURH.H
0001483885809 3;JKN DR RIZKI; 5.2.0.201712280730 4 156202
1#0##0#0#0.0#2018-03-16 10:57:52#0#12:00:00#12:00:00#12:00:00 1
bb1290a1d5ce8bfed20ef8a512f92eba 0 0 261764 0 0
1015297 0 0 0 0 980704 0 0 0 0 0
3201126 B 1 BS 1 27/02/2018 03/03/2018 05/12/1955 0 2
1 I64;E14.9 87.44;87.03 - - None None None None G-4-15-I
- 0 - 0 - 0 - 0 5734600 8430880 0
5 0 0 0 LUGIYATI D391623 62 22730 DR HARDI PRANATA
SPS 0138R01702180012446 0000060721481 3;JKN DR RIZKI; 5.2.0.201712280730
4 154925 1#0##0#0#0.0#2018-03-16
10:59:40#0#12:00:00#12:00:00#12:00:00 1 6908b7f91f9653bacf9ca73c9e5c8f27
0 0 1117063 0 0 3176764 0 0 0 0
4137053 0 0 0 0 0
3201126 B 1 BS 1 26/02/2018 03/03/2018 02/04/1972 0 1
1 D64.9;A01.0;B49;E11.9;I69.4;D47.3;E87.8 99.04;89.52 - - None
None None None D-4-13-III None None None None None None GANGGUAN SEL
DARAH MERAH SELAIN KRISIS ANEMIA SEL SICKLE (BERAT) 7570100 0 0 -
0 - 0 - 0 - 0 7570100 9603725 0 6
0 0 0 BENNY IRAWAN D381379 45 16766 DR BETTY DWI L,
4 154448 1#0##0#0#0.0#2018-03-16
11:07:38#0#12:00:00#12:00:00#12:00:00 1 14a14c220fe3b1630bfbaf0d68663536
0 0 734309 0 0 3874635 0 0 0 0
4994781 0 0 0 0 0
3201126 B 1 BS 1 01/03/2018 03/03/2018 12/09/1967 0 2
17-I None None None None None None LIGASI DAN STRIPPING PEMBULUH DARAH VENA
(RINGAN) 19082700 0 0 - 0 - 0 - 0 - 0
19082700 14145459 0 3 0 0 0 DETRI ERNA D390474
0001188974237 3;JKN DR RIZKI; 5.2.0.201712280730 4 155924
1#0##0#0#0.0#2018-03-16 11:12:18#0#12:00:00#12:00:00#12:00:00 1
7cb4355963b41ca0de7fc7dec5ce254d 0 5896000 6085660 0 0
1093395 0 0 0 0 1001400 0 0 0 0 69000
3201126 B 1 BS 1 01/03/2018 03/03/2018 27/06/2016 0 1
(RINGAN) 12096300 0 0 - 0 - 0 - 0 - 0
12096300 12689478 0 3 0 0 0 ALTHAF RAMAZAN ACHMAD
0002068672612 3;JKN DR RIZKI; 5.2.0.201712280730 4 155447
1#0##0#0#0.0#2018-03-16 14:41:00#0#12:00:00#12:00:00#12:00:00 1
8ca91654e6d47460c174585d21ae21ab 0 7205200 3386964 0 0
1066161 0 0 0 0 886153 0 0 0 0 145000
3201126 B 1 BS 1 02/03/2018 03/03/2018 07/08/2014 0 1
(RINGAN) 12096300 0 0 - 0 - 0 - 0 - 0
12096300 11795485 0 2 0 0 0 DAFFA ABIZAR ALGHIFARI
D280104 3 1303 DR CATUR S, SPB 0138R01703180000774
0002141959904 3;JKN DR RIZKI; 5.2.0.201712280730 4 156207
1#0##0#0#0.0#2018-03-16 15:12:06#0#12:00:00#12:00:00#12:00:00 1
1f56970165d1a0ca625041462c77cb9a 0 5843000 3449964 0 0
1529854 0 0 0 0 827667 0 0 0 0 145000
3201126 B 3 BS 1 24/02/2018 03/03/2018 10/04/1956 0 1
1 E11.5;Q27.3;D64.9 84.15;99.04 - - None None None None M-1-
02-II None None None None None None AMPUTASI (SEDANG) 15599100 0 0
- 0 - 0 - 0 - 0 15599100 17439694 0
8 0 0 0 BAKRI D391301 61 22600 DR DEDY PRATAMA SPBV
0138R01702180011562 0001892152978 3;JKN DR RIZKI; 5.2.0.201712280730
4 154120 1#0##0#0#0.0#2018-03-16
15:28:47#0#12:00:00#12:00:00#12:00:00 1 4616da74fb0da6dc88ac6c5c259c9d08
0 4550500 3637926 0 0 7991353 0 0 0 0
1190915 0 0 0 0 69000
3201126 B 3 BS 1 26/02/2018 03/03/2018 10/01/1969 0 2
(RINGAN) 4482300 0 0 - 0 - 0 - 0 - 0
4482300 13145971 0 6 0 0 0 JUBAEDAH D391493
3;JKN DR RIZKI; 5.2.0.201712280730 4 154274 1#0##0#0#0.0#2018-
03-16 16:17:59#0#12:00:00#12:00:00#12:00:00 1
8cad43b13c4928c1d4d5d2e27eb74b44 0 0 2250999 0 0
5795455 0 0 0 0 5030517 0 0 0 0 69000
3201126 B 3 BS 1 01/03/2018 03/03/2018 19/11/2015 0 2
1 E87.6;R14 - - - None None None None E-4-11-I None
2954900 0 0 - 0 - 0 - 0 - 0
2954900 2581320 0 3 0 0 0 HILWA DUROTUSANIYAH
D391781 2 833 DR AULIA TANGKARI, SPA 0321456 0123654 3;JKN
DR RIZKI; 5.2.0.201712280730 4 156613 1#0##0#0#0.0#2018-03-20
11:51:50#0#11:20:52#11:20:52#00:00:00 1 efc6bb5d87253fcbec87dff84a4ce82b
0 0 2581320 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 2 BS 1 28/02/2018 03/03/2018 07/08/2014 0 1
1 B34.9;J02.9 - - - None None None None A-4-13-I None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3157081 0 4 0 0 0 AHMAD AZZAM FIRDAUS
D391731 3 1301 DR AWIDIYA, SPA 0138R01702180013094
0001460090013 3;JKN DR RIZKI; 5.2.0.201712280730 4 155914
1#0##0#0#0.0#2018-03-23 11:32:57#0#12:00:00#12:00:00#12:00:00 1
1306d02887cc9248333c8b6c6697ee0d 0 0 278711 0 0
1130832 0 0 0 0 1747538 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 03/03/2018 26/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 17095200
14743707 0 2 0 0 0 EFAWITA D353470 55 20277
DR RIZKI; 5.2.0.201712280730 4 155944 1#0##0#0#0.0#2018-03-23
15:17:27#0#12:00:00#12:00:00#00:00:00 1 2e356bc34ed6207de2c3fd3a5f74f70b
0 4795000 3419040 0 0 3440125 0 0 0 0
1020542 0 0 0 0 2069000
3201126 B 3 BS 1 02/03/2018 03/03/2018 11/03/1944 0 1
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 1307954 0 2 0 0 0 M ASMAT H.TN
0000060757378 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156444
1#0##0#0#0.0#2018-03-24 10:18:35#0#12:00:00#12:00:00#00:00:00 1
7c6bafa82523c1ac983c91bc3ca6791d 0 0 371889 0 0 561498
0 0 0 0 374567 0 0 0 0 0
3201126 B 1 BS 1 01/03/2018 03/03/2018 16/12/1992 0 2
0 - 0 - 0 - 0 - 0 7464200 10999965
0 3 0 0 0 NUR MALA IL'ALA D050419 25 9206 YASMIN
SURYANDARI BACHTIAR. DR. SPB 0138R01703180000535 0001634261962 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 155923 1#0##0#0#0.0#2018-
03-24 10:31:35#0#12:00:00#12:00:00#12:00:00 1
a7403694e83831d1e03a401dd925e446 0 6241500 2152976 0 0
1760865 0 0 0 0 775624 0 0 0 0 69000
3201126 B 2 BS 1 02/03/2018 03/03/2018 24/12/1966 0 1
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 54341370 0 2 0 0 0 MIRWAN
0002319199121 3;JKN DR RIZKI; 5.2.0.201712280730 4 156460
29#0##0#0#0.0#2018-03-29 14:55:32#0#12:00:00#12:00:00#12:00:00 1
5ee8adb033124655dd2296e9707cc11d 0 9865000 8244960 0 0
27406410 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 25/02/2018 03/03/2018 07/01/2018 0 1
1 D68.4;G40.7 87.03;88.71 - - None None None None D-4-11-II
None None None None None None GANGGUAN PEMBEKUAN DARAH (SEDANG)
8717800 0 0 - 0 - 0 - 0 - 0
8717800 17974176 0 7 1 3 0 BAYI NY DESTY DWI PUTRI
1 D391470 0 49 DR NOVIK BUDIWARDHANA, SPA 0138R01702180011312
0002327713762 3;JKN DR RIZKI; 5.2.0.201712280730 4 153899
1#0##0#0#0.0#2018-03-29 15:49:10#0#12:00:00#12:00:00#12:00:00 1
25c2536ab5dca5ced0c83197bb71bab9 0 0 481220 0 0
7860075 0 0 0 0 5818881 0 0 0 0
3814000
3201126 B 1 BS 1 28/02/2018 03/03/2018 31/10/1977 0 2
1 C50.9 85.22;85.83 - - None None None None L-1-30-I None
12436800 0 0 - 0 - 0 - 0 - 0
12436800 33264349 0 4 0 0 0 INDAH SUSHANTY
0001716416109 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155389
1#1#vip#2#9327600#75.0#2018-04-07 09:22:18#0#12:00:00#12:00:00#12:00:00
1 5618f696cc2cba6a6d4bdc79200fae2a 0 13024000 6094032 0
0 12627817 0 0 0 0 1301000 0 0 0 0
217500
3201126 B 2 BS 1 25/02/2018 03/03/2018 01/08/1958 0 1
1 I21.3;E87.2;N18.5 39.95 - - None None None None I-4-10-II
0 0 - 0 - 0 - 0 - 0 8663100
29204318 0 7 0 0 0 SUNARDI D391467 59 21758
TANTIYO S;16137 5.2.1.201802140120 4 154198 1#0##0#0#0.0#2018-
04-09 15:48:24#0#12:00:00#12:00:00#12:00:00 1
a0d8b9b904c8abc7417354fab5c157de 0 0 3518236 0 0
9735482 0 0 0 0 12687600 0 0 0 0
3263000
3201126 B 1 BS 1 26/02/2018 03/03/2018 23/02/1975 0 1
1 J18.0;J90;D64.9;R57.2;K29.0;L04.8 99.04;88.76;87.44 - - None
None None None J-4-16-III None None None None None None SIMPLE
PNEUMONIA & WHOOPING COUGH (BERAT) 8987600 0 0 - 0 - 0
- 0 - 0 8987600 14030840 0 6 0 0 0
ADI ABDI LAKSMANA D391554 43 15709 DR BETTY DWI L, SPPD
0138R01702180011887 0001272441565 3;JKN DR RIZKI; 5.2.1.201802140120
4 154447 1#0##0#0#0.0#2018-04-17
11:49:20#0#12:00:00#12:00:00#12:00:00 1 1b5055d0087e00032b11f5ec5131e6f3
0 0 429362 0 0 7406073 0 0 0 0
5284405 0 0 0 0 911000
3201126 B 1 BS 1 28/02/2018 03/03/2018 18/03/1949 0 2
0 - 0 - 0 - 0 - 0 5005900 5749529
0 4 0 0 0 SUSMIYATI, SH. D383728 68 25184 DR
AGOES KOOSHARTORO SPPD-KKV 0138R01702180013098 0000060894033 3;JKN DR
RIZKI; 5.2.2.201806040537 4 156187 1#0##0#0#0.0#2018-08-09
11:34:26#0#12:00:00#12:00:00#12:00:00 2 7e04fdc5a329345c8799451a1b85f0d3
0 0 1109843 0 0 1441049 0 0 0 0
3198637 0 0 0 0 0
3201126 B 3 BS 1 03/03/2018 03/03/2018 12/11/2003 0 2
4 I46.9;C81.9;R56.8;R57.1 - - - None None None None I-4-
14-III None None None None None None CARDIAC ARREST, TIDAK DIKETAHUI
(BERAT) 6043900 0 0 - 0 - 0 - 0 - 0
6043900 3322093 0 1 0 0 0 DINA DZAKIYYAH
0001158066516 3;JKN DR RIZKI; 5.2.2.201806040537 4 156652
1#0##0#0#0.0#2018-08-09 11:56:59#0#12:00:00#12:00:00#12:00:00 2
a42890a0084a1cba04eadc38bc977217 0 0 845244 0 0
1236516 0 0 0 0 524333 0 0 0 0 716000
3201126 B 3 BS 1 03/03/2018 03/03/2018 24/09/1957 0 2
2 N18.5;R57.0;D59.3;R56.8;E11.6 39.95;87.03;87.49;90.59;96.05 - -
None None None None N-4-10-III None None None None None None TUMOR
GINJAL & SALURAN URIN & GAGAL GINJAL (BERAT) 6077700 0 0 - 0
- 0 - 0 - 0 6077700 8790995 0 1 0
0 0 MIRCE SUMIRAH D378959 60 22075 DR AHMAD HIBBAN A WRIYA
0138R01703180001209 0000038803072 3;JKN DR RIZKI; 5.2.2.201806040537
4 156465 1#0##0#0#0.0#2018-09-04
15:28:37#0#12:00:00#12:00:00#12:00:00 2 9ce7d4d0e1ca1143f4b1fb24793cdc86
0 0 546993 0 0 6223640 0 0 0 0
2020362 0 0 0 0 0
3201126 B 3 BS 1 03/03/2018 03/03/2018 05/09/1953 0 1
1 J18.0;C34.9;N17.9 93.94 - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 2828980 0 1 0 0 0 RUSDIYANTO D391122
64 23555 DR SUKMARINI 0138R01703180001344 0001211489346 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 156716 1#0##0#0#0.0#2018-
09-28 12:04:18#0#12:00:00#12:00:00#12:00:00 2
f0daf65b7873662e1bf091ff31bd539b 0 0 788580 0 0
1566327 0 0 0 0 474073 0 0 0 0 0
3201126 B 3 BS 1 03/03/2018 04/03/2018 15/12/1974 0 2
1 N18.5;J18.0;D63.8 99.04 - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 4589490 0 2 0 0 0 ATIH D330275
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156466
1#0##0#0#0.0#2018-03-15 16:45:47#0#12:00:00#12:00:00#00:00:00 1
da48435f0178d821e0642ee4774102ff 0 0 599993 0 0
1981000 0 0 0 0 2008497 0 0 0 0 0
3201126 B 3 BS 1 03/03/2018 04/03/2018 22/12/1955 0 2
1 I12.0;D63.8;I25.0 99.04;39.27 - - None None None None N-1-
- 0 8908800 12826944 0 2 0 0 0 PARTI
GIYARTI D392028 62 22717 SRI KUNMARTINI.DR,SPPD 0138R01703180001371
0001228971508 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156721
1#0##0#0#0.0#2018-03-15 16:54:59#0#12:00:00#12:00:00#12:00:00 1
50179c41188dbd2cdbee3c49e2fb31bf 0 3352300 5659396 0 0
2851102 0 0 0 0 895146 0 0 0 0 69000
3201126 B 2 BS 1 03/03/2018 04/03/2018 06/06/1960 0 1
- 0 10690500 10918180 0 2 0 0 0 PAMBUDI
0001300191445 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156717
1#0##0#0#0.0#2018-03-15 17:07:27#0#12:00:00#12:00:00#12:00:00 1
778f59f9bc4026609a1a1e38d86d8d1a 0 4231600 3153245 0 0
2694062 0 0 0 0 770273 0 0 0 0 69000
3201126 B 1 BS 1 02/03/2018 04/03/2018 13/05/1956 0 2
- 0 58821400 56163772 0 3 0 0 0 RUPINI
d389956 61 22573 DR BAMBANG DWIPUTRA SPJP 0138R01703180001151
0000073651364 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156446
1#0##0#0#0.0#2018-03-15 17:09:03#0#12:00:00#12:00:00#12:00:00 1
9e8dac8d5f287cbeeb5feeb6b0af50aa 0 10407500 9619120 0 0
0 0 0 0 0 1256000 0 0 27312152 0
7569000
3201126 B 2 BS 1 02/03/2018 04/03/2018 14/07/1953 0 2
1 I25.0;E11.6;I08.9;I11.0 88.55;36.07 - - YY02 None None None
- 0 51950600 58600950 0 3 0 0 0 HJ. YULIA
d292081 64 23607 DR BAMBANG DWIPUTRA SPJP 0138R01703180001176
0001261508872 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156453
1#0##0#0#0.0#2018-03-15 17:10:28#0#12:00:00#12:00:00#00:00:00 1
78dbd7c1e13ec36d80c832afa22e33b9 0 8986000 8244960 0 0
32484990 0 0 0 0 1316000 0 0 0 0
7569000
3201126 B 1 BS 1 02/03/2018 04/03/2018 30/12/1958 0 1
1 I25.0;I11.0;E11.6 88.55 - - None None None None I-1-15-III
0 0 - 0 - 0 - 0 - 0 17095200
15239625 0 3 0 0 0 DESPRI WIJAYA S d391640 59
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156450
1#0##0#0#0.0#2018-03-15 17:14:09#0#12:00:00#12:00:00#12:00:00 1
18a2c7f1f4b2d82758da17948c230c8e 0 0 3419040 0 0
3921600 0 0 0 0 5829985 0 0 0 0
2069000
3201126 B 1 BS 1 02/03/2018 04/03/2018 07/06/1953 0 2
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 52661970 0 3 0 0 0 SARIYATI
D384399 64 23644 DR SUPONO SPJP 0138R01703180001199
0000060673689 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156458
1#0##0#0#0.0#2018-03-15 17:16:17#0#12:00:00#12:00:00#12:00:00 1
5650ab218e1511b582dab5111f8712cf 0 0 9619120 0 0
31655850 0 0 0 0 11318000 0 0 0 0 69000
3201126 B 3 BS 1 04/03/2018 04/03/2018 14/04/2016 0 1
4 J18.9;Y84.4;I46.9 99.60 - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 2760223 0 1 0 0 0 MUSHLIH UMAR MAULANA
0002043100236 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156742
1#0##0#0#0.0#2018-03-15 17:42:58#0#12:00:00#12:00:00#12:00:00 1
b45a15ae1bb1056748ca2e8cc92148f5 0 0 325188 0 0
1947460 0 0 0 0 487575 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 04/03/2018 01/03/2012 0 1
1 D56.1;J30.3 99.04 - - None None None None D-4-13-I None
- 0 4181800 5201664 0 3 0 0 0 AQMARUL
IKHSAN D236635 6 2192 DR VERA MUNA MANOE, SPA 0138R01703180001140
0001274835126 3;JKN DR RIZKI; 5.2.0.201712280730 4 156442
1#0##0#0#0.0#2018-03-23 10:48:42#0#12:00:00#12:00:00#00:00:00 1
ca851042af51500ecf921bd3afa4510f 0 0 376362 0 0
2461506 0 0 0 0 2363796 0 0 0 0 0
3201126 B 3 BS 1 03/03/2018 04/03/2018 16/07/1969 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2069830 0 2 0 0 0 ACHMAD WINARNO YASA
0001730288035 3;JKN DR RIZKI; 5.2.0.201712280730 4 156718
1#0##0#0#0.0#2018-03-23 10:50:12#0#12:00:00#12:00:00#12:00:00 1
588587283ebf3b2d7902202403b37235 0 0 424889 0 0
1044032 0 0 0 0 600909 0 0 0 0 0
3201126 B 1 BS 1 01/03/2018 04/03/2018 27/03/2011 0 1
1 A01.0;A90;J06.9 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0 - 0
- 0 3855500 4470105 0 4 0 0 0 REYNARD
ARISTO DOLOKSARIBU D205839 6 2531 DR RIANITA SYAMSU, SPA
0138R01703180000534 0001081352283 3;JKN DR RIZKI; 5.2.0.201712280730
4 155922 1#0##0#0#0.0#2018-03-23
11:12:53#0#12:00:00#12:00:00#00:00:00 1 abaa68456cf1062e3841cc7dd37434b8
0 0 399995 0 0 973173 0 0 0 0
3096937 0 0 0 0 0
3201126 B 3 BS 1 01/03/2018 04/03/2018 18/05/2015 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3053264 0 4 0 0 0 ZALFA NAURA NASYITA
D391849 2 1018 DR RASTRA, SPA 0138R01703180000504
0001888456419 3;JKN DR RIZKI; 5.2.0.201712280730 4 155919
1#0##0#0#0.0#2018-03-23 11:34:11#0#12:00:00#12:00:00#12:00:00 1
ae2df65b96c45af885b4202d1b6fa52c 0 0 378188 0 0
1483830 0 0 0 0 1191246 0 0 0 0 0
3201126 B 1 BS 1 01/03/2018 04/03/2018 22/11/1995 0 2
1 R11;R42 90.59 - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 3793867 0 4 0 0 0 ARISTY WINI DWI SAPUTRI
D362012 22 8135 DR ARU, SPPD 0138R01703180000702
0000208966285 3;JKN DR RIZKI; 5.2.0.201712280730 4 156013
1#0##0#0#0.0#2018-03-23 14:45:59#0#12:00:00#12:00:00#12:00:00 1
ff75daaa5f568583cbf74149bcb3b5ab 0 0 386918 0 0 789752
0 0 0 0 2617197 0 0 0 0 0
3201126 B 2 BS 1 26/02/2018 04/03/2018 02/05/1932 0 2
1 J18.9;I50.0 93.94;89.52 - - None None None None J-4-16-II
(SEDANG) 6093000 0 0 - 0 - 0 - 0 - 0
6093000 14526972 0 7 0 0 0 NURANI YUSUF
d025383 85 31346 DR MOHAMAD NIZAM ERHAMZA SPP 0138R01702180011479
0000060836859 3;JKN DR RIZKI; 5.2.0.201712280730 4 153975
1#1#vvip#7#8433972#0.0#2018-03-23 14:50:30#0#12:00:00#12:00:00#12:00:00
1 57d0df57353e184bcceaf1ece08a6151 0 0 1119274 0 0
3506335 0 0 0 0 9901363 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 04/03/2018 07/11/2017 0 1
0 - 0 2772200 4300626 0 3 0 0 0 BAYI
NY SUSMAH ALBA SUFAH D382011 0 115 DR RASTRA, SPA
0138R01703180001188 0002296596723 3;JKN DR RIZKI; 5.2.0.201712280730
4 156456 1#1#vvip#3#1528426#0.0#2018-03-23
15:10:19#0#12:00:00#12:00:00#12:00:00 2 d01041e3b9f6ae8e44fe0a89cbf2ad30
0 0 489621 0 0 777656 0 0 0 0
2863349 0 0 0 0 170000
3201126 B 1 BS 1 01/03/2018 04/03/2018 29/09/1969 0 2
1 A41.9;N18.5;E87.8;K56.7 87.44;88.19 - - None None None None
A-4-10-II None None None None None None SEPTIKEMIA (SEDANG)
6062400 0 0 - 0 - 0 - 0 - 0
0001273353625 3;JKN DR RIZKI; 5.2.0.201712280730 4 155646
1#0##0#0#0.0#2018-03-23 15:15:59#0#12:00:00#12:00:00#00:00:00 1
69948b8b193ecabb0cc3e8d760d60a33 0 0 818792 0 0
2750426 0 0 0 0 4857533 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 04/03/2018 10/08/1953 0 1
1 I63.9;K30;I10 89.52;87.03;93.19 - - None None None None
G-4-14-I None None None None None None KECEDERAAN PEMBULUH DARAH
OTAK DENGAN INFARK (RINGAN) 7018400 0 0 - 0 - 0 -
0 - 0 7018400 14888698 0 9 0 0 0 SUDOSO
0000041931696 3;JKN DR RIZKI; 5.2.0.201712280730 4 153881
1#1#vvip#9#7870298#0.0#2018-03-23 16:04:40#0#12:00:00#12:00:00#12:00:00
1 3c1dd597483faa60b6bd12abe3c368f0 0 0 2084390 0 0
1856281 0 0 0 0 10948027 0 0 0 0 0
3201126 B 1 BS 1 01/03/2018 04/03/2018 09/03/1953 0 2
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4215950 0 4 0 0 0 MARTALENA D391766
DR RIZKI; 5.2.0.201712280730 4 155402 1#0##0#0#0.0#2018-03-23
16:06:44#0#12:00:00#12:00:00#12:00:00 1 a545d839758774241de3130921919222
0 0 345275 0 0 444865 0 0 0 0
3425810 0 0 0 0 0
3201126 B 3 BS 1 28/02/2018 04/03/2018 24/10/1948 0 2
0 - 0 - 0 - 0 - 0 4144700 8193526
0 5 1 4 0 RUSMINI d388763 69 25329 DR AGOES
5.2.0.201712280730 4 155391 1#0##0#0#0.0#2018-03-23
16:17:05#0#12:00:00#12:00:00#12:00:00 1 b370ab12d3cdb44dccdf155ed8eddf47
0 0 603016 0 0 2171485 0 0 0 0
3937025 0 0 0 0 1482000
3201126 B 2 BS 1 02/03/2018 04/03/2018 17/06/1985 0 2
1 K21.9;N39.0 - - - None None None None K-4-12-II None
0 - 0 - 0 - 0 - 0 4919200 3655866
0 3 0 0 0 RIA PUSPITA SARI D391870 32 11946 DR SRI
KUN, SPPD 0138R01703180000559 0001424805164 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 155935 1#0##0#0#0.0#2018-03-24
10:49:42#0#12:00:00#12:00:00#12:00:00 1 ddbd3d2e9dc8d6bc6fd005c8511227e7
0 0 311408 0 0 1564289 0 0 0 0
1780169 0 0 0 0 0
3201126 B 3 BS 1 02/03/2018 04/03/2018 10/06/2013 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6721020 0 3 0 0 0 MUHAMMAD EGA
FATHURRAHMAN D391270 4 1726 DR ASRI RAHMAWATI SPB
0138R01703180001163 0001829601876 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156451 1#0##0#0#0.0#2018-03-24
10:51:29#0#12:00:00#12:00:00#12:00:00 1 8ebc2b8d1e04862c98eb614861b2bf76
0 0 1591810 0 0 1049717 0 0 0 0
3934493 0 0 0 0 145000
3201126 B 3 BS 1 03/03/2018 04/03/2018 11/03/1964 0 1
- 0 - 0 19332400 14926033 0 2 0 0 0
SUJADI D391972 53 19715 SRI KUNMARTINI.DR,SPPD
0138R01703180001226 0001461722769 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156468 1#0##0#0#0.0#2018-04-07
09:36:34#0#12:00:00#12:00:00#12:00:00 1 134b9c6a4a921bd4bc96381aca4fab5a
0 3062500 5659396 0 0 5102668 0 0 0 0
1032469 0 0 0 0 69000
3201126 B 3 BS 1 02/03/2018 04/03/2018 28/11/1968 0 1
None None None None None None KATETERISASI JANTUNG (SEDANG) 6341300
0 0 - 0 - 0 - 0 - 0 6341300
12005133 0 3 0 0 0 JAHORMAT SIANTURI D334063 49
3;JKN DR RIZKI; 5.2.2.201806040537 4 156459 1#0##0#0#0.0#2018-
09-04 11:51:03#0#12:00:00#12:00:00#00:00:00 2
323754130188c2ad0c8abe22d0ba3db0 0 2421000 2442160 0 0
4300590 0 0 0 0 841383 0 0 0 0
2000000
3201126 B 3 BS 1 02/03/2018 04/03/2018 02/06/1948 0 1
1 D17.5;R11 - - - None None None None K-4-18-I None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1990719 0 3 0 0 0 BUDI PURNAWAN
0002311066361 3;JKN DR RIZKI; 5.2.2.201806040537 4 156434
1#0##0#0#0.0#2018-09-06 11:38:59#0#12:00:00#12:00:00#12:00:00 2
d0270b7381a5fbfa074c74fc70799c52 0 0 261764 0 0 783721
0 0 0 0 945234 0 0 0 0 0
3201126 B 1 BS 1 03/03/2018 04/03/2018 17/08/1944 0 1
1 I12.0;A04.9 39.27 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 11276434 0 2 0 0 0 H.HASAN SASTRO
0002258939226 3;JKN DR RIZKI; 5.2.2.201806040537 4 156719
1#0##0#0#0.0#2018-09-06 12:04:01#0#12:00:00#12:00:00#12:00:00 2
72630ce3665afadc6faa25ae5100d306 0 0 1815243 0 0
2475780 0 0 0 0 6916411 0 0 0 0 69000
3201126 B 2 BS 1 02/03/2018 04/03/2018 15/03/2008 0 1
0 0 - 0 - 0 - 0 - 0 2671100
3925684 0 3 0 0 0 MUHAMMAD RAIHAN RAFLY D143901
9 3639 DR RIANITA SYAMSU, SPA 0138R01703180001110 0001301995618
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 156439
1#0##0#0#0.0#2018-09-28 08:43:58#0#12:00:00#12:00:00#00:00:00 2
619f8b8753a1cfda6bc8f55ac9fa7c29 0 0 443231 0 0
1722133 0 0 0 0 1590320 0 0 0 0 170000
3201126 B 3 BS 1 04/03/2018 04/03/2018 10/07/1938 0 2
1 I61.3;E87.3;R00.1;E87.6 96.05 - - None None None None G-4-
13-II None None None None None None PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 5027802 0 1 0 0 0 ASMANIH D392098
79 29092 DR ANGGA TOMALA PUTRA 0138R01703180001421 0002050961826
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 156734
1#0##0#0#0.0#2018-09-28 08:52:08#0#12:00:00#12:00:00#12:00:00 2
0def5fc1b37407b89a63f9e916339f23 0 0 780498 0 0
2895382 0 0 0 0 635922 0 0 0 0 716000
3201126 B 3 BS 1 02/03/2018 04/03/2018 14/08/2010 0 2
1 D68.9;S42.30 99.06 - - None None None None D-4-11-I
None None None None None None GANGGUAN PEMBEKUAN DARAH (RINGAN)
4042800 0 0 - 0 - 0 - 0 - 0
4042800 3424839 0 3 0 0 0 SHAKIRA ALECYA PUTRI
0001745136584 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 156441
1#0##0#0#0.0#2018-09-28 12:10:30#0#12:00:00#12:00:00#12:00:00 1
2e2dd33fb10936bca428a59394767ef4 0 0 265266 0 0
2207018 0 0 0 0 952555 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 05/03/2018 26/08/1987 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 24893384 0 4 0 0 0 KARINA E267752
30 11146 DR NINING H, SPOG 0138R01703180001166 0001309491494 3;JKN
DR RIZKI; 5.2.0.201712280730 4 156452
10#1#vvip#4#17911884#0.0#2018-03-13 08:46:18#1#12:00:00#12:00:00#12:00:00
1 0711edbcb3a187eb5ece42a7c67bb450 0 11300512 1294259 0
0 6291913 0 0 0 0 5809700 0 0 0 197000
0
3201126 B 2 BS 1 04/03/2018 05/03/2018 16/07/1947 0 2
10406400 0 0 - 0 - 0 - 0 - 0
10406400 19485445 0 2 0 0 0 SUPARNI D392110
70 25799 DR BENNY H T, SPOT 0138R01703180001471 0000060633628
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156741
19#0##0#0#0.0#2018-03-15 16:05:54#0#12:00:00#12:00:00#12:00:00 1
4535d9e9fad54da764728946d6632cb1 0 7557500 7797756 0 0
0 0 0 0 0 1200000 0 0 2709189 221000
0
3201126 B 2 BS 1 28/02/2018 05/03/2018 23/09/2002 0 2
None None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG BELAKANG
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 7038265 0 6 0 0 0 LIDIAWATI D321365
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155383
2#0##0#0#0.0#2018-03-15 16:42:12#0#12:00:00#12:00:00#12:00:00 1
5c149b9dac3d0fd11ba82d7aa3b90ff8 0 0 504286 0 0
3225032 0 0 0 0 3308947 0 0 0 0 0
3201126 B 2 BS 1 02/03/2018 05/03/2018 02/09/2016 0 1
- 0 - 0 - 0 - 0 3187000 3461725 0
4 0 0 0 CALON BAYI NY INTAN THERESIA PURBA D344953 1
546 DR AWIDIYA, SPA 0138R01703180000819 0002082441835 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 156353 5#0##0#0#0.0#2018-
03-15 16:43:57#0#12:00:00#12:00:00#00:00:00 1
f91132b08db49a0bfbe6ca2466e0a97a 0 0 339830 0 0 849427
0 0 0 0 2272468 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 05/03/2018 20/08/1949 0 2
0 - 0 - 0 - 0 - 0 7464200 15224805
0 2 0 0 0 SRI ROCHAYATUN D392100 68 25033 DR
BENNY H T, SPOT 0138R01703180001442 0001296296436 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156739 18#0##0#0#0.0#2018-03-15
17:00:33#0#12:00:00#12:00:00#12:00:00 1 219f1d82501a169b5d71b25c6a5a4819
0 9763300 2292260 0 0 2028230 0 0 0 0
1072015 0 0 0 0 69000
3201126 B 3 BS 1 04/03/2018 05/03/2018 18/12/1955 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2358200 0 2 0 0 0 MUHAMAD NUR D384762
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156746
20#0##0#0#0.0#2018-03-15 17:01:23#0#12:00:00#12:00:00#12:00:00 1
19258f164cdb6154b924d71193c8eca9 0 0 424889 0 0
1227036 0 0 0 0 706275 0 0 0 0 0
3201126 B 2 BS 1 02/03/2018 05/03/2018 23/06/2017 0 1
0 - 0 - 0 - 0 - 0 2671100 4691466
0 4 0 0 0 BAYI NY SITI SUBHIYANTRIANA D369297 0
252 DR RASTRA, SPA 0138R01703180000558 0002235364187 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 155934 4#0##0#0#0.0#2018-
03-15 17:02:58#0#12:00:00#12:00:00#00:00:00 1
8a3f39e606f6b7aa8566bd2200fe7cf5 0 0 266858 0 0
2071690 0 0 0 0 2352918 0 0 0 0 0
3201126 B 3 BS 1 02/03/2018 05/03/2018 24/12/2014 0 2
0 0 - 0 - 0 - 0 - 0 2392700
2014149 0 4 0 0 0 ADELIA NURSALSABILLA ARIFIN
D391928 3 1164 DR RASTRA, SPA 0138R01703180001128
0002243215776 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156440
7#0##0#0#0.0#2018-03-15 17:03:50#0#12:00:00#12:00:00#12:00:00 1
a00609135cdadae52cad6a233172a4d4 0 0 268343 0 0 622539
0 0 0 0 1123267 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 05/03/2018 12/11/2016 0 2
1 A09.9;A08.0 - - - None None None None K-4-17-II None
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 4022956 0 4 0 0 0 RAIN AS-SYAUQI SAADAN
0002200351511 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156449
9#0##0#0#0.0#2018-03-15 17:05:46#0#12:00:00#12:00:00#00:00:00 1
e489601c65ab09f390bb4fc2803c1897 0 0 302498 0 0 918274
0 0 0 0 2632184 0 0 0 0 170000
3201126 B 3 BS 1 27/02/2018 05/03/2018 20/01/1970 0 2
1 E11.5;I11.0;A41.9;J81;I10 90.59;89.52;87.49 - - None None
None None I-4-15-III None None None None None None PENYAKIT PEMBULUH
DARAH PERIFER DAN LAIN-LAIN (BERAT) 7317500 0 0 - 0 - 0
- 0 - 0 7317500 13217310 0 7 0 0 0
ANIH D388414 48 17570 SRI KUNMARTINI.DR,SPPD 0138R01702180012193
0001470667217 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154886
1#0##0#0#0.0#2018-03-15 17:13:00#0#12:00:00#12:00:00#12:00:00 1
663064c7829d20d3bb7330178fc1892e 0 0 1150625 0 0
9335001 0 0 0 0 2731684 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 05/03/2018 20/03/1960 0 1
1 N39.0;A49.9;E13.1 - - - None None None None N-4-12-III
7087700 0 0 - 0 - 0 - 0 - 0
7087700 5758406 0 4 0 0 0 A. NOER D391949
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156454
11#0##0#0#0.0#2018-03-15 17:18:51#0#12:00:00#12:00:00#12:00:00 1
63658bf1107d2c71bb1e37f0eee2fdaa 0 0 690893 0 0
2321795 0 0 0 0 2745718 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 05/03/2018 07/10/1955 0 2
1 E13.2;I50.0 - - - None None None None N-4-16-II None
(SEDANG) 7385300 0 0 - 0 - 0 - 0 - 0
7385300 4739912 0 4 0 0 0 JANTI RUSMIJATI
0000045871378 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156437
6#0##0#0#0.0#2018-03-15 17:21:03#0#12:00:00#12:00:00#00:00:00 1
d4e06cac96dc0952daa3eb8f6b3a945f 0 0 633260 0 0 992064
0 0 0 0 3114588 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 05/03/2018 20/03/1969 0 1
0 - 0 - 0 - 0 - 0 4136800 6388602
0 2 0 0 0 ZAINAL ARIFIN D389391 48 17881 DR
5.2.0.201712280730 4 156751 22#0##0#0#0.0#2018-03-22
16:27:06#0#12:00:00#12:00:00#12:00:00 1 9a499ae4c0947bce6aebd8b95bd140d6
0 0 1211304 0 0 944352 0 0 0 0
2552946 0 0 0 0 1680000
3201126 B 3 BS 1 28/02/2018 05/03/2018 28/10/1982 0 2
1 A17.1;G44.8 87.03;90.59;89.52 - - None None None None G-4-
18-I None None None None None None INFEKSI BAKTERI SISTEM SARAF (RINGAN)
4429400 0 0 - 0 - 0 - 0 - 0
4429400 3115500 0 6 0 0 0 YENI NURAENI
0000436843135 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155395
3#0##0#0#0.0#2018-03-23 08:32:23#0#12:00:00#12:00:00#12:00:00 1
dd3c886d1a63e997bb242128b5458b2b 0 0 479060 0 0
1091622 0 0 0 0 1544818 0 0 0 0 0
3201126 B 3 BS 1 04/03/2018 05/03/2018 01/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 12210800
11306663 0 2 0 0 0 BURHANUDIN D391166 52 19300
DR RIZKI; 5.2.0.201712280730 4 156738 17#0##0#0#0.0#2018-03-23
08:38:15#0#12:00:00#12:00:00#12:00:00 1 b3431c2e8d81322c05dc468ba30f5400
0 2421000 2442160 0 0 3578815 0 0 0 0
795688 0 0 0 0 2069000
3201126 B 3 BS 1 04/03/2018 05/03/2018 01/04/1960 0 2
- 0 36446400 55455660 0 2 0 0 0 YATI PARINAH
0000511480877 3;JKN DR RIZKI; 5.2.0.201712280730 4 156733
16#0##0#0#0.0#2018-03-23 09:30:50#0#12:00:00#12:00:00#12:00:00 1
f8f9c67221f2cf2d273a9d2463d65447 0 7996000 5144120 0 0
33490540 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 03/03/2018 05/03/2018 03/03/2018 2000 1
(RINGAN) 6580300 0 0 - 0 - 0 - 0 - 0
6580300 1608907 0 3 0 0 0 BAYI NY FETRI MAEKASARI
0002436018478 3;JKN DR RIZKI; 5.2.0.201712280730 4 156788
24#0##0#0#0.0#2018-03-23 10:30:05#0#12:00:00#12:00:00#12:00:00 1
7447191e1dd2dd9e26574d8e962a8872 0 0 292891 0 0 463760
0 0 0 0 852256 0 0 0 0 0
3201126 B 3 BS 1 02/03/2018 05/03/2018 01/07/1953 0 2
1 N39.0;J45.9;K29.7;H81.3;N81.4 - - - None None None None
N-4-12-I None None None None None None INFEKSI GINJAL DAN SALURAN
URIN (RINGAN) 2392700 0 0 - 0 - 0 - 0 -
0 2392700 3396474 0 4 0 0 0 SAMI D391937
3;JKN DR RIZKI; 5.2.0.201712280730 4 156445 8#0##0#0#0.0#2018-
03-23 10:37:45#0#12:00:00#12:00:00#12:00:00 1
0a8f90b8440d38fb9fee33abebaae134 0 0 321343 0 0
1861432 0 0 0 0 1213699 0 0 0 0 0
3201126 B 3 BS 1 04/03/2018 05/03/2018 13/10/1963 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2212429 0 2 0 0 0 SITI CHASIDAH
0000511209819 3;JKN DR RIZKI; 5.2.0.201712280730 4 156749
21#0##0#0#0.0#2018-03-23 10:47:32#0#12:00:00#12:00:00#00:00:00 1
896f8c0eaad3ad67f04d1ba21743e665 0 0 424889 0 0
1177302 0 0 0 0 610238 0 0 0 0 0
3201126 B 1 BS 1 03/03/2018 05/03/2018 12/12/1952 0 1
1 E14.2;D63.8;J91 38.95;99.04 - - None None None None N-1-
- 0 - 0 27065300 14971184 0 3 0 0 0
FRANS MARTINUS SAMUEL D111772 65 23822 SRI KUNMARTINI.DR,SPPD
0138R01703180001221 0001318423162 3;JKN DR RIZKI; 5.2.0.201712280730
4 156467 14#0##0#0#0.0#2018-03-23
10:51:37#0#12:00:00#12:00:00#00:00:00 1 f1f4e9e978b508ed221e8cc68df33ea6
0 7429200 3669967 0 0 2767594 0 0 0 0
1035423 0 0 0 0 69000
3201126 B 2 BS 1 02/03/2018 05/03/2018 23/01/1995 0 2
0 - 0 - 0 - 0 - 0 2009900 5468080
0 4 0 0 0 FETRI MAEKASARI D387785 23 8439 DR
ATJANG S, SPOG 0138R01703180001204 0001392802389 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156462 13#0##0#0#0.0#2018-03-24
09:54:00#0#12:00:00#12:00:00#12:00:00 2 08d984dda9cdeff215d3cdcdc6bb9885
0 3060700 454980 0 0 1352610 0 0 0 0
357790 0 0 0 242000 0
3201126 B 1 BS 1 03/03/2018 05/03/2018 13/11/1952 0 1
- 0 12472300 13697144 0 3 0 0 0 SUJATMAN
HADI SANTOSO D391530 65 23851 SRI KUNMARTINI.DR,SPPD
0138R01703180001379 0000036424719 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156723 15#0##0#0#0.0#2018-03-24
10:52:27#0#12:00:00#12:00:00#12:00:00 1 afab9ad8c000b1ab646d7b3e599a41a9
0 6468200 3669967 0 0 2525902 0 0 0 0
964075 0 0 0 0 69000
3201126 B 3 BS 1 04/03/2018 05/03/2018 04/08/1987 0 2
1 I27.0;Q25.0;J93.9 99.60 - - None None None None I-4-24-II
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 6215003 0 2 0 0 0 SITI SOPIAH D392112
DR RIZKI; 5.2.1.201802140120 4 156755 23#0##0#0#0.0#2018-04-17
16:35:04#0#12:00:00#12:00:00#12:00:00 1 035135eefc678b87e326cce2dd6662a8
0 0 732582 0 0 3729832 0 0 0 0 713589
0 0 0 0 1039000
3201126 B 1 BS 1 04/03/2018 05/03/2018 25/07/2016 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2794819 0 2 0 0 0 KHAIRA GWYNETH AZALEA
0001725687426 3;JKN ECHI; 5.2.1.201804062320 4 156729
1#0##0#0#0.0#2018-04-21 14:17:59#0#12:00:00#12:00:00#12:00:00 2
6697744bd9565202e57ba7b5540d1da1 0 0 338858 0 0 685122
0 0 0 0 1770839 0 0 0 0 0
3201126 B 2 BS 1 02/03/2018 05/03/2018 20/12/1949 0 1
0 - 0 - 0 - 0 - 0 4919200 4276547
0 4 0 0 0 THE SOEY D300276 68 24909 DR. ARU
5.2.0.201712280730 4 156461 1#0##0#0#0.0#2018-08-16
08:38:09#0#12:00:00#12:00:00#00:00:00 2 d27ac552c945791d19e2cc480d6d8e44
0 0 495728 0 0 1960045 0 0 0 0
1820774 0 0 0 0 0
3201126 B 2 BS 1 01/03/2018 05/03/2018 10/03/1973 0 2
1 J02.9;R11;D64.9;A01.0 - - - None None None None U-4-
13-III None None None None None None PERADANGAN EPIGLOTIS, TELINGA
TENGAH, ISPA DAN LARINGOTRAKEITIS (BERAT) 3350500 0 0 - 0 -
0 - 0 - 0 3350500 4454213 0 5 0 0
0 ADELINA . M. SIPAHUTAR D045124 44 16427 DR BETTY DWI L, SPPD
0138R01703180001871 0002251170404 3;JKN DR RIZKI; 5.2.2.201806040537
4 156982 1#0##0#0#0.0#2018-09-04
14:56:44#0#12:00:00#12:00:00#12:00:00 2 a944c7264a235c315661c8a660d9195a
0 0 409013 0 0 1184803 0 0 0 0
2860397 0 0 0 0 0
3201126 B 3 BS 1 03/03/2018 06/03/2018 01/07/1991 0 2
1 M54.57;K29.7 - - - None None None None M-4-17-I
(RINGAN) 3687800 0 0 - 0 - 0 - 0 - 0
3687800 3627019 0 4 0 0 0 LINDA NURLITA DWI PUTRI
0000510457757 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156677
1#0##0#0#0.0#2018-03-19 09:12:27#0#12:00:00#12:00:00#12:00:00 1
60b9ec343b04e9b96f584fcbfcfa1380 0 0 437902 0 0
1873835 0 0 0 0 1315282 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 06/03/2018 12/09/2017 0 1
0 - 0 - 0 - 0 - 0 3116300 3156067
0 2 0 0 0 BAYI NY PUTRI CYNTHIA D392138 0 174
DR RASTRA, SPA 0138R01703180001619 0002265244907 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 156759 1#0##0#0#0.0#2018-03-21
14:35:23#0#12:00:00#12:00:00#12:00:00 1 fca52cfd7052a915fbd318697a7b5374
0 0 405611 0 0 955984 0 0 0 0
1794472 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 06/03/2018 10/12/1953 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3820891 0 2 0 0 0 HARDIMAN D391256
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157153
1#0##0#0#0.0#2018-03-21 14:37:13#0#12:00:00#12:00:00#12:00:00 1
604fff7a9a659928af281f47c5a40cf7 0 0 470546 0 0
1857880 0 0 0 0 1492465 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 06/03/2018 17/03/1942 0 1
7040000 0 0 - 0 - 0 - 0 - 0
7040000 1919189 0 1 0 0 0 KANDARI D386695
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157157
1#0##0#0#0.0#2018-03-21 16:08:40#0#12:00:00#12:00:00#12:00:00 1
dde1ee8b49dd55486ff21ab84e6c9dba 0 0 633600 0 0 871035
0 0 0 0 414554 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 06/03/2018 21/02/1982 0 1
10235200 0 0 - 0 - 0 - 0 - 0
10235200 14193348 0 2 0 0 0 ARFAT LUSINANTO
0001384381495 3;JKN DR RIZKI; 5.2.0.201712280730 4 156985
1#0##0#0#0.0#2018-03-22 11:29:56#0#12:00:00#12:00:00#12:00:00 1
f2e394353d8c04a4c9fb4fd9ac2c9d86 0 6833600 4115856 0 0
2144355 0 0 0 0 954537 0 0 0 0 145000
3201126 B 3 BS 1 05/03/2018 06/03/2018 01/02/1996 0 2
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 5653793 0 2 0 0 0 SUCI SYAH FITRI
D390657 22 8068 DR ATJANG S, SPOG 0138R01703180001901
0000512668866 3;JKN DR RIZKI; 5.2.0.201712280730 4 156981
1#0##0#0#0.0#2018-03-22 16:28:50#0#12:00:00#12:00:00#12:00:00 1
2dca327192551c8ad542863abbef0a80 0 2362000 644168 0 0
2152751 0 0 0 0 425874 0 0 0 0 69000
3201126 B 3 BS 1 05/03/2018 06/03/2018 05/06/1980 0 2
- 0 - 0 - 0 - 0 2168300 1563114 0
2 0 0 0 RETNO HANDAYANI d392140 37 13787 DR ERDIYAN,
5.2.0.201712280730 4 156758 1#0##0#0#0.0#2018-03-23
08:18:08#0#12:00:00#12:00:00#12:00:00 1 ae6eeff6646785c1288031aa3f16405d
0 0 498147 0 0 410707 0 0 0 0 654260
0 0 0 0 0
3201126 B 3 BS 1 02/03/2018 06/03/2018 01/06/1946 0 2
10401900 0 0 - 0 - 0 - 0 - 0
10401900 7581551 0 5 1 2 0 NAMI D391874 71
3;JKN DR RIZKI; 5.2.0.201712280730 4 156355 1#0##0#0#0.0#2018-
03-23 09:53:00#0#12:00:00#12:00:00#12:00:00 1
827cc5a3952d152aec79b16d854916a5 0 0 989171 0 0
3407391 0 0 0 0 3056989 0 0 0 0 128000
3201126 B 2 BS 1 04/03/2018 06/03/2018 09/11/1990 0 2
0 0 - 0 - 0 - 0 - 0 2009900
5672415 0 3 0 0 0 FENTI NOVA KHAIRANI D390950
27 9977 DR ATJANG S, SPOG 0138R01703180001420 0000166355673 3;JKN
DR RIZKI; 5.2.0.201712280730 4 156736 1#0##0#0#0.0#2018-03-23
09:57:35#0#12:00:00#12:00:00#12:00:00 1 921855e1918b3ddc7efc03dda12b1e2e
0 3060700 454980 0 0 1439142 0 0 0 0
486093 0 0 0 0 231500
3201126 B 3 BS 1 02/03/2018 06/03/2018 09/11/1951 0 1
1 K25.4;K29.8;D64.9 99.04;45.16;87.44 - - None None None None
(SEDANG) 3296400 0 0 - 0 - 0 - 0 - 0
3296400 11705840 0 5 0 0 0 CASMAD D391872
3;JKN DR RIZKI; 5.2.0.201712280730 4 156090 1#0##0#0#0.0#2018-
03-23 10:01:26#0#12:00:00#12:00:00#12:00:00 1
f1bf61fed9f7fcb8ef04002449a831ad 0 0 1091992 0 0
5855545 0 0 0 0 3009303 0 0 0 0
1749000
3201126 B 1 BS 1 03/03/2018 06/03/2018 10/02/1954 0 1
1 I63.9;E14.2;G81.9;I10;E16.2 87.03 - - None None None None
0 - 0 9673300 7470282 0 4 0 0 0
SOEBIYANTORO D391638 64 23397 DR NURUL KOMARI SPS
0138R01703180001385 0001725728163 3;JKN DR RIZKI; 5.2.0.201712280730
4 156725 1#0##0#0#0.0#2018-03-23
10:26:36#0#12:00:00#12:00:00#12:00:00 1 f9ac8335372743ddba13f5eda9074f30
0 0 1117063 0 0 3495509 0 0 0 0
2857710 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 06/03/2018 03/05/1994 0 2
2033900 0 0 - 0 - 0 - 0 - 0
2033900 5036683 0 3 0 0 0 ROSITA DEWI D388626
3;JKN DR RIZKI; 5.2.0.201712280730 4 156730 1#0##0#0#0.0#2018-
03-23 11:21:06#0#12:00:00#12:00:00#12:00:00 1
53839f719205c6fc091bf01eaf88c0ef 0 0 449220 0 0
1888960 0 0 0 0 2698503 0 0 0 0 0
3201126 B 3 BS 1 09/02/2018 06/03/2018 22/01/2018 0 2
1 P36.9;P22.9;P23.9;P54.1 96.72;99.07;99.04;99.05;96.05 - - None
None None None J-1-02-III None None None None None None VENTILASI
- 0 - 0 - 0 66331600 98840976 0 26 1
11 100 BY NY DWI RETNOWATI D388338 0 18 DR AULIA TANGKARI,
SPA 0138R01702180004111 0002423223325 3;JKN DR RIZKI; 5.2.0.201712280730
4 147340 1#0##0#0#0.0#2018-03-23
11:25:16#0#12:30:30#12:30:30#00:00:00 1 509dd65bf90e8911e6690387205a79ad
0 0 9971008 0 0 22920974 0 0 0 0
28858000 0 0 0 0 37090994
3201126 B 1 BS 1 28/02/2018 06/03/2018 05/12/2017 0 2
5058500 0 0 - 0 - 0 - 0 - 0
5058500 8420346 0 7 0 0 0 BAYI NY MARTA HUTASOIT
0002317789326 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155400
1#0##0#0#0.0#2018-03-24 09:43:15#0#12:00:00#12:00:00#12:00:00 1
be26e1f555bdf04e7a1dcce843047d0e 0 0 280467 0 0
2537015 0 0 0 0 4686000 0 0 0 916864
0
3201126 B 2 BS 1 03/03/2018 06/03/2018 03/12/2011 0 1
1 J45.9;A49.9 - - - None None None None J-4-18-I None
0 0 - 0 - 0 - 0 - 0 2671100
3648398 0 4 0 0 0 DENNIS MUHAMMAD RASPATI D392092
6 2282 DR RIANITA SYAMSU, SPA 0138R01703180001389 0001183490493
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156727
1#0##0#0#0.0#2018-03-24 09:49:41#0#12:00:00#12:00:00#12:00:00 1
d6b292759fb272ff222addfd6ae12560 0 0 293399 0 0
1575319 0 0 0 0 1515000 0 0 0 264680
0
3201126 B 2 BS 1 02/03/2018 06/03/2018 15/10/1961 0 2
1 A41.9;M71.07;E10.5;J18.0 84.15;90.59;93.94 - - None None
None None M-1-02-III None None None None None None AMPUTASI (BERAT)
30848800 0 0 - 0 - 0 - 0 - 0
30848800 27217464 0 5 0 0 0 TIOH ROHAETI
D391873 56 20592 DR ARU, SPPD 0138R01703180000564
0000205500993 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155936
1#0##0#0#0.0#2018-03-24 10:30:29#0#12:00:00#12:00:00#12:00:00 1
627908525eea384e3c9f05c8d6be3653 0 6156100 12392520 0 0
7323844 0 0 0 0 1276000 0 0 0 0 69000
3201126 B 1 BS 1 23/02/2018 06/03/2018 27/06/1982 0 1
1 E85.9;K25.3;K56.7 45.16 - - None None None None M-4-16-II
6567400 0 0 - 0 - 0 - 0 - 0
6567400 23409768 0 12 0 0 0 SIGIT RAHARJO
0001818904544 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153667
1#0##0#0#0.0#2018-03-24 10:45:10#0#12:00:00#12:00:00#12:00:00 1
ebe6aa4341dbe2718f27124dd8592b27 0 0 1553544 0 0
9907724 0 0 0 0 10199500 0 0 0 0
1749000
3201126 B 1 BS 1 23/02/2018 06/03/2018 15/06/1937 0 2
1 I63.9;G20;I48;I50.0;I25.1 87.03 - - None None None None
0 - 0 9673300 20971459 0 12 0 0 0 LUPINA
NAPITUPULU D196081 80 29473 DR HARDI PRANATA SPS 0138R01702180010361
0000011445581 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 153200
1#1#vvip#12#11298159#0.0#2018-03-24 10:56:14#0#12:00:00#12:00:00#12:00:00
1 cace909f683f5d441c654066a77cc1a3 0 0 2041497 0 0
4503962 0 0 0 0 14298000 0 0 0 0 128000
3201126 B 3 BS 1 05/03/2018 06/03/2018 20/07/1958 0 2
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 49826740 0 2 0 0 0 SITI AMINAH
0000511287895 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156763
1#0##0#0#0.0#2018-03-28 21:23:46#0#12:00:00#12:00:00#12:00:00 1
53142cd92a52583edd4d236247d77938 0 7996000 2145160 0 0
30929580 0 0 0 0 1256000 0 0 0 0
7500000
3201126 B 1 BS 1 03/03/2018 06/03/2018 19/08/1976 0 1
1 A01.0;B48.8;K21.9 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0 - 0
- 0 3855500 4537907 0 4 0 0 0 DANANG PRIYO
NUGROHO D391739 41 15171 SRI KUNMARTINI.DR,SPPD 0138R01703180001370
0001629920856 3;JKN DR RIZKI; 5.2.0.201712280730 4 156720
1#1#vip#4#1927750#50.0#2018-03-29 08:28:42#1#12:00:00#12:00:00#12:00:00
1 312c3b26b8fe4ab56b67fc684eddbb2b 0 0 195210 0 0
1079525 0 0 0 0 3263172 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 06/03/2018 21/07/1986 0 2
1 O35.8;R11 88.78 - - None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 3035600 4271280
0 3 0 0 0 MARIA ELVINA JULIANTI D355949 31 11549
DR ARU, SPPD 0138R01703180001544 0001642935396 3;JKN DR RIZKI;
5.2.0.201712280730 4 156747 1#0##0#0#0.0#2018-03-29
15:34:26#0#12:00:00#12:00:00#00:00:00 1 0895a82ff7acac34a90ca768bb3f23eb
0 0 641858 0 0 980992 0 0 0 0
2648430 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 06/03/2018 04/04/1984 0 2
1 I48;R00.0 89.52 - - None None None None I-4-19-I None
3914900 0 0 - 0 - 0 - 0 - 0
3914900 928967 0 1 0 0 0 ARI YANTIH d380695
3;JKN DR RIZKI; 5.2.1.201802140120 4 157388 1#0##0#0#0.0#2018-
04-17 11:31:30#0#12:00:00#12:00:00#12:00:00 1
11c85f3c62e5a92b793076b3d6544729 0 0 352341 0 0 226852
0 0 0 0 349774 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 06/03/2018 16/06/1947 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 2280209 0 1 0 0 0 DJUNAIDI d300053
3;JKN DR RIZKI; 5.2.1.201802140120 4 158578 1#0##0#0#0.0#2018-
04-17 16:28:05#0#12:00:00#12:00:00#12:00:00 1
ea26e5cc2d1bdc141eedd3d1ae0bf9b9 0 0 524232 0 0
1317804 0 0 0 0 438173 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 06/03/2018 06/05/1975 0 1
- 0 12472300 17250558 0 3 0 0 0 DENY DWIDYA
NUGRAHA D392120 42 15643 SRI KUNMARTINI.DR,SPPD 0138R01703180001547
0001102916518 3;JKN DR RIZKI; 5.2.2.201806040537 4 156748
1#0##0#0#0.0#2018-08-09 12:06:20#0#12:00:00#12:00:00#12:00:00 3
2c9cb265cbe6edc3cd50a6394371b262 0 7159200 3669967 0 0
5137850 0 0 0 0 1214541 0 0 0 0 69000
3201126 B 1 BS 1 28/02/2018 06/03/2018 05/12/2017 0 2
1 J18.0;R09.1 93.94;87.44 - - None None None None J-4-16-I
(RINGAN) 5058500 0 0 - 0 - 0 - 0 - 0
D391403 0 85 DR KRISTON SILITONGA, SPA 0138R0170218V000009
0002317789326 3;JKN DR RIZKI; 5.2.2.201806040537 4 227409
1#0##0#0#0.0#2018-09-26 14:50:58#0#00:00:00#00:00:00#12:00:00 2
d49c42c267c0cb05e36226a23322c91b 0 0 280467 0 4686000
2537015 0 0 0 0 340000 0 0 550864 26000
0
3201126 B 2 BS 1 05/03/2018 06/03/2018 20/04/1952 0 2
- 0 10690500 12025029 0 2 0 0 0 NY.SAIRAH
0001458222265 3;JKN DR RIZKI; 5.2.2.201806040537 4 157144
1#0##0#0#0.0#2018-09-26 20:34:32#0#12:00:00#12:00:00#12:00:00 2
1ce76217f0a793c685971bed05979514 0 0 3153245 0 0
3118000 0 0 0 0 5753784 0 0 0 0 0
3201126 B 1 BS 1 06/03/2018 07/03/2018 10/10/1944 0 2
- 0 12472300 19232669 0 2 0 0 0 KARWITI
ZEN,BA D389647 73 26810 SRI KUNMARTINI.DR,SPPD 0138R01703180002877
0000042984314 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157750
1#0##0#0#0.0#2018-03-15 17:32:47#0#12:00:00#12:00:00#12:00:00 1
0caeac2be76451643d6ca74a67c7527c 0 5550500 3669967 0 0
8687202 0 0 0 0 1256000 0 0 0 0 69000
3201126 B 1 BS 1 02/03/2018 07/03/2018 27/07/1961 0 1
1 A16.0;R04.2 93.94 - - None None None None J-4-15-I None
6071100 0 0 - 0 - 0 - 0 - 0
6071100 7073574 0 6 0 0 0 ARI WISNU WARDANA
0001470707662 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156463
1#0##0#0#0.0#2018-03-16 17:46:29#0#12:00:00#12:00:00#12:00:00 1
903365f793f1965737efd0a254f4473a 0 0 599399 0 0
1965418 0 0 0 0 4508757 0 0 0 0 0
3201126 B 1 BS 1 02/03/2018 07/03/2018 20/04/1946 0 1
1 I95.9;E15;J18.9;A41.9;N17.9;M47.87;D64.9;R57.2 99.04 - - None
None None None I-4-24-III None None None None None None GANGGUAN
SISTEM PEMBULUH DARAH LAIN-LAIN (BERAT) 11395800 0 0 - 0 -
0 - 0 - 0 11395800 25918623 0 6 1 5
0 MUCHTAR GOJALI D387015 71 26249 DR. ARU ARIADNO, SPPD
0138R01703180001191 0000060962128 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156457 1#0##0#0#0.0#2018-03-19
09:05:46#0#12:00:00#12:00:00#12:00:00 1 755fe6087f5e5ed7c11fe5b4f8ffa00e
0 0 1420496 0 0 14470327 0 0 0 0
7099800 0 0 0 0 2928000
3201126 B 2 BS 1 04/03/2018 07/03/2018 04/03/2018 2670 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3600390 0 4 0 0 0 BAYI NY. INCHADIO
IMANDAPUTRI ARDIANSYAH D392137 0 0 DR DYAH HARINI, SPA
0138R01703180001917 0002436148765 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 156983 1#0##0#0#0.0#2018-03-19
09:08:30#0#12:00:00#12:00:00#12:00:00 1 ff23b0af0afbcfee5b6720fc58ad4291
0 0 433812 0 0 810038 0 0 0 0
2356540 0 0 0 0 0
3201126 B 2 BS 1 06/03/2018 07/03/2018 01/01/1950 0 1
- 0 10690500 12157795 0 2 0 0 0 MISWAR
0001883606286 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157503
1#0##0#0#0.0#2018-03-19 09:10:55#0#12:00:00#12:00:00#12:00:00 1
b2ff5b67be09b38c668f4fbe1b2762dc 0 4929100 3153245 0 0
3155080 0 0 0 0 851370 0 0 0 0 69000
3201126 B 1 BS 1 03/03/2018 07/03/2018 17/06/2016 0 2
0 0 - 0 - 0 - 0 - 0 3695000
6833613 0 5 0 0 0 NAYLA RAMADHANISYA ASANI
d375498 1 624 DR RASTRA, SPA 0138R01703180001206
0002055487421 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156464
1#0##0#0#0.0#2018-03-19 11:08:22#0#12:00:00#12:00:00#12:00:00 1
bc121b7cec7e85cf4d67542d38f4df13 0 0 385550 0 0
2070004 0 0 0 0 4378059 0 0 0 0 0
3201126 B 1 BS 1 03/03/2018 07/03/2018 03/02/2016 0 2
1 R50.9;R63.8 - - - None None None None A-4-12-I None
None None None None None DEMAM YANG TIDAK DITENTUKAN (RINGAN)
3695000 0 0 - 0 - 0 - 0 - 0
3695000 4857068 0 5 0 0 0 ARSYLIA MARYAM AKHYARY
D322761 2 759 DR RASTRA, SPA 0138R01703180001329
0002034109034 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156714
1#0##0#0#0.0#2018-03-19 11:39:43#0#12:00:00#12:00:00#12:00:00 1
4df6f5b31406fb168cc7408297f69331 0 0 302498 0 0 305818
0 0 0 0 4248752 0 0 0 0 0
3201126 B 2 BS 1 05/03/2018 07/03/2018 14/10/1950 0 1
1 Z53.0;C41.1;N18.9;K76.9;R72 - - - None None None None
Z-4-12-II None None None None None None FAKTOR-FAKTOR YANG
MEMPENGARUHI STATUS KESEHATAN LAIN-LAIN (SEDANG) 4725600 0 0 -
0 - 0 - 0 - 0 4725600 4982956 0 3
0 0 0 SAYUDA D392195 67 24614 RACHMAWATI DR,SPB(K)ONK
0138R01703180002201 0001450591356 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 157147 1#0##0#0#0.0#2018-03-21
15:29:16#0#12:00:00#12:00:00#12:00:00 2 51df3269a49c19ee7bb3b493ffa7bc19
0 0 478304 0 0 2845164 0 0 0 0
1659488 0 0 0 0 0
3201126 B 2 BS 1 06/03/2018 07/03/2018 26/02/2014 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4582989 0 2 0 0 0 MUHAMMAD AFFAN DWI PUTRA
D391745 4 1469 DR CATUR S, SPB 0138R01703180002500
0001284848021 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157393
1#0##0#0#0.0#2018-03-21 16:15:25#0#12:00:00#12:00:00#12:00:00 1
fc3aa554503bad6ae581920eca8e1f95 0 2864000 556024 0 0
734643 0 0 0 0 355822 0 0 0 0 72500
3201126 B 3 BS 1 06/03/2018 07/03/2018 03/02/1964 0 1
1 I87.1;N18.5 88.60;39.50 - - None None None None I-1-20-I
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
15363900 21159748 0 2 0 0 0 SAPRIAT ROSTIADI
0001740096775 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157516
1#0##0#0#0.0#2018-03-21 16:25:41#0#12:00:00#12:00:00#00:00:00 1
5a288c1fc65d9ec26bd7d60f3f62ba4b 0 0 3072780 0 0
12148918 0 0 0 0 5869050 0 0 0 0 69000
3201126 B 1 BS 1 02/03/2018 07/03/2018 04/04/1983 0 1
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 17649212 0 6 0 0 0 WIDI PRASETIAWAN
0002300393992 3;JKN DR RIZKI; 5.2.0.201712280730 4 155937
1#0##0#0#0.0#2018-03-22 11:21:01#0#12:00:00#12:00:00#12:00:00 1
8e905b980a12ecce37c475713234f49b 0 8660000 2437861 0 0
5201730 0 0 0 0 1280621 0 0 0 0 69000
3201126 B 2 BS 1 06/03/2018 07/03/2018 22/01/1985 0 2
- 0 - 0 - 0 - 0 4101100 13827696 0
2 0 0 0 RATU BILQIUIST R D381844 33 12096 DR SIDDHI
ANDIKA, SPU 0138R01703180002407 0001190520584 3;JKN DR RIZKI;
5.2.0.201712280730 4 157197 1#0##0#0#0.0#2018-03-22
14:45:00#0#12:00:00#12:00:00#12:00:00 1 e84ad5c1a50ac151ad21465ffff30360
0 4911100 6148308 0 0 1773172 0 0 0 0
960616 0 0 0 0 34500
3201126 B 1 BS 1 03/03/2018 07/03/2018 25/03/1959 0 2
0 - 0 - 0 - 0 - 0 5802600 8906086
0 5 0 0 0 DEDE TATI HARTATI D330629 58 21528 DR.
5.2.0.201712280730 4 156722 1#0##0#0#0.0#2018-03-22
14:46:28#0#12:00:00#12:00:00#12:00:00 1 83c7a885081c490acbee124134020f7b
0 0 669260 0 0 3778685 0 0 0 0
4168141 0 0 0 0 290000
3201126 B 1 BS 1 06/03/2018 07/03/2018 05/08/1946 0 1
- 0 12472300 14342635 0 2 0 0 0 USMAN
SAEPULLOH NUR D392277 71 26146 DR. ARU ARIADNO, SPPD
0138R01703180002557 0000058364335 3;JKN DR RIZKI; 5.2.0.201712280730
4 157495 1#0##0#0#0.0#2018-03-22
14:47:45#0#12:00:00#12:00:00#12:00:00 1 1337a8b101cf92563f61625278311429
0 5914000 3669967 0 0 3729865 0 0 0 0
994303 0 0 0 0 34500
3201126 B 1 BS 1 04/03/2018 07/03/2018 27/11/1943 0 1
1 A49.9;E13.1;I10 - - - None None None None A-4-14-III
LAIN-LAIN (BERAT) 4626600 0 0 - 0 - 0 - 0 -
0 4626600 4590878 0 4 0 0 0 SYAMSIR ZAINI
0001313258747 3;JKN DR RIZKI; 5.2.0.201712280730 4 156753
1#0##0#0#0.0#2018-03-22 16:07:42#0#12:00:00#12:00:00#12:00:00 1
f5a84ce56a2aa63824928d8f0d601bc1 0 0 842120 0 0
1079420 0 0 0 0 2669338 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 07/03/2018 22/09/1958 0 1
1 I64;G81.9;I50.0 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 6844000 5766318 0
3 0 0 0 PRAYOGO D392156 59 21714 DR NURUL KOMARI
SPS 0138R01703180001827 0000041920468 3;JKN DR RIZKI; 5.2.0.201712280730
4 156877 1#0##0#0#0.0#2018-03-22
16:10:00#0#12:00:00#12:00:00#12:00:00 1 f1fcdfd3a07a287892105f4340b90341
0 0 1267110 0 0 1752972 0 0 0 0
2746236 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 07/03/2018 24/05/1965 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 6874745 0 2 0 0 0 NING ANDRIYANI
0001089754659 3;JKN DR RIZKI; 5.2.0.201712280730 4 157560
1#0##0#0#0.0#2018-03-22 16:11:26#0#12:00:00#12:00:00#12:00:00 1
b62f700199c5813217c6788aebe60c21 0 3456800 868100 0 0
2009595 0 0 0 0 505750 0 0 0 0 34500
3201126 B 3 BS 1 06/03/2018 07/03/2018 18/09/1962 0 2
(RINGAN) 8041000 0 0 - 0 - 0 - 0 - 0
8041000 12274592 0 2 0 0 0 SRI RAHAYU D383117
3;JKN DR RIZKI; 5.2.0.201712280730 4 157156 1#0##0#0#0.0#2018-
03-22 16:20:05#0#12:00:00#12:00:00#12:00:00 1
bd11e143ef18d493d9f6f15620eb9a89 0 3438800 6820084 0 0
1122197 0 0 0 0 859011 0 0 0 0 34500
3201126 B 2 BS 1 04/03/2018 07/03/2018 25/01/1994 0 2
1 O64.9;O42.9;O82.0;O41.0;Z37.0 74.0 - - None None None None
(RINGAN) 5984100 0 0 - 0 - 0 - 0 - 0
5984100 19492896 0 4 0 0 0 INCHADIO IMANDAPUTRI
ARDIANSYAH d053650 24 8804 DR KARTIKA MAYA, SPOG 0138R01703180001593
0002296744481 3;JKN DR RIZKI; 5.2.0.201712280730 4 156756
1#1#vvip#4#13508796#0.0#2018-03-22 16:25:27#0#12:00:00#12:00:00#12:00:00
1 c479a8b6709deaa10977256143a960ee 0 8121400 6592721 0
0 3270775 0 0 0 0 1311000 0 0 0 0
197000
3201126 B 1 BS 1 04/03/2018 07/03/2018 23/09/1995 0 2
1 J02.9;B34.9 - - - None None None None U-4-13-I None
0 - 0 2772200 5244317 0 4 0 0 0 SUSANA
D359643 22 8198 DR ARU, SPPD 0138R01703180001407
0001482542638 3;JKN DR RIZKI; 5.2.0.201712280730 4 156732
1#0##0#0#0.0#2018-03-22 16:30:12#0#12:00:00#12:00:00#12:00:00 1
b1effee70e6276882927cb65e49ce3a4 0 0 316331 0 0
1434900 0 0 0 0 3493086 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 07/03/2018 08/10/1933 0 1
1 I25.0;J18.9;E87.5;N18.9 88.76;87.44 - - None None None None
I-4-16-III None None None None None None ATHEROSKLEROSIS (BERAT)
5850400 0 0 - 0 - 0 - 0 - 0
5850400 16035189 0 4 1 3 0 BANDJARANSARI SUHARDIMAN
0002290848704 3;JKN DR RIZKI; 5.2.0.201712280730 4 156735
1#0##0#0#0.0#2018-03-23 10:44:02#0#12:00:00#12:00:00#12:00:00 1
7e41ce9253d5245d2b03b205272285a4 0 0 1654895 0 0
8262263 0 0 0 0 4475031 0 0 0 0
1643000
3201126 B 1 BS 1 05/03/2018 07/03/2018 14/12/1955 0 2
1 D24;N18.5 85.20 - - None None None None L-1-50-I None
0 0 - 0 - 0 - 0 - 0 9150100
13312349 0 3 0 0 0 TENDY LUMBAN TORUAN D299120
3;JKN DR RIZKI; 5.2.0.201712280730 4 157146 1#0##0#0#0.0#2018-
03-29 15:31:24#0#12:00:00#12:00:00#00:00:00 2
ae219289f533ecf7ea00bbc70c0ca932 0 6587000 2562028 0 0
3167420 0 0 0 0 926901 0 0 0 0 69000
3201126 B 3 BS 1 07/03/2018 07/03/2018 25/11/1969 0 2
1 G04.9;R40.0 - - - None None None None G-4-19-II None
- 0 - 0 6246400 2327975 0 1 0 0 0
BONITA AYU NOVELANI D392332 48 17634 DR YOHANNES DWINANDA
0138R01703180002909 0000043608835 3;JKN DR RIZKI; 5.2.0.201712280730
4 157757 1#0##0#0#0.0#2018-03-31
11:43:45#0#12:00:00#12:00:00#12:00:00 1 7b1dda9e329171200ff61c8fd70bd0a9
0 0 562176 0 0 1324502 0 0 0 0 441297
0 0 0 0 0
3201126 B 1 BS 1 07/03/2018 07/03/2018 18/01/1959 0 2
1 H11.0 11.32 - - None None None None H-1-20-I None None
None None None None PROSEDUR EKSTRAOKULER DAN ORBITA (RINGAN) 14255100
0 0 - 0 - 0 - 0 - 0 14255100
7711790 0 1 0 0 0 YAYUK MUJIASTUTI,NY D389154
59 21598 DR DIAN EKA P, SPM 0138R01703180003364 0000038454614
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 158287
1#0##0#0#0.0#2018-04-09 16:23:09#0#12:00:00#12:00:00#12:00:00 1
eb56260d9c1cefdbde1f0627fed26f0f 0 1700000 5377980 0 0
103300 0 0 0 0 530510 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 08/03/2018 05/02/1982 0 1
0 - 0 - 0 - 0 - 0 17095200 16661125
0 4 0 0 0 YUDI PRAYUDI M D136637 36 13177 DR
AGOES KOOSHARTORO SPPD-KKV 0138R01703180001767 0001622386337 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 156816 1#0##0#0#0.0#2018-
03-15 17:24:21#0#12:00:00#12:00:00#12:00:00 1
662449a9ffecd37734a03df407cdc380 0 6159000 3419040 0 0
3967105 0 0 0 0 1115980 0 0 0 0
2000000
3201126 B 2 BS 1 04/03/2018 08/03/2018 11/04/1946 0 2
1 N18.3;D63.8;L02.4 99.04;90.59;89.52;86.22 - - None None None
0 - 0 4958500 7558764 0 5 0 0 0
MACHRONI D229546 71 26260 DR ARU, SPPD 0138R01703180001518
0000039169552 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156744
1#0##0#0#0.0#2018-03-15 17:30:35#0#12:00:00#12:00:00#12:00:00 1
9e9dba16d6086ea55ba1303bb1a4c8c8 0 0 1010165 0 0
3247100 0 0 0 0 3045499 0 0 0 0 256000
3201126 B 1 BS 1 06/03/2018 08/03/2018 06/02/1966 0 2
(RINGAN) 21357400 0 0 - 0 - 0 - 0 - 0
21357400 10407409 0 3 0 0 0 RINI INDAH WULANDARI
0001294503759 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157752
1#0##0#0#0.0#2018-03-15 17:40:33#0#12:00:00#12:00:00#12:00:00 1
faada54bdfc4e7ea51b47e231c902d89 0 0 1754732 0 0
2094318 0 0 0 0 6489359 0 0 0 0 69000
3201126 B 2 BS 1 02/03/2018 08/03/2018 05/04/1960 0 1
1 E10.8;I11.0;E87.6 - - - None None None None E-4-10-III
0 - 0 7515400 11344735 0 7 0 0 0 HIN
BENG D391934 57 21150 DR AZRI NURIZAL SPPD KKV 0138R01703180001155
0002083681451 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156447
1#0##0#0#0.0#2018-03-15 17:47:17#0#12:00:00#12:00:00#12:00:00 1
5259da7993d55e05738f3e2e9d269cdd 0 0 729386 0 0
6519670 0 0 0 0 4095679 0 0 0 0 0
3201126 B 3 BS 1 04/03/2018 08/03/2018 15/12/1956 0 1
- 0 45079800 62350835 0 5 0 0 0 HAMZAH SIMIN
0001772148969 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156737
1#0##0#0#0.0#2018-03-15 17:48:22#0#12:00:00#12:00:00#12:00:00 1
d826cbeb7d1dd1407eb6da8665766dbc 0 8515000 6870800 0 0
38012035 0 0 0 0 1256000 0 0 0 0
7697000
3201126 B 2 BS 1 04/03/2018 08/03/2018 21/09/2016 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9799112 0 5 0 0 0 AHMAD FAUZI AL MUBAROK
D392124 1 529 DR CATUR S, SPB 0138R01703180001585
0002091079113 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156752
1#0##0#0#0.0#2018-03-15 17:49:39#0#12:00:00#12:00:00#12:00:00 1
fabfd9ce54f5bcfb19abd52799c4a204 0 5113300 2029010 0 0
1794739 0 0 0 0 717063 0 0 0 0 145000
3201126 B 2 BS 1 03/03/2018 08/03/2018 31/12/1943 0 2
1 E11.4;I64;G81.9;I48 90.59;89.52;87.03 - - None None None
None G-4-17-III None None None None None None GANGUAN SARAF KRANIAL
DAN PERIFER (BERAT) 9167300 0 0 - 0 - 0 - 0
- 0 9167300 7343823 0 6 0 0 0 SUM
SETIARSIH D299326 74 27091 DR NURUL KOMARI SPS 0138R01703180001336
0000168465892 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156715
1#0##0#0#0.0#2018-03-15 17:53:11#0#12:00:00#12:00:00#00:00:00 1
744d28bb1e1ff212cd7069164b0641e8 0 0 965054 0 0
2842332 0 0 0 0 3536437 0 0 0 0 0
3201126 B 1 BS 1 06/03/2018 08/03/2018 25/11/1970 0 1
(RINGAN) 21357400 0 0 - 0 - 0 - 0 - 0
21357400 26215435 0 3 0 0 0 SUHARTO D392264
47 17268 DR BENNY H T, SPOT 0138R01703180002515 0001125598138
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157418
1#0##0#0#0.0#2018-03-16 17:38:24#0#12:00:00#12:00:00#12:00:00 2
7a81ea870a632c356db075f92b32f458 0 10472300 11460220 0 0
2957915 0 0 0 0 1256000 0 0 0 0 69000
3201126 B 3 BS 1 07/03/2018 08/03/2018 15/07/1963 0 1
- 0 8908800 9076394 0 2 0 0 0 DASUKI
0001790812269 3;JKN DR RIZKI; 5.2.0.201712280730 4 158302
1#0##0#0#0.0#2018-03-19 08:35:05#0#12:00:00#12:00:00#12:00:00 1
292f145abc7e9cbe871a3d00a2f0b4d1 0 3438800 2636552 0 0
2282259 0 0 0 0 649783 0 0 0 0 69000
3201126 B 3 BS 1 06/03/2018 08/03/2018 27/11/1953 0 1
- 0 8908800 8934247 0 3 0 0 0 POEDJADI
0001212186791 3;JKN DR RIZKI; 5.2.0.201712280730 4 157746
1#0##0#0#0.0#2018-03-19 08:54:13#0#12:00:00#12:00:00#12:00:00 2
dde5605b79424f07520b71e82df76493 0 3062500 2636552 0 0
2560212 0 0 0 0 640483 0 0 0 0 34500
3201126 B 3 BS 1 07/03/2018 08/03/2018 23/06/1958 0 2
- 0 8908800 9331913 0 2 0 0 0 SUMARMI
0001740062204 3;JKN DR RIZKI; 5.2.0.201712280730 4 158301
1#0##0#0#0.0#2018-03-19 09:02:58#0#12:00:00#12:00:00#12:00:00 1
3ec4d0d011ca33cfed0bf01cc65f490f 0 3352300 2636552 0 0
2607562 0 0 0 0 666499 0 0 0 0 69000
3201126 B 1 BS 1 02/03/2018 08/03/2018 11/09/1955 0 2
1 I20.0;I50.0;J18.0 89.52;90.59;87.44;88.72 - - None None None
None I-4-20-III None None None None None None ANGINA PEKTORIS DAN
NYERI DADA (BERAT) 9856000 0 0 - 0 - 0 - 0
- 0 9856000 14679943 0 7 0 0 0 INDESWARI
0001457476029 3;JKN DR RIZKI; 5.2.0.201712280730 4 156438
1#0##0#0#0.0#2018-03-19 09:41:25#0#12:00:00#12:00:00#12:00:00 1
5fb70759cc0333d3bc77c93ec3afea00 0 0 1344940 0 0
7227133 0 0 0 0 6107870 0 0 0 0 0
3201126 B 2 BS 1 06/03/2018 08/03/2018 18/01/1973 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3878199 0 3 0 0 0 SUDIRMAN D352346
3;JKN DR RIZKI; 5.2.0.201712280730 4 157369 1#0##0#0#0.0#2018-
03-19 09:50:28#0#12:00:00#12:00:00#00:00:00 2
a5f69ac926ab9b0980db135c3eb05793 0 0 409013 0 0
1656472 0 0 0 0 1812714 0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 08/03/2018 01/08/1972 0 1
1 A16.1;A91;R57.9;K29.7 - - - None None None None J-4-
(BERAT) 6970400 0 0 - 0 - 0 - 0 - 0
6970400 1706624 0 1 0 0 0 SUPARDI D392455
DR RIZKI; 5.2.0.201712280730 4 158631 1#0##0#0#0.0#2018-03-19
11:55:55#0#11:50:00#18:20:00#12:00:00 1 8d98f41eb801d337bbd09add392290cd
0 0 627336 0 0 678640 0 0 0 0 400648
0 0 0 0 0
3201126 B 1 BS 1 06/03/2018 08/03/2018 25/03/1965 0 2
1 Z03.0;D64.9;I11.9 87.49;90.59;99.04 - - None None None None
J-4-15-II None None None None None None PERADANGAN DAN INFEKSI
PERNAFASAN (SEDANG) 7253300 0 0 - 0 - 0 - 0
- 0 7253300 2772893 0 3 0 0 0 SUMARNI
0000036549055 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157755
1#0##0#0#0.0#2018-03-21 14:47:25#0#12:00:00#12:00:00#12:00:00 1
dd96f90f83b985ac393437a9c66a0244 0 0 663597 0 0 339892
0 0 0 0 1769404 0 0 0 0 0
3201126 B 2 BS 1 02/03/2018 08/03/2018 24/12/1945 0 1
1 J18.9;E11.9;A41.9 - - - None None None None J-4-16-III
7703700 0 0 - 0 - 0 - 0 - 0
7703700 7700180 0 7 0 0 0 JUSRANI D391923
0001728049509 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156895
1#0##0#0#0.0#2018-03-21 15:56:42#0#12:00:00#12:00:00#12:00:00 1
ee84cd714270068c5569c01cff52f891 0 0 823370 0 0
3587060 0 0 0 0 3289750 0 0 0 0 0
3201126 B 2 BS 1 06/03/2018 08/03/2018 10/10/2017 0 1
0 - 0 - 0 - 0 - 0 2671100 3830542
0 3 0 0 0 BAYI NY HERAWATI SIAGIAN D392259 0
147 DR KRISTON SILITONGA, SPA 0138R01703180002439 0002289311289
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157260
1#0##0#0#0.0#2018-03-21 16:04:48#0#12:00:00#12:00:00#12:00:00 1
287e45d5bfc6b997484d486ae4ebf443 0 0 293399 0 0
1575547 0 0 0 0 1791596 0 0 0 0 170000
3201126 B 1 BS 1 05/03/2018 08/03/2018 10/02/1970 0 1
- 0 - 0 - 0 - 0 4136800 9631393 0
4 0 0 0 FRANS PATTINASARANY D030604 48 17555 DR.
ARU ARIADNO, SPPD 0138R01703180002140 0001277980378 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 157143 1#0##0#0#0.0#2018-03-21
16:10:04#0#12:00:00#12:00:00#12:00:00 1 1b8cf6110bcbf57bb5e8c608544304ec
0 3836500 943360 0 0 2416442 0 0 0 0
686091 0 0 0 0 1749000
3201126 B 2 BS 1 06/03/2018 08/03/2018 03/12/2010 0 2
6586700 0 0 - 0 - 0 - 0 - 0
6586700 8839521 0 3 0 0 0 DESTA PUTRI NIFAN
D390240 7 2650 DR CATUR S, SPB 0138R01703180002507
0001638678688 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157402
1#0##0#0#0.0#2018-03-21 16:12:18#0#12:00:00#12:00:00#12:00:00 1
360ddd2c8512ff31a2885188f60f35fb 0 5366300 1217272 0 0
1456663 0 0 0 0 654286 0 0 0 0 145000
3201126 B 1 BS 1 05/03/2018 08/03/2018 27/09/1962 0 2
9855000 0 0 - 0 - 0 - 0 - 0
9855000 14978491 0 4 0 0 0 SILVY MARIA PATTIWAEL
0001812451239 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 156892
1#0##0#0#0.0#2018-03-21 16:16:22#0#12:00:00#12:00:00#12:00:00 1
1d9c000c42e80d88d4e63cbdd8d03de6 0 7868200 2759400 0 0
2979990 0 0 0 0 1080901 0 0 0 0 290000
3201126 B 3 BS 1 06/03/2018 08/03/2018 27/05/1980 0 2
8672000 0 0 - 0 - 0 - 0 - 0
8672000 10647709 0 3 0 0 0 DESSY HARYANI
0001721030804 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157751
1#0##0#0#0.0#2018-03-21 16:17:41#0#12:00:00#12:00:00#12:00:00 1
628564f9883614fcfdb3240af0da22b9 0 3853100 4366160 0 0
1606870 0 0 0 0 752579 0 0 0 0 69000
3201126 B 2 BS 1 28/02/2018 08/03/2018 04/06/1958 0 2
1 C26.0;A41.9;D64.9 54.11;46.10;45.74;99.04 - - None None None
None K-1-20-III None None None None None None PROSEDUR INTESTINAL
KOMPLEKS (BERAT) 29795100 0 0 - 0 - 0 - 0 -
0 29795100 35138510 0 9 0 0 0 ELISABETH ELLEN.T.
LH D363093 59 21819 DR E SURYA POHAN DR SPB KBD 0138R01702180012923
0001268332479 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 155382
1#0##0#0#0.0#2018-03-21 16:22:03#0#12:00:00#12:00:00#00:00:00 1
b3081e4d68ee38db3d713aac7201f467 0 9819000 8405628 0 0
13669882 0 0 0 0 1226000 0 0 0 0
2018000
3201126 B 3 BS 1 07/03/2018 08/03/2018 01/10/1953 0 2
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 55544095 0 2 0 0 0 SURYATI
0001014230452 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158133
1#0##0#0#0.0#2018-03-28 20:53:37#0#12:00:00#12:00:00#00:00:00 1
b9408c6cc74a5e778a4571728a96d0dd 0 7996000 6870800 0 0
31852295 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 07/03/2018 08/03/2018 25/08/1942 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 68110090 0 2 0 0 0 PETRUS HERMAN LOEN
0000510007509 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158132
1#0##0#0#0.0#2018-03-28 20:56:34#0#12:00:00#12:00:00#00:00:00 1
2e46e5eade684cf7c8585ee10d636451 0 7996000 6870800 0 0
44290290 0 0 0 0 1256000 0 0 0 0
7697000
3201126 B 1 BS 1 05/03/2018 08/03/2018 10/08/1960 0 1
- 0 58821400 68957802 0 4 0 0 0 JUNAEDI
0000060513581 3;JKN DR RIZKI; 5.2.0.201712280730 4 156768
1#0##0#0#0.0#2018-03-29 15:08:38#0#12:00:00#12:00:00#00:00:00 1
cf7661ba063ddf58c1f3e2790fa40b36 0 11444000 9619120 0 0
39168682 0 0 0 0 1200000 0 0 0 0
7526000
3201126 B 1 BS 1 06/03/2018 08/03/2018 03/05/1946 0 1
1 I72.1;T82.4;N18.5 88.67;39.52 - - None None None None I-1-
20-III None None None None None None PROSEDUR SISTIM PEREDARAN DARAH
LAIN-LAIN (BERAT) 28247300 0 0 - 0 - 0 - 0 -
0 28247300 16760328 0 3 0 0 0 SUMIHARDI TN
0000060708958 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 157581
1#0##0#0#0.0#2018-04-09 16:03:00#0#12:00:00#12:00:00#00:00:00 1
1ce83cc5b1e585ecf22ee1e166a547a1 0 7177200 927880 0 0
6223528 0 0 0 0 2362720 0 0 0 0 69000
3201126 B 3 BS 1 06/03/2018 08/03/2018 14/05/1952 0 1
1 I73.8;I10 88.40;39.50 - - None None None None I-1-20-I
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
15363900 27612147 0 3 0 0 0 ATANG R. D391116
0000511887003 3;JKN DR RIZKI; 5.2.1.201802140120 4 157753
1#0##0#0#0.0#2018-04-17 10:43:02#0#12:00:00#12:00:00#12:00:00 1
27b0115db2da70a744723b44e82a7c41 0 0 4035320 0 0
16564925 0 0 0 0 4942902 0 0 0 0
2069000
3201126 B 2 BS 1 07/03/2018 08/03/2018 16/02/1966 0 2
(RINGAN) 18436700 0 0 - 0 - 0 - 0 - 0
18436700 20065121 0 2 0 0 0 SUKARMI D391125
0001172045935 3;JKN DR RIZKI; 5.2.1.201802140120 4 158131
1#0##0#0#0.0#2018-04-17 10:46:18#0#12:00:00#12:00:00#12:00:00 1
dbdea57f00ea5a31cad5decc03a94581 0 4911100 4606500 0 0
7109850 0 0 0 0 1368671 0 0 0 0
2069000
3201126 B 3 BS 1 07/03/2018 08/03/2018 27/12/1967 0 2
1 I87.8;N18.5;D63.8 88.40;39.50;99.04 - - None None None None
0 - 0 19193800 32085971 0 2 0 0 0
MULYATI D392157 50 18333 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180002907 0001322482408 3;JKN DR RIZKI; 5.2.1.201802140120
4 157756 1#0##0#0#0.0#2018-04-17
11:57:51#0#12:00:00#12:00:00#12:00:00 2 1b3bf7d9beca409d87c0cdc387dfd68c
0 3062500 4030698 0 0 1802130 0 0 0 0
687423 0 0 20434220 0 2069000
3201126 B 3 BS 1 07/03/2018 08/03/2018 12/05/1957 0 2
4854000 0 0 - 0 - 0 - 0 - 0
4854000 802350 0 2 0 0 0 FRANSISCA SULASTRI
0001469500672 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 158298
1#0##0#0#0.0#2018-04-26 15:57:50#0#12:00:00#12:00:00#00:00:00 1
2839a386d910f17ef2d06f647764921a 0 0 436860 0 0 24000
0 0 0 0 341490 0 0 0 0 0
3201126 B 2 BS 1 06/03/2018 08/03/2018 15/06/1960 0 2
1 I87.1;N18.5;D63.8 88.40;39.50;99.04 - - None None None None
0 - 0 23032500 14050415 0 3 0 0 0
SUNDARI HARTATI D068054 57 21083 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180002878 0000042653237 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 157748 1#0##0#0#0.0#2018-04-26
16:10:49#0#12:00:00#12:00:00#00:00:00 2 756ba3722cc69679164725b5170991b3
0 4703600 4606500 0 0 1696129 0 0 0 0
975186 0 0 0 0 2069000
3201126 B 1 BS 1 04/03/2018 08/03/2018 23/06/2015 0 1
1 J18.0;A09.9;E44.1;B37.0;J45.9 - - - None None None None
J-4-16-II None None None None None None SIMPLE PNEUMONIA & WHOOPING
COUGH (SEDANG) 7108500 0 0 - 0 - 0 - 0 -
0 7108500 7892359 0 5 0 0 0 KENZIE JEREMY
PANJAITAN D392010 2 985 DR RIANITA SYAMSU, SPA 0138R01703180001519
0002096233751 3;JKN DR RIZKI; 5.2.2.201806040537 4 156745
1#0##0#0#0.0#2018-08-09 12:04:02#0#12:00:00#12:00:00#12:00:00 2
61e60181d7c6b5d4d8e297515e84627d 0 0 861884 0 0
2583152 0 0 0 0 4447323 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 08/03/2018 09/01/1972 0 1
17-I None None None None None None LIGASI DAN STRIPPING PEMBULUH DARAH VENA
(RINGAN) 13630500 0 0 - 0 - 0 - 0 - 0
13630500 11399439 0 3 0 0 0 ARDIANSYAH D385096
0001335250721 3;JKN DR RIZKI; 5.2.2.201806040537 4 157749
1#0##0#0#0.0#2018-08-10 08:42:42#0#12:00:00#12:00:00#12:00:00 2
62eac96d17059ec844440b9e640c33ae 0 3438800 4841676 0 0
2179205 0 0 0 0 801758 0 0 0 0 138000
3201126 B 3 BS 1 05/03/2018 08/03/2018 02/06/1954 0 1
1 N39.0;D29.1;K29.7;E13.9 - - - None None None None N-4-
12-I None None None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN)
2392700 0 0 - 0 - 0 - 0 - 0
2392700 6455356 0 4 0 0 0 HARYADI D392190
63 23287 DR ARU, SPPD 0138R01703180002119 0001258507967 3;JKN
DR RIZKI; 5.2.2.201806040537 4 157141 1#0##0#0#0.0#2018-09-04
11:41:14#0#12:00:00#12:00:00#12:00:00 2 c610561821e9f9140684d4ac2740c017
0 0 349676 0 0 4605367 0 0 0 0
1500313 0 0 0 0 0
3201126 B 2 BS 1 07/03/2018 08/03/2018 28/01/2018 0 1
4 D68.4 99.04;96.71 - - None None None None J-1-20-I None
None None None None None PROSEDUR SISTEM PERNAFASAN NON-KOMPLEKS
(RINGAN) 17976600 0 0 - 0 - 0 - 0 - 0
17976600 19969461 0 2 1 2 24 MUHAMMAD NAUFAL ALFARIZI
0002436732314 3;JKN DR RIZKI; 5.2.2.201806040537 4 158042
1#0##0#0#0.0#2018-09-25 18:54:27#0#12:00:00#12:00:00#12:00:00 2
3ba60f257ed5b4f625daeeda8ded7582 0 0 743626 0 0
14124835 0 0 0 0 2068000 0 0 0 1833000
1200000
3201126 B 2 BS 1 04/03/2018 08/03/2018 06/07/1952 0 2
1 I11.0;J18.9;J91 34.91 - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 5968400
5967434 0 5 0 0 0 HJ.MUJENAH D378196 65 23982
DR PRIYO SUNARTO , SPJP 0138R01703180001406 0001338885022 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 156731 1#0##0#0#0.0#2018-
09-28 08:40:35#0#12:00:00#12:00:00#12:00:00 2
7f1344a17cb616b7afaad5a0b6d3c4fa 0 0 1029780 0 0
1996261 0 0 0 0 2941393 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 08/03/2018 26/05/1961 0 2
1 E87.6;A49.9;K80.8;N17.9 88.76;89.52;90.59 - - None None None
None E-4-11-III None None None None None None HIPOVOLEMIA & GANGGUAN
ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 - 0 -
0 6293300 2419295 0 3 0 0 0 TUTI N.
0001740038185 3;JKN DR RIZKI; 5.2.0.201712280730 4 157744
1#0##0#0#0.0#2018-09-29 14:31:09#0#12:00:00#12:00:00#12:00:00 2
6fac07ae3a08ecf7e5081dda20529ef0 0 0 318941 0 0
1213582 0 0 0 0 886772 0 0 0 0 0
3201126 B 1 BS 1 08/03/2018 09/03/2018 28/02/1970 0 1
- 0 12472300 14778364 0 2 0 0 0 TUAH ROBERT.
S D392183 48 17540 DR SRI KUNMARTINI, SPPD 0138R01703180003947
0001725341049 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158839
1#0##0#0#0.0#2018-03-16 17:41:02#0#12:00:00#12:00:00#12:00:00 1
e184bcd43e57d48ac3cdc1c4d73253d3 0 6486200 3669967 0 0
3530388 0 0 0 0 1022809 0 0 0 0 69000
3201126 B 1 BS 1 08/03/2018 09/03/2018 17/08/1959 0 1
1 I12.0;A49.9 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 11123511 0 2 0 0 0 AGUS PANJAITAN
0001299474257 3;JKN DR RIZKI; 5.2.0.201712280730 4 158901
1#0##0#0#0.0#2018-03-19 08:27:22#0#12:00:00#12:00:00#12:00:00 1
8685a499c9bb57dd495fe0f1aa6c12fa 0 5205000 1815243 0 0
3250562 0 0 0 0 783706 0 0 0 0 69000
3201126 B 2 BS 1 05/03/2018 09/03/2018 04/05/1980 0 1
1 E14.2;I82.8;A49.9;D63.8 38.95;99.04 - - None None None None
- 0 - 0 10690500 17397295 0 5 0 0 0
MAMAN SUPARMAN d376330 37 13819 SRI KUNMARTINI.DR,SPPD
0138R01703180002247 0002249512727 3;JKN DR RIZKI; 5.2.0.201712280730
4 157150 1#0##0#0#0.0#2018-03-19
08:40:42#0#12:00:00#12:00:00#12:00:00 2 3a4612aa6046e25dd8770ea99da4204b
0 5746600 1490965 0 0 6362589 0 0 0 0
3506641 0 0 0 0 290500
3201126 B 3 BS 1 05/03/2018 09/03/2018 01/06/1944 0 1
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 73910021 0 5 0 0 0 ONIM D386251
0001455726104 3;JKN DR RIZKI; 5.2.0.201712280730 4 156761
1#0##0#0#0.0#2018-03-19 09:06:18#0#12:00:00#12:00:00#12:00:00 1
fb4860324490c4f4705339ec61ef5588 0 10705000 9367860 0 0
43037161 0 0 0 0 1316000 0 0 0 0
9484000
3201126 B 2 BS 1 06/03/2018 09/03/2018 05/06/1971 0 2
1 M51.1;M47.86 - - - None None None None M-4-17-I
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 4057358 0 4 0 0 0 SUMIATI D098551
3;JKN DR RIZKI; 5.2.0.201712280730 4 157450 1#0##0#0#0.0#2018-
03-19 09:10:35#0#12:00:00#12:00:00#00:00:00 1
1bb9714bdbc1eac7555a1f3eb3f66b64 0 0 504286 0 0
1223637 0 0 0 0 2329435 0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 09/03/2018 01/01/1958 0 2
1 E14.9;E16.2;I11.9 - - - None None None None E-4-10-I
0 - 0 3502700 2221305 0 2 0 0 0 EIS
SUMATI D390780 60 21981 SRI KUNMARTINI.DR,SPPD 0138R01703180003559
0000510976833 3;JKN DR RIZKI; 5.2.0.201712280730 4 158316
1#0##0#0#0.0#2018-03-19 09:12:30#0#12:00:00#12:00:00#12:00:00 1
c804308b965c5eed389eca8edbc9d08d 0 0 616661 0 0 907325
0 0 0 0 697319 0 0 0 0 0
3201126 B 2 BS 1 08/03/2018 09/03/2018 20/09/1992 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3086326 0 2 0 0 0 YUDI SETIAWAN
0001868283246 3;JKN DR RIZKI; 5.2.0.201712280730 4 158619
1#0##0#0#0.0#2018-03-19 09:13:59#0#12:00:00#12:00:00#12:00:00 1
67c9397b1dfe3d0a2adef9577adfab4a 0 0 499265 0 0
1349152 0 0 0 0 1237910 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 09/03/2018 09/08/1962 0 1
1 I64;G81.9;I10 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 6844000 7126387 0
5 0 0 0 AGUS D392206 55 20297 DR NURUL KOMARI SPS
0138R01703180002197 0000036835029 3;JKN DR RIZKI; 5.2.0.201712280730
4 157148 1#0##0#0#0.0#2018-03-19
09:18:31#0#12:00:00#12:00:00#12:00:00 1 3de1846ad5e2983af321581caf99fdfd
0 0 754840 0 0 1974335 0 0 0 0
4397212 0 0 0 0 0
3201126 B 2 BS 1 03/03/2018 09/03/2018 17/08/1962 0 1
1 I50.0;K29.7 90.59;89.52;87.49 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4290800
7331128 0 7 0 0 0 AGUS BUDI PRAYITNO D387639
3;JKN DR RIZKI; 5.2.0.201712280730 4 156726 1#0##0#0#0.0#2018-
03-19 09:21:39#0#12:00:00#12:00:00#12:00:00 1
521caeadc07014b2bea8a1929b75266e 0 0 826149 0 0
2513176 0 0 0 0 3535803 0 0 0 456000
0
3201126 B 2 BS 1 08/03/2018 09/03/2018 23/05/1975 0 1
0 - 0 - 0 - 0 4101100 2640815 0 2
0 0 0 MUHAMMAD MUKHLIS D298958 42 15630 DR. ARU ARIADNO,
4 158317 1#0##0#0#0.0#2018-03-19
09:30:44#0#12:00:00#12:00:00#12:00:00 1 4cb5ffc96f29bea901fce62b67017c6f
0 0 498176 0 0 933875 0 0 0 0
1208764 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 09/03/2018 28/12/1981 0 1
1 E14.8;K29.7 90.59;87.49;88.76 - - None None None None E-4-
0 - 0 4903800 10220611 0 5 0 0 0 RA.EKI
ALFURQON D337265 36 13216 DR. ARU ARIADNO, SPPD 0138R01703180002183
0001212714505 3;JKN DR RIZKI; 5.2.0.201712280730 4 157145
1#0##0#0#0.0#2018-03-19 09:33:57#0#12:00:00#12:00:00#12:00:00 1
27d0cc712f6b47c17eb860da03d636a1 0 0 494342 0 0
5126631 0 0 0 0 4599638 0 0 0 0 0
3201126 B 1 BS 1 04/03/2018 09/03/2018 13/09/1948 0 1
1 I64;G81.9;E78.5;G90.0 87.03;87.44 - - None None None None
0 0 - 0 - 0 - 0 - 0 6844000
9660997 0 6 0 0 0 HAFRIZAL HAROEN D392115 69
DR RIZKI; 5.2.0.201712280730 4 156743 1#0##0#0#0.0#2018-03-19
09:35:53#0#12:00:00#12:00:00#12:00:00 1 fb4eee0a5dada50ec7ab434441501ab0
0 0 1020330 0 0 3296639 0 0 0 0
5344028 0 0 0 0 0
3201126 B 2 BS 1 08/03/2018 09/03/2018 01/05/2003 0 2
1743400 0 0 - 0 - 0 - 0 - 0
1743400 2248366 0 2 0 0 0 YASMINA NURUL WAFA
0001182220626 3;JKN DR RIZKI; 5.2.0.201712280730 4 158314
1#0##0#0#0.0#2018-03-19 09:42:47#0#12:00:00#12:00:00#12:00:00 1
40cbaeeb13cfdbe7c9d86050d11133c1 0 0 303524 0 0 761753
0 0 0 0 1183089 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 09/03/2018 14/12/1944 0 1
None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (RINGAN) 5164300
0 0 - 0 - 0 - 0 - 0 5164300
6034505 0 5 0 0 0 MULJOTO SOEBARDJO D392216 73
3;JKN DR RIZKI; 5.2.0.201712280730 4 157154 1#0##0#0#0.0#2018-
03-19 09:47:11#0#12:00:00#12:00:00#12:00:00 1
b2bd27f223910d5d1cc1ecc2952e406b 0 0 517787 0 0
1971937 0 0 0 0 3544781 0 0 0 0 0
3201126 B 1 BS 1 06/03/2018 09/03/2018 10/08/1934 0 1
1 J18.9;E14.9;A49.9;D29.1 87.44 - - None None None None J-4-
(RINGAN) 5058500 0 0 - 0 - 0 - 0 - 0
5058500 9028058 0 4 0 0 0 SYAWAL HASSAN
D388615 83 30524 DR SRI KUN, SPPD 0138R01703180002276
0001811786319 3;JKN DR RIZKI; 5.2.0.201712280730 4 157155
1#1#vvip#4#3969558#0.0#2018-03-19 09:54:06#0#12:00:00#12:00:00#12:00:00
1 bce5bbbc85e839b8b95fb0fa12ea2867 0 0 480118 0 0
2821319 0 0 0 0 5726621 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 09/03/2018 12/07/1957 0 1
1 I21.3;E11.9 - - - None None None None I-4-10-I None
0 - 0 - 0 - 0 - 0 4043000 1276682
0 1 0 0 0 JOKO TRIYONO D311479 60 22155 DR
NIKEN PRABHA DUHITA 0138R01703180004115 0000037649553 3;JKN DR RIZKI;
5.2.0.201712280730 4 158914 1#0##0#0#0.0#2018-03-19
11:07:31#0#00:00:00#06:30:00#00:00:00 1 7f2d2eaf46918065f0395dac9c5ffe75
0 0 649737 0 0 254424 0 0 0 0 372521
0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 09/03/2018 12/04/1968 0 1
0 - 0 - 0 - 0 1906700 967819 0 1
0 0 0 REINTJE SIMON HORHORUW D392333 49 18228 DR NIKEN
PRABHA DUHITA 0138R01703180004116 0001638585268 3;JKN DR RIZKI;
5.2.0.201712280730 4 158915 1#0##0#0#0.0#2018-03-19
11:12:50#0#00:00:00#03:07:00#12:00:00 1 0cc47a4c44ac87d0b82bc6ce7ae00acc
0 0 321804 0 0 293700 0 0 0 0 352315
0 0 0 0 0
3201126 B 2 BS 1 08/03/2018 09/03/2018 18/03/1962 0 1
- 0 10690500 11137712 0 2 0 0 0 NGADIMIN
0001296993284 3;JKN DR RIZKI; 5.2.0.201712280730 4 158896
1#0##0#0#0.0#2018-03-19 11:48:14#0#12:00:00#12:00:00#12:00:00 1
7ac87e86cafeb89c925a84d684db6dca 0 4721600 3153245 0 0
2409232 0 0 0 0 784635 0 0 0 0 69000
3201126 B 2 BS 1 07/03/2018 09/03/2018 02/08/1950 0 1
- 0 51950600 69457590 0 3 0 0 0 TEDDY HOUSEA
HAMDANI D392364 67 24689 DR AZRI NURIZAL SPPD KKV
0138R01703180003491 0001422940713 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159576 1#0##0#0#0.0#2018-03-28
21:04:37#0#12:00:00#12:00:00#12:00:00 1 4a3218357f69752ed4e713ffe3e7b793
0 9193500 8596860 0 0 42544230 0 0 0 0
1256000 0 0 0 0 7867000
3201126 B 1 BS 1 07/03/2018 09/03/2018 28/03/1954 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 68127050 0 3 0 0 0 NAZARIUS MULYADI
0001466484311 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158303
1#0##0#0#0.0#2018-03-28 21:05:44#0#12:00:00#12:00:00#12:00:00 1
f75e208ae7ebf837ba37dcdadd49a423 0 10407500 9619120 0 0
39275430 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 05/03/2018 09/03/2018 29/08/2013 0 1
0 - 0 2772200 4437271 0 5 0 0 0 SULTAN
KHOIRUL AZZAM PAKAYA D273556 4 1649 DR DYAH HARINI, SPA
0138R01703180002257 0001860055389 3;JKN DR RIZKI; 5.2.0.201712280730
4 157152 1#0##0#0#0.0#2018-03-29
08:39:13#1#12:00:00#12:00:00#12:00:00 1 90fbfd0cd091fcf42ead4d863cc7ef27
0 0 447210 0 0 2119052 0 0 0 0
1871009 0 0 0 0 0
3201126 B 2 BS 1 08/03/2018 09/03/2018 05/01/1952 0 1
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
0 5208600 7325702 0 2 0 0 0 A. SOPIANSYAH
0001480417492 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158830
1#0##0#0#0.0#2018-03-29 08:45:07#0#12:00:00#12:00:00#00:00:00 1
c7614cc3afd48e7165746d550e723c5b 0 4911100 1041720 0 0
803130 0 0 0 0 535252 0 0 0 0 34500
3201126 B 2 BS 1 08/03/2018 09/03/2018 20/01/1959 0 1
- 0 10690500 11707868 0 2 0 0 0 MOKH. MASKUR
0001882347118 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158900
1#0##0#0#0.0#2018-03-29 08:51:24#0#12:00:00#12:00:00#12:00:00 1
e33534246cd270601de0125248b2ec28 0 4514100 3153245 0 0
3149588 0 0 0 0 821935 0 0 0 0 69000
3201126 B 2 BS 1 07/03/2018 09/03/2018 26/04/2016 0 1
1 N47;N48.1;J45.9 - - - None None None None V-4-11-I
SELAIN TUMOR (RINGAN) 4431500 0 0 - 0 - 0 - 0
- 0 4431500 3667688 0 3 0 0 0 ZAVIER HASBY
HARTONO D375946 1 680 DR SRI SAPARNI, SPA 0138R01703180003763
0002084568737 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158534
1#0##0#0#0.0#2018-03-29 11:52:36#0#12:00:00#12:00:00#12:00:00 1
6027ad656260f5421dff8cc79850d2ba 0 0 451839 0 0
1094907 0 0 0 0 1780942 0 0 0 0 340000
3201126 B 3 BS 1 07/03/2018 09/03/2018 14/08/2010 0 2
1 T81.3;S42.31 79.61 - - None None None None M-1-80-II
10298800 0 0 - 0 - 0 - 0 - 0
10298800 8724579 0 3 0 0 0 SHAKIRA ALECYA PUTRI
D385923 7 2762 DR MARQUEE KENNY TUMBELAKA SPOT
0138R01703180003407 0001745136584 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 158299 1#0##0#0#0.0#2018-03-29
12:21:45#0#12:00:00#12:00:00#12:00:00 1 b4fff386951134f174d9d7a9bbc4ae54
0 3939600 2883664 0 0 1304548 0 0 0 0
596767 0 0 0 0 0
3201126 B 1 BS 1 08/03/2018 09/03/2018 26/03/1961 0 2
1 I12.0;D63.8 - - - None None None None N-4-10-II None
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 10171058 0 2 0 0 0 ERNA MARDIANA NY
0000093184075 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158897
1#1#vvip#2#4386158#0.0#2018-03-29 12:23:40#0#12:00:00#12:00:00#00:00:00
1 86aa1baa0c9df1d94c4d66bcc451d4cf 0 0 964122 0 0
5396790 0 0 0 0 3810146 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 09/03/2018 01/08/1973 0 2
2 I61.9;I11.9 - - - None None None None G-4-13-I None
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 3631408 0 1 0 0 0 ENDANG SURYATI
0000998575187 3;JKN DR RIZKI; 5.2.0.201712280730 4 158918
1#0##0#0#0.0#2018-03-29 16:12:16#0#00:00:00#16:30:00#12:00:00 1
6c33b7e2486c8fcf7a7f73dc1171653b 0 0 322857 0 0
2781982 0 0 0 0 289000 0 0 0 237569
0
3201126 B 3 BS 1 09/03/2018 09/03/2018 10/02/1954 0 2
1 M54.57;R51 - - - None None None None M-4-17-I None
(RINGAN) 3687800 0 0 - 0 - 0 - 0 - 0
3687800 2115071 0 1 0 0 0 NUNUNG,NY. D392553
0000060744868 3;JKN DR RIZKI; 5.2.0.201712280730 4 160070
1#0##0#0#0.0#2018-03-29 16:15:54#0#12:00:00#12:00:00#12:00:00 1
5be43894e475b60265ead9c31f20b3e8 0 0 331902 0 0
1355800 0 0 0 0 401369 0 0 0 26000 0
3201126 B 3 BS 1 09/03/2018 09/03/2018 23/06/1941 0 2
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1015145 0 1 0 0 0 EUNIKE WAGINI
D310626 76 28018 DR VINSENSIA NOVI KARTIKA 0138R01703180004399
0001338071861 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159250
1#0##0#0#0.0#2018-04-05 11:25:05#0#12:00:00#12:00:00#00:00:00 1
6bceb860f08d9d77dc6b338cab53c4d3 0 0 378234 0 0 281500
0 0 0 0 355411 0 0 0 0 0
3201126 B 3 BS 1 06/03/2018 09/03/2018 01/01/1997 0 2
- 0 - 0 - 0 - 0 3874400 8851345 0
4 0 0 0 ANISA SUCIATI D392301 21 7734 DR HENDRIEK
5.2.2.201806040537 4 157747 1#0##0#0#0.0#2018-08-15
12:06:58#0#12:00:00#12:00:00#12:00:00 2 49e9b18f073102d752b588f265b2040d
0 3322000 1556832 0 0 3248453 0 0 0 0
655060 0 0 0 0 69000
3201126 B 1 BS 1 07/03/2018 09/03/2018 11/03/2007 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2894333 0 3 0 0 0 NAILA TALITHA RIZKIA
0001079552845 3;JKN DR RIZKI; 5.2.2.201806040537 4 158307
1#0##0#0#0.0#2018-09-06 11:34:10#0#12:00:00#12:00:00#12:00:00 2
69a57fbc350e8940c941d92da42d709d 0 0 345275 0 0 771709
0 0 0 0 1777349 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 09/03/2018 12/07/1957 0 1
0 - 0 - 0 - 0 - 0 4043000 1276682
0 1 0 0 0 JOKO TRIYONO D311479 60 22155 DR
NIKEN PRABHA DUHITA 0138R0170318V000027 0000037649553 3;JKN DR RIZKI;
5.2.2.201806040537 4 227341 1#0##0#0#0.0#2018-09-26
13:49:50#0#00:00:00#00:00:00#00:00:00 1 95db90bc1582c0e64e6c9bf6d6df81a9
0 0 649737 0 263000 254424 0 0 0 0
83521 0 0 26000 0 0
3201126 B 1 BS 1 07/03/2018 10/03/2018 16/02/2011 0 2
1 N39.0;N30.9;N13.0 88.76 - - None None None None N-4-12-II
None None None None None None INFEKSI GINJAL DAN SALURAN URIN (SEDANG)
5888400 0 0 - 0 - 0 - 0 - 0
5888400 5193294 0 4 0 0 0 JANEETA KAMIILA RAHMAH
D203507 7 2576 DR RASTRA, SPA 0138R01703180003269
0002229521837 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158144
1#0##0#0#0.0#2018-03-19 09:00:00#0#12:00:00#12:00:00#12:00:00 2
80a9fcbd140fba20a701107f8fce623a 0 0 354482 0 0
1349064 0 0 0 0 3489748 0 0 0 0 0
3201126 B 1 BS 1 08/03/2018 10/03/2018 08/03/2018 2910 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1818592 0 3 0 0 0 BAYI NY THERESIA
OKTARIANA SITORUS D392518 0 0 DR DYAH HARINI, SPA
0138R01703180004408 0002437966743 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159260 1#0##0#0#0.0#2018-03-19
09:09:32#0#12:00:00#12:00:00#12:00:00 1 24ca3f01b8f871ffb556dd2f7219753b
0 0 499620 0 0 156499 0 0 0 0
1162473 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 10/03/2018 14/11/1974 0 2
1 R10.1 89.52;90.59 - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 6418167 0 6 0 0 0 ELFINUR ZETHA RAHMAN
0001462949008 3;JKN DR RIZKI; 5.2.0.201712280730 4 157151
1#0##0#0#0.0#2018-03-19 11:43:19#0#12:00:00#12:00:00#00:00:00 1
52b72a051e1a9adb0e6a34970ecea4c9 0 0 292275 0 0
1775012 0 0 0 0 4350880 0 0 0 0 0
3201126 B 3 BS 1 07/03/2018 10/03/2018 25/02/1939 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2558634 0 4 0 0 0 MARLIS ISKANDAR
0001335638013 3;JKN DR RIZKI; 5.2.0.201712280730 4 158306
1#0##0#0#0.0#2018-03-19 11:45:32#0#12:00:00#12:00:00#12:00:00 1
76d906ff679f7474223a1e991aa5617f 0 0 368243 0 0
1208004 0 0 0 0 982387 0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 10/03/2018 13/09/2004 0 2
- 0 - 0 - 0 - 0 3874400 8260008 0
3 0 0 0 AGHNIA RIDHOWI D391057 13 4924 DR CATUR S,
SPB 0138R01703180003689 0002271398771 3;JKN DR RIZKI; 5.2.0.201712280730
4 158413 1#0##0#0#0.0#2018-03-20
12:01:51#0#12:00:00#12:00:00#12:00:00 1 bb4b184b596fac8b05ee23dacd612ae6
0 3617900 1138832 0 0 2817902 0 0 0 0
616374 0 0 0 0 69000
3201126 B 1 BS 1 08/03/2018 10/03/2018 08/10/1986 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 12245772 0 3 0 0 0 THERESIA OKTARIANA
SITORUS D327199 31 11474 DR ERDIYAN, SPOG 0138R01703180003668
0002067971084 3;JKN DR RIZKI; 5.2.0.201712280730 4 158387
1#0##0#0#0.0#2018-03-20 15:14:28#0#12:00:00#12:00:00#12:00:00 1
b72a2604524ba11272ca3b3ceeacd4a6 0 7098900 2303895 0 0
1891852 0 0 0 0 882125 0 0 0 0 69000
3201126 B 3 BS 1 08/03/2018 10/03/2018 09/02/2011 0 1
(RINGAN) 8640200 0 0 - 0 - 0 - 0 - 0
8640200 8803761 0 3 0 0 0 MUHAMMAD RAFA KEANDRA
0002210529969 3;JKN DR RIZKI; 5.2.0.201712280730 4 158484
1#0##0#0#0.0#2018-03-20 15:15:20#0#12:00:00#12:00:00#12:00:00 1
5f750fb76b52f58c63b140986fb353af 0 3611800 2505658 0 0
1879356 0 0 0 0 661947 0 0 0 0 145000
3201126 B 1 BS 1 06/03/2018 10/03/2018 03/10/1978 0 2
1 O82.9;O99.0;O13;Z37.1 66.32;74.0 - - None None None None
(SEDANG) 7567300 0 0 - 0 - 0 - 0 - 0
7567300 34405350 0 5 0 0 0 RIKA OKTINA D107231
39 14399 DR ARJU A, SPOG 0138R01703180002866 0000036504336 3;JKN
DR RIZKI; 5.2.0.201712280730 4 157745
1#1#vvip#5#26838050#0.0#2018-03-20 15:30:53#0#12:00:00#12:00:00#12:00:00
1 dc7dfabd0560e83c82d13015ab171837 0 10942700 9666000 0
0 12313650 0 0 0 0 1286000 0 0 0 0
197000
3201126 B 1 BS 1 02/03/2018 10/03/2018 22/04/1956 0 1
1 E11.5;A41.9;D63.8;I73.9 84.15;90.59;87.49;89.52;99.04 - - None
None None None M-1-02-III None None None None None None AMPUTASI
(BERAT) 35990300 0 0 - 0 - 0 - 0 - 0
35990300 45972647 0 9 0 0 0 SUHENDI D391881
61 22594 DR ARU, SPPD 0138R01703180000813 0000037481084 3;JKN
DR RIZKI; 5.2.0.201712280730 4 156330 1#0##0#0#0.0#2018-03-20
15:38:21#0#12:00:00#12:00:00#12:00:00 1 e66f9b2e52753606ffac69a2d6272d58
0 11845200 15074120 0 0 17240327 0 0 0 0
1301000 0 0 0 512000 0
3201126 B 3 BS 1 09/03/2018 10/03/2018 15/04/1974 0 2
1 D64.9;J45.9;E11.9 99.04;87.44;93.94 - - None None None None
D-4-13-I None None None None None None GANGGUAN SEL DARAH MERAH
0 - 0 - 0 2987000 3206835 0 2 0 0
0 ABDI SITI KOMALA D028760 43 16034 DR BETTY DWI L, SPPD
0138R01703180004112 0001459619493 3;JKN DR RIZKI; 5.2.0.201712280730
4 158909 1#0##0#0#0.0#2018-03-21
09:03:48#0#12:00:00#12:00:00#12:00:00 1 ed5b735b6214e2494a9281ca2d2396be
0 0 321830 0 0 2123212 0 0 0 0 761793
0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 10/03/2018 12/07/1942 0 1
1 K92.1;R10.1;D29.1 88.76 - - None None None None K-4-18-I
(RINGAN) 1452800 0 0 - 0 - 0 - 0 - 0
1452800 1771988 0 2 0 0 0 KIYAR D392523 75
DR RIZKI; 5.2.0.201712280730 4 158908 1#0##0#0#0.0#2018-03-21
09:06:21#0#12:00:00#12:00:00#12:00:00 2 3266cba977bcdf8bbd75e089a36bd768
0 0 261764 0 0 842300 0 0 0 0 667924
0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 10/03/2018 01/07/1978 0 2
1 K25.3;R63.0 45.16;89.52 - - None None None None K-4-11-I
2319600 0 0 - 0 - 0 - 0 - 0
2319600 5819192 0 2 0 0 0 SITI ASTUTI D391879
3;JKN DR RIZKI; 5.2.0.201712280730 4 159425 1#0##0#0#0.0#2018-
03-21 09:08:23#0#12:00:00#12:00:00#12:00:00 1
58387b385a5264c01b8459186dc3a617 0 1155500 765488 0 0
1584509 0 0 0 0 436695 0 0 0 0
1877000
3201126 B 1 BS 1 09/03/2018 10/03/2018 08/04/1943 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5671742 0 2 0 0 0 UNTUNG SARTONO
0000060683602 3;JKN DR RIZKI; 5.2.0.201712280730 4 158990
1#0##0#0#0.0#2018-03-21 09:09:18#0#12:00:00#12:00:00#12:00:00 1
71e66239b6fa06280971e4892fa98649 0 0 573641 0 0
3139052 0 0 0 0 1959049 0 0 0 0 0
3201126 B 2 BS 1 04/03/2018 10/03/2018 18/11/1969 0 1
1 I63.9;I10 87.03;90.59;89.52 - - None None None None G-4-
INFARK (RINGAN) 6015800 0 0 - 0 - 0 - 0 -
0 6015800 6520197 0 7 0 0 0 MUNAWAR
0001317327491 3;JKN DR RIZKI; 5.2.0.201712280730 4 156728
1#0##0#0#0.0#2018-03-21 10:02:27#0#12:00:00#12:00:00#12:00:00 1
95ea2434e78ac2bc55130cf470123534 0 0 1066638 0 0
1971004 0 0 0 0 3482555 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 10/03/2018 05/06/1942 0 1
5802600 0 0 - 0 - 0 - 0 - 0
5802600 7989386 0 6 0 0 0 DAUD MARTADISASTRA
0000043230363 3;JKN DR RIZKI; 5.2.0.201712280730 4 156762
1#0##0#0#0.0#2018-03-21 10:09:46#0#12:00:00#12:00:00#12:00:00 1
7fa4c99daf49f6d4ff91a21d30a4baa5 0 0 927134 0 0
1827582 0 0 0 0 5234670 0 0 0 0 0
3201126 B 1 BS 1 07/03/2018 10/03/2018 09/09/1958 0 2
1 I63.9;M54.39 93.19;87.03 - - None None None None G-4-
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 6094506 0 4 0 0 0 ELLYS SURYANI
0001335727372 3;JKN DR RIZKI; 5.2.0.201712280730 4 157759
1#0##0#0#0.0#2018-03-21 10:24:16#0#12:00:00#12:00:00#12:00:00 1
2f8bc176182b261b48a7e996c92791f7 0 0 754840 0 0
1790960 0 0 0 0 3548706 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 10/03/2018 26/06/1994 0 2
1 K29.6;K20 45.16 - - None None None None K-4-11-I None
0 0 - 0 - 0 - 0 - 0 2319600
4903239 0 2 0 0 0 AULIA PRIMANANDA D392237 23
DR RIZKI; 5.2.0.201712280730 4 159427 1#0##0#0#0.0#2018-03-21
10:26:04#0#12:00:00#12:00:00#12:00:00 1 a75c699298e8f1ec97bc504ecc0a80fa
0 1155500 459784 0 0 1192182 0 0 0 0
346773 0 0 0 0 1749000
3201126 B 1 BS 1 08/03/2018 10/03/2018 15/05/1948 0 1
1 N43.1;A16.1;I50.0 63.1;90.59;88.76;87.49 - - None None None
None V-1-12-II None None None None None None PROSEDUR PADA SKROTUM
DAN PROSTAT KOMPLEK-MODERAT (SEDANG) 17029400 0 0 - 0 -
0 - 0 - 0 17029400 14965323 0 3 0 0
0 J Z JOKO SANTOSO D391541 69 25499 DR HENDRIEK S, SPB
0138R01703180003562 0000060710826 3;JKN DR RIZKI; 5.2.0.201712280730
4 158318 1#0##0#0#0.0#2018-03-21
10:27:47#0#12:00:00#12:00:00#12:00:00 1 7944ea197556472fcb811b8aa5b3795b
0 7159200 3870816 0 0 2811267 0 0 0 0
1055040 0 0 0 0 69000
3201126 B 1 BS 1 07/03/2018 10/03/2018 11/01/1961 0 1
- 0 - 0 - 0 - 0 4784600 4694356 0
4 0 0 0 OMAY TRI KOMARA D195893 57 20874 DR BETTY DWI
5.2.0.201712280730 4 158304 1#0##0#0#0.0#2018-03-21
10:51:53#0#12:00:00#12:00:00#12:00:00 3 d708fee7934b2b419f468a13c3e53473
0 0 572372 0 0 1445877 0 0 0 0
2676107 0 0 0 0 0
3201126 B 1 BS 1 08/03/2018 10/03/2018 08/03/2018 2700 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3043742 0 3 0 0 0 BAYI NY LULUS NUGRAHENI
0002437574466 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158633
1#1#vip#3#3838500#75.0#2018-03-27 15:12:06#0#12:00:00#12:00:00#12:00:00
1 bdeaf4d7516276b9d2a348fb720034b6 0 0 499620 0 0
156499 0 0 0 0 2387623 0 0 0 0 0
3201126 B 1 BS 1 10/03/2018 10/03/2018 24/11/1952 0 1
- 0 46734600 56492971 0 1 0 0 0 MULYANTO
0000060829323 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159449
1#0##0#0#0.0#2018-03-28 18:45:02#0#12:00:00#12:00:00#12:00:00 1
f2651a65926c69087ca934f0cab822f7 0 9553000 1536940 0 0
36578031 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 08/03/2018 10/03/2018 03/02/1971 0 1
1 C85.9;D63.0;A49.9 99.04;04.11 - - None None None None C-4-
11-II None None None None None None LIMFOMA & LEUKEMIA NON AKUT (SEDANG)
7110000 0 0 - 0 - 0 - 0 - 0
7110000 6146188 0 3 0 0 0 RUDY FRANSCISCO KAIIN
0001453810882 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158847
1#0##0#0#0.0#2018-03-28 18:57:15#0#12:00:00#12:00:00#12:00:00 1
9166e8601b582ba2030e43a50d9648b8 0 0 964000 0 0
3239101 0 0 0 0 1943087 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 10/03/2018 12/06/1979 0 1
1 R07.3 90.59;89.52 - - None None None None I-4-20-I None
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1628790 0 1 0 0 0 ZULHIMMAH PRAWIRA
0001259789951 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159626
1#0##0#0#0.0#2018-03-28 18:59:39#0#12:00:00#12:00:00#12:00:00 1
19fe73fa09498ab47cf428f42ccd6b27 0 0 378234 0 0 855000
0 0 0 0 395556 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 10/03/2018 06/06/1984 0 2
1 I21.1;R07.4 - - - None None None None I-4-10-I None
0 - 0 - 0 - 0 - 0 4043000 1463101
0 2 0 0 0 DERI ANGRIANI, ST D348186 33 12329 DR
ADRIAN HANDARU 0138R01703180004564 0001134343888 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159415 1#0##0#0#0.0#2018-03-28
20:59:11#0#12:00:00#12:00:00#12:00:00 1 dc93232d4225c7958e3675338fccb0ce
0 0 610344 0 0 468040 0 0 0 0 384717
0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 10/03/2018 14/10/1969 0 1
- 0 36446400 45112130 0 3 0 0 0 ANANG RUSDI
0001446446575 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158414
1#0##0#0#0.0#2018-03-28 21:07:37#0#12:00:00#12:00:00#12:00:00 1
97fb6c4657be7dc0f86408fb5cb20fe7 0 8675000 5144120 0 0
22399010 0 0 0 0 1256000 0 0 0 0
7638000
3201126 B 3 BS 1 09/03/2018 10/03/2018 01/04/1953 0 2
- 0 - 0 - 0 - 0 4043000 2123133 0
2 0 0 0 WAGINAH D392614 64 23718 DR RENDRA RAMADYA
0138R01703180004616 0001014228101 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159428 1#0##0#0#0.0#2018-03-29
07:30:58#0#12:00:00#12:00:00#12:00:00 1 e800d3fb8cd417311cc9c742ca0fe17c
0 0 363870 0 0 597366 0 0 0 0 445897
0 0 0 0 716000
3201126 B 1 BS 1 09/03/2018 10/03/2018 27/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 3247500
5977958 0 2 0 0 0 MARIA MALIK D068986 65 23813
TANTIYO S;16137 5.2.0.201712280730 4 159419 1#0##0#0#0.0#2018-
03-29 07:44:07#0#12:00:00#12:00:00#12:00:00 1
0afe8280b608f7d449d491c00f785d81 0 0 962300 0 0 989577
0 0 0 0 2346081 0 0 0 0 1680000
3201126 B 3 BS 1 09/03/2018 10/03/2018 18/11/1988 0 1
0 - 0 - 0 - 0 - 0 2319600 4687456
0 2 0 0 0 ANDI D185803 29 10703 DR. ARU ARIADNO,
5.2.0.201712280730 4 159418 1#0##0#0#0.0#2018-03-29
07:45:08#0#12:00:00#12:00:00#12:00:00 1 33d59ffe62cb84032af62e5a2190ecbc
0 0 702488 0 0 730312 0 0 0 0
1574656 0 0 0 0 1680000
3201126 B 1 BS 1 08/03/2018 10/03/2018 15/12/1971 0 2
1 D64.9;N20.0 99.04 - - None None None None D-4-13-II None
- 0 5918600 6135575 0 3 0 0 0 INTAN SAKTI
UMI YATIE D297301 46 16885 DR. ARU ARIADNO, SPPD 0138R01703180003553
0001657057803 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159640
1#0##0#0#0.0#2018-03-29 07:51:00#0#12:00:00#12:00:00#12:00:00 1
be6b65a36b32a9764134ff618d0b8502 0 0 429362 0 0
2935820 0 0 0 0 2770393 0 0 0 0 0
3201126 B 2 BS 1 09/03/2018 10/03/2018 28/09/1993 0 2
2783600 0 0 - 0 - 0 - 0 - 0
2783600 5811438 0 2 0 0 0 PUTRI SEPTIANI INDRIA
0002226326163 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159416
1#0##0#0#0.0#2018-03-29 08:04:47#0#12:00:00#12:00:00#12:00:00 1
258b27e073e5fb63588de01a94defe6e 0 0 1045824 0 0
1095426 0 0 0 0 1921188 0 0 0 0
1749000
3201126 B 1 BS 1 07/03/2018 10/03/2018 07/07/1979 0 2
0 0 - 0 - 0 - 0 - 0 6981500
23282614 0 4 0 0 0 LULUS NUGRAHENI D330100 38
14123 DR NINING H, SPOG 0138R01703180003525 0000042147257 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 158305
1#1#vvip#4#16301114#0.0#2018-03-29 08:27:42#0#12:00:00#12:00:00#12:00:00
1 8a2c11a74e0ec0516509029d2383a31d 0 9528900 8607837 0
0 3647877 0 0 0 0 1301000 0 0 0 0
197000
3201126 B 1 BS 1 08/03/2018 10/03/2018 03/06/1966 0 1
0 - 0 - 0 - 0 - 0 7464200 11308268
0 3 0 0 0 SARYONO D254286 51 18906 DR H TEDDY H
5.2.0.201712280730 4 158439 1#0##0#0#0.0#2018-03-29
08:40:40#0#12:00:00#12:00:00#12:00:00 1 a6fe48af6d0557c455bed2ccf658971e
0 6587000 2451544 0 0 1404931 0 0 0 0
795793 0 0 0 0 69000
3201126 B 2 BS 1 08/03/2018 10/03/2018 05/10/1960 0 1
1 I11.0;N13.3;I79.0;N39.0 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4973600
7696735 0 3 0 0 0 SUHADI D392370 57 20973
DR BETTY DWI L, SPPD 0138R01703180003554 0001907851781 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 158311 1#0##0#0#0.0#2018-
03-29 08:43:56#0#12:00:00#12:00:00#12:00:00 1
5be33da3dd7e3b85a597dc0e176fb5d3 0 0 1002260 0 0
3738950 0 0 0 0 2044525 0 0 0 0 911000
3201126 B 1 BS 1 09/03/2018 10/03/2018 23/12/1962 0 1
- 0 58821400 66323585 0 2 0 0 0 SUPRIYADI
0000061090727 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158996
1#0##0#0#0.0#2018-03-29 11:57:26#0#12:00:00#12:00:00#00:00:00 1
63a1e4d4742017663f43378d8c18131b 0 10062000 9619120 0 0
37886465 0 0 0 0 1256000 0 0 0 0
7500000
3201126 B 1 BS 1 09/03/2018 10/03/2018 09/05/1970 0 2
- 0 - 0 5576700 7651022 0 2 0 0 0
MARIA ONA LEWAR D296772 47 17471 DR. ARU ARIADNO, SPPD
0138R01703180004183 0001381329854 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 158920 1#0##0#0#0.0#2018-03-29
12:15:13#0#12:00:00#12:00:00#12:00:00 1 791b9f89da65df3d1d4fdfba91f5fe5b
0 0 1014016 0 0 1830972 0 0 0 0
2981034 0 0 0 0 1825000
3201126 B 3 BS 1 10/03/2018 10/03/2018 05/12/1963 0 2
- 0 8908800 9847963 0 1 0 0 0 TARSIH
0001383280615 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159443
1#0##0#0#0.0#2018-03-29 12:16:24#0#12:00:00#12:00:00#12:00:00 1
4d74ec54dd566b2ef03766543aa45ea1 0 3355800 2636552 0 0
3086352 0 0 0 0 700259 0 0 0 0 69000
3201126 B 3 BS 1 10/03/2018 10/03/2018 08/10/1994 0 1
1 N45.9 - - - None None None None V-4-11-I None None
(RINGAN) 3692900 0 0 - 0 - 0 - 0 - 0
3692900 881066 0 1 0 0 0 TEGUH MUJAKAR
D392620 23 8554 DR RENDRA RAMADYA 0138R01703180004638
0001459477967 3;JKN DR RIZKI; 5.2.0.201712280730 4 159448
1#0##0#0#0.0#2018-03-31 09:19:58#0#01:00:00#09:10:00#12:00:00 1
a29e933abbe96a07b2665019929ff50c 0 0 332361 0 0 202065
0 0 0 0 346640 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 10/03/2018 16/08/1998 0 1
(RINGAN) 3692900 0 0 - 0 - 0 - 0 - 0
3692900 1672879 0 1 0 0 0 YUDHA SUHARDIANTO
0001968527564 3;JKN DR RIZKI; 5.2.0.201712280730 4 159452
1#0##0#0#0.0#2018-03-31 11:30:37#0#12:00:00#12:00:00#12:00:00 1
c0196c3df2400603ff1f44a0b1a0d8ff 0 0 332361 0 0 942077
0 0 0 0 398441 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 10/03/2018 31/10/2011 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6666570 0 2 0 0 0 ABDUL QODIR ASSEGAP
d391948 6 2321 DR ASRI RAHMAWATI SPB 0138R01703180004222
0001211608427 3;JKN DR RIZKI; 5.2.1.201802140120 4 158931
1#0##0#0#0.0#2018-04-17 11:06:43#0#12:00:00#12:00:00#12:00:00 1
f62ffafb285a0b1bab13313294d3c11a 0 3438800 1014912 0 0
1555727 0 0 0 0 512131 0 0 0 0 145000
3201126 B 3 BS 1 09/03/2018 10/03/2018 01/02/1955 0 2
1 J22;I50.0 87.44 - - None None None None J-4-21-II None
LAIN-LAIN (SEDANG) 4508300 0 0 - 0 - 0 - 0
- 0 4508300 1360266 0 2 0 0 0 ROKIAH
d371253 63 23047 DR VINSENSIA NOVI KARTIKA 0138R01703180004567
0000511937976 3;JKN DR RIZKI; 5.2.1.201802140120 4 160069
1#0##0#0#0.0#2018-04-17 16:25:18#0#12:00:00#12:00:00#00:00:00 1
46c727b56d9c37322fa4ae5f790e4c66 0 0 456975 0 0 397302
0 0 0 0 377989 0 0 0 0 128000
3201126 B 3 BS 1 03/03/2018 10/03/2018 31/12/1949 0 1
1 I50.0;J22;N18.9;I44.3;I25.0 87.44;93.94;88.72 - - None None
None None I-4-12-II None None None None None None KEGAGALAN JANTUNG
(SEDANG) 4144700 0 0 - 0 - 0 - 0 - 0
4144700 21476680 0 8 1 6 0 SAMIN HS D389095
0001459427095 3;JKN DR RIZKI; 5.2.2.201806040537 4 156574
1#0##0#0#0.0#2018-08-09 11:46:13#0#12:00:00#12:00:00#12:00:00 2
46e5a8e7429d34f1ab08652d4cde2481 0 0 852524 0 0
9841656 0 0 0 0 6696500 0 0 0 0
4086000
3201126 B 2 BS 1 04/03/2018 10/03/2018 21/09/1969 0 1
1 H81.3;K29.7;N39.0 88.76;89.52;90.59 - - None None None None
U-4-11-II None None None None None None DYSEQUILIBRIUM (SEDANG)
2648400 0 0 - 0 - 0 - 0 - 0
2648400 6429002 0 7 0 0 0 JOHN T MANTOUW
0001379784161 3;JKN DR RIZKI; 5.2.2.201806040537 4 156757
1#0##0#0#0.0#2018-08-10 08:32:11#0#12:00:00#12:00:00#00:00:00 2
26eabacd803a59b3ee5a87e8f9f1cf32 0 0 422099 0 0
2530314 0 0 0 0 3476589 0 0 0 0 0
3201126 B 1 BS 1 10/03/2018 10/03/2018 22/02/1984 0 1
- 0 - 0 - 0 - 0 4784600 7568143 0
1 0 0 0 IQBAL NOOR HABIEB D392598 34 12435 DR SIDDHI
ANDIKA, SPU 0138R01703180004623 0000200269708 3;JKN DR RIZKI;
5.2.0.201712280730 4 159434 1#1#vvip#1#2783543#0.0#2018-09-06
17:03:01#0#12:00:00#12:00:00#12:00:00 2 fd1a194d04de91ab7f078e4838b2039b
0 0 806574 0 0 4965457 0 0 0 0
1796112 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 11/03/2018 27/05/2017 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4217510 0 3 0 0 0 NAJLA JELITA RAMADHANI
0002253682574 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158906
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3201126 B 3 BS 1 09/03/2018 11/03/2018 10/12/1953 0 1
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13:15:58#0#12:00:00#12:00:00#12:00:00 1 d29c68d57ac9e14decde18087fdd0add
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GINJAL (BERAT) 8508800 0 0 - 0 - 0 - 0 -
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3201126 B 3 BS 1 10/03/2018 11/03/2018 12/12/1945 0 2
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1#0##0#0#0.0#2018-03-27 15:17:07#0#12:00:00#12:00:00#12:00:00 1
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1#0##0#0#0.0#2018-03-28 10:07:40#0#12:00:00#12:00:00#12:00:00 1
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1733282 0 0 0 0 1790738 0 0 0 0 0
3201126 B 3 BS 1 11/03/2018 11/03/2018 16/03/1994 0 2
1 S09.9 86.28 - - None None None None G-4-24-I None None
None None None None TRAUMA KEPALA (RINGAN) 3043100 0 0 -
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21:00:53#0#12:00:00#12:00:00#12:00:00 1 c2a6ae9d90f79ff44898627261f8eb33
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3201126 B 3 BS 1 11/03/2018 11/03/2018 01/05/1968 0 2
1 I20.0;I10;K30 - - - None None None None I-4-20-I
4202600 0 0 - 0 - 0 - 0 - 0
4202600 2010654 0 1 0 0 0 SUSI MANDU CHAIRONY
D392759 49 18211 DR DICKY KARUNDENG 0138R01703180004945
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1#0##0#0#0.0#2018-03-28 21:03:34#0#12:00:00#12:00:00#12:00:00 1
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1211882 0 0 0 0 420538 0 0 0 0 0
3201126 B 1 BS 1 10/03/2018 11/03/2018 29/05/1965 0 1
1 N18.5;D63.8;J18.0 39.27;99.04 - - None None None None N-1-
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SONNY R B SIANTURI D388380 52 19278 DR SRI KUNMARTINI, SPPD
0138R01703180004808 0001262194615 3;JKN TANTIYO S;16137
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07:53:03#0#12:00:00#12:00:00#12:00:00 2 cca09e4714b1fe56fe25cf262ca5fbd5
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3201126 B 1 BS 1 09/03/2018 11/03/2018 19/09/1949 0 1
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1#0##0#0#0.0#2018-03-29 07:58:15#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 07/03/2018 11/03/2018 06/04/1947 0 2
1 M54.56;E87.6;E87.1 - - - None None None None M-4-
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(SEDANG) 7221000 0 0 - 0 - 0 - 0 - 0
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3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158308
1#0##0#0#0.0#2018-03-29 08:46:27#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 10/03/2018 11/03/2018 03/01/1950 0 2
1 E16.2 90.59;89.52 - - None None None None E-4-10-I None
- 0 3502700 1719840 0 2 0 0 0 ENAH
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1#0##0#0#0.0#2018-03-29 08:48:53#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 08/03/2018 11/03/2018 01/06/2010 0 1
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03-29 08:50:21#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 09/03/2018 11/03/2018 01/11/1963 0 2
1 M54.37;G83.1 87.44 - - None None None None M-4-17-I
(RINGAN) 3687800 0 0 - 0 - 0 - 0 - 0
3687800 3053722 0 3 0 0 0 ASMI d392543 54
TANTIYO S;16137 5.2.0.201712280730 4 159417 1#0##0#0#0.0#2018-
03-29 08:57:22#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 09/03/2018 11/03/2018 23/07/1975 0 1
1 D64.9;K29.6;K92.1;I10 99.04 - - None None None None D-4-
0 - 0 3584400 4491505 0 3 0 0 0
MUHAMAD RUSYDI D392580 42 15570 DR BETTY DWI L, SPPD
0138R01703180004553 0002267864616 3;JKN TANTIYO S;16137
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08:59:22#0#12:00:00#12:00:00#12:00:00 1 853f9c2700867ce5ea2005478718078f
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3201126 B 3 BS 1 08/03/2018 11/03/2018 06/05/2015 0 1
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1#0##0#0#0.0#2018-03-29 09:01:25#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 10/03/2018 11/03/2018 18/07/1958 0 2
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1#0##0#0#0.0#2018-03-29 11:24:06#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 06/03/2018 11/03/2018 27/01/1939 0 2
1 L02.8;D69.6;A41.9 88.01 - - None None None None L-4-12-III
None None None None None None PERADANGAN KULIT/CELLULITIS (BERAT)
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TANTIYO S;16137 5.2.0.201712280730 4 157743 1#0##0#0#0.0#2018-
03-29 11:44:32#0#12:00:00#12:00:00#12:00:00 1
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4433205 0 0 0 0 3648342 0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 11/03/2018 10/06/1947 0 1
1 A09.9;R11 - - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
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3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158632
1#0##0#0#0.0#2018-03-29 11:48:48#0#12:00:00#12:00:00#12:00:00 1
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2615320 0 0 0 0 1364829 0 0 0 0 0
3201126 B 3 BS 1 09/03/2018 11/03/2018 25/11/2000 0 1
1 H60.0 18.39 - - None None None None U-1-20-I None None
None None None None PROSEDUR TENGGOROKAN, MULUT, HIDUNG DAN TELINGA LAIN-
LAIN (RINGAN) 6189700 0 0 - 0 - 0 - 0 -
0 6189700 6663318 0 3 0 0 0 MUHAMAD RAFLI
d390414 17 6313 DR ASNOMINANDA, SPHT 0138R01703180004598
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1#0##0#0#0.0#2018-03-29 11:51:13#0#12:00:00#12:00:00#12:00:00 1
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1766460 0 0 0 0 521918 0 0 0 0 69000
3201126 B 1 BS 1 09/03/2018 11/03/2018 30/03/1962 0 1
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0 3 0 0 0 KLINIUS SERAN D392202 55 20433 DR
AGOES KOOSHARTORO SPPD 0138R01703180004308 0001642154523 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 159152 1#0##0#0#0.0#2018-03-29
11:55:48#0#12:00:00#12:00:00#12:00:00 1 cd93bb0ed0512a72dac941a4bd6dd53a
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3201126 B 1 BS 1 09/03/2018 11/03/2018 31/12/1952 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
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1#0##0#0#0.0#2018-03-29 11:59:35#0#12:00:00#12:00:00#12:00:00 1
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32023715 0 0 0 0 1256000 0 0 0 0
7628000
3201126 B 1 BS 1 09/03/2018 11/03/2018 20/04/1974 0 1
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0138R01703180004325 0001623369104 3;JKN TANTIYO S;16137
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12:01:02#0#12:00:00#12:00:00#12:00:00 1 51e27800cadce04e2d804317f397fd85
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1256000 0 0 0 0 7500000
3201126 B 1 BS 1 10/03/2018 11/03/2018 29/10/1962 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2380876 0 2 0 0 0 INTAN MURNIATI, NY
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1#0##0#0#0.0#2018-03-29 12:11:22#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 2 BS 1 09/03/2018 11/03/2018 07/12/2016 0 1
1 A09.9;J06.9 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2487292 0 3 0 0 0 AHMAD ALMALIKI ASYAFI
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1#0##0#0#0.0#2018-03-29 12:18:56#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 09/03/2018 11/03/2018 03/03/2018 3000 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3833688 0 3 0 0 0 ALISSA SHARFINA SIBARANI
0002437351176 3;JKN DR RIZKI; 5.2.0.201712280730 4 159387
1#0##0#0#0.0#2018-03-29 15:57:31#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 08/03/2018 11/03/2018 10/02/1983 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 20127598 0 4 0 0 0 INGGRI FEBRIANTI
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1#1#kelas_1#4#997400#0.0#2018-04-10 13:53:38#1#12:00:00#12:00:00#12:00:00
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3201126 B 2 BS 1 09/03/2018 11/03/2018 10/11/2009 0 2
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2507900 0 0 - 0 - 0 - 0 - 0
2507900 3011161 0 3 0 0 0 QUINSHA BUNGA ORYZA
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0001014332826 3;JKN DR RIZKI; 5.2.1.201802140120 4 158916
1#0##0#0#0.0#2018-04-17 11:10:58#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 24/02/2018 11/03/2018 27/11/2017 0 2
1 Q31.5;A41.9;I27.0 96.05;96.72;99.04 - - None None None None
0 - 0 79597900 59028267 0 16 1 4 100
RAISYAH PUTRI ADIVI D391299 0 89 DR NOVIK BUDIWARDHANA, SPA
0138R01702180010977 0002286096434 3;JKN DR RIZKI; 5.2.1.201802140120
4 153679 1#0##0#0#0.0#2018-04-17
11:38:20#0#12:00:00#12:00:00#12:00:00 1 ece3c366cb2905bc4dd732f562c9cd21
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16688000 0 0 0 0 11000000
3201126 B 3 BS 1 08/03/2018 11/03/2018 26/10/2015 0 1
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2090000 3575446 0 4 0 0 0 NOVAL FATTAH IBRAHIM
0001772093349 3;JKN ECHI; 5.2.1.201802140120 4 158903
1#0##0#0#0.0#2018-04-17 17:54:24#0#12:00:00#12:00:00#12:00:00 2
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3201126 B 3 BS 1 09/03/2018 11/03/2018 20/12/2017 0 2
0 - 0 - 0 - 0 - 0 2225900 2281515
0 3 0 0 0 BAYI NY PUNGKI PRAMITA SARI D392567 0
79 DR DYAH HARINI, SPA 0138R01703180004455 0002305350224 3;JKN
ECHI; 5.2.1.201802140120 4 159468 1#0##0#0#0.0#2018-04-17
17:56:05#0#12:00:00#12:00:00#12:00:00 2 bcf545e717b3e2d0300ed7097be55ece
0 0 253331 0 0 1063926 0 0 0 0 964258
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3201126 B 3 BS 1 11/03/2018 11/03/2018 21/11/1958 0 2
7040000 0 0 - 0 - 0 - 0 - 0
7040000 4559480 0 1 0 0 0 EMAH D392750 59
21660 DR ERTY MASIHAT 0138R01703180004882 0000166131189 3;JKN irene;
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10:57:48#0#12:00:00#12:00:00#12:00:00 2 e055658cc34ed26bc984ba2bf47454ac
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0 0 0 0 0
3201126 B 2 BS 1 09/03/2018 11/03/2018 15/07/1986 0 1
1 I25.0;I10 88.55 - - None None None None I-1-15-I None
0 - 0 - 0 - 0 - 0 5449100 19530550
0 3 0 0 0 WAHYUDI D378273 31 11560 DR AGOES
5.2.2.201806040537 4 158988 1#0##0#0#0.0#2018-08-10
08:47:03#0#12:00:00#12:00:00#12:00:00 2 5da04b0d771080d1250f6668c23865b5
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1256000 0 0 0 0 2128000
3201126 B 2 BS 1 10/03/2018 11/03/2018 25/07/1958 0 1
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- 0 - 0 23198900 12109126 0 2 0 0 0
ROKIB D348894 59 21778 DR SRI KUMARTINI 0138R01703180004622
0001125532642 3;JKN DR RIZKI; 5.2.0.201712280730 4 159433
1#0##0#0#0.0#2018-08-10 08:57:59#0#12:00:00#12:00:00#00:00:00 2
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3127595 0 0 0 0 848186 0 0 0 0 69000
3201126 B 1 BS 1 04/03/2018 11/03/2018 10/02/1941 0 1
1 E63.1;I95.9;I11.0;D64.9;R77.0 99.04 - - None None None None
- 0 - 0 8768000 33324042 0 8 0 0 0
PDT.S.F.PASARIBU D392117 77 28146 SRI KUNMARTINI.DR,SPPD
0138R01703180001577 0002433201952 3;JKN DR RIZKI; 5.2.2.201806040537
4 156750 1#0##0#0#0.0#2018-09-29
14:08:24#0#12:00:00#12:00:00#12:00:00 2 6708a5068a88d3a6bff9f35dead3e68c
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7337000 0 0 0 0 6120000
3201126 B 3 BS 1 09/03/2018 12/03/2018 17/03/2010 0 1
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0 2987000 3570729 0 4 0 0 0 ALFATHIRA
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0001265724505 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159455
1#0##0#0#0.0#2018-03-24 09:00:53#0#12:00:00#12:00:00#12:00:00 1
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2147300 0 0 0 0 789000 0 0 0 259599
0
3201126 B 1 BS 1 11/03/2018 12/03/2018 13/05/1956 0 2
- 0 - 0 - 0 - 0 4136800 5774556 0
2 0 0 0 RUPINI d389956 61 22582 DR ZULFAN, SPPD
0138R01703180004995 0000073651364 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159680 1#0##0#0#0.0#2018-03-24
11:45:00#0#12:00:00#12:00:00#12:00:00 1 8c802bf61e419b6ccccc82ef7f28560f
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2035275 0 0 0 0 1714500
3201126 B 2 BS 1 07/03/2018 12/03/2018 12/10/2005 0 2
1 A91;A01.0 - - - None None None None A-4-13-III None
3841100 0 0 - 0 - 0 - 0 - 0
3841100 5607117 0 6 0 0 0 ANISA SYAHIRA RAMADHANI
0001649033717 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 157768
1#0##0#0#0.0#2018-03-27 13:07:15#0#12:00:00#12:00:00#12:00:00 1
40cecb4089592d29793162ce90cc53c1 0 0 278711 0 0
2070585 0 0 0 0 2917821 0 0 0 0 340000
3201126 B 1 BS 1 11/03/2018 12/03/2018 17/08/1959 0 2
4 I63.8;I46.9 99.60 - - None None None None G-4-14-III None
(BERAT) 12141100 0 0 - 0 - 0 - 0 - 0
12141100 3447464 0 2 1 0 0 KUSRIATI,NY D392762
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159667
1#0##0#0#0.0#2018-03-27 13:12:43#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1813535 0 0 0 0 0
3201126 B 2 BS 1 10/03/2018 12/03/2018 28/02/1958 0 1
1 I11.0;I49.3;E11.6 89.52;90.59 - - None None None None I-4-
5968400 0 0 - 0 - 0 - 0 - 0
5968400 4399870 0 3 0 0 0 MARLIN SINAGA
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1#0##0#0#0.0#2018-03-27 13:14:50#0#12:00:00#12:00:00#12:00:00 1
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1980872 0 0 0 0 1828842 0 0 0 0 0
3201126 B 2 BS 1 11/03/2018 12/03/2018 20/12/1963 0 1
0 - 0 - 0 - 0 - 0 7892000 6773442
0 2 0 0 0 SYARIFUDIN d292677 54 19805 DR
5.2.0.201712280730 4 159656 1#0##0#0#0.0#2018-03-27
13:17:47#0#12:00:00#12:00:00#12:00:00 1 e7e15427fb82b4c43834e7a5aed86d5c
0 4389100 710760 0 0 1105460 0 0 0 0
499122 0 0 0 0 69000
3201126 B 2 BS 1 11/03/2018 12/03/2018 14/04/1953 0 2
- 0 10690500 12719183 0 2 0 0 0 SITI
KOMARIYAH D392764 64 23707 SRI KUNMARTINI.DR,SPPD 0138R01703180004951
0000060656646 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159672
1#0##0#0#0.0#2018-03-27 14:41:01#0#12:00:00#12:00:00#12:00:00 1
06503295e110c8650dca5a37016460ab 0 4411600 3153245 0 0
4231742 0 0 0 0 888096 0 0 0 0 34500
3201126 B 1 BS 1 11/03/2018 12/03/2018 06/07/1971 0 1
0 - 0 - 0 - 0 4260400 3648021 0 2
0 0 0 NOPENDI D192797 46 17050 DR NURUL KOMARI SPS
0138R01703180004910 0000060513985 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159663 1#0##0#0#0.0#2018-03-27
15:25:56#0#12:00:00#12:00:00#12:00:00 1 a1635a5ac53fb3fe6d1ede6c041a397b
0 0 437436 0 0 1383929 0 0 0 0
1826656 0 0 0 0 0
3201126 B 2 BS 1 08/03/2018 12/03/2018 08/12/2015 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3717776 0 5 0 0 0 NATHANIA ELZIRA BORU
PAKPAHAN D347082 2 821 DR KRISTON SILITONGA, SPA
0138R01703180004105 0002075857435 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 158902 1#0##0#0#0.0#2018-03-27
15:28:30#0#12:00:00#12:00:00#12:00:00 1 529f607a695078e83c95bd2a61ba902c
0 0 278711 0 0 639846 0 0 0 0
2289219 0 0 0 0 510000
3201126 B 3 BS 1 11/03/2018 12/03/2018 06/05/1960 0 1
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 1941972 0 2 0 0 0 SYAMSUL RIZAL
0002304849464 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159651
1#0##0#0#0.0#2018-03-28 09:30:23#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 679045 0 0 0 0 0
3201126 B 3 BS 1 07/03/2018 12/03/2018 15/04/1977 0 2
1 I63.8;R90.0;R47.1;G81.9 90.59;89.52 - - None None None None
0 - 0 6909500 6760469 0 6 0 0 0
WULANSARI D392340 40 14936 DR HARDI PRANATA SPS
0138R01703180002916 0000512404301 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 157760 1#0##0#0#0.0#2018-03-28
09:57:16#0#12:00:00#12:00:00#12:00:00 1 e9932e1ce054d43a19d1aeb09cb3bb38
0 0 674855 0 0 4039340 0 0 0 0
2046274 0 0 0 0 0
3201126 B 1 BS 1 11/03/2018 12/03/2018 02/04/1967 0 2
0 - 0 - 0 - 0 - 0 17095200 14085742
0 2 0 0 0 MARIA CHRISTINA ATJE NY D078740 50 18606
TANTIYO S;16137 5.2.0.201712280730 4 159658 1#0##0#0#0.0#2018-
03-28 20:47:01#0#12:00:00#12:00:00#00:00:00 1
1994dec285fbf7a95b919393a91e898f 0 4777000 3419040 0 0
2843205 0 0 0 0 977497 0 0 0 0
2069000
3201126 B 1 BS 1 11/03/2018 12/03/2018 15/04/1938 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 56551310 0 2 0 0 0 ABD SOMAD RAHMAN,H
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1#0##0#0#0.0#2018-03-28 20:51:07#0#12:00:00#12:00:00#00:00:00 1
a76d761b4bc3d25a67c35c789134239d 0 10062000 9619120 0 0
28045190 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 10/03/2018 12/03/2018 11/10/1959 0 1
1 N18.5;D63.8;J18.0 38.95;99.04;93.94 - - None None None None
- 0 - 0 19332400 12908407 0 3 0 0 0
CECEP D374795 58 21335 SRI KUNMARTINI.DR,SPPD 0138R01703180004765
0001841397794 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159638
1#0##0#0#0.0#2018-03-28 21:10:35#0#12:00:00#12:00:00#12:00:00 1
ec774ecf300e089bab33467701fd9342 0 3149000 3316552 0 0
5473380 0 0 0 0 900475 0 0 0 0 69000
3201126 B 1 BS 1 11/03/2018 12/03/2018 06/11/1970 0 2
- 0 - 0 12472300 13234791 0 2 0 0 0
MAIMUNAH D392430 47 17292 SRI KUNMARTINI.DR,SPPD
0138R01703180004912 0000168357317 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159664 1#0##0#0#0.0#2018-03-29
07:32:19#0#12:00:00#12:00:00#12:00:00 1 5145be427137613e417ec0c68740f166
0 6486200 3669967 0 0 2087797 0 0 0 0
921827 0 0 0 0 69000
3201126 B 2 BS 1 08/03/2018 12/03/2018 06/08/1967 0 1
1 G45.9;I48;R10.4 - - - None None None None G-4-16-II
None None None None None None ISKEMIK TRANSIENT (SEDANG) 5379700
0 0 - 0 - 0 - 0 - 0 5379700
7631777 0 5 0 0 0 KELANA SUGIHARTO D352465 50
TANTIYO S;16137 5.2.0.201712280730 4 158611 1#0##0#0#0.0#2018-
03-29 07:35:00#0#12:00:00#12:00:00#00:00:00 1
b3e10d8d9c9cc0875d1b4d17095d4139 0 0 590970 0 0
3990532 0 0 0 0 3050275 0 0 0 0 0
3201126 B 1 BS 1 11/03/2018 12/03/2018 14/02/1958 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3295566 0 2 0 0 0 SRI MOELYATI
0000060943612 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159676
1#0##0#0#0.0#2018-03-29 07:36:45#0#12:00:00#12:00:00#12:00:00 1
701bd39bb5f00b208e6d9b80701397f1 0 0 573641 0 0
1263827 0 0 0 0 1458098 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 12/03/2018 14/05/1970 0 2
1 C50.9;D63.0 85.12;99.04 - - None None None None L-1-50-II
10518600 0 0 - 0 - 0 - 0 - 0
10518600 6294528 0 3 0 0 0 RANITI D391895
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159704
1#0##0#0#0.0#2018-03-29 07:41:30#0#12:00:00#12:00:00#12:00:00 1
280f4623be708bcd8a91d9ce8687ccc6 0 0 641800 0 0
4295936 0 0 0 0 1356792 0 0 0 0 0
3201126 B 1 BS 1 07/03/2018 12/03/2018 26/05/2016 0 1
None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL (RINGAN)
3705200 0 0 - 0 - 0 - 0 - 0
3705200 7104627 0 6 0 0 0 AZTAN KHAIRI
D392401 1 650 DR RASTRA, SPA 0138R01703180003475
0002061836289 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158300
1#0##0#0#0.0#2018-03-29 07:42:46#0#12:00:00#12:00:00#12:00:00 1
ed028331f530eef23b46f80bf1173fd3 0 0 439468 0 0
1833870 0 0 0 0 4831289 0 0 0 0 0
3201126 B 1 BS 1 08/03/2018 12/03/2018 05/06/1945 0 1
0 0 - 0 - 0 - 0 - 0 5005900
5667849 0 5 0 0 0 MUHAMMAD NUH NASUTION D389807
0001819580016 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158315
1#0##0#0#0.0#2018-03-29 08:00:33#0#12:00:00#12:00:00#12:00:00 1
41257abf0815ec3e8e9184b7630bf57c 0 0 491786 0 0 874269
0 0 0 0 4301794 0 0 0 0 0
3201126 B 2 BS 1 10/03/2018 12/03/2018 23/02/1953 0 2
- 0 4203300 3477775 0 3 0 0 0 AISYAH
0001185968788 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159436
1#0##0#0#0.0#2018-03-29 08:03:11#0#12:00:00#12:00:00#12:00:00 1
082e604eedcb8b3999f627e1333dd23d 0 0 317771 0 0
1391486 0 0 0 0 1768518 0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 12/03/2018 01/06/1942 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 4722096 0 5 0 0 0 MARIYAH D132189
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158312
1#0##0#0#0.0#2018-03-29 08:05:49#0#12:00:00#12:00:00#00:00:00 2
685b7d2870298cf73e622bed72cb3311 0 0 261764 0 0
2682410 0 0 0 0 1649922 0 0 0 0 128000
3201126 B 1 BS 1 09/03/2018 12/03/2018 31/01/1946 0 2
1 E11.5;A09.9 90.59;89.52 - - None None None None I-4-15-I
LAIN (RINGAN) 6275300 0 0 - 0 - 0 - 0 -
0 6275300 4683407 0 4 0 0 0 ERRY,NY
0000060625045 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159158
1#0##0#0#0.0#2018-03-29 08:24:15#0#12:00:00#12:00:00#12:00:00 1
78d4fa643c10c6697b456fbd385e09aa 0 0 494342 0 0 732674
0 0 0 0 3456391 0 0 0 0 0
3201126 B 3 BS 1 11/03/2018 12/03/2018 02/03/1964 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 4184014 0 2 0 0 0 ROMLI TN
0001743644902 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159670
1#0##0#0#0.0#2018-03-29 08:29:47#0#12:00:00#12:00:00#00:00:00 1
38ecb21dac9f50861a75a4931190c414 0 0 424889 0 0
1777154 0 0 0 0 1981971 0 0 0 0 0
3201126 B 2 BS 1 08/03/2018 12/03/2018 21/11/1963 0 1
1 E87.1;R42;E87.6 - - - None None None None E-4-11-I
3545800 0 0 - 0 - 0 - 0 - 0
3545800 6039534 0 5 0 0 0 ADE SUHARDIMAN
0001261076253 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158895
1#0##0#0#0.0#2018-03-29 08:36:29#0#12:00:00#12:00:00#12:00:00 1
fc8177d94ff4ba5afa3212f680526a32 0 0 581597 0 0
2511827 0 0 0 0 2946110 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 12/03/2018 05/11/1973 0 2
1 H11.0 11.39 - - None None None None H-1-20-I None None
None None None None PROSEDUR EKSTRAOKULER DAN ORBITA (RINGAN) 10182200
0 0 - 0 - 0 - 0 - 0 10182200
7269532 0 1 0 0 0 MAESAROH D392410 44 16198
DR ERRY, SPM 0138R01703180005243 0001739877884 3;JKN TANTIYO
S;16137 5.2.0.201712280730 4 159870 1#0##0#0#0.0#2018-03-29
08:39:12#0#12:00:00#12:00:00#12:00:00 1 a53b5666055aaa4883071b990bdfaa55
0 2889500 3286440 0 0 467015 0 0 0 0
557577 0 0 0 0 69000
3201126 B 1 BS 1 04/03/2018 12/03/2018 10/08/1953 0 1
None None None None None None INFEKSI-INFEKSI GASTROINTESTINAL (BERAT)
7223500 0 0 - 0 - 0 - 0 - 0
7223500 17278356 0 9 1 1 0 NASRULLAH D383565
64 23582 DR ARU, SPPD 0138R01703180001589 0000045810898 3;JKN
DR RIZKI; 5.2.0.201712280730 4 156754 1#0##0#0#0.0#2018-03-29
16:02:51#0#12:00:00#12:00:00#12:00:00 1 56a8000d8d5af2cb27b75da0f7a7fa59
0 0 681243 0 0 8939753 0 0 0 0
6501000 0 0 0 1156360 0
3201126 B 3 BS 1 11/03/2018 12/03/2018 27/08/1942 0 1
1 I63.8;D38.1 87.44;87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 5013100 0 0 - 0 - 0 - 0 -
0 5013100 6251201 0 2 0 0 0 ANWARI
0000060754814 3;JKN DR RIZKI; 5.2.0.201712280730 4 161964
1#0##0#0#0.0#2018-03-31 10:56:34#0#12:00:00#12:00:00#12:00:00 1
28a02079754f4073bf65c6c4566384b3 0 0 368658 0 0
5184586 0 0 0 0 697957 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 12/03/2018 12/12/1952 0 1
0 - 0 - 0 - 0 - 0 7219300 1407812
0 1 0 0 0 FRANS MARTINUS SAMUEL D111772 65 23831
DR ANGGA TOMALA PUTRA 0138R01703180005460 0001318423162 3;JKN DR
RIZKI; 5.2.0.201712280730 4 160096 1#0##0#0#0.0#2018-03-31
11:49:58#0#12:00:00#12:00:00#00:00:00 1 836c8c5ca63babfc1f651964ffa1f4ef
0 0 649737 0 0 376975 0 0 0 0 381100
0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 12/03/2018 17/01/1942 0 1
1 J21.9;R07.4;I50.0 89.52 - - None None None None J-4-18-II
None None None None None None ASTHMA & BRONKIOLITIS (SEDANG)
2969700 0 0 - 0 - 0 - 0 - 0
2969700 1933745 0 1 0 0 0 SJAMSUDIN D370698
76 27813 DR RENDRA RAMADYA 0138R01703180005425 0000060724012 3;JKN
DR RIZKI; 5.2.0.201712280730 4 160077 1#0##0#0#0.0#2018-03-31
11:51:14#0#12:00:00#12:00:00#00:00:00 1 89b5ce9ae2e86c651ebd095e4b8e5e92
0 0 378234 0 0 1140004 0 0 0 0 415507
0 0 0 0 0
3201126 B 2 BS 1 09/03/2018 12/03/2018 25/03/2009 0 1
1 A01.0;J02.9 90.59;99.21 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 3425152 0 4 0 0 0 MUHAMMAD
AZAM D372846 8 3271 DR AWIDIYA, SPA 0138R01703180004117
0001631490636 3;JKN DR RIZKI; 5.2.1.201802140120 4 158917
1#0##0#0#0.0#2018-04-17 11:40:30#0#12:00:00#12:00:00#12:00:00 1
f37cfeecfc8ccbfac109c741ecfbafd4 0 0 298025 0 0 857052
0 0 0 0 2270075 0 0 0 0 0
3201126 B 2 BS 1 07/03/2018 12/03/2018 05/08/1989 0 2
- 0 - 0 - 0 - 0 3479400 4944527 0
6 0 0 0 SILVI MAHARANI D220288 28 10441 DR NINING H,
SPOG 0138R01703180003547 0001959587032 3;JKN ECHI; 5.2.1.201802140120
4 158310 1#0##0#0#0.0#2018-04-17
17:51:46#0#12:00:00#12:00:00#12:00:00 2 ac7b4fa0fa6c24cca3e477da740c5245
0 0 419146 0 0 2116907 0 0 0 0
1982474 0 0 0 0 426000
3201126 B 2 BS 1 11/03/2018 12/03/2018 03/04/1944 0 1
1 I63.9;G81.9;J18.9 87.03 - - None None None None G-4-14-III
INFARK (BERAT) 10406600 0 0 - 0 - 0 - 0 -
0 10406600 4685329 0 2 0 0 0 PARDJO
0000059061971 3;JKN DR RIZKI; 5.2.0.201712280730 4 159649
1#0##0#0#0.0#2018-08-10 11:40:15#0#12:00:00#12:00:00#00:00:00 2
eb77cf6205de332f3b1fea9823135793 0 0 799226 0 0
2543586 0 0 0 0 1342517 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 13/03/2018 05/06/1980 0 2
- 0 - 0 - 0 - 0 2168300 1634477 0
5.2.0.201712280730 4 159646 1#0##0#0#0.0#2018-03-27
15:24:22#0#12:00:00#12:00:00#12:00:00 1 eaaf9ca5502f87e7d981cff2e57aabc3
0 0 248147 0 0 446402 0 0 0 0 939928
0 0 0 0 0
3201126 B 2 BS 1 12/03/2018 13/03/2018 17/04/1947 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 2353481 0 2 0 0 0 PERIN AL MARDJUKI
0000059231338 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159890
1#0##0#0#0.0#2018-03-27 15:27:27#0#12:00:00#12:00:00#12:00:00 1
246c9e691793e4400a5b78010b422314 0 0 499265 0 0 664250
0 0 0 0 1189966 0 0 0 0 0
3201126 B 2 BS 1 05/03/2018 13/03/2018 15/04/1943 0 1
1 I11.0;J18.9 93.94 - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 5968400 12853664
0 9 0 0 0 MURSADI D341321 74 27353 DR AZRI
5.2.0.201712280730 4 156874 1#0##0#0#0.0#2018-03-27
15:31:17#0#12:00:00#12:00:00#12:00:00 1 d2f4ae26ffdbe252c509fd92f45bd9b6
0 0 1284002 0 0 3509768 0 0 0 0
6883894 0 0 0 0 1176000
3201126 B 1 BS 1 07/03/2018 13/03/2018 25/05/1955 0 2
1 I21.4;I11.0;E10.5;J18.0 87.49;89.52;90.59;99.17 - - None None
None None I-4-10-III None None None None None None INFARK MYOKARD
AKUT (BERAT) 14562700 0 0 - 0 - 0 - 0 -
0 14562700 17296428 0 7 1 0 0 PUDJIATI
0001298012027 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 158153
1#0##0#0#0.0#2018-03-28 09:36:15#0#12:00:00#12:00:00#12:00:00 1
74b948e6d6950f22098792206a8b25ad 0 0 1509270 0 0
7251616 0 0 0 0 6900542 0 0 0 0
1635000
3201126 B 2 BS 1 11/03/2018 13/03/2018 15/09/1984 0 2
1 K21.0;B98.0 45.16 - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 3545800 6373645
0 3 0 0 0 LIA SULIHATI D389060 33 12230 DR
5.2.0.201712280730 4 159679 1#1#vvip#3#2827845#0.0#2018-03-28
09:49:03#0#12:00:00#12:00:00#12:00:00 2 3919eef4339836738a61e3d9edd9b749
0 0 1045824 0 0 1383354 0 0 0 0
2195467 0 0 0 0 1749000
3201126 B 1 BS 1 11/03/2018 13/03/2018 25/03/1965 0 2
1 L04.0;D63.8 99.04;83.49 - - None None None None M-1-50-II
None None None None None None PROSEDUR JARINGAN LUNAK (SEDANG)
12386700 0 0 - 0 - 0 - 0 - 0
12386700 13206340 0 3 0 0 0 SUMARNI D391537
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159673
1#0##0#0#0.0#2018-03-28 10:21:25#0#12:00:00#12:00:00#12:00:00 1
25b09b4f8de3a18bd98cfec70bbe79f2 0 6241500 3592143 0 0
2307731 0 0 0 0 919966 0 0 0 0 145000
3201126 B 2 BS 1 10/03/2018 13/03/2018 18/08/1983 0 2
1 E16.2;R11;R42 - - - None None None None E-4-10-I
0 - 0 4203300 4792901 0 4 0 0 0 RAHAYU
PURWANINGSIH D392623 34 12623 DR. ARU ARIADNO, SPPD
0138R01703180004649 0001226915469 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159451 1#0##0#0#0.0#2018-03-28
10:36:13#0#12:00:00#12:00:00#12:00:00 1 9a4f369165a13f5f7869995eae093e2b
0 0 431297 0 0 2002050 0 0 0 0
2359554 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 13/03/2018 05/12/2017 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 1812977 0 2 0 0 0 SYAHRIL DERMAWAN
d392397 0 97 DR AULIA TANGKARI, SPA 0138R01703180005483
0002317248461 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160097
1#0##0#0#0.0#2018-03-28 16:08:13#0#12:00:00#12:00:00#12:00:00 1
b40454c74a5666336467db8f7bba8f3d 0 0 268830 0 0 960041
0 0 0 0 584106 0 0 0 0 0
3201126 B 3 BS 1 11/03/2018 13/03/2018 29/09/2016 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3600872 0 3 0 0 0 RAVITA KHALISTA PUTRI
0002276507823 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159666
1#0##0#0#0.0#2018-03-28 16:09:40#0#12:00:00#12:00:00#12:00:00 1
2180241b48afe50b73a28934c6ad8d3b 0 0 378188 0 0
2172113 0 0 0 0 1050571 0 0 0 0 0
3201126 B 2 BS 1 12/03/2018 13/03/2018 11/09/1986 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 11983941 0 2 0 0 0 NASRULLOH
SAPARUDIN D392334 31 11505 SRI KUNMARTINI.DR,SPPD 0138R01703180005333
0001622779975 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159975
1#0##0#0#0.0#2018-03-28 16:21:55#0#12:00:00#12:00:00#12:00:00 1
9ffbd6f65d74783b68a337c4cc5998d4 0 4911100 3100245 0 0
3063600 0 0 0 0 839996 0 0 0 0 69000
3201126 B 2 BS 1 12/03/2018 13/03/2018 18/08/1954 0 1
- 0 51950600 53942975 0 2 0 0 0 ARTIM
0001341573131 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159681
1#0##0#0#0.0#2018-03-28 16:56:45#0#12:00:00#12:00:00#12:00:00 2
f0d32a360663f80ad02f63d011ae3c24 0 8986000 8244960 0 0
27887015 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 12/03/2018 13/03/2018 22/12/1955 0 1
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 42135540 0 2 0 0 0 MASLIHAN SANJAYA
0001864751771 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159787
1#0##0#0#0.0#2018-03-28 19:01:58#0#12:00:00#12:00:00#00:00:00 1
c36de55df3fbfc36d6b0cceaabd37e97 0 8986000 2930600 0 0
21393940 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 12/03/2018 13/03/2018 05/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 6341300
9770528 0 2 0 0 0 SUTARMI d392578 46 16990
TANTIYO S;16137 5.2.0.201712280730 4 159777 1#0##0#0#0.0#2018-
03-28 20:49:03#0#12:00:00#12:00:00#12:00:00 1
dd76eb31c8d12619424ece592eb59122 0 2439000 1268260 0 0
3299075 0 0 0 0 695193 0 0 0 0
2069000
3201126 B 3 BS 1 12/03/2018 13/03/2018 29/07/1970 0 2
(RINGAN) 15255300 0 0 - 0 - 0 - 0 - 0
15255300 11321247 0 2 0 0 0 ABDUL ROHIM D391906
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160018
1#0##0#0#0.0#2018-03-28 21:02:06#0#12:00:00#12:00:00#12:00:00 1
43ebae1a1954ac31398f8a4f6e419092 0 3784600 4424037 0 0
2226968 0 0 0 0 816642 0 0 0 0 69000
3201126 B 1 BS 1 12/03/2018 13/03/2018 27/04/1966 0 2
- 0 - 0 - 0 - 0 4136800 5948562 0
2 0 0 0 RINI WIDIASTUTI D053112 51 18947 DR ZULFAN,
5.2.0.201712280730 4 160103 1#0##0#0#0.0#2018-03-28
21:18:18#0#12:00:00#12:00:00#12:00:00 1 a7f7282b6aebdb86115fe2abd9009fb9
0 0 1211304 0 0 648600 0 0 0 0
2374158 0 0 0 0 1714500
3201126 B 3 BS 1 13/03/2018 13/03/2018 30/07/1951 0 1
4 E14.5;R57.2 - - - None None None None I-4-15-I None
(RINGAN) 4482300 0 0 - 0 - 0 - 0 - 0
4482300 4393337 0 1 0 0 0 NUSYIRWAN LAMSYA
d392930 66 24333 DR YOHANNES DWINANDA 0138R01703180005703
0001458053111 3;JKN DR RIZKI; 5.2.0.201712280730 4 161594
1#0##0#0#0.0#2018-03-31 11:14:44#0#00:10:00#09:00:00#12:00:00 1
675190a74c51d09580fca23a3238e5dd 0 0 789120 0 0
3027802 0 0 0 0 576415 0 0 0 0 0
3201126 B 3 BS 1 05/03/2018 13/03/2018 09/01/2018 0 1
1 Q21.2;I50.0 96.05;96.72;93.94 - - None None None None J-1-
- 0 40168300 34746886 0 9 1 2 48 BAYI NY.
SITI AISYAH D392125 0 55 DR NOVIK BUDIWARDHANA, SPA
0138R01703180001618 0002328123925 3;JKN DR RIZKI; 5.2.1.201802140120
4 156760 1#0##0#0#0.0#2018-04-17
11:20:18#0#12:00:00#12:00:00#12:00:00 1 24010ebfffb2d7a3734de05d2c384490
0 0 3289730 0 0 13210156 0 0 0 0
8990000 0 0 0 0 9257000
3201126 B 1 BS 1 23/02/2018 13/03/2018 23/02/2018 3140 2
1 P22.8;P24.0;P29.3;P03.4 96.72;99.04 - - None None None None
P-8-07-I None None None None None None NEONATAL, BERAT BADAN LAHIR
GROUP-5 DENGAN PROSEDUR MAYOR (RINGAN) 7138700 0 0 - 0 -
0 - 0 - 0 7138700 95621984 0 19 0 0
0 BAYI GABRIELLA JUNIKE MARIA AZALIA SIMANJUNTAK D391289 0 0
RIZKI; 5.2.2.201806040537 4 159223 1#0##0#0#0.0#2018-09-05
14:58:34#0#12:00:00#12:00:00#12:00:00 3 959593bbe713bfae2e65298c437b75f0
0 0 2487031 0 0 39451953 0 0 0 0
21314000 0 0 0 0 32369000
3201126 B 3 BS 1 09/03/2018 13/03/2018 01/06/1969 0 1
None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (RINGAN)
4640500 0 0 - 0 - 0 - 0 - 0
4640500 9691104 0 5 0 0 0 SUYANTO D392565
0002099893511 3;JKN DR RIZKI; 5.2.2.201806040537 4 159420
1#0##0#0#0.0#2018-09-06 17:07:03#0#12:00:00#12:00:00#12:00:00 2
5f60ee3d7abd3afe41b691c85368887b 0 3408500 1396000 0 0
4196607 0 0 0 0 689997 0 0 0 0 0
3201126 B 2 BS 1 10/03/2018 13/03/2018 01/09/1971 0 1
1 I64;G81.9;M54.32 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 5866300 6127355 0
4 0 0 0 TRINAMIKA WIBOWO D067136 46 16992 DR NURUL
KOMARI SPS 0138R01703180004705 0001635174167 3;JKN irene;
5.2.2.201806040537 4 159554 1#0##0#0#0.0#2018-09-12
08:36:29#0#12:00:00#12:00:00#00:00:00 3 ec4a6f9c544f95f85a9bb6979a1ab569
0 0 495386 0 0 3185114 0 0 0 0
2446855 0 0 0 0 0
3201126 B 2 BS 1 13/03/2018 14/03/2018 08/02/1967 0 1
- 0 10690500 11651851 0 2 0 0 0 SURJO
0001128934528 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160590
1#0##0#0#0.0#2018-03-28 15:57:08#0#12:00:00#12:00:00#12:00:00 1
3e045841d4e8b11e2507d0e8a2aa69bf 0 4703600 3153245 0 0
2907735 0 0 0 0 818271 0 0 0 0 69000
3201126 B 3 BS 1 13/03/2018 14/03/2018 01/10/1971 0 2
- 0 8908800 11456376 0 2 0 0 0 EEN
MAILASTRI D392962 46 16965 DR SRI KUN, SPPD 0138R01703180005801
0000368676358 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160442
1#0##0#0#0.0#2018-03-28 16:27:06#0#12:00:00#12:00:00#12:00:00 1
bfc3a866e39c7474849d9710a587007b 0 0 2636552 0 0
4951841 0 0 0 0 3867983 0 0 0 0 0
3201126 B 1 BS 1 11/03/2018 14/03/2018 27/06/2015 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4404105 0 4 0 0 0 MUHAMMAD FAIZ RAMADHAN
0001899999213 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159669
1#0##0#0#0.0#2018-03-28 18:47:28#0#12:00:00#12:00:00#12:00:00 1
8940297d4308964dfb1dd869ccc2756b 0 0 338858 0 0 627128
0 0 0 0 3438119 0 0 0 0 0
3201126 B 2 BS 1 13/03/2018 14/03/2018 02/07/1962 0 2
1 N23;E11.9 - - - None None None None N-4-13-I None
- 0 - 0 - 0 - 0 4101100 3592684 0
2 0 0 0 TUTI SUPRIATI D080581 55 20343 DR BETTY DWI
L, SPPD 0138R01703180006082 0000060636249 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160597 1#1#vvip#2#0#0.0#2018-03-28
19:05:15#0#12:00:00#12:00:00#12:00:00 1 fc54420e6c8fdf4fcab57c1a13d615c3
0 0 324000 0 0 838149 0 0 0 0
2430535 0 0 0 0 0
3201126 B 3 BS 1 13/03/2018 14/03/2018 13/06/1981 0 1
1 I13.1;D63.8;R18;B17.1 38.95;87.49;90.59;89.52;99.04 - - None
None None None N-1-12-II None None None None None None MEMBUAT
BARU, MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (SEDANG) 8908800 0 0 -
0 - 0 - 0 - 0 8908800 11623639 0 2
0 0 0 SUGIARNO D392977 36 13422 SRI KUNMARTINI.DR,SPPD
0138R01703180005969 0002432144643 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160583 1#0##0#0#0.0#2018-03-28
19:06:54#0#12:00:00#12:00:00#12:00:00 1 4c044c522ce4a61556c351ea33284396
0 0 2636552 0 0 5035662 0 0 0 0
3882425 0 0 0 0 69000
3201126 B 2 BS 1 12/03/2018 14/03/2018 08/06/1963 0 2
1 I63.9;G81.9 87.03;89.52;90.59 - - None None None None G-4-
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 4028474 0 3 0 0 0 ENY RATNA
0001337065817 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160106
1#0##0#0#0.0#2018-03-28 19:09:18#0#12:00:00#12:00:00#12:00:00 1
f769b7855e6cce4720fc0af8a8e97d53 0 0 485739 0 0
1945690 0 0 0 0 1597045 0 0 0 0 0
3201126 B 1 BS 1 11/03/2018 14/03/2018 13/08/1993 0 2
1 D27;D64.9;N13.3 65.49;99.04 - - None None None None W-1-
20-II None None None None None None PROSEDUR PADA RAHIM & ADNEKSA (SEDANG)
14456700 0 0 - 0 - 0 - 0 - 0
14456700 16387172 0 4 0 0 0 ASSYIFA NUR AZIZAH
0001150160657 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159674
1#0##0#0#0.0#2018-03-28 19:15:27#0#12:00:00#12:00:00#12:00:00 1
f1d81c85d7a80c41fd129d3b09796cee 0 7441500 3596029 0 0
4142585 0 0 0 0 1138058 0 0 0 0 69000
3201126 B 1 BS 1 11/03/2018 14/03/2018 26/10/1965 0 1
1 E10.2;R11;J18.0 99.17;90.59;87.49;89.52 - - None None None
None N-4-16-III None None None None None None PENYAKIT GINJAL DAN
SALURAN URIN LAIN-LAIN (BERAT) 10134400 0 0 - 0 - 0
- 0 - 0 10134400 7736978 0 4 0 0 0
WALUYO ATMADA D392746 52 19129 DR. ARU ARIADNO, SPPD
0138R01703180004896 0001478348649 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159662 1#0##0#0#0.0#2018-03-28
20:35:33#0#12:00:00#12:00:00#12:00:00 1 d19f26b1e7406530b2ea54b3c400662b
0 0 701641 0 0 3379180 0 0 0 0
3656157 0 0 0 0 0
3201126 B 2 BS 1 10/03/2018 14/03/2018 23/05/1975 0 1
1 N20.0;N23 87.71;89.52;90.59 - - None None None None N-4-
13-I None None None None None None BATU URIN (RINGAN) 4101100 0
0 - 0 - 0 - 0 - 0 4101100 4765861
0 5 0 0 0 MUHAMMAD MUKHLIS D298958 42 15632 DR.
ARU ARIADNO, SPPD 0138R01703180004809 0001631159706 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159643 1#0##0#0#0.0#2018-03-28
20:37:58#0#12:00:00#12:00:00#12:00:00 1 8896e54036cfb805e7d30c1e946dea2d
0 0 475099 0 0 1932977 0 0 0 0
2357785 0 0 0 0 0
3201126 B 1 BS 1 05/03/2018 14/03/2018 14/05/1951 0 1
1 I11.0;E13.7;L03.9;E16.2 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 5802600
11829603 0 10 0 0 0 RUSLIYANTO d258016 66 24402
TANTIYO S;16137 5.2.0.201712280730 4 157142 1#0##0#0#0.0#2018-
03-28 20:41:48#0#12:00:00#12:00:00#00:00:00 1
dd6e6d98b33f204294c55f36ca44e3af 0 0 628234 0 0
2811970 0 0 0 0 8389399 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 14/03/2018 06/05/1985 0 1
1 A15.0;K21.9 90.59;87.49 - - None None None None J-4-15-I
(RINGAN) 4336500 0 0 - 0 - 0 - 0 - 0
4336500 6981408 0 5 0 0 0 ROBERTHO BINSAR
PARULIAN.S D301492 32 11996 DR MOHAMAD NIZAM ERHAMZA SPP
0138R01703180004650 0001838460339 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159453 1#0##0#0#0.0#2018-03-28
20:50:08#0#12:00:00#12:00:00#00:00:00 1 b8433e62d591692bccfb2b84b8851b41
0 0 353285 0 0 2929395 0 0 0 0
3698728 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 14/03/2018 06/06/1968 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2528719 0 3 0 0 0 ROFIQOH
d373316 49 18176 DR SRI KUN, SPPD 0138R01703180005506
0000510188657 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160098
1#0##0#0#0.0#2018-03-28 21:08:30#0#12:00:00#12:00:00#12:00:00 1
6cd788379c6ade2b63f122b0f745f9bd 0 0 424889 0 0
1209900 0 0 0 0 893930 0 0 0 0 0
3201126 B 1 BS 1 12/03/2018 14/03/2018 25/04/2008 0 1
- 0 - 0 - 0 - 0 5424200 13414020 0
3 0 0 0 NOUVAL RIFQY SETIAWAN D158942 9 3608 DR
CATUR SUZANTARA 0138R01703180005227 0000038722397 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159816 1#0##0#0#0.0#2018-03-28
21:12:35#0#12:00:00#12:00:00#12:00:00 1 db9d8ab79778715d957bef8f27094c42
0 7205200 1635776 0 0 3411991 0 0 0 0
943553 0 0 0 0 217500
3201126 B 2 BS 1 11/03/2018 14/03/2018 20/01/1976 0 2
1 A09.9;I10;B37.9 - - - None None None None K-4-17-II
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 3714809 0 4 0 0 0 RAOMAULI LUMBAN TOBING
D392770 42 15391 DR SRI KUN, SPPD 0138R01703180004985
0002248264102 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159678
1#0##0#0#0.0#2018-03-28 21:17:04#0#12:00:00#12:00:00#12:00:00 1
420c4f464144a766456be740d32803a5 0 0 238535 0 0
1692249 0 0 0 0 1784025 0 0 0 0 0
3201126 B 1 BS 1 10/03/2018 14/03/2018 05/01/1951 0 1
- 0 58821400 69860727 0 5 0 0 0 KUNWALUYO
0001302586143 3;JKN DR RIZKI; 5.2.0.201712280730 4 159645
1#0##0#0#0.0#2018-03-29 14:24:38#0#12:00:00#12:00:00#00:00:00 1
edd80a50563fcc43b2528919f2247ca8 0 11444000 9672120 0 0
39919607 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 13/03/2018 14/03/2018 26/07/1945 0 2
4 I24.9;R57.0 90.59;89.52 - - None None None None I-4-20-III
7040000 0 0 - 0 - 0 - 0 - 0
7040000 5981272 0 2 0 0 0 ASMA D335828 72
26528 DR AHMAD HIBBAN A WRIYA 0138R01703180006020 0001799913824 3;JKN
DR RIZKI; 5.2.0.201712280730 4 160586 1#0##0#0#0.0#2018-03-31
11:25:00#0#12:00:00#12:00:00#00:00:00 1 376463e77796d0909c2f848bf34708aa
0 0 633600 0 0 4667374 0 0 0 0 680298
0 0 0 0 0
3201126 B 3 BS 1 14/03/2018 14/03/2018 01/01/1946 0 2
1 D48.6 - - - None None None None L-4-14-I None None
2944000 0 0 - 0 - 0 - 0 - 0
2944000 1423447 0 1 0 0 0 HJ.SALBIAH D324418
3;JKN DR RIZKI; 5.2.0.201712280730 4 160600 1#0##0#0#0.0#2018-
03-31 11:48:36#0#12:00:00#12:00:00#00:00:00 1
39b592ef137f3b93b202395fae969fb4 0 0 386622 0 0 654702
0 0 0 0 382123 0 0 0 0 0
3201126 B 3 BS 1 13/03/2018 14/03/2018 01/03/1971 0 1
1 M79.97;E14.9 83.39 - - None None None None M-1-50-I
5331600 0 0 - 0 - 0 - 0 - 0
5331600 6724854 0 2 0 0 0 NGALIMAN D391876
3;JKN DR RIZKI; 5.2.0.201712280730 4 160115 1#0##0#0#0.0#2018-
03-31 11:52:48#0#12:00:00#12:00:00#12:00:00 1
db8c17f006235894729092673ce1c18b 0 3062500 1545848 0 0
1551562 0 0 0 0 495944 0 0 0 0 69000
3201126 B 2 BS 1 13/03/2018 14/03/2018 10/12/1968 0 1
(RINGAN) 5178700 0 0 - 0 - 0 - 0 - 0
5178700 9079351 0 2 0 0 0 TAUFIK NASIR
0001156622286 3;JKN DR RIZKI; 5.2.0.201712280730 4 160499
20#0##0#0#0.0#2018-03-31 12:52:33#0#12:00:00#12:00:00#12:00:00 1
5f8f1d21173c6ce4582db05bde5a45a2 0 5180500 2075036 0 0
1028839 0 0 0 0 649976 0 0 0 0 145000
3201126 B 2 BS 1 11/03/2018 14/03/2018 15/08/1967 0 1
1 A41.9;J18.0;N18.5;J81;D63.8 87.44;99.04 - - None None None
7006300 0 0 - 0 - 0 - 0 - 0
7006300 12973785 0 4 0 0 0 KUSROTO D326979
3;JKN DR RIZKI; 5.2.0.201712280730 4 159654 1#0##0#0#0.0#2018-
03-31 12:54:22#0#12:00:00#12:00:00#00:00:00 1
5969fec1cbade4858281cde6b389797f 0 0 683567 0 0
4496966 0 0 0 0 6311252 0 0 0 0
1482000
3201126 B 2 BS 1 13/03/2018 14/03/2018 31/12/1942 0 1
1 D37.5;N18.4;N39.0;R19.0;R54 45.23;48.24 - - None None None
None K-4-18-II None None None None None None GANGGUAN SISTEM
PENCERNAAN LAIN-LAIN (SEDANG) 2941900 0 0 - 0 - 0 -
0 - 0 2941900 6529629 0 2 0 0 0
SUHAIRI D391211 75 27466 DR BETTY DWI L, SPPD
0138R01703180005763 0001229073096 3;JKN DR RIZKI; 5.2.0.201712280730
4 160386 1#0##0#0#0.0#2018-03-31
12:56:19#0#12:00:00#12:00:00#12:00:00 1 e4836cd12fa295bc550f89cf9a787307
0 0 876732 0 0 1698225 0 0 0 0
2205672 0 0 0 0 1749000
3201126 B 2 BS 1 11/03/2018 14/03/2018 25/02/1980 0 2
1 D61.8;E87.6;K21.9;R55;C50.9 - - - None None None None
D-4-13-II None None None None None None GANGGUAN SEL DARAH MERAH
SELAIN KRISIS ANEMIA SEL SICKLE (SEDANG) 5073100 0 0 - 0 -
0 - 0 - 0 5073100 7426423 0 4 1 2
0 SRI SUNARSIH D344877 38 13894 SRI KUNMARTINI.DR,SPPD
0138R01703180004933 0001609123702 3;JKN DR RIZKI; 5.2.0.201712280730
4 159668 1#0##0#0#0.0#2018-03-31
13:26:21#0#12:00:00#12:00:00#12:00:00 1 cb64635cdd219da8e5e14c5064aa914f
0 0 431297 0 0 1855285 0 0 0 0
3267841 0 0 0 0 1872000
3201126 B 2 BS 1 13/03/2018 14/03/2018 25/04/1952 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 2830666 0 2 0 0 0 DIDI SUHENDRI
0001459026955 3;JKN DR RIZKI; 5.2.0.201712280730 4 160596
1#0##0#0#0.0#2018-03-31 13:27:17#0#12:00:00#12:00:00#00:00:00 1
6571d869c3abdbbc78f38b8a2d65e458 0 0 499265 0 0
1317717 0 0 0 0 1013684 0 0 0 0 0
3201126 B 3 BS 1 14/03/2018 14/03/2018 02/06/1962 0 1
1 I21.1;E13.8;I63.9;R57.9 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 7519306 0 1 0 0 0 GOPA KUSTRIONO
0000045251212 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 161042
1#0##0#0#0.0#2018-04-26 16:37:24#0#12:00:00#12:00:00#00:00:00 1
df74d0d1c69874e38335a120617617a5 0 0 936171 0 0
4915218 0 0 0 0 798917 0 0 0 0 869000
3201126 B 3 BS 1 11/03/2018 14/03/2018 03/08/1961 0 1
1 I63.9;G81.9 - - - None None None None G-4-14-II None
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 4079484 0 4 0 0 0 ABDUL RACHMAN
0001728091675 3;JKN DR RIZKI; 5.2.0.201712280730 4 165399
1#0##0#0#0.0#2018-08-10 10:25:39#0#12:00:00#12:00:00#12:00:00 2
9191be51834222e6b65f193725f19b6a 0 0 428857 0 0
2305745 0 0 0 0 1344882 0 0 0 0 0
3201126 B 2 BS 1 12/03/2018 14/03/2018 24/10/1983 0 1
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 5754616 0 3 0 0 0 WINDU S. ANUGRAH
TN D331384 34 12558 SRI KUNMARTINI.DR,SPPD 0138R01703180005445
0001638965226 3;JKN DR RIZKI; 5.2.0.201712280730 4 160095
1#0##0#0#0.0#2018-08-10 10:43:15#0#12:00:00#12:00:00#00:00:00 3
26a495f53047795c39fab6aa4acff45a 0 0 499265 0 0
2181631 0 0 0 0 3073720 0 0 0 0 0
3201126 B 2 BS 1 13/03/2018 14/03/2018 18/10/1971 0 2
1 K21.0;A01.0 45.16 - - None None None None K-4-12-III None
0 - 0 - 0 - 0 - 0 8137900 7325133
0 2 0 0 0 YASMA NELLY SUBHAN D391216 46 16948
DR BETTY DWI L, SPPD 0138R01703180005983 0001179557752 3;JKN DR
RIZKI; 5.2.2.201806040537 4 160584 1#0##0#0#0.0#2018-09-05
18:28:44#0#12:00:00#12:00:00#12:00:00 3 d0d4676728bee253e34a8507af60f55e
0 0 2331612 0 0 986807 0 0 0 0
2257714 0 0 0 0 1749000
3201126 B 2 BS 1 03/03/2018 14/03/2018 07/05/2000 0 1
1 E10.2;A41.9;K29.6 38.95;90.59;39.95;89.52 - - None None None
0 - 0 - 0 23198900 34327410 0 12 1 4
0 ADIDYA ISWAHYUDA D392079 17 6509 DR. ARU ARIADNO, SPPD
0138R01703180001380 0002063562041 3;JKN DR RIZKI; 5.2.0.201712280730
4 156724 1#0##0#0#0.0#2018-09-06
17:04:22#0#12:00:00#12:00:00#12:00:00 2 3924f8f2602ac4183905d6ab50ed0b95
0 0 6780681 0 0 10951879 0 0 0 0
14602850 0 0 0 0 1992000
3201126 B 3 BS 1 13/03/2018 14/03/2018 01/04/1965 0 2
1 T82.4;N18.5;D64.9 99.04 - - None None None None I-4-23-II
None None None None None None MALFUNGSI, REAKSI DAN KOMPLIKASI DARI
ALAT ATAU PROSEDUR KARDIOVASKULAR (SEDANG) 4108200 0 0 - 0
- 0 - 0 - 0 4108200 5758995 0 2 0
0 0 UMIATI D392934 52 19339 DR YOHANES DWINANDA R P
0138R01703180005673 0000511828751 3;JKN DR RIZKI; 5.2.2.201806040537
4 160134 1#0##0#0#0.0#2018-09-10
13:45:30#0#12:00:00#12:00:00#12:00:00 3 76c17f577ef3cdd1f9b5eefbb33512ac
0 0 369738 0 0 4723500 0 0 0 0 665757
0 0 0 0 0
3201126 B 3 BS 1 14/03/2018 14/03/2018 01/01/1946 0 2
1 D48.6 - - - None None None None L-4-14-I None None
2944000 0 0 - 0 - 0 - 0 - 0
2944000 1423447 0 1 0 0 0 HJ.SALBIAH D324418
72 26370 RACHMAWATI DR,SPB(K)ONK 0138R0170318V000021 0001257935646
3;JKN DR RIZKI; 5.2.2.201806040537 4 227406 1#0##0#0#0.0#2018-
09-26 14:35:27#0#00:00:00#00:00:00#00:00:00 1
e9562c0cfa1ee86b4f38c2af5e5b4e42 0 0 386622 0 263000
654702 0 0 0 0 93123 0 0 26000 0 0
3201126 B 1 BS 1 13/03/2018 15/03/2018 27/09/1943 0 1
- 0 - 0 12472300 13932314 0 3 0 0 0
AMRAN USMAN,DRS D392961 74 27196 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180006098 0000043368985 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160601 1#1#vvip#3#1460014#0.0#2018-03-28
15:40:01#0#12:00:00#12:00:00#12:00:00 2 8f8272d614b6f466382abe1a01383ed3
0 4689000 3824000 0 0 4382854 0 0 0 0
967460 0 0 0 0 69000
3201126 B 2 BS 1 12/03/2018 15/03/2018 29/09/1955 0 2
0 - 0 - 0 - 0 - 0 7892000 12136114
0 4 0 0 0 MARDIYAH D388357 62 22810 DR RISMAN S,
SPTHT 0138R01703180005512 0000196081986 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160102 1#0##0#0#0.0#2018-03-28
15:48:19#0#12:00:00#12:00:00#12:00:00 1 0e4a0d0d9572a45cf991fbdc1d01fc14
0 7540800 1165336 0 0 2435027 0 0 0 0
849951 0 0 0 0 145000
3201126 B 3 BS 1 13/03/2018 15/03/2018 31/01/2018 0 2
1 Q56.4 83.39 - - None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 5331600 7022914
0 3 0 0 0 BAYI NY KARLINAH D389781 0 41 DR
CATUR S, SPB 0138R01703180005749 0002319755376 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160385 1#0##0#0#0.0#2018-03-28
15:55:41#0#12:00:00#12:00:00#12:00:00 1 e86f07107126efb46cd406c009813bcf
0 3617900 1555848 0 0 1188723 0 0 0 0
515443 0 0 0 0 145000
3201126 B 1 BS 1 14/03/2018 15/03/2018 21/12/2007 0 1
- 0 4181800 5623540 0 2 0 0 0 IQBAL
0138R01703180006120 0001335363658 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160604 1#0##0#0#0.0#2018-03-28
15:58:43#0#12:00:00#12:00:00#12:00:00 1 8158a9bb1e63b6cdb25ab926cd748704
0 0 429362 0 0 3238283 0 0 0 0
1955895 0 0 0 0 0
3201126 B 2 BS 1 13/03/2018 15/03/2018 23/07/2017 0 1
(RINGAN) 10368300 0 0 - 0 - 0 - 0 - 0
10368300 10379014 0 3 0 0 0 BAYI NY ANA LESTARI
0002268117808 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160543
1#0##0#0#0.0#2018-03-28 15:59:32#0#12:00:00#12:00:00#12:00:00 1
4b0820fb1b760687a4ffcbd467c06677 0 5348300 2903124 0 0
1247589 0 0 0 0 735001 0 0 0 0 145000
3201126 B 1 BS 1 12/03/2018 15/03/2018 04/04/1967 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4410794 0 4 0 0 0 NY.YOSSY JOHATHANS
D289474 50 18605 DR ARU, SPPD 0138R01703180005534
0000036661757 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160108
1#0##0#0#0.0#2018-03-28 16:02:12#0#12:00:00#12:00:00#12:00:00 1
b89a17aa69892aa849225dc88f6bac5c 0 0 236051 0 0
1517186 0 0 0 0 2657557 0 0 0 0 0
3201126 B 2 BS 1 10/03/2018 15/03/2018 01/01/1950 0 2
1 J91;I11.0 93.94 - - None None None None J-4-20-III None
None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (BERAT)
9325200 0 0 - 0 - 0 - 0 - 0
9325200 17128986 0 6 0 0 0 SALBIYAH, HJ
0000976208883 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159447
1#0##0#0#0.0#2018-03-28 16:05:17#0#12:00:00#12:00:00#12:00:00 1
be1ee050a44fdc7a2765c7ed74962c05 0 0 2328772 0 0
6877626 0 0 0 0 5648588 0 0 0 0
2274000
3201126 B 2 BS 1 07/03/2018 15/03/2018 06/06/1963 0 1
1 I13.1;K30;J18.0;D63.8;A15.2 87.49;90.59;88.76;99.04;89.52;39.95;38.95
- - None None None None N-1-12-III None None None None None
None MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (BERAT)
23198900 0 0 - 0 - 0 - 0 - 0
23198900 30945481 0 9 0 0 0 RIANTO SAPARI
D359392 54 19998 DR ARU, SPPD 0138R01703180004293
0002069457928 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159064
1#1#vvip#9#7746581#0.0#2018-03-28 16:13:26#0#12:00:00#12:00:00#00:00:00
1 4a11986bd7d8d1a37c1cf145bbb53045 0 0 5763000 0 0
10862531 0 0 0 0 14299250 0 0 0 0 20700
3201126 B 1 BS 1 10/03/2018 15/03/2018 21/12/1958 0 2
1 J45.9;J40;K21.9 89.52;87.49;90.59;93.94 - - None None None
None J-4-18-I None None None None None None ASTHMA & BRONKIOLITIS
(RINGAN) 3116300 0 0 - 0 - 0 - 0 - 0
3116300 8080634 0 6 0 0 0 SUMIYATI D392616
0000041645081 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159644
1#0##0#0#0.0#2018-03-28 16:19:18#0#12:00:00#12:00:00#12:00:00 1
112f933298f6094326d2b675ac77c9ee 0 0 446867 0 0
3174127 0 0 0 0 4459640 0 0 0 0 0
3201126 B 1 BS 1 14/03/2018 15/03/2018 08/03/2018 3000 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2686969 0 2 0 0 0 BAYI NY THERESIA
OKTARIANA SITORUS D392518 0 6 DR DYAH HARINI, SPA
0138R01703180006297 0002437966743 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 160916 1#0##0#0#0.0#2018-03-28
16:28:27#0#12:00:00#12:00:00#12:00:00 1 068f175aad62c861d7df765ed2a4b251
0 0 460620 0 0 201566 0 0 0 0
1555783 0 0 0 0 469000
3201126 B 2 BS 1 12/03/2018 15/03/2018 25/12/1946 0 2
1 J45.9;I11.9;I25.0 93.94 - - None None None None J-4-18-I
None None None None None None ASTHMA & BRONKIOLITIS (RINGAN)
2671100 0 0 - 0 - 0 - 0 - 0
2671100 3754703 0 4 0 0 0 ENIK SURATMI
0000060707979 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160099
1#0##0#0#0.0#2018-03-28 16:34:51#0#12:00:00#12:00:00#00:00:00 1
f75160f1a8886bc5c9c18f8e657f3456 0 0 287216 0 0
1680852 0 0 0 0 1786635 0 0 0 0 0
3201126 B 2 BS 1 11/03/2018 15/03/2018 15/03/2012 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3804877 0 5 0 0 0 AXELLA ELZIRA SIHOTANG
D271706 5 2187 DR RASTRA, SPA 0138R01703180004980
0002070511187 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159677
1#0##0#0#0.0#2018-03-28 16:37:16#0#12:00:00#12:00:00#00:00:00 1
00b298a3891cc59a16761f31ca7b6c23 0 0 278711 0 0 933749
0 0 0 0 2592417 0 0 0 0 0
3201126 B 1 BS 1 07/03/2018 15/03/2018 06/10/1969 0 1
0 0 - 0 - 0 - 0 - 0 17095200
38449694 0 9 0 0 0 ENRIKO P.SIDABUTAR D392374
0001618118381 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159764
1#0##0#0#0.0#2018-03-28 16:55:32#0#12:00:00#12:00:00#12:00:00 1
f72e0f571eb4038d55e8be59ad1a14d3 0 9373000 10024020 0 0
15727674 0 0 0 0 1256000 0 0 0 0
2069000
3201126 B 1 BS 1 10/03/2018 15/03/2018 10/02/1970 0 1
1 R10.4 90.59;89.52 - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 7069688 0 6 0 0 0 FRANS PATTINASARANY
0001277980378 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159637
1#0##0#0#0.0#2018-03-28 16:59:19#0#12:00:00#12:00:00#12:00:00 1
ba2ebbdb400facaf7d10a1445797cd4a 0 0 345275 0 0
1549910 0 0 0 0 5174503 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 15/03/2018 25/12/1961 0 2
1 E14.9;R10.4;R33 - - - None None None None E-4-10-I
0 - 0 3502700 5690800 0 6 0 0 0 SRI
HENDRANI D389928 56 20529 DR. ARU ARIADNO, SPPD 0138R01703180004824
0002282991221 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159647
1#0##0#0#0.0#2018-03-28 17:01:20#0#12:00:00#12:00:00#12:00:00 1
6ab4404ab78a13d7ed939e8ce26069f7 0 0 273635 0 0
3703870 0 0 0 0 1713295 0 0 0 0 0
3201126 B 3 BS 1 10/03/2018 15/03/2018 12/06/1959 0 2
1 K56.7;K29.7;J18.8 45.16;88.76;88.19 - - None None None None
K-4-15-III None None None None None None OBSTRUKSI SALURAN
0 - 0 5725500 14231574 0 6 0 0 0
RUSMIYATI D392688 58 21456 DR. ARU ARIADNO, SPPD
0138R01703180004806 0000511708779 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 159641 1#0##0#0#0.0#2018-03-28
17:07:32#0#12:00:00#12:00:00#12:00:00 2 fee52aad20475f32568f0b914a4eb35d
0 0 1144992 0 0 8537544 0 0 0 0
2834538 0 0 0 0 1714500
3201126 B 3 BS 1 12/03/2018 15/03/2018 02/06/1948 0 1
1 D21.4;D63.0 99.04 - - None None None None M-4-21-II None
None None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
PENGHUBUNG LAIN-LAIN (SEDANG) 3692700 0 0 - 0 - 0 -
0 - 0 3692700 4873707 0 4 0 0 0 BUDI
PURNAWAN D376501 69 25485 DR. ARU ARIADNO, SPPD 0138R01703180005432
0002311066361 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160079
1#0##0#0#0.0#2018-03-28 17:10:45#0#12:00:00#12:00:00#12:00:00 1
140a6d30f5e0cc32497b471204ec9d9a 0 0 321830 0 0
3241536 0 0 0 0 1310341 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 15/03/2018 25/05/1963 0 2
4 I49.3;E87.2;I11.0;R57.0 99.60 - - None None None None I-4-
(BERAT) 7295800 0 0 - 0 - 0 - 0 - 0
7295800 22836610 0 4 0 0 0 TITI SUHAETI
0001258367095 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 160101
1#0##0#0#0.0#2018-03-28 18:40:06#0#12:00:00#12:00:00#00:00:00 1
9e46227eb2c1aede3c232a2a7e12d664 0 0 682330 0 0
15610280 0 0 0 0 3845000 0 0 0 0
2699000
3201126 B 1 BS 1 12/03/2018 15/03/2018 17/01/1975 0 1
1 S42.00;M66.24 79.39;82.45 - - None None None None M-1-
0 - 0 11182000 22691769 0 4 0 0 0 EKO
HARYANTO D392913 43 15760 DR BENNY H T, SPOT 0138R01703180005550
0001372399514 3;JKN DR RIZKI; 5.2.0.201712280730 4 160111
1#0##0#0#0.0#2018-03-29 13:51:33#0#12:00:00#12:00:00#12:00:00 1
1a4ed02cea4ce7e1d30b08feb13435ef 0 7524600 8920780 0 0
4951389 0 0 0 0 1226000 0 0 0 0 69000
3201126 B 1 BS 1 14/03/2018 15/03/2018 14/05/1947 0 1
17095200 0 0 - 0 - 0 - 0 - 0
17095200 15978925 0 2 0 0 0 H. BAMBANG SULISTIYO
ADIWIJOYO D390156 70 25872 DR AZRI NURIZAL SPPD KKV
0138R01703180006224 0001295103194 3;JKN DR RIZKI; 5.2.0.201712280730
4 160655 1#0##0#0#0.0#2018-03-29
14:03:10#0#12:00:00#12:00:00#12:00:00 1 f19c9d3d51778f4a026f64066e5a8dca
0 4777000 3419040 0 0 4612535 0 0 0 0
1101350 0 0 0 0 2069000
3201126 B 1 BS 1 13/03/2018 15/03/2018 18/03/1967 0 2
1 T82.4;N18.5;I82.8 38.95;88.66 - - None None None None N-1-
- 0 12472300 30823068 0 3 0 0 0 SITI NURAINI
d390277 50 18623 DR DEDY PRATAMA SPBV 0138R01703180005797
0000061127302 3;JKN DR RIZKI; 5.2.0.201712280730 4 160441
1#0##0#0#0.0#2018-03-29 14:10:46#0#12:00:00#12:00:00#12:00:00 1
91f70f6b21da680995ebf115afcbfff2 0 7116500 6495672 0 0
11698646 0 0 0 0 2727250 0 0 0 0
2785000
3201126 B 1 BS 1 09/03/2018 15/03/2018 22/08/1947 0 1
1 N18.5;B17.1;I21.2;R00.1;E87.5 38.95;39.95;99.04 - - None None
- 0 - 0 - 0 27065300 33718309 0 7 1
4 0 H.M.SANUSI D379247 70 25767 DR BETTY DWI L, SPPD
0138R01703180005166 0001455427113 3;JKN DR RIZKI; 5.2.0.201712280730
4 159745 1#0##0#0#0.0#2018-03-31
08:46:04#0#12:00:00#12:00:00#12:00:00 1 dd612836074e54b95b5b1dc1778af176
0 10140200 8172590 0 0 10817269 0 0 0 0
2432250 0 0 0 0 2156000
3201126 B 1 BS 1 13/03/2018 15/03/2018 09/05/2013 0 2
2033900 0 0 - 0 - 0 - 0 - 0
2033900 10357545 0 3 0 0 0 LIDYA SHOPYA W BOMA
D388776 4 1769 DR CATUR S, SPB 0138R01703180005831
0001109843831 3;JKN DR RIZKI; 5.2.0.201712280730 4 160467
1#0##0#0#0.0#2018-03-31 08:49:44#0#12:00:00#12:00:00#12:00:00 1
7b5ceeb9dbb5ac3318a8bad5884ef1e8 0 7187200 569492 0 0
1824757 0 0 0 0 703596 0 0 0 0 72500
3201126 B 3 BS 1 14/03/2018 15/03/2018 06/10/1963 0 2
1 N18.5;T82.4;I85.0 - - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 2495644 0 2 0 0 0 ARI GALIH BASTARI
D374340 54 19883 DR TANTIYO SETIYOWATI 0138R01703180006611
0001369145665 3;JKN DR RIZKI; 5.2.0.201712280730 4 161053
1#0##0#0#0.0#2018-03-31 11:16:44#0#12:00:00#12:00:00#12:00:00 1
e28ece2c690c8adc4fbcea73ac8ea91e 0 0 765792 0 0
1277586 0 0 0 0 452266 0 0 0 0 0
3201126 B 3 BS 1 14/03/2018 15/03/2018 10/07/1976 0 2
1 I12.0 38.95;87.44;89.52 - - None None None None N-1-12-I
- 0 4340500 7234997 0 2 0 0 0 MARYATUN
0002267696575 3;JKN DR RIZKI; 5.2.0.201712280730 4 161050
1#0##0#0#0.0#2018-03-31 11:23:14#0#12:00:00#12:00:00#12:00:00 1
a5e172271ed8a164e6b8ef220d2180e3 0 2976000 1311745 0 0
2348934 0 0 0 0 529318 0 0 0 0 69000
3201126 B 3 BS 1 14/03/2018 15/03/2018 19/08/1981 0 2
- 0 8908800 9015585 0 2 0 0 0 IIN
SUPRIATIN D385388 36 13356 DR SRI KUNMARTINI, SPPD 0138R01703180006606
0002282454371 3;JKN DR RIZKI; 5.2.0.201712280730 4 161052
1#0##0#0#0.0#2018-03-31 11:38:35#0#12:00:00#12:00:00#12:00:00 1
113ceec2a32975aabff29df61330e603 0 3352300 2636552 0 0
2311928 0 0 0 0 645805 0 0 0 0 69000
3201126 B 3 BS 1 14/03/2018 15/03/2018 24/06/1977 0 1
3 E14.9;R57.1;K29.7 89.52 - - None None None None E-4-10-III
0 - 0 6262900 912347 0 2 0 0 0 RIZKI
KAMO D347629 40 14873 DR DINI DANIATY 0138R01703180006324
0002053158985 3;JKN DR RIZKI; 5.2.0.201712280730 4 161520
1#0##0#0#0.0#2018-03-31 11:42:21#0#12:00:00#12:00:00#12:00:00 1
3941f25c102b41ec075ed57133899fa4 0 0 563661 0 0 0
0 0 0 0 348686 0 0 0 0 0
3201126 B 3 BS 1 13/03/2018 15/03/2018 27/03/2017 0 2
0 0 - 0 - 0 - 0 - 0 5331600
7392246 0 3 0 0 0 MAHILA ALONA MESSI D392406
3;JKN DR RIZKI; 5.2.0.201712280730 4 160383 1#0##0#0#0.0#2018-
03-31 11:56:18#0#12:00:00#12:00:00#12:00:00 1
f4ecae8cc6d4b0d347b0127d1446f117 0 3617900 1546848 0 0
1532893 0 0 0 0 549605 0 0 0 0 145000
3201126 B 2 BS 1 13/03/2018 15/03/2018 01/03/1968 0 1
INTERNAL (RINGAN) 5178700 0 0 - 0 - 0 - 0 -
0 5178700 11372944 0 3 0 0 0 ROHADI
0001464053141 3;JKN DR RIZKI; 5.2.0.201712280730 4 160593
1#0##0#0#0.0#2018-03-31 13:00:45#0#12:00:00#12:00:00#00:00:00 1
3aa6b40c42c180ad65013a8dd232a524 0 5388000 2700036 0 0
2319884 0 0 0 0 820024 0 0 0 0 145000
3201126 B 2 BS 1 13/03/2018 15/03/2018 25/10/1967 0 2
0 0 - 0 - 0 - 0 - 0 6397900
10401922 0 3 0 0 0 ROSYIDAH LASTRIANA d370697
3;JKN DR RIZKI; 5.2.0.201712280730 4 160585 1#0##0#0#0.0#2018-
03-31 13:23:16#0#12:00:00#12:00:00#00:00:00 1
cdb2995888b152bca0b933216a746b62 0 5388000 1791412 0 0
2397010 0 0 0 0 756500 0 69000 0 0 0
3201126 B 2 BS 1 12/03/2018 15/03/2018 13/04/1966 0 2
4 J96.0;M32.9;J18.0 87.44 - - None None None None J-4-11-III
None None None None None None KEGAGALAN PERNAFASAN (BERAT) 6158000
0 0 - 0 - 0 - 0 - 0 6158000
8100721 0 4 0 0 0 EVA IRENE SIAGIAN D385103 51
RIZKI; 5.2.0.201712280730 4 160110 1#0##0#0#0.0#2018-03-31
13:29:31#0#12:00:00#12:00:00#12:00:00 1 19a8a8fe38d99b9eacc8fa9551170ea3
0 0 1187792 0 0 4841975 0 0 0 0
2070954 0 0 0 0 0
3201126 B 2 BS 1 04/03/2018 15/03/2018 04/03/2018 2166 2
1 P22.9;P59.9;P03.4 99.82 - - None None None None P-8-13-I
PROSEDUR MAYOR (RINGAN) 6580300 0 0 - 0 - 0 - 0
- 0 6580300 21101108 0 12 0 0 0 BAYI NY
FENTI NOVA KHAIRANI D392101 0 0 DR AULIA TANGKARI, SPA
0138R01703180001818 0002436047458 3;JKN DR RIZKI; 5.2.0.201712280730
4 156867 1#0##0#0#0.0#2018-04-05
11:27:53#0#12:00:00#12:00:00#12:00:00 2 0196fb540bf08a5dd89cdbdae9e8393b
0 0 658030 0 0 4721078 0 0 0 0
10598000 0 0 0 0 5124000
3201126 B 1 BS 1 08/03/2018 15/03/2018 01/12/1970 0 1
I-1-40-I None None YY-02-III None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (RINGAN) 15016100 0 0 PCI 10725800 - 0 - 0
- 0 25741900 75332964 0 8 1 2 0 DR. FERRI
SABARUDDIN SP. OG D190439 47 17264 DR AZRI NURIZAL SPPD KKV
0138R01703180007044 0001456390776 3;JKN TANTIYO S;16137
5.2.1.201802140120 4 161527 1#0##0#0#0.0#2018-04-09
15:54:50#0#12:00:00#12:00:00#12:00:00 1 2984d00b80ec487cd500a784c0ac7988
0 15077500 3807025 0 0 47027439 0 0 0 0
1256000 0 0 0 0 8165000
3201126 B 3 BS 1 14/03/2018 15/03/2018 24/06/1977 0 1
3 E14.9;R57.1;K29.7 89.52 - - None None None None E-4-10-III
0 - 0 6262900 912347 0 2 0 0 0 RIZKI
KAMO D347629 40 14873 DR DINI DANIATY 0138R01703180007454
0002053158985 3;JKN irene; 5.2.1.201802140120 4 161520
1#0##0#0#0.0#2018-04-11 14:59:21#0#12:00:00#12:00:00#12:00:00 2
09d094b85dce63d29ad93e4229ccfd45 0 0 563661 0 0 0
0 0 0 0 348686 0 0 0 0 0
3201126 B 3 BS 1 13/03/2018 15/03/2018 06/01/2012 0 2
- 0 - 0 - 0 - 0 3874400 8938991 0
3 0 0 0 ALENA ADZKIYA MUTIARA HAFIZH D222364 6 2258
DR CATUR SUZANTARA 0138R01703180006391 0001258347925 3;JKN DR
RIZKI; 5.2.1.201802140120 4 172354 1#0##0#0#0.0#2018-04-17
11:22:07#0#00:00:00#00:00:00#12:00:00 1 41f1db0dc1b13872e16f464833909290
0 3617900 1254832 0 0 3250465 0 0 0 0
670794 0 0 0 0 145000
3201126 B 3 BS 1 15/03/2018 15/03/2018 08/09/1960 0 2
1 I20.9;J46;R57.0 93.94 - - None None None None I-4-20-III
7040000 0 0 - 0 - 0 - 0 - 0
7040000 5466516 0 1 0 0 0 SUMINI D383476
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 161059
1#0##0#0#0.0#2018-04-26 16:32:17#0#12:00:00#12:00:00#12:00:00 2
74747224869edb0e9d12b12c0d59ee9d 0 0 477081 0 0
3583812 0 0 0 0 664623 0 0 0 0 741000
3201126 B 2 BS 1 13/03/2018 15/03/2018 28/02/1978 0 1
1 R10.4;J06.9 89.52;90.59 - - None None None None K-4-17-I
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2977978 0 3 0 0 0 FERRY MUHAMMAD LUJATI
ARIANTO D392960 40 14623 SRI KUNMARTINI.DR,SPPD 0138R01703180005774
0001473716428 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 160429
1#0##0#0#0.0#2018-09-28 13:02:53#0#12:00:00#12:00:00#12:00:00 2
24898c7569c411713ee36a85d23915d0 0 0 372122 0 0 870035
0 0 0 0 1735821 0 0 0 0 0
3201126 B 2 BS 1 11/03/2018 15/03/2018 16/05/2011 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4213239 0 5 0 0 0 AISYAH CALLISTA FAIRUZ
D392737 6 2491 DR GUNAWAN S, SPA 0138R01703180004828
0001653863578 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 159648
1#0##0#0#0.0#2018-09-28 13:05:57#0#12:00:00#12:00:00#12:00:00 2
caeeaeac1893462bdda853640f14ebbe 0 0 238535 0 0 638072
0 0 0 0 2826632 0 0 0 0 510000
3201126 B 3 BS 1 16/03/2018 16/03/2018 31/12/1952 0 1
1 J44.9;R40.2;I67.9 96.05 - - None None None None J-4-17-II
None None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (SEDANG)
4417400 0 0 - 0 - 0 - 0 - 0
4417400 4602228 0 1 0 0 0 WAWAN RIDWAN TN
D393065 65 23816 DR ADITIA NATA KUSUMA 123456789 123 3;JKN DR
RIZKI; 5.2.0.201712280730 4 161984 1#0##0#0#0.0#2018-03-26
08:50:34#0#17:04:42#17:04:42#00:00:00 1 d06523f7ad59aa6fbc1ccdb82dbce656
0 0 397566 0 0 3000582 0 0 0 0 608080
0 0 0 596000 0
3201126 B 1 BS 1 15/03/2018 16/03/2018 06/09/1980 0 1
1 I12.0;J18.0;D63.8 99.04;39.27 - - None None None None N-1-
- 0 - 0 27065300 17323612 0 2 0 0 0
MUHAMMAD NUR'ALAM D392933 37 13704 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180006666 0001266142757 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 161065 1#0##0#0#0.0#2018-03-26
17:08:49#0#12:00:00#12:00:00#12:00:00 1 ce34da776f78157d6e10d8fc5b63be9b
0 6468200 6495672 0 0 3101420 0 0 0 0
1189320 0 0 0 0 69000
3201126 B 1 BS 1 15/03/2018 16/03/2018 27/12/2012 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5155013 0 2 0 0 0 NARENDRA DIMAS
YUDHONUGROHO D242108 5 1904 DR CATUR SUZANTARA
0138R01703180006885 0001826050408 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 161335 1#0##0#0#0.0#2018-03-27
12:54:26#0#12:00:00#12:00:00#12:00:00 1 7629762828536bb374e167dcffd55670
0 3398000 575204 0 0 719565 0 0 0 0
393244 0 0 0 0 69000
3201126 B 1 BS 1 14/03/2018 16/03/2018 10/11/1938 0 1
- 0 58821400 68665766 0 3 0 0 0 SAIFUDIN
LATIF YASIN D095978 79 28979 DR AZRI NURIZAL SPPD KKV
0138R01703180006244 0000061038281 3;JKN DR RIZKI; 5.2.0.201712280730
4 160724 1#0##0#0#0.0#2018-03-29
13:52:58#0#12:00:00#12:00:00#00:00:00 1 3d5a2bc28b4ecd74240af3615abbd7a5
0 10753000 9619120 0 0 38880646 0 0 0 0
1256000 0 0 0 0 8157000
3201126 B 1 BS 1 14/03/2018 16/03/2018 05/10/1957 0 2
- 0 58821400 63066854 0 3 0 0 0 TUTI
ASMIYATI D030696* 60 22075 DR AZRI NURIZAL SPPD KKV
0138R01703180006620 0000042207625 3;JKN DR RIZKI; 5.2.0.201712280730
4 161056 1#0##0#0#0.0#2018-03-29
13:54:09#0#12:00:00#12:00:00#12:00:00 1 e6d2f9f644f2dc06acdefc751f053ad3
0 10062000 9619120 0 0 34560734 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 1 BS 1 15/03/2018 16/03/2018 06/07/1980 0 2
1 N85.1;N92.0 69.09 - - None None None None W-1-11-I None
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 5401696 0 2 0 0 0 LILY FITRIA d123648
DR RIZKI; 5.2.0.201712280730 4 161533 1#0##0#0#0.0#2018-03-29
14:20:04#0#12:00:00#12:00:00#12:00:00 1 282e4e86c8abd302cfd620476885d0f2
0 3052500 964824 0 0 902490 0 0 0 0
409382 0 0 0 0 72500
3201126 B 1 BS 1 15/03/2018 16/03/2018 10/12/1953 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 9708174 0 2 0 0 0 HARDIMAN D391256
DR RIZKI; 5.2.0.201712280730 4 161410 25#0##0#0#0.0#2018-03-29
14:49:52#0#12:00:00#12:00:00#12:00:00 1 71207f10484fb69e2feaed12b194e110
0 6468200 1215340 0 0 1136520 0 0 0 0
691114 0 0 0 0 197000
3201126 B 1 BS 1 13/03/2018 16/03/2018 03/07/1957 0 2
1 A01.0;R11 89.52;90.59 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 4318638 0 4 0 0 0 SULISTYAWATI
0001119689921 3;JKN DR RIZKI; 5.2.0.201712280730 4 160595
1#0##0#0#0.0#2018-03-31 08:16:29#0#12:00:00#12:00:00#00:00:00 1
ec221a2572e39e33a488d72d4494134c 0 0 269459 0 0 962151
0 0 0 0 3087028 0 0 0 0 0
3201126 B 1 BS 1 12/03/2018 16/03/2018 03/05/2015 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 6551364 0 5 0 0 0 KHANSA AZALIA KURNIAWAN
D365163 2 1044 DR HUDA, SPA 0138R01703180005336
0002204443596 3;JKN DR RIZKI; 5.2.0.201712280730 4 160021
1#0##0#0#0.0#2018-03-31 08:19:54#0#12:00:00#12:00:00#12:00:00 1
c1d3f5e36f4859dc36fd33c443cd3e18 0 0 316331 0 0
1875439 0 0 0 0 4359594 0 0 0 0 0
3201126 B 1 BS 1 13/03/2018 16/03/2018 24/09/2017 0 2
1 A09.9;A91;J06.9 - - - None None None None K-4-17-III
(BERAT) 3554300 0 0 - 0 - 0 - 0 - 0
3554300 5556614 0 4 0 0 0 AYUMI ADEEVA PUTRI
0002312906703 3;JKN DR RIZKI; 5.2.0.201712280730 4 160565
1#0##0#0#0.0#2018-03-31 08:22:21#0#12:00:00#12:00:00#12:00:00 1
e62c8920be2c270a40d5ad29bbd9fdf2 0 0 316331 0 0
1386766 0 0 0 0 3513517 0 0 0 0 340000
3201126 B 1 BS 1 11/03/2018 16/03/2018 16/04/1976 0 2
1 O75.1;O36.4;O46.9;O99.0;O99.1;Z37.1 99.04;69.02 - - None None
None None O-6-11-II None None None None None None PERSALINAN VAGINAL
DENGAN STERILISASI &/ DILATASI & KURET (SEDANG) 5345400 0 0 - 0
- 0 - 0 - 0 5345400 24501667 0 6 1
4 0 SITI HANNAH D392758 41 15304 DR ERDIYAN, SPOG
0138R01703180004918 0000041979249 3;JKN DR RIZKI; 5.2.0.201712280730
4 159665 1#0##0#0#0.0#2018-03-31
08:42:50#0#12:00:00#12:00:00#12:00:00 2 9b4cc84fea1be6597282313b096c9033
0 0 2026848 0 0 11540819 0 0 0 0
8221500 0 0 0 0 2712500
3201126 B 3 BS 1 15/03/2018 16/03/2018 05/12/2017 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6892314 0 2 0 0 0 SYAHRIL DERMAWAN
d392397 0 100 DR CATUR S, SPB 0138R01703180006817
0002317248461 3;JKN DR RIZKI; 5.2.0.201712280730 4 161157
1#0##0#0#0.0#2018-03-31 09:25:42#0#12:00:00#12:00:00#12:00:00 1
54901c2fc11744e78275925abaea0646 0 3444900 1536920 0 0
1258595 0 0 0 0 506899 0 0 0 0 145000
3201126 B 3 BS 1 15/03/2018 16/03/2018 02/03/1964 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 7271582 0 2 0 0 0 ROMLI TN
0001743644902 3;JKN DR RIZKI; 5.2.0.201712280730 4 161064
1#0##0#0#0.0#2018-03-31 09:28:27#0#00:55:00#12:00:00#00:00:00 1
cbde023747451a1ddc7175f9d102f8e8 0 0 371889 0 0
3822482 0 0 0 0 3077211 0 0 0 0 0
3201126 B 3 BS 1 15/03/2018 16/03/2018 12/07/1967 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 5614900 0 2 0 0 0 SUMARNI D391159
3;JKN DR RIZKI; 5.2.0.201712280730 4 161491 1#0##0#0#0.0#2018-
03-31 09:39:20#0#12:00:00#12:00:00#12:00:00 1
1e254b60958c1d3f0f1cda5c251c1317 0 3438800 868100 0 0
815670 0 0 0 0 423330 0 0 0 0 69000
3201126 B 3 BS 1 16/03/2018 16/03/2018 05/04/1960 0 1
1 I63.9;I50.0 87.03;87.44 - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5392633 0 1 0 0 0 HIN BENG
0002083681451 3;JKN DR RIZKI; 5.2.0.201712280730 4 161545
1#0##0#0#0.0#2018-03-31 10:53:00#0#00:00:00#09:00:00#12:00:00 1
e97b00b0abbe7dd098eb0093f1151686 0 0 439974 0 0
3534870 0 0 0 0 659789 0 0 0 0 758000
3201126 B 3 BS 1 14/03/2018 16/03/2018 20/06/1985 0 1
1 N39.0;R11 88.76 - - None None None None N-4-12-I None
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2950652 0 3 0 0 0 HARI SULISTIANTO
0001448815048 3;JKN DR RIZKI; 5.2.0.201712280730 4 160602
1#0##0#0#0.0#2018-03-31 11:07:05#0#12:00:00#12:00:00#12:00:00 1
894f041c653c98dccebae65bfd0d315d 0 0 268343 0 0
1674276 0 0 0 0 1008033 0 0 0 0 0
3201126 B 3 BS 1 14/03/2018 16/03/2018 05/06/1970 0 2
1 K74.6;R18;E87.6;E11.9;R77.0 54.91;90.59;89.52 - - None None
None None B-4-13-II None None None None None None GANGGUAN HATI
LAIN-LAIN (SEDANG) 4897800 0 0 - 0 - 0 - 0
- 0 4897800 2347149 0 3 0 0 0 MASKUNA
0002274086801 3;JKN DR RIZKI; 5.2.0.201712280730 4 161057
1#0##0#0#0.0#2018-03-31 11:12:09#0#12:00:00#12:00:00#12:00:00 1
bfb5214eeb7d9f6bc1cc1a6d1949ddf5 0 0 493802 0 0
1147795 0 0 0 0 705552 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 16/03/2018 11/09/2010 0 1
8041000 0 0 - 0 - 0 - 0 - 0
8041000 11472250 0 5 0 0 0 ABDULLAH SYAKIR
0002326619496 3;JKN DR RIZKI; 5.2.0.201712280730 4 160055
1#0##0#0#0.0#2018-03-31 11:17:56#0#12:00:00#12:00:00#12:00:00 1
f90249b3f66c05a15b96ff0d4d308ecc 0 3981900 2251480 0 0
4194849 0 0 0 0 826521 0 0 0 0 217500
3201126 B 3 BS 1 15/03/2018 16/03/2018 11/03/1964 0 1
1 I13.1;D63.8;G47.0 38.95;90.59;89.52;87.49;99.04 - - None None
- 0 - 0 - 0 8908800 9664784 0 2 0
0 0 SUJADI D391972 54 19727 DR IRFIANSYAH LESMANA DR
SPBTKV 0138R01703180006737 0001461722769 3;JKN DR RIZKI;
5.2.0.201712280730 4 161066 1#0##0#0#0.0#2018-03-31
11:21:18#0#12:00:00#12:00:00#12:00:00 1 3d3b800ee88d81c85c914aa56b3c4582
0 0 2583552 0 0 2885156 0 0 0 0
4127076 0 0 0 0 69000
3201126 B 3 BS 1 15/03/2018 16/03/2018 04/08/1987 0 2
0 0 - 0 - 0 - 0 - 0 8264200
9943498 0 2 0 0 0 LUSIANA D393125 30 11181
DR MARLY, SPOG 0138R01703180006659 0001721659792 3;JKN DR RIZKI;
5.2.0.201712280730 4 161063 1#0##0#0#0.0#2018-03-31
11:28:31#0#12:00:00#12:00:00#12:00:00 1 334071363782084981f597daa4323038
0 0 2244900 0 0 3408089 0 0 0 0
4221509 0 0 0 0 69000
3201126 B 3 BS 1 15/03/2018 16/03/2018 07/01/1963 0 1
1 J18.0;I11.0;K21.9 90.59;89.52 - - None None None None J-4-
(BERAT) 6419700 0 0 - 0 - 0 - 0 - 0
6419700 2502735 0 2 0 0 0 MUHAMMAD UBAIDILLAH.MZ
0001652610835 3;JKN DR RIZKI; 5.2.0.201712280730 4 161534
1#0##0#0#0.0#2018-03-31 11:34:12#0#12:00:00#12:00:00#12:00:00 1
42300c099827c4289845606c8d5579b3 0 0 577773 0 0
1472232 0 0 0 0 452730 0 0 0 0 0
3201126 B 2 BS 1 11/03/2018 16/03/2018 31/01/2018 0 1
1 J18.0;R56.0 87.44;93.94 - - None None None None J-4-16-II
(SEDANG) 6093000 0 0 - 0 - 0 - 0 - 0
6093000 11026579 0 6 0 0 0 BAYI NY AFRAINA DEWI
PUTRI NAZAR D392744 0 39 DR OTTY MITHA S, SPA 0138R01703180004848
0002314900877 3;JKN DR RIZKI; 5.2.0.201712280730 4 159657
1#0##0#0#0.0#2018-03-31 12:42:12#0#12:00:00#12:00:00#12:00:00 1
1b781285d9878ef1e4c5177d5388a258 0 0 601370 0 0
4347844 0 0 0 0 3777365 0 0 0 0
2300000
3201126 B 2 BS 1 15/03/2018 16/03/2018 26/07/1973 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 2664101 0 2 0 0 0 SUMARTANA D369438
3;JKN DR RIZKI; 5.2.0.201712280730 4 161539 1#0##0#0#0.0#2018-
03-31 12:47:52#0#12:00:00#12:00:00#00:00:00 1
625b17dd9c02cbeaf4594b53efcf107e 0 0 499265 0 0
1459549 0 0 0 0 705287 0 0 0 0 0
3201126 B 2 BS 1 14/03/2018 16/03/2018 15/01/1942 0 2
1 D64.9;L89.9;K92.1;I69.4 99.04 - - None None None None D-4-
0 - 0 3584400 5427773 0 3 0 0 0
SUHARTI, NY D362387 76 27817 DR BETTY DWI L, SPPD
0138R01703180006640 0000060728589 3;JKN DR RIZKI; 5.2.0.201712280730
4 161058 16#1#vvip#3#1843373#0.0#2018-03-31
12:57:53#0#12:00:00#12:00:00#00:00:00 1 33add5892c2e048caad4b2f0519bd2a3
0 0 324000 0 0 1746685 0 0 0 0
3357088 0 0 0 0 0
3201126 B 2 BS 1 15/03/2018 16/03/2018 02/05/1964 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 7226842 0 2 0 0 0 SUKEN RINI , S.PD ,MM
0001633805886 3;JKN DR RIZKI; 5.2.0.201712280730 4 161375
1#0##0#0#0.0#2018-03-31 12:59:54#0#12:00:00#12:00:00#12:00:00 1
694e11179a500f7107ede4403d34356d 0 1760000 1206214 0 0
3612844 0 0 0 0 578784 0 69000 0 0 0
3201126 B 2 BS 1 11/03/2018 16/03/2018 04/04/1964 0 1
3 K56.7;R57.2;A41.9 - - - None None None None K-4-15-III
(BERAT) 6870600 0 0 - 0 - 0 - 0 - 0
6870600 25945549 0 6 1 6 0 PARNINGOTAN D392741
53 19699 DR ARU, SPPD 0138R01703180004885 0002256229102 3;JKN
DR RIZKI; 5.2.0.201712280730 4 159660 4#0##0#0#0.0#2018-04-05
11:25:29#0#12:00:00#12:00:00#12:00:00 1 a068601987202d0b77280c9bf92e51aa
0 0 740060 0 0 13445489 0 0 0 0
6464000 0 0 0 0 5296000
3201126 B 1 BS 1 13/03/2018 16/03/2018 05/03/2018 0 2
0 - 0 - 0 - 0 - 0 5886000 4692566
0 4 0 0 0 BAYI NY. MARIA ULFA D392984 0 8
RIZKI; 5.2.0.201712280730 4 161155 9#0##0#0#0.0#2018-04-05
14:02:18#0#12:00:00#12:00:00#12:00:00 1 d453f46ffcf3549ccf466fc20423e7d2
0 0 529740 0 0 271836 0 0 0 0
3040990 0 850000 0 0 0
3201126 B 1 BS 1 13/03/2018 16/03/2018 05/04/2012 0 2
1 J18.0;R11 87.44 - - None None None None J-4-16-I None
5058500 0 0 - 0 - 0 - 0 - 0
5058500 5837452 0 4 0 0 0 FAIQA AZHIMA SETYAWAN
0002051079423 3;JKN DR RIZKI; 5.2.0.201712280730 4 160588
1#0##0#0#0.0#2018-04-05 14:42:31#0#12:00:00#12:00:00#00:00:00 1
257294b0c5ed18c0d1601e5bcf8b141d 0 0 508265 0 0
2142798 0 0 0 0 3186389 0 0 0 0 0
3201126 B 1 BS 1 15/03/2018 16/03/2018 31/03/2009 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5148122 0 2 0 0 0 ANINDITO PANDU
FAHRINUGROHO D166005 8 3271 DR CATUR SUZANTARA
0138R01703180006886 0001826048733 3;JKN DR RIZKI; 5.2.0.201712280730
4 161334 23#0##0#0#0.0#2018-04-05
14:43:44#0#12:00:00#12:00:00#12:00:00 1 99c8f8a956416f9eeae015dea3d16483
0 3398000 638204 0 0 646625 0 0 0 0
392793 0 0 0 0 72500
3201126 B 3 BS 1 09/03/2018 16/03/2018 23/08/1975 0 1
1 I11.0;I25.1;R18;E87.6 89.52;87.44 - - None None None None
4144700 0 0 - 0 - 0 - 0 - 0
4144700 6231662 0 8 0 0 0 AL IHWAN D391267
42 15539 DR SUPONO SPJP 0138R01703180004507 0002296539382 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 159413 1#0##0#0#0.0#2018-
04-06 11:01:14#0#12:00:00#12:00:00#12:00:00 2
a23d78a60357fee7aec5a24518f684c7 0 0 699568 0 0
2994415 0 0 0 0 2537679 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 16/03/2018 14/02/2018 1654 1
1 P22.0;P01.1;P07.3 96.05;96.72;38.97 - - None None None None
0 - 0 - 0 30082000 81167277 0 31 1 2
100 BAYI NY SITI JUBAEDAH I/MUHAMMAD HAIDAR D390450 0 0 DR
AULIA TANGKARI, SPA 0138R01702180006901 0002430202825 3;JKN DR RIZKI;
5.2.2.201806040537 4 150032 1#0##0#0#0.0#2018-08-16
09:09:26#0#12:00:00#12:00:00#12:00:00 3 edd4f1ff6f29bb934727dd4f52b340c4
0 0 3360100 0 0 17252177 0 0 0 0
28684000 0 0 0 0 31871000
3201126 B 1 BS 1 08/03/2018 16/03/2018 25/08/2016 0 1
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LAIN (BERAT) 8736200 0 0 - 0 - 0 - 0 -
0 8736200 16098655 0 9 0 0 0 ASYTAR SALIM GHALI
ASYA D342594 1 560 DR NOVIK BUDIWARDHANA, SPA 0138R01703180003548
0002077408214 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 158309
1#0##0#0#0.0#2018-09-28 12:58:32#0#12:00:00#12:00:00#00:00:00 2
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5302274 0 0 0 0 8889183 0 0 0 0 919000
3201126 B 1 BS 1 16/03/2018 17/03/2018 25/09/1948 0 1
0 0 - 0 - 0 - 0 - 0 17095200
14246098 0 2 0 0 0 MOCHAMAD YUNUS, IR D351662
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1#0##0#0#0.0#2018-03-26 09:31:31#0#12:00:00#12:00:00#00:00:00 1
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2993070 0 0 0 0 987988 0 0 0 0
2069000
3201126 B 1 BS 1 15/03/2018 17/03/2018 04/06/1985 0 2
0 0 - 0 - 0 - 0 - 0 12140800
16196085 0 3 0 0 0 GALIH FOURINASARI D393182 32
11972 DR BENNY H T, SPOT 0138R01703180007159 0001307691639 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 161536 1#0##0#0#0.0#2018-
03-27 13:00:34#0#12:00:00#12:00:00#12:00:00 1
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1942864 0 0 0 0 10908857 0 0 0 0 145000
3201126 B 2 BS 1 14/03/2018 17/03/2018 28/02/2011 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4004464 0 4 0 0 0 HAGAN JABBAR KAMAL
MINALDI D208102 7 2571 DR HUDA HILMAN 0138R01703180006327
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1#0##0#0#0.0#2018-03-29 09:02:29#1#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 2706814 0 0 0 0 0
3201126 B 1 BS 1 13/03/2018 17/03/2018 13/03/1947 0 2
1 L03.9;I82.9 88.77 - - None None None None L-4-12-II None
None None None None None PERADANGAN KULIT/CELLULITIS (SEDANG)
3245500 0 0 - 0 - 0 - 0 - 0
3245500 8409571 0 5 0 0 0 DJAHRO Y,HJ D391853
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1#1#vvip#5#5164071#0.0#2018-03-29 13:47:30#0#12:00:00#12:00:00#12:00:00
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1542246 0 0 0 0 5676159 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 17/03/2018 21/11/1947 0 1
1 I25.0;Q24.5;I11.0;K30 88.55 - - None None None None I-1-
17095200 0 0 - 0 - 0 - 0 - 0
17095200 15752133 0 2 0 0 0 MANAHAN.NP D362963
0001269110856 3;JKN DR RIZKI; 5.2.0.201712280730 4 162039
1#0##0#0#0.0#2018-03-29 13:56:41#0#12:00:00#12:00:00#00:00:00 1
20f61e99f78770e2631d7d2d482bc713 0 5468000 3419040 0 0
3778580 0 0 0 0 1086513 0 0 0 0
2000000
3201126 B 1 BS 1 16/03/2018 17/03/2018 11/03/1957 0 2
1 G56.0;M62.54;I10 82.01 - - None None None None M-1-80-II
14418300 0 0 - 0 - 0 - 0 - 0
14418300 16098763 0 2 0 0 0 PONIYEM D053105
61 22285 DR BENNY H T, SPOT 0138R01703180007403 0000037936405
3;JKN DR RIZKI; 5.2.0.201712280730 4 161817 1#0##0#0#0.0#2018-
03-29 13:58:40#0#12:00:00#12:00:00#12:00:00 1
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1688997 0 0 0 0 10872490 0 0 0 0 69000
3201126 B 1 BS 1 16/03/2018 17/03/2018 21/05/2002 0 1
1 B34.9;C41.9 - - - None None None None A-4-13-II None
3734400 0 0 - 0 - 0 - 0 - 0
3734400 4035301 0 2 0 0 0 ARVANDY YUSTICIO
0000126245801 3;JKN DR RIZKI; 5.2.0.201712280730 4 161541
1#1#vvip#2#300901#0.0#2018-03-29 14:22:22#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 2839992 0 0 0 0 0
3201126 B 1 BS 1 14/03/2018 17/03/2018 17/12/1957 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 16483380 0 4 0 0 0 LENDA OLGA D012148
3;JKN DR RIZKI; 5.2.0.201712280730 4 160772 1#0##0#0#0.0#2018-
03-29 14:31:24#0#12:00:00#12:00:00#12:00:00 2
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4157532 0 0 0 0 1179352 0 0 0 0 217500
3201126 B 1 BS 1 11/03/2018 17/03/2018 28/06/1941 0 2
1 I11.0;I48;J18.9 89.52;88.72 - - None None None None I-4-
6963100 0 0 - 0 - 0 - 0 - 0
6963100 11135822 0 7 0 0 0 ENDAH MURDAYA, NY
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1#0##0#0#0.0#2018-03-29 14:35:16#0#12:00:00#12:00:00#12:00:00 1
513c92417abf1f4fc78e2d17d3370792 0 0 1031579 0 0
3882731 0 0 0 0 6221512 0 0 0 0 0
3201126 B 1 BS 1 12/03/2018 17/03/2018 29/03/1968 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 15322662 0 6 0 0 0 LINDA FRIDA PURBA
0001257112642 3;JKN DR RIZKI; 5.2.0.201712280730 4 160107
1#0##0#0#0.0#2018-03-29 14:37:19#0#12:00:00#12:00:00#12:00:00 1
855e79c9a9359e27d9cfc54cbc21d16a 0 8541200 3054660 0 0
2564385 0 0 0 0 1093417 0 0 0 0 69000
3201126 B 1 BS 1 15/03/2018 17/03/2018 05/05/1957 0 1
1 A16.1;M49.07 87.24 - - None None None None J-4-15-I
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 5921895 0 3 0 0 0 ZAENAL ABIDIN,DRS
0000060521049 3;JKN DR RIZKI; 5.2.0.201712280730 4 161060
1#0##0#0#0.0#2018-03-29 14:48:14#0#12:00:00#12:00:00#12:00:00 1
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2375660 0 0 0 0 2825414 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 17/03/2018 06/09/1956 0 2
3 D37.5;R10.4;A41.9 89.52 - - None None None None K-4-18-III
(BERAT) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 1786822 0 1 0 0 0 EMMY SRI LESTARI
D288276 61 22472 DR RICO ADITYA 0138R01703180007758
0001282950876 3;JKN DR RIZKI; 5.2.0.201712280730 4 162009
1#0##0#0#0.0#2018-03-31 09:04:26#0#00:12:00#12:00:00#12:00:00 2
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0 0 0 0 405895 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 17/03/2018 01/04/1954 0 1
1 I50.0;J44.9 87.44 - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 4144700 1778044
0 1 0 0 0 SUDJANA D371453 63 23361 DR RICO
ADITYA 0138R01703180007721 0000511686461 3;JKN DR RIZKI;
5.2.0.201712280730 4 162003 1#0##0#0#0.0#2018-03-31
09:13:34#0#00:00:00#09:00:00#12:00:00 1 e852b2127b4f7448375372f9951bb197
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0 0 0 0 0
3201126 B 3 BS 1 16/03/2018 17/03/2018 12/08/1957 0 1
1 E14.5;E87.1;R57.2 - - - None None None None I-4-15-II
LAIN (SEDANG) 6097900 0 0 - 0 - 0 - 0 -
0 6097900 3051784 0 2 0 0 0 ABDUL ROCHMAN
D391652 60 22131 DR RICO ADITYA 0138R01703180007697
0002435310461 3;JKN DR RIZKI; 5.2.0.201712280730 4 161996
1#0##0#0#0.0#2018-03-31 09:16:45#0#22:10:00#04:30:00#12:00:00 1
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1139258 0 0 0 0 506649 0 0 0 0 716000
3201126 B 3 BS 1 17/03/2018 17/03/2018 16/06/1978 0 1
- 0 - 0 - 0 - 0 4096200 8600354 0
1 0 0 0 NURDIN D393339 39 14519 DR RICO ADITYA
0138R01703180007736 0001384154649 3;JKN DR RIZKI; 5.2.0.201712280730
4 162005 1#0##0#0#0.0#2018-03-31
09:23:54#0#05:56:00#19:33:00#12:00:00 1 03a89e2e89b900838746251da9cb7f38
0 0 569658 0 0 6122056 0 0 0 0 869640
0 0 0 0 1039000
3201126 B 3 BS 1 16/03/2018 17/03/2018 27/12/1967 0 2
- 0 8908800 9728487 0 2 0 0 0 MULYATI
0001322482408 3;JKN DR RIZKI; 5.2.0.201712280730 4 161993
1#0##0#0#0.0#2018-03-31 09:35:19#0#12:00:00#12:00:00#12:00:00 1
39d313ffb3133c49187c49fb52e57baa 0 2976000 2636552 0 0
3354492 0 0 0 0 692443 0 0 0 0 69000
3201126 B 3 BS 1 14/03/2018 17/03/2018 01/06/1970 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 7634268 0 4 0 0 0 HABUDIN D391878
0001267822416 3;JKN DR RIZKI; 5.2.0.201712280730 4 160791
1#0##0#0#0.0#2018-03-31 09:37:16#0#12:00:00#12:00:00#12:00:00 1
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1688110 0 0 0 0 555438 0 0 0 0 69000
3201126 B 3 BS 1 15/03/2018 17/03/2018 26/05/1980 0 1
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EDWIN KUSNANDAR D389164 37 13807 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180006748 0002090950659 3;JKN DR RIZKI; 5.2.0.201712280730
4 161067 1#0##0#0#0.0#2018-03-31
10:11:00#0#12:00:00#12:00:00#12:00:00 1 71761485e7e4000cb87e8073009ef5b5
0 3611800 2138112 0 0 4155300 0 0 0 0
1995302 0 0 0 0 69000
3201126 B 3 BS 1 16/03/2018 17/03/2018 07/11/1995 0 2
1 B34.9;E87.6;E83.5 - - - None None None None A-4-13-II
(SEDANG) 2667400 0 0 - 0 - 0 - 0 - 0
2667400 1365825 0 2 0 0 0 ESIH KUS NAFITRI
D355585 22 8165 DR RICO ADITYA 0138R01703180007682
0001317784667 3;JKN DR RIZKI; 5.2.0.201712280730 4 161995
1#0##0#0#0.0#2018-03-31 10:50:26#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 378353 0 0 0 0 0
3201126 B 3 BS 1 12/03/2018 17/03/2018 04/05/1965 0 1
1 J90;J18.0;N20.0 34.91;88.76;87.49;90.59;89.52 - - None None
None None J-4-20-III None None None None None None PLEURAL EFUSI DAN
PNEUMOTORAK (BERAT) 7771000 0 0 - 0 - 0 - 0
- 0 7771000 10094134 0 6 0 0 0 HASAN
0001268854661 3;JKN DR RIZKI; 5.2.0.201712280730 4 160104
1#0##0#0#0.0#2018-03-31 11:08:55#0#12:00:00#12:00:00#12:00:00 1
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4991682 0 0 0 0 2202864 0 0 0 0 128000
3201126 B 3 BS 1 14/03/2018 17/03/2018 01/06/1942 0 2
- 0 3502700 3398773 0 4 0 0 0 MARIYAH
0001338017905 3;JKN DR RIZKI; 5.2.0.201712280730 4 160603
1#0##0#0#0.0#2018-03-31 11:53:49#0#12:00:00#12:00:00#00:00:00 1
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1730180 0 0 0 0 1300350 0 0 0 0 0
3201126 B 3 BS 1 13/03/2018 17/03/2018 20/03/1984 0 1
1 N18.9;R57.2;A41.9 - - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 9307075 0 5 0 0 0 SUPRIYADI
0001739707637 3;JKN DR RIZKI; 5.2.0.201712280730 4 160579
1#0##0#0#0.0#2018-03-31 11:55:15#0#12:00:00#12:00:00#12:00:00 1
1be3c09c9ebfd26e6d2f2e1d0f2819af 0 0 424889 0 0
4230312 0 0 0 0 3169874 0 0 0 0
1482000
3201126 B 2 BS 1 16/03/2018 17/03/2018 08/08/1953 0 2
1 I25.0;I11.0;I48 88.55 - - None None None None I-1-15-III
0 0 - 0 - 0 - 0 - 0 14653000
12827267 0 2 0 0 0 SARTIAH, NY D381239 64 23596
DR RIZKI; 5.2.0.201712280730 4 161553 1#0##0#0#0.0#2018-03-31
12:10:44#0#12:00:00#12:00:00#12:00:00 1 508bf6df56e4387ea3012ca2dbd179cd
0 3555000 2930600 0 0 3377500 0 0 0 0
895167 0 0 0 0 2069000
3201126 B 2 BS 1 13/03/2018 17/03/2018 24/08/1955 0 2
1 I63.9;E14.9 90.59;87.49;87.03;89.52 - - None None None None
0 - 0 6015800 7043570 0 5 0 0 0 ZAHROH
0001284986204 3;JKN DR RIZKI; 5.2.0.201712280730 4 160112
1#0##0#0#0.0#2018-03-31 12:37:58#0#12:00:00#12:00:00#12:00:00 1
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3514133 0 0 0 0 3011794 0 0 0 0 0
3201126 B 2 BS 1 15/03/2018 17/03/2018 11/09/1984 0 2
1 O69.9;O82.9;Z37.0;Z30.2 74.0;66.39 - - None None None None
(RINGAN) 5984100 0 0 - 0 - 0 - 0 - 0
5984100 28273644 0 3 0 0 0 ROSI HANDAYANI
d130087 33 12238 DR NINING H, SPOG 0138R01703180006832
0001450390331 3;JKN DR RIZKI; 5.2.0.201712280730 4 162020
1#1#vvip#1#22289544#0.0#2018-03-31 12:45:59#0#15:43:45#15:43:45#12:00:00
1 d891d89d8322ff38d531e50a5bda3418 0 10266700 11655012 0
0 4863932 0 0 0 0 1291000 0 0 0 0
197000
3201126 B 2 BS 1 13/03/2018 17/03/2018 02/01/2018 0 2
0 0 - 0 - 0 - 0 - 0 2871200
4444441 0 5 0 0 0 MAISYARA SALSABILA PUTRI
D392976 0 70 DR RASTRA, SPA 0138R01703180005924
0002310982953 3;JKN DR RIZKI; 5.2.0.201712280730 4 160578
1#0##0#0#0.0#2018-03-31 13:01:47#0#12:00:00#12:00:00#12:00:00 1
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1286275 0 0 0 0 2336758 0 0 0 0 510000
3201126 B 2 BS 1 13/03/2018 17/03/2018 04/05/1977 0 1
9351000 0 0 - 0 - 0 - 0 - 0
9351000 14082691 0 5 0 0 0 SUMIRAT D393000
DR RIZKI; 5.2.0.201712280730 4 160594 1#0##0#0#0.0#2018-03-31
13:02:49#0#12:00:00#12:00:00#12:00:00 1 74ce95588903c648d19c183e318ba5d0
0 5948600 2734280 0 0 4333513 0 0 0 0
997298 0 0 0 0 69000
3201126 B 2 BS 1 16/03/2018 17/03/2018 03/12/1981 0 2
None None None None PERSALINAN PALSU (RINGAN) 1896900 0 0
- 0 - 0 - 0 - 0 1896900 2930033 0
2 0 0 0 NANCY OCTAVIA RUSTANDY D105380 36 13252 DR
ENDANG T. K, SPOG 0138R01703180007544 0001639972901 3;JKN DR RIZKI;
5.2.0.201712280730 4 161905 1#0##0#0#0.0#2018-03-31
13:13:48#0#12:00:00#12:00:00#00:00:00 1 6a7c0f7bac2945543f9246606e1536bc
0 0 287171 0 0 1415178 0 0 0 0
1227684 0 0 0 0 0
3201126 B 2 BS 1 15/03/2018 17/03/2018 14/08/1991 0 2
3530200 0 0 - 0 - 0 - 0 - 0
3530200 2162305 0 3 0 0 0 INDAH NUR FAZRIAH
D393159 26 9710 DR ZULFAN, SPPD 0138R01703180006895
0002260681132 3;JKN DR RIZKI; 5.2.0.201712280730 4 161361
1#0##0#0#0.0#2018-03-31 13:16:19#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 1682459 0 0 0 0 0
3201126 B 2 BS 1 14/03/2018 17/03/2018 01/01/1974 0 2
1 C50.9 85.85;85.21 - - None None None None L-1-30-I None
10660100 0 0 - 0 - 0 - 0 - 0
10660100 21058071 0 4 0 0 0 AGNES SARIE D386934
3;JKN DR RIZKI; 5.2.0.201712280730 4 161055 1#0##0#0#0.0#2018-
03-31 13:17:45#0#12:00:00#12:00:00#12:00:00 1
6f3080ba17e5cee4f25853b39dd94039 0 7446500 3091429 0 0
8809142 0 0 0 0 1276000 0 0 0 0 435000
3201126 B 2 BS 1 13/03/2018 17/03/2018 15/08/1949 0 2
1 M79.2;M54.59 87.24;89.52;90.59 - - None None None None
G-4-17-I None None None None None None GANGUAN SARAF KRANIAL DAN
PERIFER (RINGAN) 5397100 0 0 - 0 - 0 - 0 -
0 5397100 6257057 0 5 0 0 0 SORMIANNA SIBORO
0002049104193 3;JKN DR RIZKI; 5.2.0.201712280730 4 160113
1#0##0#0#0.0#2018-03-31 13:20:42#0#12:00:00#12:00:00#12:00:00 1
df2f5bf693b02ba40f68c83f5e9fe340 0 0 504286 0 0
2792431 0 0 0 0 2960340 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 17/03/2018 28/10/1949 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1754271 0 1 0 0 0 SUDRADJAT D393344
68 24977 DR. SUKMARINI 0138R01703180007765 0000060975066 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 162013 1#0##0#0#0.0#2018-
04-05 11:21:46#0#12:00:00#12:00:00#12:00:00 1
34d29256a152f8befb0d435b01ff987a 0 0 378234 0 0 238272
0 0 0 0 421765 0 0 0 0 715999
3201126 B 2 BS 1 15/03/2018 17/03/2018 15/03/2018 3051 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2737337 0 3 0 0 0 BAYI NY ROSI HANDAYANI
0002427243985 3;JKN DR RIZKI; 5.2.0.201712280730 4 161974
1#0##0#0#0.0#2018-04-05 11:23:56#0#12:00:00#12:00:00#12:00:00 1
ff5449cecad28bd98fbfa6d232356b53 0 0 310000 0 0 272259
0 0 0 0 2155078 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 17/03/2018 16/06/1977 0 1
- 0 58821400 54875463 0 2 0 0 0 YUSYUS
RUSMADIAN D256727 40 14883 DR BAMBANG DWIPUTRA SPJP
0138R01703180007221 0001642573045 3;JKN DR RIZKI; 5.2.0.201712280730
4 161547 1#0##0#0#0.0#2018-04-06
10:59:43#0#12:00:00#12:00:00#12:00:00 1 c6f45f600e7be3d604b19566df0d04d6
0 10062000 7201763 0 0 28717700 0 0 0 0
1256000 0 0 0 0 7638000
3201126 B 1 BS 1 16/03/2018 17/03/2018 22/04/1956 0 1
4 E14.0;A41.9;N18.5;I46.9 - - - None None None None E-4-
0 - 0 8768000 11300807 0 2 0 0 0
SUHENDI D391881 61 22608 DR ARU, SPPD 0138R01703180007558
0000037481084 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 161930
1#0##0#0#0.0#2018-04-07 13:54:51#0#12:00:00#12:00:00#12:00:00 1
32e9d6dabb9aac31daf3941a3f663d78 0 0 539858 0 0
8180644 0 0 0 0 2580305 0 0 0 0 0
3201126 B 3 BS 1 16/03/2018 17/03/2018 15/09/1950 0 1
- 0 45079800 71927270 0 2 0 0 0 RATOSIMO
0001459748643 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 161546
1#0##0#0#0.0#2018-05-02 11:59:32#0#12:00:00#12:00:00#12:00:00 1
ddc8dd083ff7ebc9ff6e29910a886964 0 7996000 840520 0 0
54334750 0 0 0 0 1256000 0 0 0 0
7500000
3201126 B 1 BS 1 15/03/2018 17/03/2018 04/03/1946 0 1
4 L03.9;I50.0 - - - None None None None L-4-12-II None
3245500 0 0 - 0 - 0 - 0 - 0
3245500 7960352 0 3 0 0 0 KAMSO D305849 72
RIZKI; 5.2.1.201804062320 4 161521 1#0##0#0#0.0#2018-05-03
16:30:01#0#12:00:00#12:00:00#00:00:00 1 13416bca06673dae4b619b3cbde4b662
0 0 975005 0 0 4095576 0 0 0 0
2889771 0 0 0 0 0
3201126 B 2 BS 1 12/03/2018 17/03/2018 26/05/2017 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 7183559 0 6 0 0 0 AQMAR RAFFASYA
D392799 0 290 DR RASTRA, SPA 0138R01703180005276
0002253299488 3;JKN irene; 5.2.2.201806040537 4 160081
1#0##0#0#0.0#2018-08-11 13:50:11#0#12:00:00#12:00:00#12:00:00 2
8afa97246d3aeb290e8fa6f7ed5a72b9 0 0 443231 0 0
3480376 0 0 0 0 3020952 0 239000 0 0
0
3201126 B 2 BS 1 17/03/2018 17/03/2018 11/12/1948 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 3745903 0 1 0 0 0 IR PAUL RAUBUN, M.S.E
0001222739706 3;JKN DR RIZKI; 5.2.0.201712280730 4 162001
1#0##0#0#0.0#2018-09-29 14:15:18#0#12:00:00#12:00:00#00:00:00 2
14af2ef2bfbe6aa7ffb6fdbf2f46a968 0 0 499265 0 0
1314329 0 0 0 0 1932309 0 0 0 0 0
3201126 B 1 BS 1 09/03/2018 18/03/2018 02/12/1974 0 2
1 A41.9;I50.0;E13.2;R77.0;J18.0 - - - None None None DD05
A-4-10-III None None None None None DD-05-II SEPTIKEMIA (BERAT)
8174100 0 0 - 0 - 0 - 0 HUMAN ALBUMIN FOR
SEPTICAEMIA 2027800 10201900 17070801 0 10 0 0 0 DEWI
SUGIARTI D354487 43 15803 DR AZRI NURIZAL SPPD KKV
0138R01703180004128 0000043603031 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 158919 1#0##0#0#0.0#2018-03-27
12:48:50#0#12:00:00#12:00:00#12:00:00 1 879cf216622581f7a446af3994fba5bd
0 0 1363643 0 0 5737377 0 0 0 0
9228781 0 0 0 0 741000
3201126 B 3 BS 1 18/03/2018 18/03/2018 15/10/1959 0 2
None None None None None None PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 2783111 0 1 0 0 0 RUMINI D393412
DR RIZKI; 5.2.0.201712280730 4 162038 1#0##0#0#0.0#2018-03-31
09:08:38#0#07:00:00#13:40:00#12:00:00 1 4eb884c6913db7db31679ee777c200cc
0 0 439974 0 0 1872064 0 0 0 0 471073
0 0 0 0 0
3201126 B 3 BS 1 18/03/2018 18/03/2018 24/03/1942 0 2
1 I25.0;J45.9 93.94 - - None None None None I-4-16-I None
None None None None None ATHEROSKLEROSIS (RINGAN) 2168700 0
0 - 0 - 0 - 0 - 0 2168700 1571638
0 1 0 0 0 MENIL D390424 75 27753 DR RENDRA RAMADYA
0138R01703180007882 0001740612025 3;JKN DR RIZKI; 5.2.0.201712280730
4 162030 1#0##0#0#0.0#2018-03-31
09:18:34#0#00:00:00#09:45:00#12:00:00 1 cdab5e7961825f24bb274eac82fd8518
0 0 376101 0 0 803720 0 0 0 0 391817
0 0 0 0 0
3201126 B 3 BS 1 11/03/2018 18/03/2018 11/04/1962 0 2
1 I63.8;I48;I50.0;R13;J18.0 87.03;87.49;90.59;89.52;99.60 - -
None None None None G-4-14-III None None None None None None
KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK (BERAT) 8672200 0 0
- 0 - 0 - 0 - 0 8672200 12129548 0
8 0 0 0 JUBAEDAH D390855 55 20423 DR. ARU ARIADNO,
4 159650 1#0##0#0#0.0#2018-03-31
09:48:16#0#12:00:00#12:00:00#12:00:00 1 01a0c517f96f81ab54023293c7990ac1
0 0 801813 0 0 8404213 0 0 0 0
2923522 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 18/03/2018 25/12/1952 0 1
- 0 8908800 10144704 0 2 0 0 0 SUYONO BIN
KUWATNO D393377 65 23823 DR SRI KUNMARTINI, SPPD 0138R01703180007813
0001318676512 3;JKN DR RIZKI; 5.2.0.201712280730 4 162019
1#0##0#0#0.0#2018-03-31 10:04:37#0#12:00:00#12:00:00#12:00:00 1
4282b13491d1cf4d6615fac87a0eba95 0 3438800 2636552 0 0
3280680 0 0 0 0 719672 0 0 0 0 69000
3201126 B 3 BS 1 12/03/2018 18/03/2018 01/12/1950 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 8248426 0 7 0 0 0 MUHAYAR D392788
0000511116399 3;JKN DR RIZKI; 5.2.0.201712280730 4 160078
1#0##0#0#0.0#2018-03-31 10:47:56#0#12:00:00#12:00:00#12:00:00 1
29e61c785487dd666ce5d1e268cea48a 0 0 710972 0 0
5393837 0 0 0 0 2143617 0 0 0 0 0
3201126 B 3 BS 1 15/03/2018 18/03/2018 02/06/1972 0 1
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 2913656 0 4 0 0 0 MOCH. CHAIDIR SAID S.S.
0001740063194 3;JKN DR RIZKI; 5.2.0.201712280730 4 161061
1#0##0#0#0.0#2018-03-31 11:04:15#0#12:00:00#12:00:00#12:00:00 1
43b9f1a1fbb88256aa4f6e85f4aabd84 0 0 557179 0 0
1087864 0 0 0 0 1268613 0 0 0 0 0
3201126 B 2 BS 1 16/03/2018 18/03/2018 13/08/2015 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2212975 0 3 0 0 0 ANA SHOFIA D307562
3;JKN DR RIZKI; 5.2.0.201712280730 4 161990 1#0##0#0#0.0#2018-
03-31 12:12:38#0#12:00:00#12:00:00#00:00:00 1
3c263d65d5822efb58d487714f253cfe 0 0 278711 0 0 455990
0 0 0 0 1478274 0 0 0 0 0
3201126 B 2 BS 1 16/03/2018 18/03/2018 19/01/2009 0 2
1 M08.09;K30 - - - None None None None M-4-16-I None
0 0 - 0 - 0 - 0 - 0 3409700
2603559 0 3 0 0 0 RAJWA TADZKI ALIFA D393237
3;JKN DR RIZKI; 5.2.0.201712280730 4 161544 1#0##0#0#0.0#2018-
03-31 12:13:31#0#12:00:00#12:00:00#12:00:00 1
8afa00537413cab564d6fa8d94faccf5 0 0 412873 0 0 479360
0 0 0 0 1711326 0 0 0 0 0
3201126 B 2 BS 1 15/03/2018 18/03/2018 21/11/1989 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3913757 0 4 0 0 0 GRETHA HILDA TITIAHY
D392398 28 10341 DR ARU, SPPD 0138R01703180007137
0001651947107 3;JKN DR RIZKI; 5.2.0.201712280730 4 161532
1#0##0#0#0.0#2018-03-31 12:14:51#0#12:00:00#12:00:00#12:00:00 1
7710e4a58c7e5797fd50140c8d571250 0 0 238535 0 0
1580682 0 0 0 0 2094540 0 0 0 0 0
3201126 B 2 BS 1 14/03/2018 18/03/2018 10/10/1950 0 2
1 I11.0;R50.9;I49.3 - - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 5968400
10241664 0 5 0 0 0 SUHASNI MARSIDIN D393084 67
24627 DR SUPONO SPJP 0138R01703180006601 0001448109369 3;JKN DR
RIZKI; 5.2.0.201712280730 4 161051 1#1#vvip#4#4273264#0.0#2018-
03-31 12:36:43#0#12:00:00#12:00:00#12:00:00 1
6ee224cd910f47c067730c3a81f7395b 0 0 1408000 0 0
2485649 0 0 0 0 6348011 0 0 0 0 0
3201126 B 2 BS 1 15/03/2018 18/03/2018 07/07/1939 0 1
1 I21.2;J18.9;I11.0;M54.59 89.52;87.44;88.72;93.94 - - None
None None None I-4-10-III None None None None None None INFARK
MYOKARD AKUT (BERAT) 12482300 0 0 - 0 - 0 - 0
- 0 12482300 7460732 0 4 0 0 0 MUHAMAD RAIS
0000060601509 3;JKN DR RIZKI; 5.2.0.201712280730 4 161062
1#0##0#0#0.0#2018-03-31 13:06:25#0#12:00:00#12:00:00#00:00:00 1
9d22bcd4ac88cb98491e4cfacccdb9b1 0 0 1175270 0 0
3751377 0 0 0 0 2534085 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 18/03/2018 27/12/1985 0 2
- 0 8908800 11506747 0 2 0 0 0 LAILIAH
0002189846632 3;JKN DR RIZKI; 5.2.0.201712280730 4 162022
1#0##0#0#0.0#2018-04-04 11:32:42#0#12:00:00#12:00:00#12:00:00 1
ffd961e10fdf0f5e88d9b846271ec510 0 3438800 2636552 0 0
4434617 0 0 0 0 858778 0 0 0 0 138000
3201126 B 2 BS 1 16/03/2018 18/03/2018 13/04/1984 0 1
(RINGAN) 3976600 0 0 - 0 - 0 - 0 - 0
3976600 2217761 0 3 0 0 0 HEZRON PANDIANGAN
0001336724368 3;JKN DR RIZKI; 5.2.0.201712280730 4 161991
1#0##0#0#0.0#2018-04-04 11:46:42#0#12:00:00#12:00:00#12:00:00 1
0c1eb0e59c2bd3f5da92f537b4df6e70 0 0 499264 0 0 537410
0 0 0 0 1181087 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 18/03/2018 04/11/1953 0 2
4 I21.9;R57.0;N18.5;A41.9 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 9946660 0 2 0 0 0 TUTY KARSUTI
D393335 64 23509 DR ARU, SPPD 0138R01703180007746
0002290986033 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 162006
1#0##0#0#0.0#2018-04-06 10:59:06#0#12:00:00#12:00:00#12:00:00 1
3bcd55e3ea0bbdd8feeac3dd29ddf163 0 0 456270 0 0
7677674 0 0 0 0 1812716 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 18/03/2018 22/10/1984 0 1
1 H81.3;R10.1 - - - None None None None U-4-11-I None
- 0 - 0 - 0 - 0 1517500 1352346 0
2 0 0 0 AHMAD JEPRI MAULANA D393297 33 12199 DR
5.2.2.201806040537 4 162015 1#0##0#0#0.0#2018-08-10
10:46:47#0#12:00:00#12:00:00#12:00:00 2 944b1d940927c85e596b23eec684b930
0 0 189575 0 0 522300 0 0 0 0 640471
0 0 0 0 0
3201126 B 1 BS 1 18/03/2018 19/03/2018 27/08/1958 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4125674 0 2 0 0 0 SUTARNO TN D362350
3;JKN DR RIZKI; 5.2.0.201712280730 4 162052 1#0##0#0#0.0#2018-
03-26 08:56:44#0#12:00:00#12:00:00#00:00:00 1
77b2fe8895dd425d7bf635a40a7c1e00 0 0 573641 0 0
1318879 0 0 0 0 2233154 0 0 0 0 0
3201126 B 1 BS 1 18/03/2018 19/03/2018 26/12/1964 0 2
1 E14.2;A49.9;I10 39.42;99.17 - - None None None None N-1-
- 0 6076700 13734201 0 2 0 0 0 ERMIATI
TANJUNG D374992 53 19440 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180007894 0001292033079 3;JKN DR RIZKI; 5.2.0.201712280730
4 162612 1#0##0#0#0.0#2018-03-26
09:02:08#0#19:08:36#19:08:36#12:00:00 1 d85d8e35d9315f5c9180d2f6e542f549
0 0 2993352 0 0 3786850 0 0 0 0
6850499 0 0 0 0 103500
3201126 B 1 BS 1 19/03/2018 19/03/2018 12/08/1931 0 1
4 I63.9;A41.9;G31.0 87.03 - - None None None None G-4-14-III
INFARK (BERAT) 12141100 0 0 - 0 - 0 - 0 -
0 12141100 6769647 0 1 0 0 0 SUMARDI,H
D252281 86 31631 DR MAYSAM I., SPS 0138R01703180008305
0000060888284 3;JKN DR RIZKI; 5.2.0.201712280730 4 162317
1#1#vvip#1#0#0.0#2018-03-26 09:04:35#0#12:00:00#12:00:00#12:00:00 1
0e827d5841cb556b3850189746b946e3 0 0 1965223 0 0
3042550 0 0 0 0 1761874 0 0 0 0 0
3201126 B 1 BS 1 15/03/2018 19/03/2018 13/03/1948 0 2
1 I63.9;E75.6;E10.9;G40.9 - - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 7055564 0 5 0 0 0 STELLA MARIA BACAS
D041794 70 25569 DR MAYSAM I., SPS 0138R01703180007163
0001336570907 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 161537
1#0##0#0#0.0#2018-03-26 17:07:00#0#12:00:00#12:00:00#12:00:00 1
44df17a1164b5021eb6ebe6647cfcca0 0 0 754840 0 0
2689145 0 0 0 0 3611579 0 0 0 0 0
3201126 B 1 BS 1 24/02/2018 19/03/2018 25/05/2017 0 2
1 G91.8;G04.0;J99.8;A41.9 87.03;96.72 - - None None None None
0 - 0 92864200 99442542 0 24 1 4 96 BAYI
NY YUNI ARIANIE D382900 0 275 DR NOVIK BUDIWARDHANA, SPA
0138R01702180011167 0002253198069 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 153876 1#0##0#0#0.0#2018-03-26
17:13:42#0#12:00:00#12:00:00#12:00:00 1 f73e0ec0f0f4c254ce9ee9c060502227
0 0 13093346 0 0 42403196 0 0 0 0
23753000 0 0 0 0 20193000
3201126 B 1 BS 1 14/03/2018 19/03/2018 15/07/2016 0 1
0 0 - 0 - 0 - 0 - 0 3695000
6222328 0 6 0 0 0 KHALIFAH ABDILLAH KAREEM
d365385 1 607 DR RASTRA, SPA 0138R01703180006516
0001969076733 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 161047
1#0##0#0#0.0#2018-03-27 12:53:36#0#12:00:00#12:00:00#00:00:00 2
d120f96b3ae58292ea25f8e45a368d3b 0 0 338858 0 0
1545402 0 0 0 0 4338068 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 19/03/2018 05/04/1959 0 2
1 E87.6;H81.3;R11 - - - None None None None E-4-11-I
4136800 0 0 - 0 - 0 - 0 - 0
4136800 5109598 0 4 0 0 0 DINA HANDAYANI,NY
0000037016605 3;JKN DR RIZKI; 5.2.0.201712280730 4 161827
6#0##0#0#0.0#2018-03-29 14:39:39#0#12:00:00#12:00:00#12:00:00 1
270eb5567768bfcc32973abc5c6bb73e 0 0 244205 0 0
1381120 0 0 0 0 3484273 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 19/03/2018 20/10/1960 0 2
1 H81.1;M75.0;K29.7;M76.59 81.92 - - None None None None
U-4-11-I None None None None None None DYSEQUILIBRIUM (RINGAN)
1517500 0 0 - 0 - 0 - 0 - 0
1517500 2683535 0 3 0 0 0 IIS DAHLIAWATI
0001256622175 3;JKN DR RIZKI; 5.2.0.201712280730 4 162459
1#0##0#0#0.0#2018-03-31 08:53:34#0#12:00:00#12:00:00#00:00:00 1
e6e59c9495f411f7cc8323a9f7efdcc1 0 0 189575 0 0
1503402 0 0 0 0 990558 0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 19/03/2018 04/09/1961 0 2
1 I20.0;R07.4;K30 89.52 - - None None None None I-4-20-I
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1041418 0 1 0 0 0 NOERHIDAYATI
D371360 56 20650 DR YOHANNES DWINANDA 0138R01703180008074
0001835810921 3;JKN DR RIZKI; 5.2.0.201712280730 4 162057
1#0##0#0#0.0#2018-03-31 09:11:26#0#00:00:00#12:00:00#00:00:00 1
1ba9c0aeb2edc31c2a42dd29ee977ce1 0 0 378234 0 0 306054
0 0 0 0 357130 0 0 0 0 0
3201126 B 3 BS 1 16/03/2018 19/03/2018 03/09/1953 0 2
1 G40.8;I63.8;E78.5;E79.0 87.49;90.59;87.03;89.14 - - None None
None None G-4-22-III None None None None None None SERANGAN KEJANG
(BERAT) 3965000 0 0 - 0 - 0 - 0 - 0
3965000 5880722 0 4 0 0 0 ILOH MARYAMAH
0001771603997 3;JKN DR RIZKI; 5.2.0.201712280730 4 161839
1#0##0#0#0.0#2018-03-31 09:30:55#0#12:00:00#12:00:00#00:00:00 1
6c88efb8188e7a734c1605c461cf62e6 0 0 409849 0 0
4008153 0 0 0 0 1462720 0 0 0 0 0
3201126 B 3 BS 1 17/03/2018 19/03/2018 07/07/1954 0 2
1 K51.9;I84.2;I10;M14.6;R54 45.16 - - None None None None
K-4-13-I None None None None None None DIVERTIKULITIS,
DIVERTIKULOSIS DAN PENYAKIT PERADANGAN USUS BESAR (RINGAN) 3983300 0 0
- 0 - 0 - 0 - 0 3983300 6493797 0
3 0 0 0 IDJAH D391880 63 23264 DR BETTY DWI L, SPPD
0138R01703180007867 0000510712817 3;JKN DR RIZKI; 5.2.0.201712280730
4 162028 1#0##0#0#0.0#2018-03-31
10:08:08#0#12:00:00#12:00:00#12:00:00 1 c978a6219e130a647fb6fb81175ece20
0 0 1168324 0 0 1653145 0 0 0 0
1719328 0 0 0 0 1953000
3201126 B 2 BS 1 18/03/2018 19/03/2018 15/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 3955700
6370722 0 2 0 0 0 D E V I D392838 47 17198
5.2.0.201712280730 4 162049 1#0##0#0#0.0#2018-03-31
12:51:06#0#12:00:00#12:00:00#12:00:00 1 bd53a2a79789cce81302b10f140c4d81
0 0 1160596 0 0 1473350 0 0 0 0
1987776 0 0 0 0 1748999
3201126 B 2 BS 1 17/03/2018 19/03/2018 02/06/1952 0 1
1 I25.0;I08.9;I50.0;I20.0 88.55;36.07 - - None None None None
I-1-40-II None None None None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (SEDANG) 30864700 0 0 - 0 - 0 - 0 -
0 30864700 56362801 0 3 0 0 0 T. FIRDAUS HUSEIN
0001257761068 3;JKN DR RIZKI; 5.2.0.201712280730 4 161997
1#0##0#0#0.0#2018-03-31 13:08:05#0#12:00:00#12:00:00#12:00:00 1
37d294231ce855508694c5462b1ae46a 0 0 6225940 0 0
37341861 0 0 0 0 5226000 0 0 0 0
7569000
3201126 B 2 BS 1 16/03/2018 19/03/2018 08/12/2016 0 2
1 A09.9;Q25.0 - - - None None None None K-4-17-II None
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 3651063 0 4 0 0 0 BAYI NY SHEILA EL SAFIRA
D353000 1 463 DR SUPROHAITA, SPA 0138R01703180007230
0002206997201 3;JKN DR RIZKI; 5.2.0.201712280730 4 161548
1#0##0#0#0.0#2018-03-31 13:30:59#0#12:00:00#12:00:00#00:00:00 1
f6c89e105c8abd98448b2fab326f855d 0 0 590435 0 0 775773
0 0 0 0 2284855 0 0 0 0 0
3201126 B 3 BS 1 18/03/2018 19/03/2018 01/04/1944 0 2
- 0 36446400 58609304 0 2 0 0 0 MAIMUNAH
0000511776639 3;JKN DR RIZKI; 5.2.0.201712280730 4 162036
1#0##0#0#0.0#2018-04-04 10:47:09#0#12:00:00#12:00:00#12:00:00 1
364fe3550217062704ce56c2c29ba800 0 7996000 5496020 0 0
36164284 0 0 0 0 1256000 0 0 0 0
7697000
3201126 B 1 BS 1 18/03/2018 19/03/2018 20/05/1960 0 1
1 E14.2;D63.8;I10 99.17;99.04;39.27 - - None None None None
- 0 - 0 12472300 13703739 0 2 0 0 0
ISMAYADI D393425 57 21121 DR SRI KUNMARTINI, SPPD
0138R01703180008005 0000040888416 3;JKN DR RIZKI; 5.2.0.201712280730
4 162044 1#0##0#0#0.0#2018-04-04
12:16:32#0#12:00:00#12:00:00#12:00:00 1 e3e04e1e661b0b1938fde1632053567d
0 6122700 3669967 0 0 2820566 0 0 0 0
952506 0 0 0 0 138000
3201126 B 1 BS 1 18/03/2018 19/03/2018 10/02/1964 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 12913081 0 2 0 0 0 MAIN D393429 54
DR RIZKI; 5.2.0.201712280730 4 162046 16#0##0#0#0.0#2018-04-04
12:18:53#0#12:00:00#12:00:00#12:00:00 1 d9f467842f8243dc8966d18eabbfad00
0 6468200 3669967 0 0 1805133 0 0 0 0
900781 0 0 0 0 69000
3201126 B 1 BS 1 17/03/2018 19/03/2018 01/06/1954 0 2
2033900 0 0 - 0 - 0 - 0 - 0
2033900 5785923 0 3 0 0 0 ATY SYAMSIAH
D393337 63 23300 DR ARU, SPPD 0138R01703180007724
0000061033948 3;JKN DR RIZKI; 5.2.0.201712280730 4 162004
11#0##0#0#0.0#2018-04-05 08:55:26#0#12:00:00#12:00:00#12:00:00 1
ccdd2beaf0c40ac0918712d44b59b1a0 0 0 236050 0 0
2802355 0 0 0 0 2747518 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 19/03/2018 23/07/1952 0 1
- 0 58821400 60303495 0 4 0 0 0 ISKANDAR
0000036896275 3;JKN DR RIZKI; 5.2.0.201712280730 4 161865
1#0##0#0#0.0#2018-04-05 09:34:24#0#12:00:00#12:00:00#12:00:00 1
2744ab1b3861e8dd0325c9aa3dcf9c3c 0 0 9619120 0 0
30415375 0 0 0 0 12700000 0 0 0 0
7569000
3201126 B 2 BS 1 17/03/2018 19/03/2018 04/06/1976 0 1
4 I61.5;I60.9;I10;J80 96.05;96.71 - - None None None None
J-1-20-II None None None None None None PROSEDUR SISTEM PERNAFASAN
NON-KOMPLEKS (SEDANG) 22642000 0 0 - 0 - 0 - 0
- 0 22642000 18972442 0 3 1 3 36 ALI WAHYUDI
0001142415505 3;JKN DR RIZKI; 5.2.0.201712280730 4 162423
1#0##0#0#0.0#2018-04-05 11:31:02#0#12:00:00#12:00:00#12:00:00 1
4157bf4c0d91a46ed80009ed5e072fff 0 0 2291780 0 0
8785662 0 0 0 0 3845000 0 0 0 0
4050000
3201126 B 3 BS 1 19/03/2018 19/03/2018 09/05/1954 0 2
3914900 0 0 - 0 - 0 - 0 - 0
3914900 5666948 0 1 0 0 0 UMIYATI D393464
3;JKN DR RIZKI; 5.2.0.201712280730 4 162061
23#0##0#0#0.0#2018-04-05 15:26:28#0#00:15:00#15:10:00#12:00:00 1
fe7b427047c71278708a556ad46d2f2c 0 0 352341 0 0
4654872 0 0 0 0 659735 0 0 0 0 0
3201126 B 3 BS 1 18/03/2018 19/03/2018 10/03/1953 0 2
1 E16.2;I64 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 6262900 0 0 - 0 - 0 - 0 -
0 6262900 4486689 0 2 0 0 0 RUSYANTI, NY
0000061037177 3;JKN DR RIZKI; 5.2.0.201712280730 4 162031
1#0##0#0#0.0#2018-04-05 15:28:57#0#00:30:00#20:00:00#12:00:00 1
c11e3c45733563da55e1cd19e0009316 0 0 315243 0 0
3588924 0 0 0 0 582522 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 19/03/2018 24/10/1981 0 2
0 0 - 0 - 0 - 0 - 0 6981500
19443532 0 4 0 0 0 OCTAVIA EKA YOLLA KOWAL D235012
0002424807066 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 161992
1#1#vvip#4#12462032#0.0#2018-04-07 13:58:14#0#12:00:00#12:00:00#12:00:00
1 1a22828b32d2903c6f894dc9efae462d 0 8271400 6551000 0
0 2968132 0 0 0 0 1328000 0 0 0 0
325000
3201126 B 2 BS 1 11/03/2018 19/03/2018 07/01/2018 0 1
1 D68.5;P90 99.06 - - None None None None D-4-11-III None
None None None None None GANGGUAN PEMBEKUAN DARAH (BERAT) 12346500
0 0 - 0 - 0 - 0 - 0 12346500
34895066 0 9 0 0 0 BAYI NY DESTY DWI PUTRI 2
0002327714908 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 159675
1#0##0#0#0.0#2018-04-07 14:24:20#0#12:00:00#12:00:00#12:00:00 1
a1ab7e67f8c59dd94f4b2db457478a75 0 0 6967040 0 0
15395526 0 0 0 0 7679500 0 0 0 0
4853000
3201126 B 3 BS 1 18/03/2018 19/03/2018 05/09/1947 0 1
5013100 0 0 - 0 - 0 - 0 - 0
5013100 902202 0 2 0 0 0 SUKIMIN D393445
TANTIYO S;16137 5.2.1.201804062320 4 162050 1#0##0#0#0.0#2018-
05-02 10:10:30#0#12:00:00#12:00:00#12:00:00 1
b0628c0c4cde84d0d4442344a0dcce05 0 0 451179 0 0 103000
0 0 0 0 348023 0 0 0 0 0
3201126 B 1 BS 1 17/03/2018 20/03/2018 02/11/2012 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4494662 0 4 0 0 0 FAIQAH SALSABILA AHYA
D341921 5 1961 DR RASTRA, SPA 0138R01703180007794
0001795253365 3;JKN DR RIZKI; 5.2.0.201712280730 4 162016
1#0##0#0#0.0#2018-03-26 09:10:10#0#12:00:00#12:00:00#00:00:00 1
d150d18fe6c3513a7e44f98d49db1ca2 0 0 316331 0 0 734288
0 0 0 0 3444043 0 0 0 0 0
3201126 B 1 BS 1 17/03/2018 20/03/2018 12/03/1946 0 1
1 K74.6;E87.1;G93.4;B17.1 - - - None None None None B-4-
13-III None None None None None None GANGGUAN HATI LAIN-LAIN (BERAT)
9446100 0 0 - 0 - 0 - 0 - 0
9446100 6563567 0 4 0 0 0 SUGIMAN A KASDURI
0000060883053 3;JKN DR RIZKI; 5.2.0.201712280730 4 162025
1#0##0#0#0.0#2018-03-26 09:35:24#0#12:00:00#12:00:00#12:00:00 1
40862620ea48882e84b4cd6219dbcbbf 0 0 670130 0 0
2749545 0 0 0 0 3143892 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 20/03/2018 11/03/1965 0 1
1 B15.9;K80.0;R17;A41.9;E11.9 90.59;89.52 - - None None None
(BERAT) 9446100 0 0 - 0 - 0 - 0 - 0
9446100 7470219 0 5 0 0 0 SAMSUL ANWAR
0001142790603 3;JKN DR RIZKI; 5.2.0.201712280730 4 161831
1#0##0#0#0.0#2018-03-26 09:38:26#0#12:00:00#12:00:00#12:00:00 1
f7a514d4994f86de5aa21a1149b7cc7b 0 0 997610 0 0
2142903 0 0 0 0 4329706 0 0 0 0 0
3201126 B 1 BS 1 19/03/2018 20/03/2018 20/06/1952 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 56792545 0 2 0 0 0 DAYAT RUKAYAT
0000040018432 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 162244
1#0##0#0#0.0#2018-03-27 12:50:29#0#12:00:00#12:00:00#12:00:00 1
379330f38ff0eab87dea2abf4acc92b1 0 10062000 3419040 0 0
34358505 0 0 0 0 1256000 0 0 0 0
7697000
3201126 B 1 BS 1 18/03/2018 20/03/2018 18/05/2012 0 1
1 A49.9;R10.4 - - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4327339 0 3 0 0 0 MUHAMMAD KANZIE ADIB AL
FATIH D386626 5 2130 DR OTTY MITHA S, SPA 0138R01703180007906
0001086031517 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 162037
1#0##0#0#0.0#2018-03-27 12:56:47#0#12:00:00#12:00:00#12:00:00 1
2ba68283bffa537bde991f6b817f9963 0 0 338858 0 0
1336384 0 0 0 0 2652097 0 0 0 0 0
3201126 B 1 BS 1 14/03/2018 20/03/2018 08/02/2018 0 1
1 Q43.1 46.10 - - None None None None K-1-20-I None None
None None None None PROSEDUR INTESTINAL KOMPLEKS (RINGAN) 17044400
0 0 - 0 - 0 - 0 - 0 17044400
18608948 0 7 0 0 0 BAYI NY PINTA LUSINDA SIREGAR
D391634 0 34 DR CATUR S, SPB 0138R01703180006555
0002317537675 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 161048
1#0##0#0#0.0#2018-03-27 13:02:02#0#12:00:00#12:00:00#12:00:00 1
3b3c007549f8a29368d5ea7e655235d4 0 9260200 4825432 0 0
2762316 0 0 0 0 1276000 0 0 0 0 485000
3201126 B 1 BS 1 19/03/2018 20/03/2018 01/11/1945 0 1
- 0 12472300 21646864 0 2 0 0 0 DR. SYAHRIR
HUSIN LUBIS D093160 72 26436 SRI KUNMARTINI.DR,SPPD 0138R01703180008512
0000045151029 3;JKN DR RIZKI; 5.2.0.201712280730 4 162609
1#1#vvip#2#9174564#0.0#2018-03-29 14:00:29#0#12:00:00#12:00:00#12:00:00
1 83ca0b9068cf80f8fa480100ec1e5590 0 0 6382692 0 0
5903022 0 0 0 0 9361150 0 0 0 0 0
3201126 B 1 BS 1 15/03/2018 20/03/2018 03/04/2012 0 2
1 A90;J06.9 - - - None None None None A-4-13-I None
2925900 0 0 - 0 - 0 - 0 - 0
2925900 7305277 0 6 0 0 0 NURUL AMALINA FATIN
0001815624314 3;JKN DR RIZKI; 5.2.0.201712280730 4 161279
1#0##0#0#0.0#2018-03-29 14:01:40#0#12:00:00#12:00:00#12:00:00 1
9e32283de8debf55d355fd069253f3aa 0 0 316331 0 0
1453031 0 0 0 0 5195915 0 0 0 0 340000
3201126 B 3 BS 1 20/03/2018 20/03/2018 11/04/1962 0 2
4 I50.9;R57.0;I24.9;K21.9 99.60 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 2950538 0 1 0 0 0 JUBAEDAH D390855
55 20432 DR DICKY PRATAMA 0138R01703180008677 0001233001078 3;JKN
DR RIZKI; 5.2.0.201712280730 4 164437 1#0##0#0#0.0#2018-03-31
09:52:13#0#00:00:00#02:30:00#12:00:00 1 d4016704cf6f059338c8beb3b8c303c9
0 0 313416 0 0 2155096 0 0 0 0 482026
0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 20/03/2018 01/06/1947 0 2
1 K30 90.59;89.52 - - None None None None K-4-18-I None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2270317 0 2 0 0 0 IMI D393439 70
3;JKN DR RIZKI; 5.2.0.201712280730 4 162054 1#0##0#0#0.0#2018-
03-31 09:54:32#0#12:00:00#12:00:00#12:00:00 1
046bdd66bdb7502f93afb6a80d986e06 0 0 183752 0 0
1386040 0 0 0 0 700525 0 0 0 0 0
3201126 B 2 BS 1 18/03/2018 20/03/2018 28/03/2004 0 2
1 K30;A49.9 - - - None None None None K-4-18-I None
1743400 0 0 - 0 - 0 - 0 - 0
1743400 2832014 0 3 0 0 0 SISKA HOLIFAH
D393424 13 5103 DR AWIDIYA, SPA 0138R01703180007967
0001796322115 3;JKN DR RIZKI; 5.2.0.201712280730 4 162041
1#0##0#0#0.0#2018-03-31 12:18:40#0#12:00:00#12:00:00#12:00:00 1
5d0cd15c174aabecabfb3d0584c2cd82 0 0 298025 0 0 807717
0 0 0 0 1726272 0 0 0 0 0
3201126 B 2 BS 1 17/03/2018 20/03/2018 25/01/2014 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3812747 0 4 0 0 0 EVAN DWI KURNIAWAN
D393329 4 1512 DR RASTRA, SPA 0138R01703180007712
0001865070246 3;JKN DR RIZKI; 5.2.0.201712280730 4 162002
1#0##0#0#0.0#2018-03-31 13:11:52#0#12:00:00#12:00:00#12:00:00 1
d79a950c770f158188fd37aa3b4db221 0 2020000 278711 0 0
1062604 0 0 0 0 281432 0 0 0 0 170000
3201126 B 2 BS 1 20/03/2018 20/03/2018 17/12/2015 0 2
- 0 3584400 2534430 0 1 0 0 0 ADEEVA
AFSHEEN MYESHA D339916 2 824 DR VERA MUNA MANOE, SPA
0138R01703180008791 0001898497269 3;JKN DR RIZKI; 5.2.0.201712280730
4 162944 1#0##0#0#0.0#2018-04-02
08:36:46#0#12:00:00#12:00:00#00:00:00 2 839f3da76a145608ffe2246d2d00c84c
0 0 322596 0 0 1515030 0 0 0 0 696804
0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 20/03/2018 01/09/1941 0 1
4 I64;G81.9;K21.9;A41.9;E87.8 87.03;90.59;89.52 - - None None
6899800 0 0 - 0 - 0 - 0 - 0
6899800 4432515 0 2 0 0 0 G.H.MANULLANG
0001262318995 3;JKN DR RIZKI; 5.2.0.201712280730 4 163743
1#0##0#0#0.0#2018-04-02 10:17:17#0#07:50:00#19:21:00#00:00:00 2
cc9b2df3c3d0078d8d365c92e61364b2 0 0 780498 0 0
3073039 0 0 0 0 578978 0 0 0 0 0
3201126 B 1 BS 1 18/03/2018 20/03/2018 13/05/1951 0 2
9856000 0 0 - 0 - 0 - 0 - 0
9856000 6898461 0 3 0 0 0 RITA ADE. SARAGIH
0001258695707 3;JKN DR RIZKI; 5.2.0.201712280730 4 162032
1#0##0#0#0.0#2018-04-04 08:26:31#0#12:00:00#12:00:00#00:00:00 1
cb5defbb4ad5b4495b2f71a305c92460 0 0 326258 0 0
1963902 0 0 0 0 2820301 0 0 0 0
1788000
3201126 B 1 BS 1 19/03/2018 20/03/2018 01/04/1965 0 1
- 0 - 0 5576700 7528559 0 2 0 0 0
ARIS SETIAWAN D392831 52 19345 DR ZULFAN, SPPD
0138R01703180008335 0001340227721 3;JKN DR RIZKI; 5.2.0.201712280730
4 162394 1#0##0#0#0.0#2018-04-04
08:27:40#0#12:00:00#12:00:00#12:00:00 1 80dc2ea9ccd98cf3b497ba13cf313ffc
0 0 1614476 0 0 1144060 0 0 0 0
3021023 0 0 0 0 1749000
3201126 B 3 BS 1 19/03/2018 20/03/2018 01/10/2004 0 2
1 D56.1;E83.1 99.04 - - None None None None D-4-13-II None
- 0 4227600 3771600 0 2 0 0 0 OKTARIAS
ANANDA R D386020 13 4917 DR VERA MUNA MANOE, SPA 0138R01703180008632
0001014393644 3;JKN DR RIZKI; 5.2.0.201712280730 4 162614
1#0##0#0#0.0#2018-04-04 10:05:03#0#12:00:00#12:00:00#12:00:00 1
28c81f36a604723c14300f42b5d9c543 0 0 268830 0 0
2790530 0 0 0 0 712240 0 0 0 0 0
3201126 B 3 BS 1 08/03/2018 20/03/2018 12/09/1948 0 1
1 E11.2;J18.0;I10;D63.8;J90 39.95;34.91;99.04 - - None None
None None N-4-16-III None None None None None None PENYAKIT GINJAL
DAN SALURAN URIN LAIN-LAIN (BERAT) 7238900 0 0 - 0 - 0
- 0 - 0 7238900 46074996 0 13 0 0 0
SYAFEI B NAMAN D388858 69 25379 DR. ARU ARIADNO, SPPD
0138R01703180003556 0001739716716 3;JKN DR RIZKI; 5.2.0.201712280730
4 158313 1#0##0#0#0.0#2018-04-04
10:17:55#0#12:00:00#12:00:00#12:00:00 1 bde172b9573680a469b5cb26b6a618f8
0 12928300 3011002 0 0 20544694 0 0 0 0
6481000 0 0 0 0 3110000
3201126 B 3 BS 1 13/03/2018 20/03/2018 02/02/1965 0 1
1 H81.1;I67.9;G81.9 87.03 - - None None None None U-4-11-II
None None None None None None DYSEQUILIBRIUM (SEDANG) 2207000 0
0 - 0 - 0 - 0 - 0 2207000 8178542
0 8 0 0 0 FERI ENRI D390355 53 19397 DR MAYSAM
I., SPS 0138R01703180006062 0001719849205 3;JKN DR RIZKI;
5.2.0.201712280730 4 160591 1#0##0#0#0.0#2018-04-04
11:45:08#0#12:00:00#12:00:00#12:00:00 1 032e918bf482805dd3ab2ce61e956498
0 0 610179 0 0 4989818 0 0 0 0
2578545 0 0 0 0 0
3201126 B 1 BS 1 17/03/2018 20/03/2018 06/07/2017 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4902851 0 4 0 0 0 BAYI NY.NIHAYAH
D393331 0 254 DR RASTRA, SPA 0138R01703180007701
0002261294886 3;JKN DR RIZKI; 5.2.0.201712280730 4 161998
1#0##0#0#0.0#2018-04-05 10:15:59#0#12:00:00#12:00:00#12:00:00 1
14bf5f371d7ed98e5f7f141a857ff475 0 0 382163 0 0
1049941 0 0 0 0 3470747 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 20/03/2018 08/08/1978 0 1
3 A41.9;L03.1;R50.9 - - - None None None None A-4-10-I
None None None None None None SEPTIKEMIA (RINGAN) 2534700 0
0 - 0 - 0 - 0 - 0 2534700 1422386
0 1 0 0 0 PIRMANSYAH D393629 39 14469 DR ANGGA
TOMALA PUTRA 0138R01703180009004 0001604941356 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 163025 1#0##0#0#0.0#2018-04-05
11:17:07#0#12:00:00#12:00:00#12:00:00 1 309a8dd17c89b136606f8d3260bfe1c4
0 0 689877 0 0 350456 0 0 0 0 382053
0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 20/03/2018 22/06/1949 0 2
1 I63.9;G81.9;E11.8 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3699776 0 1 0 0 0 MARIA YOHANITA
ROSGIYARTI D393636 68 25108 DR ANGGA TOMALA PUTRA 0138R01703180008982
0001728314482 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163022
1#0##0#0#0.0#2018-04-05 11:31:15#0#12:00:00#12:00:00#12:00:00 1
33d197e1556327aaac9b0994ea3bf367 0 0 621855 0 0
1812880 0 0 0 0 549041 0 0 0 0 716000
3201126 B 3 BS 1 18/03/2018 20/03/2018 29/09/1979 0 2
1 A18.2 40.29 - - None None None None D-1-20-I None None
LAIN (RINGAN) 5164200 0 0 - 0 - 0 - 0 -
0 5164200 7096781 0 3 0 0 0 WIDIYASTUTI
0002302912348 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 162047
1#0##0#0#0.0#2018-04-09 12:09:32#0#12:00:00#12:00:00#12:00:00 1
82eebb56f22afc059935965dcd4c53a0 0 3149000 1445976 0 0
1816530 0 0 0 0 540275 0 0 0 0 145000
3201126 B 3 BS 1 13/03/2018 20/03/2018 19/08/2016 0 1
1 K56.7;J18.0;G40.9 93.94 - - None None None None K-4-15-III
(BERAT) 5725500 0 0 - 0 - 0 - 0 - 0
5725500 6821068 0 8 0 0 0 MUHAMMAD ALWI
D391309 1 571 DR RASTRA, SPA 0138R01703180006086
0002316514994 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 160598
1#0##0#0#0.0#2018-04-09 12:14:11#0#12:00:00#12:00:00#12:00:00 1
a9a4d731daab6b816751ce90a21be314 0 0 509975 0 0
3827855 0 0 0 0 2313238 0 0 0 0 170000
3201126 B 3 BS 1 13/03/2018 20/03/2018 20/06/2017 0 2
1 K65.9;K56.1;A41.9;D64.9 54.11;46.04;45.94;99.04 - - None None
None None K-1-20-III None None None None None None PROSEDUR
INTESTINAL KOMPLEKS (BERAT) 24829300 0 0 - 0 - 0 -
0 - 0 24829300 36741915 0 8 0 0 0
NADHIRA AZZAHRA RAMADHANI D392916 0 266 DR CATUR S, SPB
987456321 123654 3;JKN irene; 5.2.1.201802140120 4 160582
1#0##0#0#0.0#2018-04-10 10:02:03#0#16:12:10#16:12:10#00:00:00 2
dbb265c92e99e8f0a1f6548c2dc94432 0 8257300 9248669 0 0
14159946 0 0 0 0 3806000 0 0 0 70000
1200000
3201126 B 3 BS 1 13/03/2018 20/03/2018 01/04/1943 0 1
1 I21.2;I20.0;I25.0;I08.9;I11.0 88.55;36.07 - - YY02 None None
0 - 0 - 0 45079800 78330128 0 8 1 6
0 MUGENIH D365733 74 27375 DR AGOES KOOSHARTORO SPPD-KKV
0138R01703180005557 0000511015432 3;JKN DR RIZKI; 5.2.1.201802140120
4 160114 1#0##0#0#0.0#2018-04-16
08:47:50#0#12:00:00#12:00:00#00:00:00 1 35cc25eafc58f88f04ff98a308adc7bb
0 13252000 5197120 0 0 47775508 0 0 0 0
1256000 0 0 0 0 10849500
3201126 B 3 BS 1 20/03/2018 20/03/2018 13/11/1954 0 2
1 E16.2;E87.1;A41.9 - - - None None None None E-4-10-III
0 - 0 6262900 2556668 0 1 0 0 0 ELSYE
LOUISE GUMANSALANGI D393626 63 23138 DR VINSENSIA NOVI KARTIKA
0138R01703180009771 0001718925254 3;JKN irene; 5.2.1.201804062320
4 170945 1#0##0#0#0.0#2018-04-26
08:26:22#0#00:00:00#00:00:00#12:00:00 2 cb13d66db90c0fa5013c9c2c246441f5
0 0 566397 0 0 1021012 0 0 0 0 474259
0 0 0 0 495000
3201126 B 3 BS 1 19/03/2018 20/03/2018 24/06/1973 0 1
- 0 8908800 10460339 0 2 0 0 0 JONNY
TAMBUNAN D393556 44 16339 SRI KUNMARTINI.DR,SPPD 0138R01703180008634
0001742179375 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 162616
1#0##0#0#0.0#2018-04-26 16:39:08#0#12:00:00#12:00:00#12:00:00 1
79825a0529e15807569ff870698c9edf 0 3156000 2636552 0 0
3892966 0 0 0 0 740321 0 0 0 0 34500
3201126 B 1 BS 1 18/03/2018 20/03/2018 20/07/2010 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3501055 0 3 0 0 0 NUR JULIA YASFI AZZAHRA
D392985 7 2798 DR RASTRA, SPA 0138R01703180007977
0001742633605 3;JKN DR RIZKI; 5.2.1.201804062320 4 162042
1#0##0#0#0.0#2018-05-03 16:33:44#0#12:00:00#12:00:00#12:00:00 1
059f6e44ad57157ec142cf843392cd03 0 0 316331 0 0 416683
0 0 0 0 2598041 0 0 0 0 170000
3201126 B 1 BS 1 19/03/2018 20/03/2018 05/08/1967 0 1
0 - 0 - 0 - 0 - 0 7464200 13177407
0 2 0 0 0 AGUS SUPARNGADI D203570 50 18489 DR RAY
HENDRY, SPOT 0138R01703180008403 0002292411003 3;JKN DR RIZKI;
5.2.2.201806040537 4 162449 1#0##0#0#0.0#2018-08-10
14:08:06#0#12:00:00#12:00:00#12:00:00 2 4b693abb0a79303d7c34f2fe2de85b15
0 0 3426164 0 0 1912570 0 7769673 0 0
0 0 0 0 0 69000
3201126 B 3 BS 1 20/03/2018 20/03/2018 08/08/1978 0 1
1 A41.9;L03.9;R50.9 - - - None None None None A-4-10-I
0 - 0 - 0 - 0 - 0 2534700 1422386
0 1 0 0 0 PIRMANSYAH D393629 39 14469 DR ANGGA
TOMALA PUTRA 0138R0170318V000020 0001604941356 3;JKN DR RIZKI;
5.2.2.201806040537 4 227403 1#0##0#0#0.0#2018-09-26
14:33:51#0#00:00:00#00:00:00#12:00:00 1 83df47adb5e07ccbd4bed8aeadd497b4
0 0 689877 0 263000 350456 0 0 0 0
93053 0 0 26000 0 0
3201126 B 3 BS 1 20/03/2018 20/03/2018 16/09/1983 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 659034 0 1 0 0 0 AGUS KURNAEN
D393253 34 12604 DR BETTY 0138R01703180008799 0002089984836
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 163000
1#0##0#0#0.0#2018-10-06 10:17:55#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 332114 0 0 0 0 0
3201126 B 1 BS 1 17/03/2018 21/03/2018 12/01/1963 0 1
1 I20.0;E11.9 89.52 - - None None None None I-4-20-I None
5883600 0 0 - 0 - 0 - 0 - 0
5883600 8240239 0 5 0 0 0 WAGEN SITUNGKIR
0001128770662 3;JKN DR RIZKI; 5.2.0.201712280730 4 161999
1#0##0#0#0.0#2018-03-26 09:16:05#0#12:00:00#12:00:00#12:00:00 1
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3127598 0 0 0 0 4380081 0 0 0 0 0
3201126 B 1 BS 1 18/03/2018 21/03/2018 03/06/1970 0 1
1 I50.0;I08.9;K30 - - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 5802600
8912167 0 4 0 0 0 MOH. ARIFIN D380192 47 17455
DR RIZKI; 5.2.0.201712280730 4 162040
1#1#vvip#4#3109567#0.0#2018-03-26 09:20:36#0#12:00:00#12:00:00#12:00:00
1 f922b181561f3e05aec98b12bf056298 0 0 1809280 0 0
1393848 0 0 0 0 5709039 0 0 0 0 0
3201126 B 2 BS 1 19/03/2018 21/03/2018 22/04/1990 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 16773567 0 3 0 0 0 ISNAENI AMALIA
0000512262314 3;JKN DR RIZKI; 5.2.0.201712280730 4 162062
1#0##0#0#0.0#2018-03-29 08:42:27#1#12:00:00#12:00:00#12:00:00 1
dedc4af403cdd72fc090235276ff4d27 0 5479830 6956280 0 0
2932121 0 0 0 0 1208336 0 0 0 197000
0
3201126 B 3 BS 1 13/03/2018 21/03/2018 28/09/1968 0 1
1 J44.1;I50.0;I25.0 93.94;88.72;89.52 - - None None None None
J-4-17-II None None None None None None PENYAKIT PARU OBSTRUKTIF
KRONIS (SEDANG) 4417400 0 0 - 0 - 0 - 0 -
0 4417400 16437174 0 9 1 4 0 BUDIMAN
0002142505383 3;JKN DR RIZKI; 5.2.0.201712280730 4 160592
1#0##0#0#0.0#2018-03-31 08:56:46#0#12:00:00#12:00:00#12:00:00 2
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6984205 0 0 0 0 5686329 0 0 0 0
2920000
3201126 B 3 BS 1 19/03/2018 21/03/2018 01/12/1950 0 2
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2514025 0 3 0 0 0 USNI D393469 67
DR RIZKI; 5.2.0.201712280730 4 162426 1#0##0#0#0.0#2018-03-31
08:59:14#0#12:00:00#12:00:00#12:00:00 1 ac3ac8da3ebb7c11b18d5fd479fa5176
0 0 207620 0 0 1308936 0 0 0 0 997469
0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 21/03/2018 01/02/1965 0 2
1 K21.9;B34.9 - - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 2954900 1477759
0 3 0 0 0 SUKILAH D393466 53 19404 DR SOEGIONO,
4 163295 1#0##0#0#0.0#2018-03-31
09:33:09#0#12:00:00#12:00:00#12:00:00 1 153c094529f61cc5470c312c1e83bf64
0 0 257183 0 0 308900 0 0 0 0 911676
0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 21/03/2018 28/12/1956 0 2
1 B34.9;K30 90.59;89.52 - - None None None None A-4-13-I
(RINGAN) 2090000 0 0 - 0 - 0 - 0 - 0
2090000 1767460 0 3 0 0 0 AMINAM D393456
DR RIZKI; 5.2.0.201712280730 4 162058 1#0##0#0#0.0#2018-03-31
09:33:50#0#12:00:00#12:00:00#12:00:00 1 7f6335a4109413ada0cba3d1d341d640
0 0 241100 0 0 595732 0 0 0 0 930628
0 0 0 0 0
3201126 B 2 BS 1 19/03/2018 21/03/2018 07/04/2016 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4244938 0 3 0 0 0 DAFFA ALFARIZKI SETIAWAN
0002033866451 3;JKN DR RIZKI; 5.2.0.201712280730 4 162056
1#0##0#0#0.0#2018-03-31 11:59:00#0#12:00:00#12:00:00#00:00:00 1
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1983001 0 0 0 0 1818706 0 0 0 0 0
3201126 B 2 BS 1 19/03/2018 21/03/2018 22/08/1999 0 2
- 0 - 0 - 0 - 0 3545800 3385207 0
3 0 0 0 ANGEL AGUSTINA ERRYANTI D393447 18 6784 DR
5.2.0.201712280730 4 162055 1#0##0#0#0.0#2018-03-31
12:00:39#0#12:00:00#12:00:00#12:00:00 1 5187a20094805277d8a23984e5bdae46
0 0 785411 0 0 837334 0 0 0 0
1762462 0 0 0 0 0
3201126 B 2 BS 1 16/03/2018 21/03/2018 23/02/1953 0 2
1 K30;K56.7 - - - None None None None K-4-18-II None
2941900 0 0 - 0 - 0 - 0 - 0
2941900 5715579 0 6 0 0 0 AISYAH D392327
3;JKN DR RIZKI; 5.2.0.201712280730 4 161985 1#0##0#0#0.0#2018-
03-31 12:09:24#0#12:00:00#12:00:00#12:00:00 1
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2175347 0 0 0 0 3222416 0 0 0 0 0
3201126 B 3 BS 1 21/03/2018 21/03/2018 20/09/2002 0 2
1 K21.9;S29.9;S06.00 90.59;87.49;87.03 - - None None None
(BERAT) 6781600 0 0 - 0 - 0 - 0 - 0
6781600 1616726 0 1 0 0 0 EKA SUMIYADI PUTRI
0001269935649 3;JKN DR RIZKI; 5.2.0.201712280730 4 163334
1#0##0#0#0.0#2018-04-02 09:59:56#0#08:45:00#16:00:00#12:00:00 1
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0 0 0 0 412767 0 0 0 0 0
3201126 B 3 BS 1 21/03/2018 21/03/2018 16/01/1946 0 2
1 I61.9;A09.9 87.03;89.52;90.59 - - None None None None G-4-
13-I None None None None None None PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 2749130 0 1 0 0 0 SRI MARYATI,BA.
0000061044131 3;JKN DR RIZKI; 5.2.0.201712280730 4 163225
1#0##0#0#0.0#2018-04-02 10:04:08#0#00:00:00#17:30:00#00:00:00 1
18b7088e5b4409506796faac39a80a0c 0 0 265968 0 0
1280312 0 0 0 0 486850 0 0 0 0 716000
3201126 B 3 BS 1 21/03/2018 21/03/2018 25/01/1958 0 2
1 E16.2;J06.9;A01.0 90.59;87.49;89.52 - - None None None None
- 0 - 0 6262900 1508893 0 1 0 0 0
RODIAH D154678 60 21970 DR AHMAD HIBBAN A WRIYA
0138R01703180009567 0001456655938 3;JKN DR RIZKI; 5.2.0.201712280730
4 163511 1#0##0#0#0.0#2018-04-02
10:11:48#0#11:52:00#18:00:00#00:00:00 1 6f33661f31c0996b94fbbab6ec23120f
0 0 563661 0 0 557519 0 0 0 0 387713
0 0 0 0 0
3201126 B 1 BS 1 20/03/2018 21/03/2018 03/04/1964 0 1
0 0 - 0 - 0 - 0 - 0 4615000
7267418 0 2 0 0 0 HERMANWIR MARTINO D392493 53
19709 DR ZULFAN, SPPD 0138R01703180009061 0001484682445 3;JKN DR
RIZKI; 5.2.0.201712280730 4 163030 1#0##0#0#0.0#2018-04-02
15:48:17#0#12:00:00#12:00:00#12:00:00 1 7a8a42cfde1454dce604f322ddcf1a41
0 0 1345200 0 0 1367279 0 0 0 0
2805939 0 0 0 0 1749000
3201126 B 1 BS 1 18/03/2018 21/03/2018 10/08/1954 0 1
1 J40;M17.9 - - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 3917900 0 0 - 0 - 0 - 0
- 0 3917900 4364120 0 4 0 0 0 GUN NURLETTE
0000061141713 3;JKN DR RIZKI; 5.2.0.201712280730 4 163333
1#0##0#0#0.0#2018-04-04 09:33:15#0#12:00:00#12:00:00#12:00:00 1
512d4e6712fed13e147ab30efc2ed1bf 0 0 405611 0 0 523006
0 0 0 0 3435503 0 0 0 0 0
3201126 B 2 BS 1 16/03/2018 21/03/2018 22/10/1959 0 1
1 I63.9;J90 89.52;87.44;87.03 - - None None None None G-4-
- 0 10406600 12382225 0 6 0 0 0 HERMAN
0001459582727 3;JKN DR RIZKI; 5.2.0.201712280730 4 161542
1#0##0#0#0.0#2018-04-04 11:49:05#0#12:00:00#12:00:00#12:00:00 1
0a449de56f3e72e2f961d5422d124c6f 0 0 2052568 0 0
6463605 0 0 0 0 3866052 0 0 0 0 0
3201126 B 1 BS 1 16/03/2018 21/03/2018 26/11/1969 0 1
1 I63.9;E11.9;I50.0;G81.9 87.49;87.03;89.52;90.59 - - None None
None None G-4-14-II None None None None None None KECEDERAAN
PEMBULUH DARAH OTAK DENGAN INFARK (SEDANG) 9673300 0 0 - 0
- 0 - 0 - 0 9673300 9797283 0 6 0
0 0 MOCHAMAD BADRUZAMAN D313235 48 17642 DR MAYSAM I., SPS
0138R01703180007183 0002269836573 3;JKN DR RIZKI; 5.2.0.201712280730
4 161540 3#0##0#0#0.0#2018-04-05
09:10:42#0#12:00:00#12:00:00#12:00:00 1 386db5648f524227899ee27db1f96317
0 0 1213794 0 0 3230545 0 0 0 0
5352944 0 0 0 0 0
3201126 B 1 BS 1 20/03/2018 21/03/2018 22/07/1942 0 1
- 0 12472300 16831292 0 2 0 0 0 NURHARYONO
0001257881196 3;JKN DR RIZKI; 5.2.0.201712280730 4 163033
1#0##0#0#0.0#2018-04-05 09:21:08#0#12:00:00#12:00:00#12:00:00 1
5d1ac584530fb2c114c12174777e4a1c 0 5896000 7845677 0 0
1911802 0 0 0 0 1157113 0 0 0 0 20700
3201126 B 1 BS 1 20/03/2018 21/03/2018 05/08/1946 0 1
1 N18.5;G81.9;I69.4 39.27;89.52;90.59 - - None None None None
- 0 - 0 12472300 11100993 0 2 0 0 0
USMAN SAEPULLOH NUR D392277 71 26160 DEDY PRATAMA,SPBV
0138R01703180008802 0000058364335 3;JKN DR RIZKI; 5.2.0.201712280730
4 163002 1#0##0#0#0.0#2018-04-05
09:28:09#0#12:00:00#12:00:00#12:00:00 1 dd9ae718f97302a39b9b5e1ec269e0ec
0 5896000 2494460 0 0 1859300 0 0 0 0
782233 0 0 0 0 69000
3201126 B 1 BS 1 20/03/2018 21/03/2018 01/03/1999 0 1
12140800 0 0 - 0 - 0 - 0 - 0
12140800 17555740 0 2 0 0 0 FARHAN FADHILAH
d393600 19 6959 DR BENNY H T, SPOT 0138R01703180008763
0002234532339 3;JKN DR RIZKI; 5.2.0.201712280730 4 162997
1#0##0#0#0.0#2018-04-05 10:04:09#0#12:00:00#12:00:00#12:00:00 2
82777ea94750168ebe6f2fa3d0c8df69 0 0 5390424 0 0
1105010 0 0 0 0 10987806 0 0 0 0 72500
3201126 B 3 BS 1 21/03/2018 21/03/2018 18/02/1953 0 1
1 I64;I10 - - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 5302096 0 1 0
0 0 AMSI D393676 65 23772 DR NIKEN PRABHA DUHITA
0138R01703180009109 0001739698773 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 163040 1#0##0#0#0.0#2018-04-05
11:19:48#0#12:00:00#12:00:00#12:00:00 1 5b1d1a8b1757d4717b6216fd2ae4e4ff
0 0 368658 0 0 3539572 0 0 0 0 635866
0 0 0 0 758000
3201126 B 3 BS 1 21/03/2018 21/03/2018 12/07/1979 0 1
1 K30;I20.0 - - - None None None None K-4-18-II None
2451500 0 0 - 0 - 0 - 0 - 0
2451500 2287432 0 1 0 0 0 YUNUS D391449 38
TANTIYO S;16137 5.2.0.201712280730 4 164405 1#0##0#0#0.0#2018-
04-05 11:23:10#0#12:00:00#12:00:00#12:00:00 1
c795742460aa7030c6c21a46a0e73694 0 0 220635 0 0
1192152 0 0 0 0 456645 0 0 0 0 418000
3201126 B 1 BS 1 20/03/2018 21/03/2018 08/11/1974 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 4161771 0 2 0 0 0 ERWAN HENDRA
RUSMAN D228271 43 15838 DR SRI KUNMARTINI, SPPD 0138R01703180009062
0001622060886 3;JKN DR RIZKI; 5.2.0.201712280730 4 163031
21#0##0#0#0.0#2018-04-05 14:50:15#0#12:00:00#12:00:00#00:00:00 1
b3be993424af58b3543f1fdb4da17fff 0 0 573641 0 0
1352615 0 0 0 0 2235515 0 0 0 0 0
3201126 B 3 BS 1 14/02/2018 21/03/2018 14/02/2018 1634 1
1 P01.1;P22.0;P07.1;P36.5;P07.3 96.72;38.97 - - None None None
None P-8-05-III None None None None None None NEONATAL, BERAT BADAN
LAHIR GROUP-3 DENGAN PROSEDUR MAYOR (BERAT) 40034400 0 0 - 0
- 0 - 0 - 0 40034400 81939915 0 36 1
2 48 BAYI NY SITI JUBAEDAH II d390452 0 0 DR AULIA
TANGKARI, SPA 0138R01702180006903 0002430203376 3;JKN DR RIZKI;
5.2.0.201712280730 4 150028 1#0##0#0#0.0#2018-04-05
16:11:28#0#12:00:00#12:00:00#12:00:00 1 9c1bef9506ec8253f4584e9978791c4d
0 0 4355340 0 0 18363575 0 0 0 0
30563000 0 0 0 0 28658000
3201126 B 3 BS 1 17/03/2018 21/03/2018 01/06/1955 0 1
4 I21.9;J81;I46.9;R57.0 99.60 - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 12344370 0 5 0 0 0 SUHERMAN D389779
62 22935 DR PRIYO SUNARTO , SPJP 0138R01703180007819 0001014459895
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 162021
1#0##0#0#0.0#2018-04-05 16:34:08#0#12:00:00#12:00:00#12:00:00 1
53b229561ca56ec76f0cd6ec24935045 0 0 500624 0 0
5036170 0 0 0 0 3715576 0 0 0 0
3092000
3201126 B 2 BS 1 20/03/2018 21/03/2018 07/09/1992 0 2
- 0 - 0 - 0 - 0 3479400 4149829 0
2 0 0 0 TRI LUSIANDA D262581 25 9325 DR ERDIYAN,
5.2.0.201712280730 4 162982 1#0##0#0#0.0#2018-04-07
12:58:56#0#12:00:00#12:00:00#00:00:00 2 3da9d49df71d8ff5e32257caea630213
0 0 636767 0 0 1523578 0 0 0 0
1307484 0 0 0 0 682000
3201126 B 1 BS 1 17/03/2018 21/03/2018 20/11/1950 0 2
1 G57.0;M51.2;M43.16 90.59;89.52 - - None None None None
G-4-17-I None None None None None None GANGUAN SARAF KRANIAL DAN
PERIFER (RINGAN) 6296600 0 0 - 0 - 0 - 0 -
0 6296600 12874884 0 5 0 0 0 ERIKA SIREGAR
0000060782714 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 162024
1#1#vvip#5#6578284#0.0#2018-05-02 09:11:32#0#12:00:00#12:00:00#12:00:00
1 8db226d3548712ccdd737cd7563bce0d 0 0 1950000 0 0
3478102 0 0 0 0 7276782 0 0 0 0 170000
3201126 B 1 BS 1 19/03/2018 21/03/2018 01/04/1980 0 2
1 N39.0;A01.0 90.59;89.52 - - None None None None N-4-12-III
7087700 0 0 - 0 - 0 - 0 - 0
7087700 3525579 0 3 0 0 0 SUSANTI d382150
3;JKN DR RIZKI; 5.2.2.201806040537 4 162059 1#0##0#0#0.0#2018-
08-10 11:25:25#0#12:00:00#12:00:00#12:00:00 3
57b0ec8b438cfe17610a4a1cfd4a22eb 0 0 338858 0 0 587076
0 0 0 0 2599645 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 21/03/2018 23/10/1970 0 2
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 1075255 0 2 0 0 0 NURHASANAH D306350
3;JKN DR RIZKI; 5.2.2.201806040537 4 163036 1#0##0#0#0.0#2018-
08-10 14:28:21#0#12:00:00#12:00:00#00:00:00 2
ceceb253bb3aebef1853e4b2e8308947 0 0 451179 0 0 264732
0 0 0 0 359344 0 0 0 0 0
3201126 B 3 BS 1 16/03/2018 21/03/2018 20/05/1978 0 2
4 J96.9;I21.9;J45.9;J18.9 96.71 - - None None None None J-1-
KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0 -
0 29135800 22177169 0 6 0 0 0 DEWI AMBARWATI
D391548 39 14545 DR ARU, SPPD 0138R01703180007202
0001740119343 3;JKN DR RIZKI; 5.2.1.201804062320 4 161543
1#0##0#0#0.0#2018-09-06 17:01:07#0#12:00:00#12:00:00#12:00:00 2
f66040d0358504cde60f85d1135bccd8 0 0 1380331 0 0
14439338 0 0 0 0 3707500 0 0 0 0
2650000
3201126 B 3 BS 1 21/03/2018 22/03/2018 08/07/1966 0 2
K-4-12-I None None None None None None GANGGUAN ESOFAGUS (RINGAN)
2954900 0 0 - 0 - 0 - 0 - 0
2954900 6013001 0 2 0 0 0 NURHAYATI D379179
DR RIZKI; 5.2.0.201712280730 4 163538 1#0##0#0#0.0#2018-04-02
10:01:29#0#12:00:00#12:00:00#12:00:00 1 9f1cb400d1506269ebabb0de0448d012
0 0 943372 0 0 1719255 0 0 0 0
1601374 0 0 0 0 1749000
3201126 B 3 BS 1 20/03/2018 22/03/2018 03/01/1937 0 2
0 - 0 - 0 - 0 - 0 6781600 2908189
0 3 0 0 0 SULASTRI d393587 81 29661 DR BETTY DWI
5.2.0.201712280730 4 162964 1#0##0#0#0.0#2018-04-02
10:02:11#0#12:00:00#12:00:00#12:00:00 1 646d8e645cc184154ea0c24624c06786
0 0 663344 0 0 1239590 0 0 0 0
1005255 0 0 0 0 0
3201126 B 2 BS 1 20/03/2018 22/03/2018 23/05/1993 0 2
- 0 - 0 - 0 - 0 3545800 2680864 0
3 0 0 0 INA PURNAWATI d382552 24 9067 DR SOEGIONO,
4 163024 1#0##0#0#0.0#2018-04-02
10:49:55#0#12:00:00#12:00:00#12:00:00 1 1182ccc4a788a265b881fd956cb2c0bb
0 0 356524 0 0 725456 0 0 0 0
1598884 0 0 0 0 0
3201126 B 1 BS 1 21/03/2018 22/03/2018 12/03/1967 0 2
- 0 - 0 12472300 13412018 0 2 0 0 0
SUHAIMI, NY D376840 51 18637 DR IRFIANSYAH LESMANA DR SPBTKV
0138R01703180009160 0000061100357 3;JKN DR RIZKI; 5.2.0.201712280730
4 163162 1#0##0#0#0.0#2018-04-02
14:47:30#0#12:00:00#12:00:00#12:00:00 1 6cf12da64eff5859b93fb786c3800480
0 6468200 2494460 0 0 3446936 0 0 0 0
933422 0 0 0 0 69000
3201126 B 1 BS 1 20/03/2018 22/03/2018 31/08/2000 0 1
1 R10.1;R07.4 - - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4493757 0 3 0 0 0 DIMAS MUHAMMAD RAIHAN
0002212649392 3;JKN DR RIZKI; 5.2.0.201712280730 4 162959
1#0##0#0#0.0#2018-04-02 15:53:01#0#12:00:00#12:00:00#12:00:00 1
4cd7924f8c3e7d6262c5877435943ab8 0 0 236051 0 0
1594722 0 0 0 0 2662984 0 0 0 0 0
3201126 B 1 BS 1 17/03/2018 22/03/2018 07/05/2016 0 2
5058500 0 0 - 0 - 0 - 0 - 0
5058500 8034937 0 6 0 0 0 FELICIA GAVRIELA
SITUMORANG D355721 1 679 DR RASTRA, SPA 0138R01703180007854
0002322421839 3;JKN DR RIZKI; 5.2.0.201712280730 4 162027
1#0##0#0#0.0#2018-04-02 15:55:36#0#12:00:00#12:00:00#12:00:00 1
a7e3b04c80c6871f1065a00b9ad77346 0 0 508265 0 0
2270022 0 0 0 0 4456650 0 0 0 0 800000
3201126 B 3 BS 1 16/03/2018 22/03/2018 18/08/2015 0 1
- 0 - 0 - 0 - 0 2655900 4037093 0
7 0 0 0 JUNIOR ALRAFAEYZA ARMAND D393234 2 941
DR AWIDIYA, SPA 0138R01703180007409 0001774320513 3;JKN DR RIZKI;
5.2.0.201712280730 4 161825 1#0##0#0#0.0#2018-04-04
10:48:38#0#12:00:00#12:00:00#12:00:00 1 5ffa4e76cbae1c7899c735c0bf9bfb92
0 0 533132 0 0 1032852 0 0 0 0
2131109 0 0 0 0 340000
3201126 B 3 BS 1 20/03/2018 22/03/2018 26/09/1976 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
S TN D239322 41 15150 DR SRI KUNMARTINI, SPPD 0138R01703180008795
0001743628138 3;JKN DR RIZKI; 5.2.0.201712280730 4 162962
1#0##0#0#0.0#2018-04-04 10:55:58#0#12:00:00#12:00:00#00:00:00 1
25f4bf37ea84df67f5e63e2f888239a4 0 0 424889 0 0
4250304 0 0 0 0 2436501 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 22/03/2018 11/11/1976 0 2
30-II None None None None None None PROSEDUR PADA VAGINA, SERVIK & VULVA
(SEDANG) 7441100 0 0 - 0 - 0 - 0 - 0
7441100 7855820 0 3 0 0 0 AMINAH d393627
41 15104 DR ARIS WAHJU, SPOG 0138R01703180008729 0001740270892
3;JKN DR RIZKI; 5.2.0.201712280730 4 162995 1#0##0#0#0.0#2018-
04-04 11:09:21#0#12:00:00#12:00:00#12:00:00 1
1e44d2b8b1bf0d7d0e13719668ea464e 0 3615000 1248960 0 0
2204928 0 0 0 0 589932 0 0 0 0 197000
3201126 B 3 BS 1 17/03/2018 22/03/2018 12/08/1963 0 1
0 0 - 0 - 0 - 0 - 0 3575600
4235375 0 6 0 0 0 ABDILLAH D393407 54 19941
DR RIZKI; 5.2.0.201712280730 4 162029 1#0##0#0#0.0#2018-04-04
11:37:21#0#12:00:00#12:00:00#12:00:00 1 da74a9e6f8a3f3092ae1043f51689c80
0 0 726704 0 0 1890590 0 0 0 0
1618081 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 22/03/2018 07/05/1963 0 2
1 K29.6;K29.8;K31.7 45.16 - - None None None None K-4-11-II
3296400 0 0 - 0 - 0 - 0 - 0
3296400 4869504 0 3 0 0 0 SRI SUWARNI D392283
DR RIZKI; 5.2.0.201712280730 4 163028 1#0##0#0#0.0#2018-04-04
11:42:37#0#12:00:00#12:00:00#12:00:00 1 a2c5fedd401ff9d5459a1a3c7ac439e5
0 0 702488 0 0 804950 0 0 0 0
1613066 0 0 0 0 1749000
3201126 B 2 BS 1 21/03/2018 22/03/2018 08/08/1983 0 2
0 0 - 0 - 0 - 0 - 0 9917100
8675070 0 2 0 0 0 AGUSTINA GINTING D200680 34
RIZKI; 5.2.0.201712280730 4 163537 1#0##0#0#0.0#2018-04-04
11:51:34#0#12:00:00#12:00:00#12:00:00 1 c274c42161bda67ea22e3859624a91c6
0 4251200 2875959 0 0 855383 0 0 0 0
623528 0 0 0 0 69000
3201126 B 2 BS 1 19/03/2018 22/03/2018 01/10/1967 0 1
0 0 - 0 - 0 - 0 - 0 5043100
3744065 0 4 0 0 0 LIA SORAYA D019119 50 18432
DR RIZKI; 5.2.0.201712280730 4 162984 1#0##0#0#0.0#2018-04-04
11:55:09#0#12:00:00#12:00:00#12:00:00 1 8f4d9f0648e46ec40d3042cffa692d83
0 0 439172 0 0 1221454 0 0 0 0
2083439 0 0 0 0 0
3201126 B 2 BS 1 20/03/2018 22/03/2018 27/06/2010 0 2
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9086773 0 3 0 0 0 ASQIA SITI NURHALIZA
D391737 7 2823 DR CATUR S, SPB 0138R01703180008788
0001627443808 3;JKN DR RIZKI; 5.2.0.201712280730 4 162947
1#0##0#0#0.0#2018-04-04 11:56:19#0#12:00:00#12:00:00#12:00:00 1
e2000c9b30c0b2ef973efa4943233c5b 0 5348300 1271272 0 0
1734239 0 0 0 0 660462 0 0 0 0 72500
3201126 B 2 BS 1 15/03/2018 22/03/2018 09/03/1970 0 1
1 I63.9;I10 87.03;87.49;90.59;89.52 - - None None None None
0 - 0 6015800 9462367 0 8 0 0 0 RUDI
SETIAWAN D075834 48 17538 DR HARDI PRANATA SPS 0138R01703180006829
0001371898653 3;JKN DR RIZKI; 5.2.0.201712280730 4 161184
1#0##0#0#0.0#2018-04-04 11:58:13#0#12:00:00#12:00:00#12:00:00 1
b05fc30354709fd7dee28d0121f44b47 0 0 657422 0 0
4119912 0 0 0 0 4685033 0 0 0 0 0
3201126 B 2 BS 1 19/03/2018 22/03/2018 03/03/1986 0 2
1 K80.1 90.59;89.52;51.22 - - None None None None B-1-12-I
None None None None None None CHOLESISTEKTOMI TANPA LAPAROSKOPIK
(RINGAN) 8447200 0 0 - 0 - 0 - 0 - 0
8447200 13899081 0 4 0 0 0 KHAIRIYAH IMAS MASITOH
D380862 32 11704 DR SURYA POHAN SPB 0138R01703180008256
0001407720543 3;JKN DR RIZKI; 5.2.0.201712280730 4 162177
11#0##0#0#0.0#2018-04-04 12:06:17#0#12:00:00#12:00:00#12:00:00 1
d2e3d5a6c3dea14dc4101e5d27fb623d 0 5269100 2878960 0 0
4450735 0 0 0 0 1010286 0 0 0 0 290000
3201126 B 1 BS 1 20/03/2018 22/03/2018 23/04/1945 0 2
1 H81.1;I10;K30;E87.6 - - - None None None None U-4-
11-II None None None None None None DYSEQUILIBRIUM (SEDANG) 3089800 0
0 - 0 - 0 - 0 - 0 3089800 4367181
0 3 0 0 0 CHRISTINA HARTONO D002545 72 26629 DR
5.2.0.201712280730 4 162983 22#0##0#0#0.0#2018-04-05
09:07:19#0#12:00:00#12:00:00#00:00:00 1 7fb568e91f871409278ede0ae805a335
0 0 244205 0 0 1468273 0 0 0 0
2654703 0 0 0 0 0
3201126 B 1 BS 1 20/03/2018 22/03/2018 18/05/2001 0 2
1 I13.1 39.27;90.59;89.52 - - None None None None N-1-12-I
- 0 6076700 10697799 0 3 0 0 0 DHENISWARI H
PUTRI d391599 16 6150 DR SOEGIONO, SPPD 0138R01703180009025
0001421988772 3;JKN DR RIZKI; 5.2.0.201712280730 4 163026
25#0##0#0#0.0#2018-04-05 09:24:42#0#12:00:00#12:00:00#12:00:00 1
27a0aa02d3a9d2a456a35563fb0a991d 0 6468200 1815243 0 0
1589500 0 0 0 0 755856 0 0 0 0 69000
3201126 B 1 BS 1 20/03/2018 22/03/2018 25/08/1962 0 1
0 - 0 - 0 5576700 8571360 0 3 0 0
0 IRIANTO d392958 55 20296 DR ZULFAN, SPPD
0138R01703180008785 0000037570048 3;JKN DR RIZKI; 5.2.0.201712280730
4 162987 1#0##0#0#0.0#2018-04-05
09:26:40#0#12:00:00#12:00:00#12:00:00 1 7d29251b9794c5be33bb626e68685d2d
0 0 2179379 0 0 1751738 0 0 0 0
2891243 0 0 0 0 1749000
3201126 B 1 BS 1 20/03/2018 22/03/2018 20/11/1942 0 1
1 N35.9;D29.1;I11.9 60.29 - - None None None None V-1-14-I
(RINGAN) 12373100 0 0 - 0 - 0 - 0 - 0
12373100 14120595 0 3 0 0 0 DARMIN D388285
3;JKN DR RIZKI; 5.2.0.201712280730 4 162942
17#0##0#0#0.0#2018-04-05 09:29:48#0#12:00:00#12:00:00#12:00:00 1
03b4208788d2ca239dc1763f1475c21d 0 7159200 3588199 0 0
2324419 0 0 0 0 979777 0 0 0 0 69000
3201126 B 1 BS 1 18/03/2018 22/03/2018 30/07/1956 0 1
None None None None None None ATHEROSKLEROSIS (BERAT) 5850400 0
0 - 0 - 0 - 0 - 0 5850400 5686330
0 5 0 0 0 YANS HATUMESSEN D316196 61 22511 DR
5.2.0.201712280730 4 162048 10#0##0#0#0.0#2018-04-05
09:31:03#0#12:00:00#12:00:00#12:00:00 1 11ee9c6d766b63746cb007f56fdfaf69
0 0 1097468 0 0 631359 0 0 0 0
3957503 0 0 0 0 0
3201126 B 1 BS 1 15/03/2018 22/03/2018 14/11/1946 0 1
1 I63.9;G81.9;E79.0;E78.5 90.59;89.52;87.03;87.44 - - None None
- 0 - 0 - 0 9673300 16650071 0 8 0
0 0 SUKAMDI D042020 71 26054 DR MAYSAM I., SPS
0138R01703180007056 0000060727408 3;JKN DR RIZKI; 5.2.0.201712280730
4 161529 1#1#vvip#6#6976771#0.0#2018-04-05
09:38:28#0#12:00:00#12:00:00#00:00:00 1 3df404e4d33648933b46b4d912133b0d
0 0 1950000 0 0 2280814 0 0 0 0
12419257 0 0 0 0 0
3201126 B 1 BS 1 15/03/2018 22/03/2018 27/08/1970 0 2
1 M54.2;R51;E78.5 - - - None None None None M-4-17-I
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 13296052 0 8 0 0 0 TINE AGUSTINE
D393164 47 17367 DR MAYSAM I., SPS 0138R01703180007077
0001335400964 3;JKN DR RIZKI; 5.2.0.201712280730 4 161530
6#0##0#0#0.0#2018-04-05 09:41:20#0#12:00:00#12:00:00#12:00:00 1
494c0ce0e07ac3b08200b3d486340896 0 0 350205 0 0
5366512 0 0 0 0 7579335 0 0 0 0 0
3201126 B 1 BS 1 21/03/2018 22/03/2018 08/09/1942 0 1
1 I25.1;I08.9;I11.0 88.55;36.07;89.52;90.59 - - YY02 None None
0 - 0 - 0 58821400 64654069 0 2 0 0
0 H ROBANI D134984 75 27588 DR AZRI NURIZAL SPPD KKV
0138R01703180009232 0001338490765 3;JKN DR RIZKI; 5.2.0.201712280730
4 163052 28#0##0#0#0.0#2018-04-05
09:59:04#0#12:00:00#12:00:00#12:00:00 1 b02a55a2550bdc23b82d6baac4343311
0 10062000 9619120 0 0 36182449 0 0 0 0
1256000 0 0 0 0 7534500
3201126 B 1 BS 1 21/03/2018 22/03/2018 22/06/1963 0 2
1 I25.0;I50.0;E11.9 88.55 - - None None None None I-1-15-II
0 0 - 0 - 0 - 0 - 0 8877800
15037937 0 2 0 0 0 ESIH SUKAESIH D389091 54
3;JKN DR RIZKI; 5.2.0.201712280730 4 163077 1#0##0#0#0.0#2018-
04-05 10:00:44#0#12:00:00#12:00:00#12:00:00 1
78c1dd0ba26585c03746e0398018b9e9 0 4787000 3419040 0 0
3723107 0 0 0 0 1039790 0 0 0 0
2069000
3201126 B 1 BS 1 20/03/2018 22/03/2018 21/12/2017 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 11317604 0 3 0 0 0 BAYI NY FAJAR JAMILAH
0002322902586 3;JKN DR RIZKI; 5.2.0.201712280730 4 163563
1#0##0#0#0.0#2018-04-05 13:36:11#0#08:41:11#08:41:11#12:00:00 1
9c1a876fa188bc589e2991bbe6e0e78c 0 7187200 1463660 0 0
1695340 0 0 0 0 826404 0 0 0 0 145000
3201126 B 3 BS 1 15/03/2018 22/03/2018 02/06/1946 0 1
2 K80.0;R16.0 87.44;88.76 - - None None None None B-4-14-II
(SEDANG) 4899600 0 0 - 0 - 0 - 0 - 0
4899600 7660019 0 8 0 0 0 SONGIRIN BIN ROHIMI
D393078 71 26219 DR SURYA POHAN SPB 0138R01703180006930
0001220721772 3;JKN DR RIZKI; 5.2.0.201712280730 4 161391
4#0##0#0#0.0#2018-04-06 09:17:41#0#12:00:00#12:00:00#12:00:00 1
74cd9e8211b70d37cb96c00e79dc8fc7 0 0 536982 0 0
4491914 0 0 0 0 2631123 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 22/03/2018 28/08/1994 0 1
(RINGAN) 3692900 0 0 - 0 - 0 - 0 - 0
3692900 2261038 0 3 0 0 0 JONATAN ARITONANG
d393585 23 8605 DR H. H PUAR, SPB 0138R01703180008805
0001379502707 3;JKN DR RIZKI; 5.2.0.201712280730 4 162965
21#0##0#0#0.0#2018-04-06 09:23:47#0#12:00:00#12:00:00#12:00:00 1
422b5b9df2a99ce9dd9f5aaf29495724 0 0 385361 0 0 912759
0 0 0 0 962918 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 22/03/2018 14/08/1954 0 1
1 I12.0;D63.8;E79.0 99.04;89.52;90.59 - - None None None None
- 0 4132100 2965410 0 3 0 0 0 SOBANDI
0001406328006 3;JKN DR RIZKI; 5.2.0.201712280730 4 162939
1#0##0#0#0.0#2018-04-06 09:25:25#0#12:00:00#12:00:00#12:00:00 1
7e1f578dd8de091e86805753d33975c1 0 0 424889 0 0
1531522 0 0 0 0 1008999 0 0 0 0 0
3201126 B 3 BS 1 21/03/2018 22/03/2018 10/07/1976 0 2
1 N18.5;J18.0;T82.4 39.42 - - None None None None N-1-12-III
- 0 19332400 9808714 0 2 0 0 0 MARYATUN
0002267696575 3;JKN DR RIZKI; 5.2.0.201712280730 4 163536
1#0##0#0#0.0#2018-04-06 09:31:37#0#12:00:00#12:00:00#12:00:00 1
ee08e7ca91b8fb4b94120fbbc5570ec5 0 3438800 4005845 0 0
1597377 0 0 0 0 697692 0 0 0 0 69000
3201126 B 3 BS 1 20/03/2018 22/03/2018 05/08/1991 0 2
- 0 - 0 - 0 - 0 2168300 1504158 0
3 0 0 0 RAHMA EKA SAPUTRI D393656 26 9724 DR
ERDIYAN, SPOG 0138R01703180009321 0001339364079 3;JKN DR RIZKI;
5.2.0.201712280730 4 163168 1#0##0#0#0.0#2018-04-06
10:03:23#0#12:00:00#12:00:00#12:00:00 1 d03c757dc61e2555db8416bc6e875ac1
0 0 248147 0 0 429108 0 0 0 0 826903
0 0 0 0 0
3201126 B 3 BS 1 22/03/2018 22/03/2018 11/05/1970 0 2
- 0 7516400 17303717 0 1 0 0 0 SULASTRI
0001740591099 3;JKN DR RIZKI; 5.2.0.201712280730 4 164067
1#0##0#0#0.0#2018-04-06 10:29:30#0#12:00:00#12:00:00#12:00:00 1
63cb6bb96cef4dbfe08043cce0cfafb4 0 6599300 2245756 0 0
6414642 0 0 0 0 1158019 0 0 0 0 886000
3201126 B 3 BS 1 21/03/2018 22/03/2018 19/03/2018 2600 1
None None None None NEONATAL, BERAT BADAN LAHIR GROUP-5 DENGAN SINDROMA
DISTRES PERNAFASAN (RINGAN) 4222000 0 0 - 0 - 0 -
0 - 0 4222000 1775850 0 2 0 0 0 BY NY
BELLA PUTRI ASHARI D393521 0 2 DR MUHAMMAD RIZKI YUWANA
84N505000210318 012345678 3;JKN DR RIZKI; 5.2.0.201712280730 4
168833 36#0##0#0#0.0#2018-04-06 16:26:00#0#16:21:32#16:21:32#00:00:00
2 fed4ac1f807198b78096ed48c89c987c 0 0 1251250 0 0
524600 0 0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 21/03/2018 22/03/2018 21/12/1966 0 2
- 0 10690500 10880529 0 2 0 0 0 MARSIAH
0001275077733 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163362
1#0##0#0#0.0#2018-04-07 13:12:34#0#12:00:00#12:00:00#12:00:00 2
1e9e95064f8b3de4986ef98747394c7e 0 0 1510494 0 0
3622125 0 0 0 0 5678910 0 0 0 0 69000
3201126 B 2 BS 1 20/03/2018 22/03/2018 18/10/2009 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2634034 0 3 0 0 0 FARHAN ESHAN WIBAWA
D393634 8 3075 DR RASTRA, SPA 0138R01703180008961
0001301058235 3;JKN DR RIZKI; 5.2.1.201804062320 4 163688
1#0##0#0#0.0#2018-05-03 16:36:51#0#12:00:00#12:00:00#12:00:00 2
9c1877f7e6c6110a907b5543ad507401 0 0 278711 0 0 472003
0 0 0 0 1713320 0 0 0 0 170000
3201126 B 2 BS 1 12/03/2018 22/03/2018 02/05/1966 0 1
(BERAT) 8448000 0 0 - 0 - 0 - 0 - 0
8448000 21128810 0 11 1 7 0 HASYIM FIRDAUS S.
0002206163305 3;JKN DR RIZKI; 5.2.2.201806040537 4 160105
1#0##0#0#0.0#2018-08-10 13:26:58#0#12:00:00#12:00:00#00:00:00 2
81550d43b1651eedb9376e87bae757c0 0 0 1197726 0 0
9041084 0 0 0 0 9392000 0 0 0 0
1498000
3201126 B 2 BS 1 20/03/2018 22/03/2018 09/05/1962 0 2
1 N20.1;N20.0;J45.9 56.0;59.8 - - None None None None N-1-
(RINGAN) 9649200 0 0 - 0 - 0 - 0 - 0
9649200 16276565 0 3 0 0 0 ROMLAH D391725
55 20404 DR SIDHI,SPU 0138R01703180008786 0001337549624 3;JKN
DR RIZKI; 5.2.2.201806040537 4 162986 1#0##0#0#0.0#2018-08-10
14:26:17#0#12:00:00#12:00:00#12:00:00 2 ee37753fb9357da2b1410c4c09059635
0 5326100 8023308 0 0 1717335 0 0 0 0
1140822 0 0 0 0 69000
3201126 B 3 BS 1 19/03/2018 22/03/2018 11/05/1952 0 1
1 G04.8;R40.2;K92.0;A16.1;E87.2;I46.9 87.03;87.44;96.05 - - None
None None None G-4-19-III None None None None None None INFEKSI NON
BAKTERI SISTEM SARAF ,TIDAK TERMASUK MENINGITIS VIRUS (BERAT) 8201200 0
0 - 0 - 0 - 0 - 0 8201200 10591619
0 4 0 0 0 STEPANUS CORPUTTY TN D393539 65 24053
DR ANGGA TOMALA PUTRA 0138R01703180008515 0001740599144 3;JKN DR
RIZKI; 5.2.2.201806040537 4 162606 1#0##0#0#0.0#2018-09-10
13:46:49#0#12:00:00#12:00:00#12:00:00 2 ea0c08fb14fb1a94771163f04aa3c13e
0 0 939108 0 0 7936601 0 0 0 0 999910
0 0 0 0 716000
3201126 B 2 BS 1 22/03/2018 23/03/2018 21/01/1966 0 1
- 0 10690500 11615299 0 2 0 0 0 IRI SETIANTO
0001652980983 3;JKN DR RIZKI; 5.2.0.201712280730 4 164522
1#0##0#0#0.0#2018-04-02 08:33:42#0#20:15:22#20:15:22#12:00:00 1
bb0eea26cfc83ab343e1ae97d17c1e9b 0 4703600 3153245 0 0
2942575 0 0 0 0 815879 0 0 0 0 0
3201126 B 3 BS 1 22/03/2018 23/03/2018 17/03/1972 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 10371164 0 2 0 0 0 ERLIYANI
0001264472122 3;JKN DR RIZKI; 5.2.0.201712280730 4 163553
1#0##0#0#0.0#2018-04-02 09:17:39#0#12:00:00#12:00:00#12:00:00 1
95e42674bffb6c414a3cee9b851ae562 0 3062500 1311745 0 0
3747182 0 0 0 0 1890737 0 0 0 0 359000
3201126 B 3 BS 1 19/03/2018 23/03/2018 10/04/1988 0 1
1 K35.2;K66.0;A41.9 54.19 - - None None None None K-1-40-III
(BERAT) 15009700 0 0 - 0 - 0 - 0 - 0
15009700 10323430 0 5 0 0 0 IKHWAN AL KINDY
0138R01703180008578 0001786286103 3;JKN DR RIZKI; 5.2.0.201712280730
4 162611 1#0##0#0#0.0#2018-04-02
09:26:21#0#12:00:00#12:00:00#12:00:00 1 9e8b5f878eeeff5f793d196bad98859c
0 3513000 2431740 0 0 3503325 0 0 0 0
806365 0 0 0 0 69000
3201126 B 3 BS 1 20/03/2018 23/03/2018 30/03/1980 0 2
1 O14.1;O82.9;Z37.1 74.0;68.9 - - None None None None W-1-
20-II None None None None None None PROSEDUR PADA RAHIM & ADNEKSA (SEDANG)
10326200 0 0 - 0 - 0 - 0 - 0
10326200 9350741 0 4 0 0 0 MELI YANTI D393622
37 13869 DR ARI K, SPOG 0138R01703180008872 0002060155427 3;JKN
DR RIZKI; 5.2.0.201712280730 4 162931 1#0##0#0#0.0#2018-04-02
10:20:58#0#12:00:00#12:00:00#12:00:00 1 e2b3f1720c0cfb8e4c8ef2fbbe0d4282
0 3707500 1629456 0 0 3109054 0 0 0 0
707731 0 0 0 0 197000
3201126 B 3 BS 1 21/03/2018 23/03/2018 05/06/1980 0 2
- 0 - 0 - 0 - 0 2168300 1818718 0
SPOG 0138R01703180009732 0001739612496 3;JKN DR RIZKI; 5.2.0.201712280730
4 163544 1#0##0#0#0.0#2018-04-02
10:22:37#0#12:00:00#12:00:00#12:00:00 1 00b51789307be5c9aff219284f281b98
0 0 248147 0 0 899589 0 0 0 0 670982
0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 23/03/2018 31/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 4144700
4422611 0 4 0 0 0 SAMIN HS D389095 68 24916
DR RIZKI; 5.2.0.201712280730 4 163023 1#0##0#0#0.0#2018-04-02
10:25:07#0#12:00:00#12:00:00#12:00:00 1 3da76f6c992fcc97f43e81b01cd50388
0 0 603017 0 0 1668764 0 0 0 0
1280830 0 0 0 0 870000
3201126 B 3 BS 1 21/03/2018 23/03/2018 30/12/1963 0 2
1 D64.9;A49.9;K92.1;E87.8;D25.9 99.04 - - None None None None
0 - 0 - 0 4227600 4449477 0 3 0 0
0 SOLIYAH D345581 54 19805 DR BETTY DWI L, SPPD
0138R01703180009714 0001772550437 3;JKN DR RIZKI; 5.2.0.201712280730
4 163541 1#0##0#0#0.0#2018-04-02
10:28:12#0#12:00:00#12:00:00#12:00:00 1 c9c8ffe5bfcc65cb4cf1ba25dc2e7212
0 0 433484 0 0 2136906 0 0 0 0
1879087 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 23/03/2018 01/05/1947 0 1
1 D29.1;N39.0;I11.9;J22 60.29 - - None None None None V-1-
14-II None None None None None None PENGANGKATAN PROSTAT MELALUI URETRA
(SEDANG) 12841200 0 0 - 0 - 0 - 0 - 0
12841200 20913345 0 4 0 0 0 HASAN BASRI D387803
3;JKN DR RIZKI; 5.2.0.201712280730 4 162954 1#0##0#0#0.0#2018-
04-02 10:39:42#0#12:00:00#12:00:00#12:00:00 2
632aaa760638dcf9550e523c2b8b464d 0 3408500 9489688 0 0
6202157 0 0 0 0 1276000 0 0 0 0 537000
3201126 B 2 BS 1 19/03/2018 23/03/2018 03/12/1944 0 2
1 J18.8;H81.1;K30;K52.9 87.44;89.52 - - None None None None
J-4-16-I None None None None None None SIMPLE PNEUMONIA & WHOOPING
COUGH (RINGAN) 4335900 0 0 - 0 - 0 - 0 -
0 4335900 5264409 0 5 0 0 0 ALA SUHAELA ABD
SABAB D349069 73 26769 DR AZRI NURIZAL SPPD KKV 0138R01703180008631
0000060750819 3;JKN DR RIZKI; 5.2.0.201712280730 4 162613
1#0##0#0#0.0#2018-04-02 10:56:24#0#12:00:00#12:00:00#00:00:00 1
06ad3df59824b88088630cee46e3fde7 0 0 355238 0 0
2221270 0 0 0 0 2687901 0 0 0 0 0
3201126 B 2 BS 1 22/03/2018 23/03/2018 23/03/1955 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 4529508 0 2 0 0 0 ASTUTI D365706
3;JKN DR RIZKI; 5.2.0.201712280730 4 164070 1#0##0#0#0.0#2018-
04-02 10:58:13#0#12:00:00#12:00:00#00:00:00 1
b1eb1061e408e581d45128b21941c900 0 0 1015145 0 0
1233290 0 0 0 0 2281073 0 0 0 0 0
3201126 B 2 BS 1 17/03/2018 23/03/2018 06/08/1967 0 1
1 A49.9;I48;I50.0;E14.9 89.52;88.72;93.94 - - None None None
None A-4-14-II None None None None None None PENYAKIT INFEKSI BAKTERI
DAN PARASIT LAIN-LAIN (SEDANG) 3304700 0 0 - 0 - 0
- 0 - 0 3304700 11589295 0 7 0 0 0
KELANA SUGIHARTO D352465 50 18486 DR ARU, SPPD
0138R01703180007768 0000042233578 3;JKN DR RIZKI; 5.2.0.201712280730
4 162014 1#0##0#0#0.0#2018-04-02
11:03:10#0#12:00:00#12:00:00#00:00:00 1 73abd3659191e154a1a8ba8c837795da
0 0 808322 0 0 6333795 0 0 0 0
4319178 0 0 0 0 128000
3201126 B 2 BS 1 20/03/2018 23/03/2018 01/11/1964 0 2
1 C73 06.39 - - None None None None E-1-20-I None None
- 0 9019700 15973966 0 4 0 0 0 ENY RETNO
PURWANINGSIH D388717 53 19497 RACHMAWATI DR,SPB(K)ONK
0138R01703180009068 0002280598659 3;JKN DR RIZKI; 5.2.0.201712280730
4 163034 1#0##0#0#0.0#2018-04-02
11:04:38#0#12:00:00#12:00:00#12:00:00 1 354aa18f5f551568d0a9b017897f1952
0 8964600 2615695 0 0 3102645 0 0 0 0
1146026 0 0 0 0 145000
3201126 B 1 BS 1 14/03/2018 23/03/2018 06/04/1947 0 2
1 J18.9;L10.0;R63.8;D68.5;H81.3;M54.59 93.39;87.44 - - None
None None None J-4-16-II None None None None None None SIMPLE
PNEUMONIA & WHOOPING COUGH (SEDANG) 7108500 0 0 - 0 - 0
- 0 - 0 7108500 22904095 0 10 0 0 0
ALIFA ARBIE D048514 70 25910 DR SUKAMTO SPPD 0138R01703180006614
0002059434303 3;JKN DR RIZKI; 5.2.0.201712280730 4 161054
1#1#vvip#10#15795595#0.0#2018-04-02 16:10:30#0#12:00:00#12:00:00#12:00:00
1 0ab0308493b25df76e4e98dd3fb3e52f 0 0 1850509 0 0
8322586 0 0 0 0 12731000 0 0 0 0 0
3201126 B 1 BS 1 19/03/2018 23/03/2018 04/02/1940 0 1
1 I21.1;I25.1;I08.9;I11.0;E11.9 88.55 - - None None None None
17095200 0 0 - 0 - 0 - 0 - 0
17095200 24398362 0 5 0 0 0 DJOKO WINARDI,H
0000060578201 3;JKN DR RIZKI; 5.2.0.201712280730 4 162349
1#1#vvip#5#7303162#0.0#2018-04-02 16:24:49#0#12:00:00#12:00:00#00:00:00
2 c3eea1f2a7ca175512bdabc6922c154c 0 9151500 3942350 0
0 6640512 0 0 0 0 1266000 0 0 0 0
3398000
3201126 B 1 BS 1 21/03/2018 23/03/2018 11/05/1965 0 1
0 - 0 - 0 - 0 4784600 3637231 0 3
0 0 0 BAMBANG IRAWAN d323855 52 19307 DR SIDDHI ANDIKA,
SPU 0138R01703180009560 0001483727411 3;JKN DR RIZKI; 5.2.0.201712280730
4 163478 1#0##0#0#0.0#2018-04-02
16:27:08#0#12:00:00#12:00:00#12:00:00 1 65c8f3471c2701df57fd4c4b60a6ef39
0 0 483614 0 0 2100667 0 0 0 0
1052950 0 0 0 0 0
3201126 B 1 BS 1 18/03/2018 23/03/2018 31/12/2006 0 1
1 G92;R45.3 87.03 - - None None None None G-4-21-I None
None None None None None KOMA & STUPOR NON TRAUMA (RINGAN) 3769000
0 0 - 0 - 0 - 0 - 0 3769000
18430288 0 6 1 2 0 FAREL IKHSAN HARIZ PRASETYO
0001647777688 3;JKN DR RIZKI; 5.2.0.201712280730 4 162035
1#0##0#0#0.0#2018-04-03 11:02:09#0#12:00:00#12:00:00#12:00:00 1
4b40e5be8fd8816611028406c4e4af4e 0 0 285550 0 0
10894238 0 0 0 0 6314500 0 0 0 936000
0
3201126 B 1 BS 1 20/03/2018 23/03/2018 30/08/1937 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 12112647 0 4 0 0 0 EDWIN WILLEM P,DRS
0000060779812 3;JKN DR RIZKI; 5.2.0.201712280730 4 163032
1#0##0#0#0.0#2018-04-03 11:14:28#0#12:00:00#12:00:00#12:00:00 1
9cb0afb9adf05b10a93719f589a55a7a 0 6587000 2151660 0 0
2426571 0 0 0 0 878416 0 0 0 0 69000
3201126 B 1 BS 1 19/03/2018 23/03/2018 01/10/2012 0 2
- 0 - 0 - 0 - 0 3718200 5675833 0
5 0 0 0 OLIVIA KAYLA PRAMESWARI INDRIATMOKO D259540 5
1995 DR RASTRA, SPA 0138R01703180008194 0001815182638 3;JKN DR
RIZKI; 5.2.0.201712280730 4 162064 1#0##0#0#0.0#2018-04-03
11:16:49#0#12:00:00#12:00:00#12:00:00 1 37b580eb1b19afa00b48686e1a52a611
0 0 387637 0 0 985880 0 0 0 0
4302316 0 0 0 0 0
3201126 B 1 BS 1 20/03/2018 23/03/2018 11/09/1983 0 2
0 0 - 0 - 0 - 0 - 0 6981500
12458650 0 4 0 0 0 MIRANTI LESTARI d314617 34
12609 DR ENDANG T. K, SPOG 0138R01703180009093 0000976636102 3;JKN
DR RIZKI; 5.2.0.201712280730 4 163035 1#0##0#0#0.0#2018-04-03
11:58:28#0#12:00:00#12:00:00#12:00:00 1 053375aa8bd142ce783dbc3a235b8d24
0 7098900 2419895 0 0 1826803 0 0 0 0
916052 0 0 0 0 197000
3201126 B 1 BS 1 21/03/2018 23/03/2018 03/12/1944 0 2
- 0 - 0 - 0 - 0 4136800 3532351 0
3 0 0 0 HJ. FATIMAH D392849 73 26771 DR SOEGIONO, SPPD
0138R01703180009482 0002033680667 3;JKN DR RIZKI; 5.2.0.201712280730
4 163370 1#0##0#0#0.0#2018-04-03
12:13:40#0#12:00:00#12:00:00#12:00:00 1 ee8a13bca454fd4f6535c317c864f12d
0 0 425312 0 0 506951 0 0 0 0
2600088 0 0 0 0 0
3201126 B 1 BS 1 19/03/2018 23/03/2018 02/10/1949 0 2
(RINGAN) 7018400 0 0 - 0 - 0 - 0 - 0
7018400 8911801 0 5 0 0 0 SRI FAVORIETATUN
0000060688506 3;JKN DR RIZKI; 5.2.0.201712280730 4 162610
1#0##0#0#0.0#2018-04-03 12:18:08#0#12:00:00#12:00:00#12:00:00 1
042db88c089d2593cfc0f5c9ca15a777 0 0 1117063 0 0
3626223 0 0 0 0 4168515 0 0 0 0 0
3201126 B 2 BS 1 17/03/2018 23/03/2018 04/05/1980 0 1
1 N18.5;E87.8;D63.8;B49;I82.8 99.04;89.52;90.59;39.95 - - None
None None None N-4-10-II None None None None None None TUMOR GINJAL
& SALURAN URIN & GAGAL GINJAL (SEDANG) 4958500 0 0 - 0 -
0 - 0 - 0 4958500 18152169 0 7 1 5
0 MAMAN SUPARMAN d376330 37 13831 SRI KUNMARTINI.DR,SPPD
0138R01703180007853 0002249512727 3;JKN DR RIZKI; 5.2.0.201712280730
4 162026 1#0##0#0#0.0#2018-04-05
10:30:03#0#12:00:00#12:00:00#12:00:00 1 40af16938ce9fb87e6b74f90b511ad70
0 0 424889 0 0 7908505 0 0 0 0
7732775 0 0 0 0 2086000
3201126 B 1 BS 1 20/03/2018 23/03/2018 03/02/1965 0 2
1 D25.9;N93.9;D63.0 99.04 - - None None None None W-4-12-II
0 - 0 5399900 4260137 0 4 0 0 0 RIA
PURWITA LARASATI d137198 53 19403 DR MAMAN H, SPOG 0138R01703180009101
0001634101288 3;JKN DR RIZKI; 5.2.0.201712280730 4 163037
1#0##0#0#0.0#2018-04-05 14:04:07#0#12:00:00#12:00:00#12:00:00 1
ae43ea075728d9049ee5327a2dc8aef2 0 0 326204 0 0
1286232 0 0 0 0 2647701 0 0 0 0 0
3201126 B 3 BS 1 18/03/2018 23/03/2018 21/09/1958 0 2
1 A41.9;N18.3;E16.2;E87.6 90.59;89.52 - - None None None None
A-4-10-II None None None None None None SEPTIKEMIA (SEDANG)
4330300 0 0 - 0 - 0 - 0 - 0
4330300 5360311 0 6 0 0 0 ALIAH D393434 59
TANTIYO S;16137 5.2.0.201712280730 4 162045 1#0##0#0#0.0#2018-
04-05 15:34:15#0#12:00:00#12:00:00#12:00:00 1
cd5ef3d1e6c60cc5678471b43522f3c6 0 0 663344 0 0
2828792 0 0 0 0 1868175 0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 23/03/2018 02/04/1942 0 1
0 - 0 - 0 - 0 - 0 4043000 3562526
0 1 0 0 0 EMBEH D393882 75 27749 DR YOHANES
DWINANDA R P 0138R01703180010476 0001455666467 3;JKN DR RIZKI;
5.2.0.201712280730 4 164242 29#0##0#0#0.0#2018-04-05
15:52:28#0#12:00:00#12:00:00#12:00:00 1 aebb416e3af0fc2d4dc946b05b7b9a8c
0 0 649737 0 0 2262727 0 0 0 0 522062
0 0 0 0 128000
3201126 B 3 BS 1 23/03/2018 23/03/2018 10/06/1964 0 2
1 I63.9;M54.59 87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 5013100 0 0 - 0 - 0 - 0 -
0 5013100 897304 0 1 0 0 0 FLORENTINA
WIDIASTUTI d393922 53 19644 DR LIDYA SANTALIA 0138R01703180010783
0001257641122 3;JKN DR RIZKI; 5.2.0.201712280730 4 164511
30#0##0#0#0.0#2018-04-05 15:59:29#0#12:00:00#12:00:00#12:00:00 1
e1742bd4e4c759c40d27db5f3aafa334 0 0 331902 0 0 217700
0 0 0 0 347702 0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 23/03/2018 20/02/1973 0 1
3 I10;I63.9 87.03 - - None None None None I-4-17-III None
None None None None None HIPERTENSI (BERAT) 2663700 0 0
- 0 - 0 - 0 - 0 2663700 3786494 0
1 0 0 0 SUYITNO D393938 45 16467 DR LIDYA SANTALIA
0138R01703180010795 0001461840445 3;JKN DR RIZKI; 5.2.0.201712280730
4 164513 31#0##0#0#0.0#2018-04-05
16:05:05#0#12:00:00#12:00:00#12:00:00 1 28cdfb1c7fa85fbe0c50c5786a86762a
0 0 451179 0 0 2798600 0 0 0 0 536715
0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 23/03/2018 01/10/1964 0 2
4 I63.9;R57.2 87.44;87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 5013100 0 0 - 0 - 0 - 0 -
0 5013100 4909920 0 1 0 0 0 HOLILA
0001844218258 3;JKN DR RIZKI; 5.2.0.201712280730 4 164076
28#0##0#0#0.0#2018-04-06 08:44:39#0#12:00:00#12:00:00#12:00:00 1
eb17ded4198773d9ccd4e73d375419a1 0 0 451179 0 0
3260531 0 0 0 0 610210 0 0 0 0 588000
3201126 B 3 BS 1 20/03/2018 23/03/2018 09/06/2017 0 1
1 G40.9;R56.0 - - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 2655900 2325525
0 4 0 0 0 MIRZA UKAIL RAMADHAN D393618 0 284
DR RASTRA, SPA 0138R01703180009027 0002252264488 3;JKN DR RIZKI;
5.2.0.201712280730 4 163027 15#0##0#0#0.0#2018-04-06
10:02:02#0#12:00:00#12:00:00#12:00:00 1 8ab827420665f02ae3946f7a4fe86b37
0 0 292030 0 0 803358 0 0 0 0
1230137 0 0 0 0 0
3201126 B 2 BS 1 22/03/2018 23/03/2018 07/06/2013 0 1
(RINGAN) 3536800 0 0 - 0 - 0 - 0 - 0
3536800 7878564 0 2 0 0 0 HAIDAR FAWWAS ADZ DZAKI
0001816838392 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163878
1#0##0#0#0.0#2018-04-07 13:02:01#0#12:00:00#12:00:00#12:00:00 1
7a8da8db027a6b5aef4547767253a6c3 0 0 990304 0 0 738740
0 0 0 0 6077020 0 0 0 0 72500
3201126 B 2 BS 1 20/03/2018 23/03/2018 23/09/2009 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4969512 0 4 0 0 0 NAYYARA AYESHA SYAWALIA
D393591 8 3100 DR RASTRA, SPA 0138R01703180008672
0001602700986 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 162988
1#0##0#0#0.0#2018-04-07 13:14:10#0#12:00:00#12:00:00#12:00:00 1
e555d3573a51b1549567ca168cdcc80e 0 0 443230 0 0
2155174 0 0 0 0 2371108 0 0 0 0 0
3201126 B 3 BS 1 06/02/2018 23/03/2018 06/02/2018 1997 1
1 Q79.1;P28.5;P23.9;Q24.0;P59.8 96.05;96.72 12 - None None None
- 0 - 0 - 0 40034400 132665278 0 46 1
4 4 BAYI RATIH APRIYANTI d389728 0 0 DR AULIA TANGKARI,
SPA 0138R01702180003801 0002324395719 3;JKN irene; 5.2.1.201804062320
4 146810 1#0##0#0#0.0#2018-04-19
17:21:47#0#12:00:00#12:00:00#12:00:00 2 d1873276bc9f2cd98abdc02585c05bce
0 0 3804088 0 0 27763196 0 0 0 0
45127000 0 0 0 0 55970994
3201126 B 1 BS 1 22/03/2018 23/03/2018 17/06/2003 0 1
(RINGAN) 6041900 0 0 - 0 - 0 - 0 - 0
6041900 14699568 0 2 0 0 0 ARIF RAHMAN HALIM
NASUTION D053182 14 5392 DR BENNY H T, SPOT 0138R01703180009999
0002076185259 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 163816
1#0##0#0#0.0#2018-05-02 10:01:36#0#12:00:00#12:00:00#12:00:00 1
d5792384804e0b342d97ebb201848d91 0 9763300 2316732 0 0
1436882 0 0 0 0 1037654 0 0 0 0 145000
3201126 B 1 BS 1 21/03/2018 23/03/2018 21/03/2018 2737 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040617 0 3 0 0 0 BAYI NY MIRANTI LESTARI
D393721 0 0 DR SUPROHAITA, SPA 0138R01703180009937
0002441955914 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 163658
1#0##0#0#0.0#2018-05-02 10:27:08#0#12:00:00#12:00:00#12:00:00 1
5a1b0b488196d4c34d114c28a99fe85b 0 0 499620 0 0 88899
0 0 0 0 1452098 0 0 0 0 0
3201126 B 2 BS 1 21/03/2018 23/03/2018 02/06/1952 0 1
0 0 - 0 - 0 - 0 - 0 4973600
3300337 0 3 0 0 0 T. FIRDAUS HUSEIN D375845 65
3;JKN DR RIZKI; 5.2.1.201804062320 4 163039 1#0##0#0#0.0#2018-
05-14 16:15:13#0#12:00:00#12:00:00#12:00:00 2
5b49a07226d21f144815ed5cecac9783 0 0 858779 0 1515000
684648 0 0 0 0 215910 0 0 0 26000 0
3201126 B 3 BS 1 21/03/2018 23/03/2018 02/03/1964 0 1
1 I12.0;D63.8;B17.1 96.05 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 21889121 0 3 0 0 0 ROMLI TN
0001743644902 3;JKN DR RIZKI; 5.2.2.201806040537 4 163038
1#0##0#0#0.0#2018-08-16 08:59:00#0#12:00:00#12:00:00#00:00:00 2
9439b67a413aaa3513e5ad5b4be9592b 0 0 4242654 0 0
11776967 0 0 0 0 5869500 0 0 0 0 0
3201126 B 2 BS 1 22/03/2018 24/03/2018 27/06/2012 0 1
1743400 0 0 - 0 - 0 - 0 - 0
1743400 4297454 0 3 0 0 0 KEANU RAFQIERO BUMI
WIJAYA D231516 5 2094 DR KRISTON SILITONGA, SPA
0138R01703180010464 0001745177038 3;JKN DR RIZKI; 5.2.0.201712280730
4 164216 1#1#vvip#3#2554054#0.0#2018-04-02
08:19:20#0#12:00:00#12:00:00#00:00:00 1 31d65a13c509027b245f28333abd146e
0 0 327585 0 0 415227 0 0 0 0
3554642 0 0 0 0 0
3201126 B 2 BS 1 23/03/2018 24/03/2018 13/04/1984 0 1
1 I13.1;D63.8;A49.9;E14.9;R60.0 99.04;90.59;89.52 - - None None
None None N-4-10-II None None None None None None TUMOR GINJAL &
SALURAN URIN & GAGAL GINJAL (SEDANG) 4958500 0 0 - 0 -
0 - 0 - 0 4958500 2692725 0 2 0 0
0 HEZRON PANDIANGAN D388984 33 12397 SRI KUNMARTINI.DR,SPPD
0138R01703180010777 0001336724368 3;JKN DR RIZKI; 5.2.0.201712280730
4 164507 1#0##0#0#0.0#2018-04-02
08:25:36#0#12:00:00#12:00:00#12:00:00 1 634cc7746019e92f7133d60d13075eb7
0 0 499265 0 0 1188800 0 0 0 0
1004660 0 0 0 0 0
3201126 B 1 BS 1 23/03/2018 24/03/2018 21/07/1963 0 1
1 I64 87.03 - - None None None None G-4-15-I None None
None None None None KECEDERAAN PEMBULUH DARAH OTAK NON SPESIFIK &
- 0 - 0 - 0 5734600 3986948 0 2 0
0 0 CHANDRA YULIAWAN D393879 54 19969 DR HARDI PRANATA SPS
0138R01703180010272 0001142009458 3;JKN DR RIZKI; 5.2.0.201712280730
4 164074 1#0##0#0#0.0#2018-04-02
09:28:20#0#12:00:00#12:00:00#12:00:00 1 7ce6137e27fcc8e389fd395516509c12
0 0 1020330 0 0 1117790 0 0 0 0
1848828 0 0 0 0 0
3201126 B 1 BS 1 21/03/2018 24/03/2018 25/08/1994 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5521354 0 4 0 0 0 ARYANTI DWI ASTUTI
0000041198769 3;JKN DR RIZKI; 5.2.0.201712280730 4 164514
1#0##0#0#0.0#2018-04-02 09:30:46#0#18:37:18#18:37:18#00:00:00 1
90eee5aa26101843163b6e2c281dfaaa 0 0 338858 0 0
1671286 0 0 0 0 3511210 0 0 0 0 0
3201126 B 1 BS 1 21/03/2018 24/03/2018 16/07/1979 0 2
9855000 0 0 - 0 - 0 - 0 - 0
9855000 14878618 0 4 0 0 0 CATTY ULININGTIUR
0001338428485 3;JKN DR RIZKI; 5.2.0.201712280730 4 163141
1#0##0#0#0.0#2018-04-02 09:34:34#0#12:00:00#12:00:00#12:00:00 1
24171607b735c00fbf730f97e7d84bf0 0 7278000 2759400 0 0
3476850 0 0 0 0 1074368 0 0 0 0 290000
3201126 B 1 BS 1 23/03/2018 24/03/2018 25/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 3247500
6224556 0 2 0 0 0 SUMIYATUN,NY D381297 63
RIZKI; 5.2.0.201712280730 4 164520 1#0##0#0#0.0#2018-04-02
09:35:41#0#12:00:00#12:00:00#12:00:00 1 0ce38507bfd970aec7d7f6221ef57aa2
0 0 909300 0 0 1174042 0 0 0 0
2392214 0 0 0 0 1749000
3201126 B 1 BS 1 22/03/2018 24/03/2018 12/10/1953 0 1
0 - 0 - 0 - 0 8335900 11717935 0 3
0 0 0 THOMAS SARJONO D392504 64 23537 DR HENDRIEK SP B
0138R01703180009763 0000061087105 3;JKN DR RIZKI; 5.2.0.201712280730
4 163552 1#0##0#0#0.0#2018-04-04
08:53:53#0#12:00:00#12:00:00#12:00:00 1 1ea264b1ddf0b94a737bb288d51f6a09
0 6587000 2417411 0 0 1821930 0 0 0 0
822594 0 0 0 0 69000
3201126 B 1 BS 1 23/03/2018 24/03/2018 15/11/1981 0 2
0 0 - 0 - 0 - 0 - 0 3247500
5649529 0 2 0 0 0 DIAN NOVITA D135332 36 13277
RIZKI; 5.2.0.201712280730 4 164524 1#0##0#0#0.0#2018-04-04
09:16:52#0#12:00:00#12:00:00#12:00:00 1 ef6e3a4be95a3422f074fb39660d2b15
0 0 962300 0 0 993634 0 0 0 0
1979095 0 0 0 0 1714500
3201126 B 3 BS 1 23/03/2018 24/03/2018 01/08/1963 0 1
- 0 8908800 10931233 0 2 0 0 0 M. SOLEH
0000511384307 3;JKN DR RIZKI; 5.2.0.201712280730 4 164505
1#0##0#0#0.0#2018-04-04 10:09:08#0#12:00:00#12:00:00#12:00:00 1
84a84ddeabe1c3cd577f227f4275ed71 0 3062500 2636552 0 0
4392054 0 0 0 0 771127 0 0 0 0 69000
3201126 B 3 BS 1 23/03/2018 24/03/2018 12/12/1957 0 1
1 I12.0;I25.0 39.27;87.49 - - None None None None N-1-12-I
- 0 4340500 8507329 0 2 0 0 0 EKO PURWANTO
0001211608012 3;JKN DR RIZKI; 5.2.0.201712280730 4 164506
1#0##0#0#0.0#2018-04-04 10:15:09#0#12:00:00#12:00:00#12:00:00 1
767c9c16526a64d352f26f31eeba6ced 0 3438800 2636552 0 0
1750423 0 0 0 0 612554 0 0 0 0 69000
3201126 B 1 BS 1 22/03/2018 24/03/2018 07/05/1955 0 2
1 I64;G81.9;I10;M79.66 87.03;82.96 - - None None None None
0 0 - 0 - 0 - 0 - 0 6844000
5132319 0 3 0 0 0 LAUW GIOK KOAN D022714 62
DR RIZKI; 5.2.0.201712280730 4 163549 1#0##0#0#0.0#2018-04-04
12:10:37#0#12:00:00#12:00:00#00:00:00 1 0bc96566551d022a7730c28a9140bdbe
0 0 684656 0 0 1742904 0 0 0 0
2704759 0 0 0 0 0
3201126 B 1 BS 1 21/03/2018 24/03/2018 07/08/2007 0 1
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4848477 0 4 0 0 0 MUHAMMAD HANAN ILHAM
D131801 10 3879 DR RASTRA, SPA 0138R01703180009333
0001813656936 3;JKN DR RIZKI; 5.2.0.201712280730 4 163180
8#0##0#0#0.0#2018-04-04 12:12:23#0#12:00:00#12:00:00#00:00:00 1
13b160ccabc564dc462d699506a3a6f4 0 0 316330 0 0
1064957 0 0 0 0 3467190 0 0 0 0 0
3201126 B 1 BS 1 20/03/2018 24/03/2018 26/10/1965 0 1
1 E11.2;N39.0;J18.0;A41.9;E87.8 - - - None None None None
- 0 10134400 7810055 0 5 0 0 0 WALUYO
ATMADA D392746 52 19138 DR BETTY DWI L, SPPD 0138R01703180009221
0001478348649 3;JKN DR RIZKI; 5.2.0.201712280730 4 163160
1#0##0#0#0.0#2018-04-04 12:21:38#0#12:00:00#12:00:00#12:00:00 1
69709b79cb039fe76046579f3cb157b6 0 0 494342 0 0
2873775 0 0 0 0 4441938 0 0 0 0 0
3201126 B 1 BS 1 09/03/2018 24/03/2018 04/06/1946 0 1
1 I63.9;L02.4;E14.5 89.52;87.03;86.22 - - None None None None
0 - 0 9673300 32851350 0 16 1 1 0
SUWATDI BACHRUN,DRS D239273 71 26211 DR HARDI PRANATA SPS
0138R01703180004459 0000061044535 3;JKN DR RIZKI; 5.2.0.201712280730
4 159372 1#0##0#0#0.0#2018-04-04
12:31:35#0#12:00:00#12:00:00#12:00:00 2 f0d44da7d430e922613bfe8fd609c729
0 0 4274220 0 0 10677030 0 0 0 0
17363100 0 0 0 0 537000
3201126 B 1 BS 1 22/03/2018 24/03/2018 03/05/1994 0 2
(RINGAN) 10909500 0 0 - 0 - 0 - 0 - 0
10909500 10712652 0 3 0 0 0 ROSITA DEWI D388626
DR RIZKI; 5.2.0.201712280730 4 163554 18#0##0#0#0.0#2018-04-05
09:45:09#0#12:00:00#12:00:00#12:00:00 1 2569c839afa3ff95d6f6f92418dd9114
0 5878100 1518776 0 0 2469948 0 0 0 0
776828 0 0 0 0 69000
3201126 B 1 BS 1 23/03/2018 24/03/2018 02/12/1965 0 2
None None None None KATETERISASI JANTUNG (RINGAN) 6357300 0 0
- 0 - 0 - 0 - 0 6357300 13544525 0
2 0 0 0 DEDEH KURNIA D367302 52 19104 DR AGOES
5.2.0.201712280730 4 164293 1#0##0#0#0.0#2018-04-05
10:05:44#0#12:00:00#12:00:00#00:00:00 1 37b53beb651a07373c7f878be0749a0c
0 5478000 1271460 0 0 3783975 0 0 0 0
942090 0 0 0 0 2069000
3201126 B 1 BS 1 23/03/2018 24/03/2018 03/08/1955 0 2
- 0 58821400 66781185 0 2 0 0 0 IDA
EMILDA,NY. D321264 62 22878 DR AGOES KOOSHARTORO SPPD-KKV
0138R01703180010411 0000060951914 3;JKN DR RIZKI; 5.2.0.201712280730
4 164138 21#0##0#0#0.0#2018-04-05
10:13:09#0#12:00:00#12:00:00#00:00:00 1 48ad63fa3ce9788fb30028aa2519696b
0 10062000 9619120 0 0 38240565 0 0 0 0
1256000 0 0 0 0 7603500
3201126 B 2 BS 1 21/03/2018 24/03/2018 02/09/1971 0 1
0 - 0 - 0 - 0 - 0 8137900 3848281
0 4 0 0 0 ACHMAD SYAIFULLAH D393755 46 17002 DR
5.2.0.201712280730 4 163542 1#0##0#0#0.0#2018-04-05
10:24:24#0#12:00:00#12:00:00#12:00:00 1 774ddf9dd72d1b879706dae28df6dd2a
0 0 372122 0 0 1683402 0 0 0 0
1792757 0 0 0 0 0
3201126 B 2 BS 1 21/03/2018 24/03/2018 28/06/1989 0 2
1 O64.9;O99.8;O82.9;Z37.0 74.0 - - None None None None O-6-
6486300 0 0 - 0 - 0 - 0 - 0
6486300 11508738 0 4 0 0 0 RATI NURUL ALFIAH
0001627432929 3;JKN DR RIZKI; 5.2.0.201712280730 4 163543
1#0##0#0#0.0#2018-04-05 10:31:46#0#12:00:00#12:00:00#00:00:00 1
6ac7cd393040fc36609575005915dcf2 0 5251900 2389958 0 0
2825972 0 0 0 0 843908 0 0 0 0 197000
3201126 B 2 BS 1 23/03/2018 24/03/2018 20/03/1960 0 1
14653000 0 0 - 0 - 0 - 0 - 0
14653000 24277884 0 2 0 0 0 SYAHRUL BASUKI
0001211036501 3;JKN DR RIZKI; 5.2.0.201712280730 4 164108
1#0##0#0#0.0#2018-04-05 10:35:51#0#12:00:00#12:00:00#12:00:00 1
6d296f1789afe9262bcac8f03395355d 0 0 2930600 0 0
3121284 0 0 0 0 10657000 0 0 0 0
7569000
3201126 B 2 BS 1 17/03/2018 24/03/2018 02/05/1950 0 1
1 E11.5;A41.9 86.22;84.12 - - None None None None M-1-02-III
None None None None None None AMPUTASI (BERAT) 30848800 0 0
- 0 - 0 - 0 - 0 30848800 18717635 0
8 0 0 0 SUDARNO D393327 67 24791 DEDY PRATAMA,SPBV
0138R01703180007705 0000060929774 3;JKN DR RIZKI; 5.2.0.201712280730
4 162000 1#0##0#0#0.0#2018-04-05
10:39:53#0#12:00:00#12:00:00#12:00:00 1 cd9822aeee6dc639754cc6a5b5af10d1
0 6929100 6020570 0 0 4442965 0 0 0 0
1256000 0 0 0 0 69000
3201126 B 2 BS 1 23/03/2018 24/03/2018 02/08/1996 0 2
1 O42.0;O99.0;O36.5;O80.9;Z37.0 73.59;99.04 - - None None None
None O-6-13-II None None None None None None PERSALINAN VAGINAL
(SEDANG) 2379000 0 0 - 0 - 0 - 0 - 0
2379000 6932024 0 2 0 0 0 SISKA FARADILLA KUMALA
SARI D393884 21 7903 DR BAGUS T, SPOG 0138R01703180010347
0002096195488 3;JKN DR RIZKI; 5.2.0.201712280730 4 167242
2#0##0#0#0.0#2018-04-05 11:09:19#0#09:38:15#09:38:15#00:00:00 1
49d26439571ad8ad6057ef635771173b 0 0 528800 0 0
3066027 0 0 0 0 3140197 0 0 0 0 197000
3201126 B 2 BS 1 21/03/2018 24/03/2018 13/10/2017 0 1
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 3586756 0 4 0 0 0 RAYHAN ARSHAD PELANI
D393747 0 159 DR RASTRA, SPA 0138R01703180009654
0002297212119 3;JKN DR RIZKI; 5.2.0.201712280730 4 163534
1#0##0#0#0.0#2018-04-05 11:18:23#0#12:00:00#12:00:00#12:00:00 1
19961864c85ba5f2dead953140435528 0 0 350422 0 0 955686
0 0 0 0 2280648 0 0 0 0 0
3201126 B 1 BS 1 17/03/2018 24/03/2018 25/08/2012 0 2
5058500 0 0 - 0 - 0 - 0 - 0
5058500 12436703 0 8 0 0 0 ALIKA FAQIHA AGIS
D258115 5 2030 DR RASTRA, SPA 0138R01703180008311
0001628690567 3;JKN DR RIZKI; 5.2.0.201712280730 4 162334
5#0##0#0#0.0#2018-04-05 14:48:26#0#12:00:00#12:00:00#12:00:00 1
0dbe32790c4754129293c988fc8c9470 0 0 508264 0 0
5313823 0 0 0 0 6324616 0 0 0 0 290000
3201126 B 3 BS 1 24/03/2018 24/03/2018 15/08/1935 0 2
0 - 0 - 0 - 0 - 0 3575600 1201066
0 1 0 0 0 PATMINAH SURO D393988 82 30172 DR
AHMAD HIBBAN A WRIYA 0138R01703180010946 0000060960723 3;JKN DR RIZKI;
5.2.0.201712280730 4 164602 36#0##0#0#0.0#2018-04-05
15:01:56#0#05:15:00#13:00:00#12:00:00 1 a50284e9bcc48d88e28cddfd8ba67302
0 0 566190 0 0 267302 0 0 0 0 367574
0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 24/03/2018 26/08/2017 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 2178811 0 2 0 0 0 MUHAMMAD ARKA PRADIPTA
0001735054389 3;JKN DR RIZKI; 5.2.0.201712280730 4 164516
31#0##0#0#0.0#2018-04-05 15:03:45#0#12:00:00#12:00:00#12:00:00 3
dfc0ca0ed0c58dc06c1e8143a586a1dd 0 0 555265 0 0
1192007 0 0 0 0 431539 0 0 0 0 0
3201126 B 3 BS 1 24/03/2018 24/03/2018 27/02/2004 0 1
None None None None INFEKSI-INFEKSI GASTROINTESTINAL (RINGAN) 3687100
0 0 - 0 - 0 - 0 - 0 3687100 750433
0 1 0 0 0 SAMUEL FEBRIANO SINURAT D393959 14 5139
DR ADRIAN HANDARU 0138R01703180010872 0000511367016 3;JKN DR RIZKI;
5.2.0.201712280730 4 164532 1#0##0#0#0.0#2018-04-05
15:24:25#0#00:00:00#03:10:00#12:00:00 1 8c8d3a7263aba71d847482641689dd40
0 0 331839 0 0 80500 0 0 0 0 338094
0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 24/03/2018 03/03/1958 0 2
0 0 - 0 - 0 - 0 - 0 6341300
13790074 0 2 0 0 0 RAHARDJO d392852 60 21935
DR RIZKI; 5.2.0.201712280730 4 164145 22#0##0#0#0.0#2018-04-05
15:30:55#0#12:00:00#12:00:00#12:00:00 1 c213c02b7871d1da952e476333c73ed5
0 2421000 1268260 0 0 7073660 0 0 0 0
958154 0 0 0 0 2069000
3201126 B 3 BS 1 21/03/2018 24/03/2018 24/07/2011 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2032762 0 4 0 0 0 AISYAH NAFILA PUTRI
D303730 6 2432 DR AWIDIYA, SPA 0138R01703180009713
0001222697889 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163540
1#0##0#0#0.0#2018-04-05 15:41:51#0#12:00:00#12:00:00#12:00:00 1
5e6fa04658a2aca127fd9fc85ad0d92b 0 0 241100 0 0 503678
0 0 0 0 947984 0 0 0 0 340000
3201126 B 3 BS 1 24/03/2018 24/03/2018 22/07/1956 0 2
0 - 0 - 0 - 0 - 0 4973600 1752715
0 1 0 0 0 NURFUADI D360012 61 22525 DR AHMAD
HIBBAN A WRIYA 0138R01703180010968 0000023824258 3;JKN DR RIZKI;
5.2.0.201712280730 4 164745 1#0##0#0#0.0#2018-04-05
15:45:53#0#12:00:00#12:00:00#00:00:00 1 d531ccdd0dffed7f24bb3acd1e14f086
0 0 936171 0 0 412880 0 0 0 0 403664
0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 24/03/2018 06/12/1949 0 2
5013100 0 0 - 0 - 0 - 0 - 0
5013100 5275165 0 2 0 0 0 N SUKAESIH D393949
DR RIZKI; 5.2.0.201712280730 4 164523 1#0##0#0#0.0#2018-04-06
08:32:36#0#12:00:00#12:00:00#12:00:00 1 5242c928fa9a953e28b5cc390ee910ce
0 0 451179 0 0 4189882 0 0 0 0 634104
0 0 0 0 0
3201126 B 3 BS 1 21/03/2018 24/03/2018 17/02/2014 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2080555 0 4 0 0 0 MIFTAHUL HAFIDZ RIZKI
FAUZI D393727 4 1493 DR AWIDIYA, SPA 0138R01703180009612
0002285901652 3;JKN DR RIZKI; 5.2.0.201712280730 4 163532
10#0##0#0#0.0#2018-04-06 09:48:57#0#12:00:00#12:00:00#12:00:00 1
b2caf4c7748238d1e679eb74f7fa7e3e 0 0 241100 0 0 548344
0 0 0 0 951111 0 0 0 0 340000
3201126 B 3 BS 1 21/03/2018 24/03/2018 04/04/1983 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8553935 0 4 0 0 0 MASITOH D393732
34 12770 DR ARI KUSUMA JANUARTO, DR. SPOG 0138R01703180009519
0001014246033 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163445
1#0##0#0#0.0#2018-04-06 11:02:17#0#12:00:00#12:00:00#12:00:00 1
b076e0ed416cdda300eaea492501e972 0 3534500 1708644 0 0
2483188 0 0 0 0 630603 0 0 0 0 197000
3201126 B 2 BS 1 22/03/2018 24/03/2018 22/03/2018 2755 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1968705 0 3 0 0 0 BAYI NY RATI NURUL
ALFIAH D393818 0 0 DR SUPROHAITA SPA(K) 0138R01703180010563
0002442473335 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 164440
1#0##0#0#0.0#2018-04-07 13:05:41#0#12:00:00#12:00:00#12:00:00 1
f093370bb34a227f6219b7814f32d68d 0 0 506812 0 0 510099
0 0 0 0 951794 0 0 0 0 0
3201126 B 2 BS 1 21/03/2018 24/03/2018 08/07/2010 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4048084 0 4 0 0 0 JONATHAN CORNELIUS MUNTE
D393740 7 2813 DR AWIDIYA, SPA 0138R01703180009736
0001290261183 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163546
1#0##0#0#0.0#2018-04-07 13:15:13#0#12:00:00#12:00:00#12:00:00 1
db4c9f9f4e866949a19545b464a27bca 0 0 278711 0 0 626545
0 0 0 0 2334828 0 0 0 0 808000
3201126 B 3 BS 1 24/03/2018 24/03/2018 09/03/1953 0 2
2 I11.0;A09.9;R60.9;K92.0 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
1524463 0 1 0 0 0 MARTALENA D391766 65 23756
DR DINI DANIATY 0138R01703180010967 0001474353257 3;JKN TANTIYO
S;16137 5.2.1.201802140120 4 164731 1#0##0#0#0.0#2018-04-12
08:34:57#0#12:00:00#12:00:00#12:00:00 1 7062bb16c026dbbc51ae8f0ad8c4f7df
0 0 373023 0 0 816098 0 0 0 0 335342
0 0 0 0 0
3201126 B 3 BS 1 21/03/2018 24/03/2018 21/03/2018 2227 2
(RINGAN) 5483600 0 0 - 0 - 0 - 0 - 0
5483600 3114943 0 4 0 0 0 BAYI NY MASITOH
D393738 0 0 DR KHARNINA, SPA 0138R01703180009981
0002428046651 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 163771
1#0##0#0#0.0#2018-05-02 09:54:52#0#12:00:00#12:00:00#12:00:00 1
783cb654e91ebacde8aa2a13c2eec8ef 0 0 532524 0 0
1817038 0 0 0 0 765381 0 0 0 0 0
3201126 B 2 BS 1 23/03/2018 24/03/2018 05/03/1961 0 1
0 - 0 - 0 - 0 - 0 7609600 11498583
0 2 0 0 0 E D D Y D392861 57 20837 DR AGOES
5.2.2.201806040537 4 164193 1#0##0#0#0.0#2018-09-04
11:53:04#0#12:00:00#12:00:00#12:00:00 4 1e43585b8a9e8d2cca27898b709c6472
0 3555000 1521934 0 0 3509905 0 0 0 0
808244 0 0 0 0 2103500
3201126 B 3 BS 1 24/03/2018 24/03/2018 01/03/1941 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 2242912 0 1 0 0 0 SAENAH SAMIN
D394015 77 28147 DR LIDYA SANTALIA 0138R0170318V000003
0000511454349 3;JKN DR RIZKI; 5.2.2.201806040537 4 174010
1#0##0#0#0.0#2018-09-05 15:15:55#0#00:00:00#00:00:00#12:00:00 3
6c22df608ced4bef8eb46978ba580528 0 0 451179 0 0
1356000 0 0 0 0 435733 0 0 0 0 0
3201126 B 2 BS 1 23/03/2018 24/03/2018 17/05/1976 0 1
1 I84.1;K58.9;I84.5 45.23 - - None None None None K-4-18-I
(RINGAN) 1743400 0 0 - 0 - 0 - 0 - 0
1743400 6031236 0 2 0 0 0 IWAN D392492 41
RIZKI; 5.2.0.201712280730 4 164203 1#0##0#0#0.0#2018-09-06
09:14:20#0#12:00:00#12:00:00#12:00:00 2 309f65af8dc0ac8a217e3385a5c41da9
0 0 594152 0 0 1545017 0 0 0 0
2143067 0 0 0 0 1749000
3201126 B 3 BS 1 24/03/2018 24/03/2018 09/03/1953 0 2
1 I11.0;A09.9;R60.9;K92.0 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700 708365
0 1 0 0 0 MARTALENA D391766 65 23756 DR DINI
DANIATY 0138R0170318V000024 0001474353257 3;JKN DR RIZKI;
5.2.2.201806040537 4 227350 1#0##0#0#0.0#2018-09-26
13:56:56#0#00:00:00#00:00:00#12:00:00 1 c23148ea21a345c566eda2e21b02dfb0
0 0 373023 0 263000 0 0 0 0 0 46342
0 0 26000 0 0
3201126 B 2 BS 1 24/03/2018 25/03/2018 06/10/1967 0 1
- 0 10690500 11046461 0 2 0 0 0 DRS. HELMI
PURWANA D026488 50 18432 SRI KUNMARTINI.DR,SPPD 0138R01703180011183
0002142462868 3;JKN DR RIZKI; 5.2.0.201712280730 4 164767
1#0##0#0#0.0#2018-04-02 08:21:35#0#12:00:00#12:00:00#12:00:00 1
5004ef8868d25283510218c224d09e03 0 4451000 3100245 0 0
2647550 0 0 0 0 778666 0 0 0 0 69000
3201126 B 2 BS 1 23/03/2018 25/03/2018 12/03/1978 0 2
1 I63.9;G81.9;R51;I10 90.59;89.52;87.03 - - None None None
- 0 - 0 8291400 5621122 0 3 0 0 0
HIHIN CHRISTIANA DEWI D025178 40 14621 DR NURUL KOMARI SPS
0138R01703180010629 0001623403473 3;JKN DR RIZKI; 5.2.0.201712280730
4 164442 1#0##0#0#0.0#2018-04-02
08:31:41#0#12:00:00#12:00:00#00:00:00 1 15c147702b2eb39bee062f8c9f139904
0 0 799226 0 0 2913159 0 0 0 0
1908737 0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 25/03/2018 14/09/1968 0 2
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 5347772 0 7 0 0 0 KUSNIAWATI D393577
3;JKN DR RIZKI; 5.2.0.201712280730 4 162615 1#0##0#0#0.0#2018-
04-02 09:07:49#0#12:00:00#12:00:00#12:00:00 1
43a974898564bdc63169e3d9b4f2cd50 0 0 727855 0 0
2489563 0 0 0 0 2130354 0 0 0 0 0
3201126 B 3 BS 1 20/03/2018 25/03/2018 01/08/1948 0 2
1 A16.1;K21.9 87.49;90.59;89.52 - - None None None None J-4-
(RINGAN) 4336500 0 0 - 0 - 0 - 0 - 0
4336500 6398532 0 6 0 0 0 DEWI D393658 69
3;JKN DR RIZKI; 5.2.0.201712280730 4 163029 1#0##0#0#0.0#2018-
04-02 09:13:29#0#12:00:00#12:00:00#12:00:00 1
e2299151a78678445ea02dee35804809 0 0 443285 0 0
4195651 0 0 0 0 1759596 0 0 0 0 0
3201126 B 1 BS 1 24/03/2018 25/03/2018 07/07/1953 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3428490 0 2 0 0 0 ROFIAH,NY D394076
3;JKN DR RIZKI; 5.2.0.201712280730 4 164748 1#0##0#0#0.0#2018-
04-02 09:29:35#0#12:00:00#12:00:00#12:00:00 1
336b9702a867b04f09ff17ea00fc7f7a 0 0 573641 0 0
1388055 0 0 0 0 1466794 0 0 0 0 0
3201126 B 1 BS 1 22/03/2018 25/03/2018 12/06/1989 0 1
1 A16.1;R04.2 90.59;90.42 - - None None None None J-4-15-I
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 6439600 0 4 0 0 0 ROBY ADHI SUNJAYA
0001790668473 3;JKN DR RIZKI; 5.2.0.201712280730 4 163551
1#0##0#0#0.0#2018-04-02 09:31:48#0#12:00:00#12:00:00#12:00:00 1
78b9098b58d6f026225d6ae442312c99 0 0 599399 0 0
2176919 0 0 0 0 3663282 0 0 0 0 0
3201126 B 1 BS 1 24/03/2018 25/03/2018 05/03/1963 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 10962000 0 2 0 0 0 YASIR D387102
3;JKN DR RIZKI; 5.2.0.201712280730 4 164675 1#0##0#0#0.0#2018-
04-02 09:39:08#0#12:00:00#12:00:00#12:00:00 1
02d4b764bb5adc8f2caf38a827fd99ae 0 6468200 2494460 0 0
1157200 0 0 0 0 773140 0 69000 0 0 0
3201126 B 1 BS 1 22/03/2018 25/03/2018 18/09/1978 0 2
1 I63.9;R25.2;J06.9 87.22;90.59;87.03;87.49;89.52 - - None None
None None G-4-14-I None None None None None None KECEDERAAN
PEMBULUH DARAH OTAK DENGAN INFARK (RINGAN) 7018400 0 0 - 0
- 0 - 0 - 0 7018400 6515155 0 4 0
0 0 CAHYA DEWI D393780 39 14430 DR MAYSAMIRAWATI SPS
0138R01703180009750 0001256824192 3;JKN DR RIZKI; 5.2.0.201712280730
4 163547 1#0##0#0#0.0#2018-04-02
09:54:22#0#12:00:00#12:00:00#12:00:00 1 0073e1904afb4afe5e3daec03abbc724
0 0 684656 0 0 2254274 0 0 0 0
3576225 0 0 0 0 0
3201126 B 2 BS 1 23/03/2018 25/03/2018 02/01/2017 0 2
1 B08.4;A49.9;R63.8 - - - None None None None A-4-13-I
(RINGAN) 2507900 0 0 - 0 - 0 - 0 - 0
2507900 2749900 0 3 0 0 0 RANINDYA PUTRI AZAHIRA
D354561 1 445 DR AWIDIYA, SPA 0138R01703180010478
0002213037415 3;JKN DR RIZKI; 5.2.0.201712280730 4 164254
1#0##0#0#0.0#2018-04-04 10:33:07#0#12:00:00#12:00:00#00:00:00 1
418dcdc5f9d24d98c1c44ceda0243baa 0 0 298025 0 0 730975
0 0 0 0 1720900 0 0 0 0 0
3201126 B 1 BS 1 19/03/2018 25/03/2018 31/05/1944 0 1
1 C22.0;D63.0;A41.9;N18.9 99.04 - - None None None None B-4-
11-III None None None None None None TUMOR SISTEM HEPATOBILLIARI DAN
PANCREAS (BERAT) 11575500 0 0 - 0 - 0 - 0 -
0 11575500 10919055 0 7 0 0 0 SARMIN BIN SUMAR
D393471 73 26955 DR ZULFAN, SPPD 0138R01703180008472
0000060970858 3;JKN DR RIZKI; 5.2.0.201712280730 4 162565
1#0##0#0#0.0#2018-04-04 12:15:04#0#12:00:00#12:00:00#12:00:00 1
3f568f1647922ffff10540570c3d2852 0 0 763850 0 0
4293374 0 0 0 0 5861831 0 0 0 0 0
3201126 B 1 BS 1 22/03/2018 25/03/2018 07/04/1986 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12596198 0 4 0 0 0 NIKMAH D393542
31 11672 DR BAGUS T, SPOG 0138R01703180010216 0001607510878 3;JKN
DR RIZKI; 5.2.0.201712280730 4 164808 13#0##0#0#0.0#2018-04-05
14:07:07#0#12:00:00#12:00:00#12:00:00 1 e055b5e04eefed25a29d2739610e60ac
0 7426400 2303895 0 0 1931853 0 0 0 0
865050 0 0 0 0 69000
3201126 B 1 BS 1 21/03/2018 25/03/2018 29/07/1964 0 2
0 0 - 0 - 0 - 0 - 0 11569900
17142969 0 5 0 0 0 RETNO SANGKAN AYU WARDANI
0138R01703180009710 0000042026038 3;JKN DR RIZKI; 5.2.0.201712280730
4 164807 5#0##0#0#0.0#2018-04-05
14:14:44#0#12:00:00#12:00:00#12:00:00 2 cf4c3f49fd8fcee9ba12986a6c7c8e94
0 8132500 4280863 0 0 3463103 0 0 0 0
1197503 0 0 0 0 69000
3201126 B 1 BS 1 22/03/2018 25/03/2018 16/09/2014 0 2
1 J22;G80.0 93.94 - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 3917900 0 0 - 0 - 0 - 0
- 0 3917900 4483900 0 4 0 0 0 HIKMAH
ANINDYA FAHREZA D285190 3 1283 DR AWIDIYA, SPA 0138R01703180010247
0001438971423 3;JKN DR RIZKI; 5.2.0.201712280730 4 164073
1#0##0#0#0.0#2018-04-05 14:40:26#0#12:00:00#12:00:00#12:00:00 1
8e8d0091796606d1ee2d119ac0f990e3 0 0 563695 0 0
1257866 0 0 0 0 2662339 0 0 0 0 0
3201126 B 3 BS 1 24/03/2018 25/03/2018 13/05/1986 0 2
1 I63.9;I48;R57.1 87.03 - - None None None None G-4-14-III
INFARK (BERAT) 8672200 0 0 - 0 - 0 - 0 -
0 8672200 4500527 0 2 0 0 0 ANITA D331162
DR RIZKI; 5.2.0.201712280730 4 164752 22#0##0#0#0.0#2018-04-05
15:22:15#0#12:00:00#12:00:00#12:00:00 1 439677811eeaf635354c40aee01e5c40
0 0 780498 0 0 3136602 0 0 0 0 583427
0 0 0 0 0
3201126 B 3 BS 1 22/03/2018 25/03/2018 19/11/2014 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3159464 0 4 0 0 0 ADAM ZIDAN PRATAMA
0002096724306 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 163931
1#0##0#0#0.0#2018-04-05 15:43:15#0#12:00:00#12:00:00#12:00:00 1
ddc9ce44e7bbb104be2061d54f361c57 0 0 337688 0 0
1367082 0 0 0 0 1284694 0 0 0 0 170000
3201126 B 3 BS 1 22/03/2018 25/03/2018 11/12/2017 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1694968 0 4 0 0 0 ABRIZAM RAFIF ARDHY
d393866 0 101 DR AWIDIYA, SPA 0138R01703180010238
0002319214533 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 164072
1#0##0#0#0.0#2018-04-05 15:50:05#0#12:00:00#12:00:00#12:00:00 1
1ecc92a0c2e1f5fc0d31699a10d47ea3 0 0 207620 0 0 561462
0 0 0 0 925886 0 0 0 0 0
3201126 B 3 BS 1 22/03/2018 25/03/2018 12/04/1968 0 1
1 E10.1;N39.0;N18.1;I10 99.17;90.59;87.49 - - None None None
0 - 0 - 0 4894400 4191169 0 4 0 0
0 BUDIMAN D393779 49 18241 DR BETTY DWI L, SPPD
0138R01703180009753 0001014219191 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 163550 1#0##0#0#0.0#2018-04-05
15:53:00#0#12:00:00#12:00:00#12:00:00 1 2c5dd713670c4b04da6bcd2ac644df12
0 0 704501 0 0 2134479 0 0 0 0
1352189 0 0 0 0 0
3201126 B 3 BS 1 21/03/2018 25/03/2018 04/06/1959 0 2
1 G40.3;I63.9;G81.9 87.44;87.03 - - None None None None G-4-
22-III None None None None None None SERANGAN KEJANG (BERAT) 3965000
0 0 - 0 - 0 - 0 - 0 3965000
4829719 0 5 0 0 0 JUSNIMAR D393753 58 21475
DR MAYSAM I., SPS 0138R01703180009735 0001269429309 3;JKN DR RIZKI;
5.2.0.201712280730 4 163545 6#0##0#0#0.0#2018-04-06
09:07:54#0#12:00:00#12:00:00#12:00:00 1 5b53efefbfeca9f036e47eb2b0fcf21c
0 0 504178 0 0 2931578 0 0 0 0
1393963 0 0 0 0 0
3201126 B 3 BS 1 24/03/2018 25/03/2018 15/01/1966 0 2
1 N95.0;D39.0;I50.0;D62 99.04 - - None None None None W-4-
0 - 0 3857000 3547964 0 2 0 0 0 SITI
BAIDAH D379826 52 19061 DR ARIS WAHJU, SPOG 0138R01703180010942
0001014200831 3;JKN DR RIZKI; 5.2.0.201712280730 4 164566
19#0##0#0#0.0#2018-04-06 09:15:15#0#12:00:00#12:00:00#12:00:00 1
c1165933b5bf6396aa24c7c5275472d0 0 0 703130 0 0
2060724 0 0 0 0 784110 0 0 0 0 0
3201126 B 3 BS 1 19/03/2018 25/03/2018 23/04/1959 0 1
1 M51.2;M54.3 87.24;90.59;89.52 - - None None None None M-4-
(RINGAN) 3687800 0 0 - 0 - 0 - 0 - 0
3687800 5090457 0 7 0 0 0 M YUNASRIL D393467
3;JKN DR RIZKI; 5.2.0.201712280730 4 162087 1#0##0#0#0.0#2018-
04-06 09:27:10#0#12:00:00#12:00:00#12:00:00 1
f85bc53e27521d7b1ea1278af2978fd6 0 0 490902 0 0
2399534 0 0 0 0 2200021 0 0 0 0 0
3201126 B 3 BS 1 25/03/2018 25/03/2018 01/06/1977 0 2
1 I60.9;A41.9;R57.1 - - - None None None None G-4-13-III
(BERAT) 6111900 0 0 - 0 - 0 - 0 - 0
6111900 2613415 0 1 0 0 0 YUNIE WIYANTI
0001624140584 3;JKN DR RIZKI; 5.2.0.201712280730 4 164760
23#0##0#0#0.0#2018-04-06 10:07:10#0#12:00:00#12:00:00#12:00:00 1
0ed378e1930955ad99e9152a3bae2906 0 0 780498 0 0
1372946 0 0 0 0 459971 0 0 0 0 0
3201126 B 2 BS 1 22/03/2018 25/03/2018 04/06/1993 0 2
0 0 - 0 - 0 - 0 - 0 5984100
13109379 0 4 0 0 0 YUNITA RIFANI D393870 24
9057 DR MAMAN H, SPOG 0138R01703180010227 0001257302913 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 164071 1#0##0#0#0.0#2018-
04-07 13:04:03#0#12:00:00#12:00:00#12:00:00 1
5992405a20e278dfc8fff8068c4b7851 0 5251900 2326958 0 0
4512898 0 0 0 0 948623 0 0 0 0 69000
3201126 B 1 BS 1 23/03/2018 25/03/2018 23/03/2018 4062 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2101673 0 3 0 0 0 BY NY NIKMAH
D393898 0 0 DR AD PASARIBU, SPA 0138R01703180011515
0002443227827 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 165118
1#0##0#0#0.0#2018-05-02 09:55:57#0#12:00:00#12:00:00#12:00:00 1
86832b337cf7ab0ca69a8c15dc63aad7 0 0 499620 0 0 145960
0 0 0 0 1456093 0 0 0 0 0
3201126 B 3 BS 1 22/03/2018 25/03/2018 27/12/1967 0 2
- 0 8908800 17775499 0 4 0 0 0 MULYATI
0138R01703180010031 0001322482408 3;JKN DR RIZKI; 5.2.2.201806040537
4 163903 1#0##0#0#0.0#2018-08-10
14:37:50#0#12:00:00#12:00:00#12:00:00 2 8ca6ba2ea5a15b9b3815494bae8454b3
0 0 6731592 0 0 4738974 0 0 0 0
6159933 0 0 0 0 145000
3201126 B 3 BS 1 22/03/2018 25/03/2018 26/05/1980 0 1
1 T82.4;I12.0;D63.8 99.04;39.42;39.95;88.72 - - None None None
0 - 0 - 0 8908800 18861551 0 4 0 0
0 EDWIN KUSNANDAR D389164 37 13814 SRI KUNMARTINI.DR,SPPD
0138R01703180010033 0002090950659 3;JKN DR RIZKI; 5.2.2.201806040537
4 163904 1#0##0#0#0.0#2018-08-10
16:09:50#0#12:00:00#12:00:00#12:00:00 2 a9d1d1118b2b62f695db1c46e68ba685
0 3784800 5378324 0 0 7217177 0 0 0 0
2412250 0 0 0 0 69000
3201126 B 3 BS 1 25/03/2018 25/03/2018 10/06/1945 0 1
2 I21.1;A49.9 89.52 - - None None None None I-4-10-I None
0 - 0 - 0 - 0 - 0 4043000 3187244
0 1 0 0 0 YUNUS D320088 72 26586 DR DINI DANIATY
0138R01703180011081 0000060733686 3;JKN DR RIZKI; 5.2.2.201806040537
4 164758 1#0##0#0#0.0#2018-09-05
16:43:35#0#12:00:00#12:00:00#12:00:00 3 e38ef53373353554400f76b1675bdf13
0 0 936171 0 0 1625562 0 0 0 0 497511
0 0 0 0 128000
3201126 B 3 BS 1 25/03/2018 26/03/2018 22/04/1983 0 2
0 - 0 - 0 - 0 - 0 2954900 5297476
0 2 0 0 0 JUNITA.M. MARPAUNG D393308 34 12756
5.2.0.201712280730 4 164769 1#0##0#0#0.0#2018-04-02
08:42:24#0#12:00:00#12:00:00#12:00:00 1 2094dc8a22d170d41be846fc9a4ef1d5
0 0 880372 0 0 1027040 0 0 0 0
1641064 0 0 0 0 1749000
3201126 B 3 BS 1 23/03/2018 26/03/2018 05/10/1958 0 1
1 D64.9;R19.0;C25.9 99.04;90.59;88.76;89.52 - - None None None
0 - 0 - 0 2987000 4313610 0 4 0 0
0 USMAN D393940 59 21719 DR. ARU ARIADNO, SPPD
0138R01703180010841 0000510926084 3;JKN DR RIZKI; 5.2.0.201712280730
4 164526 1#0##0#0#0.0#2018-04-02
08:44:27#0#12:00:00#12:00:00#12:00:00 1 f9e81de1f2d3d602a4b3455cb19d4c75
0 0 635309 0 0 2581102 0 0 0 0
1097199 0 0 0 0 0
3201126 B 3 BS 1 23/03/2018 26/03/2018 01/08/1997 0 2
1 N39.0;A01.0;K56.7 88.76;90.59;89.52 - - None None None None
URIN (BERAT) 5062600 0 0 - 0 - 0 - 0 -
0 5062600 3809093 0 4 0 0 0 SANTA MONICA
HUTABARAT D393683 20 7539 DR BETTY DWI L, SPPD 0138R01703180010275
0000235089639 3;JKN DR RIZKI; 5.2.0.201712280730 4 164075
1#0##0#0#0.0#2018-04-02 08:54:40#0#12:00:00#12:00:00#12:00:00 1
338a47c6a44bcc0c364d6a67bb42b76b 0 0 776890 0 0
1705010 0 0 0 0 1327193 0 0 0 0 0
3201126 B 1 BS 1 24/03/2018 26/03/2018 12/03/1991 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 14407478 0 3 0 0 0 LIA LIANA D335191
27 9874 DR FERRI SABARUDDIN SPOG 0138R01703180010900
0001651379253 3;JKN DR RIZKI; 5.2.0.201712280730 4 164538
1#0##0#0#0.0#2018-04-02 09:37:25#0#12:00:00#12:00:00#12:00:00 1
d8297014cf83876f4d923aaa1e452289 0 7080900 3818067 0 0
2395966 0 0 0 0 1043545 0 69000 0 0 0
3201126 B 1 BS 1 24/03/2018 26/03/2018 10/08/1960 0 1
1 E11.2;E16.2;D63.8;I10 38.95;99.04 - - None None None None
- 0 - 0 12472300 15837210 0 3 0 0 0
MOCH BACHIR D394062 57 21045 DR SRI KUNMARTINI, SPPD
0138R01703180011048 0000157938603 3;JKN DR RIZKI; 5.2.0.201712280730
4 164751 1#0##0#0#0.0#2018-04-04
10:02:20#0#12:00:00#12:00:00#12:00:00 1 9c8f29691523bc79c7b80e99bee4c522
0 6587000 3669967 0 0 4419164 0 0 0 0
1092079 0 0 0 0 69000
3201126 B 3 BS 1 23/03/2018 26/03/2018 26/11/1965 0 1
1 T82.4;I13.2;R06.0;E87.7 99.60;38.95;88.50 - - None None None
0 - 0 - 0 19332400 18776154 0 4 0 0
0 DARSONO D373005 52 19110 DEDY PRATAMA,SPBV
0138R01703180010840 0001729632069 3;JKN DR RIZKI; 5.2.0.201712280730
4 164525 1#0##0#0#0.0#2018-04-04
10:31:08#0#12:00:00#12:00:00#12:00:00 1 b6acb32bc2eb31c5f62f5ab39cd7a958
0 3235500 1834760 0 0 10909644 0 0 0 0
2727250 0 0 0 0 69000
3201126 B 2 BS 1 24/03/2018 26/03/2018 05/01/1957 0 1
- 0 10690500 12277969 0 3 0 0 0 SUGIYONO
0000171935155 3;JKN DR RIZKI; 5.2.0.201712280730 4 164755
1#0##0#0#0.0#2018-04-04 10:41:19#0#12:00:00#12:00:00#12:00:00 1
d542380da43c1d0db141c59492a98047 0 4911100 3153245 0 0
3285392 0 0 0 0 859232 0 0 0 0 69000
3201126 B 2 BS 1 22/03/2018 26/03/2018 15/12/1972 0 1
1 I84.0 49.46;90.59;89.52 - - None None None None K-1-50-I
None None None None None None PROSEDUR ANAL (RINGAN) 7145100 0
0 - 0 - 0 - 0 - 0 7145100 13309039
0 5 0 0 0 MUHAMMAD FATONI D331019 45 16533 DR
HENDRIEK SP B 0138R01703180009751 0001437173763 3;JKN DR RIZKI;
5.2.0.201712280730 4 163548 1#0##0#0#0.0#2018-04-05
11:17:10#0#12:00:00#12:00:00#12:00:00 1 a688a2ed95e871ec2872ab0c1f3d1ed6
0 6174100 2188079 0 0 3905175 0 0 0 0
896685 0 0 0 0 145000
3201126 B 2 BS 1 24/03/2018 26/03/2018 04/05/1980 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4807818 0 3 0 0 0 MAMAN SUPARMAN
0002249512727 3;JKN DR RIZKI; 5.2.0.201712280730 4 164750
1#0##0#0#0.0#2018-04-05 11:34:28#0#12:00:00#12:00:00#12:00:00 1
12a0ab1d6daadd14040b85eb1e401eda 0 0 709388 0 0
2322400 0 0 0 0 1648030 0 0 0 0 128000
3201126 B 1 BS 1 21/03/2018 26/03/2018 30/01/1965 0 2
2 D64.9;K92.1;D37.2;K29.7;I24.9 99.04 - - None None None None
0 - 0 - 0 5918600 15902184 0 6 1 1
0 E LUTHFIAH d371534 53 19408 DR BETTY DWI L, SPPD
0138R01703180009286 0000061085788 3;JKN DR RIZKI; 5.2.0.201712280730
4 163130 5#0##0#0#0.0#2018-04-05
14:37:35#0#12:00:00#12:00:00#00:00:00 1 2a444eedfb1b28c6f661073913e5f986
0 0 529362 0 0 9367492 0 0 0 0
6005330 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 26/03/2018 13/07/2010 0 1
4 A41.9;R57.1;E27.9 99.60 - - None None None None A-4-10-III
0 - 0 - 0 - 0 - 0 5838600 901244
0 1 0 0 0 MUHAMMAD SYAMIL KHAAS D360172 7 2813
DR DICKY PRATAMA 0138R01703180011222 0001807601376 3;JKN DR RIZKI;
5.2.0.201712280730 4 164782 20#0##0#0#0.0#2018-04-05
15:11:36#0#00:00:00#12:00:00#00:00:00 1 5793903335ac5960eb76c304f34870e6
0 0 305559 0 0 247725 0 0 0 0 347960
0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 26/03/2018 14/12/1968 0 2
2 A09.9;K30 87.44 - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2305937 0 1 0 0 0 HIDAYATI SYARIFAH
0001304572781 3;JKN DR RIZKI; 5.2.0.201712280730 4 165304
22#0##0#0#0.0#2018-04-05 16:30:06#0#12:00:00#12:00:00#00:00:00 1
19acdc361b30d9cb8e705081103f1f55 0 0 251631 0 0
1614450 0 0 0 0 439856 0 0 0 0 0
3201126 B 3 BS 1 25/03/2018 26/03/2018 01/06/1976 0 1
- 0 8908800 10131221 0 2 0 0 0 KISNO
0000367261435 3;JKN DR RIZKI; 5.2.0.201712280730 4 164763
18#0##0#0#0.0#2018-04-05 16:34:45#0#12:00:00#12:00:00#12:00:00 1
eb4d987120314ce404bf60d9e783bec5 0 3438800 2636552 0 0
3248079 0 0 0 0 738790 0 0 0 0 69000
3201126 B 3 BS 1 21/03/2018 26/03/2018 06/11/1967 0 1
1 E14.7 86.91 - - None None None None L-1-30-I None None
None None None None PEMINDAHAN KULIT TANPA LUKA BAKAR (RINGAN)
8883500 0 0 - 0 - 0 - 0 - 0
8883500 10399223 0 6 0 0 0 ERWIN IRAWAN
0001463679876 3;JKN DR RIZKI; 5.2.0.201712280730 4 163065
1#0##0#0#0.0#2018-04-06 10:00:34#0#12:00:00#12:00:00#00:00:00 1
b97ea45ffed8431b9dcd59ee77233c7a 0 3754500 2550380 0 0
3134020 0 0 0 0 891323 0 0 0 0 69000
3201126 B 1 BS 1 24/03/2018 26/03/2018 02/08/1950 0 2
1 I25.1;I05.9;I11.0 88.55;90.59;89.52 - - None None None None
17095200 0 0 - 0 - 0 - 0 - 0
17095200 14895165 0 3 0 0 0 UMIATI D393980
0002298157885 3;JKN DR RIZKI; 5.2.0.201712280730 4 164537
1#0##0#0#0.0#2018-04-06 11:13:12#0#12:00:00#12:00:00#12:00:00 1
311f8bac9c880a8dac11a045af207340 0 5192000 1324460 0 0
4202255 0 0 0 0 1000450 0 0 0 0
3176000
3201126 B 1 BS 1 24/03/2018 26/03/2018 11/09/1955 0 2
- 0 46734600 65336920 0 3 0 0 0 INDESWARI
0001457476029 3;JKN DR RIZKI; 5.2.0.201712280730 4 164749
1#0##0#0#0.0#2018-04-06 11:29:22#0#12:00:00#12:00:00#12:00:00 1
7ba0eab61835a3a1143e00c0203adf52 0 10407500 9619120 0 0
36485300 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 24/03/2018 26/03/2018 24/03/2018 3472 2
1 P03.4;Q66.0 - - - None None None None P-8-17-I None
(RINGAN) 5118000 0 0 - 0 - 0 - 0 - 0
5118000 1961599 0 3 0 0 0 BAYI NY LIA LIANA
0002443165018 3;JKN DR RIZKI; 5.2.0.201712280730 4 165099
21#0##0#0#0.0#2018-04-06 14:28:55#0#12:00:00#12:00:00#12:00:00 1
ff3cc8a5856abff0e8f32fea1b18ef06 0 0 499620 0 0 82650
0 0 0 0 1379329 0 0 0 0 0
3201126 B 2 BS 1 15/03/2018 26/03/2018 13/03/2018 2700 1
1 P70.4;P90;P59.9 99.82 - - None None None None P-8-17-III
None None None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR
MAYOR (BERAT) 11111500 0 0 - 0 - 0 - 0 -
0 11111500 34770878 0 12 0 0 0 BAYI NY. RISMA
OPPI OKTAVIANI D393142 0 2 DR AULIA TANGKARI, SPA
0138R01703180007103 0002439991247 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 161531 1#0##0#0#0.0#2018-04-07
13:22:05#0#12:00:00#12:00:00#12:00:00 1 8328a8c8b0548561eafb790aca21e45b
0 0 447244 0 0 9549634 0 0 0 0
12932000 0 0 0 0 11842000
3201126 B 1 BS 1 26/02/2018 26/03/2018 26/02/2018 1300 2
1 P07.1;P07.3;P59.0 99.82 - - None None None None P-8-11-II
- 0 20239600 49679467 0 29 1 29 0 BAYI NY NOVI
DAWATI d391585 0 0 DR AULIA TANGKARI, SPA 0138R01702180012109
0002434249192 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 154711
1#0##0#0#0.0#2018-04-07 13:33:17#0#12:00:00#12:00:00#12:00:00 1
06a2a63c649c0be5ff3341e163ebef9b 0 0 2575421 0 0
11789546 0 0 0 0 23529500 0 0 0 0
11785000
3201126 B 1 BS 1 21/03/2018 26/03/2018 12/05/1946 0 1
1 E16.2;I25.0;I11.0 - - - None None None None E-4-10-III
0 - 0 8768000 8599537 0 6 0 0 0 NIAN
DAIMAN,H,MBA. D370989 71 26246 DR AZRI NURIZAL SPPD KKV
0138R01703180009681 0000061030394 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 163535 1#0##0#0#0.0#2018-04-07
14:03:29#0#12:00:00#12:00:00#00:00:00 1 1721443a3e5f2e87339cd3bb9c66a3d5
0 0 579536 0 0 1537914 0 0 0 0
5136087 0 0 0 0 1346000
3201126 B 3 BS 1 24/03/2018 26/03/2018 12/05/1982 0 1
- 0 8908800 7490410 0 3 0 0 0 MUCH USMAN
YAHYA D394086 35 13100 SRI KUNMARTINI.DR,SPPD 000000240318001 1234569
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 165116
23#0##0#0#0.0#2018-04-09 12:18:33#0#12:07:46#12:07:46#00:00:00 1
484a539482a554635710a5b773c05f1c 0 7490410 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 26/03/2018 31/10/1977 0 2
1 C50.3 99.25 - - None None None None L-4-11-I None None
None None None None TUMOR PAYUDARA (RINGAN) 5011800 0 0 -
0 - 0 - 0 - 0 5011800 4330957 0 1
0 0 0 INDAH SUSHANTY D381833 40 14756 RACHMAWATI
DR,SPB(K)ONK 0138R01703180011444 0001716416109 3;JKN TANTIYO S;16137
5.2.1.201802140120 4 164979 1#0##0#0#0.0#2018-04-12
16:41:12#0#12:00:00#12:00:00#12:00:00 1 d9ea0b01c23b67cd81f3d458e27df72b
0 0 1002360 0 0 2328263 0 0 0 0
1000334 0 0 0 0 0
3201126 B 2 BS 1 19/03/2018 26/03/2018 13/04/1956 0 1
1 S09.9;H81.3;E14.9 87.03;90.59;89.52 - - None None None None
G-4-24-I None None None None None None TRAUMA KEPALA (RINGAN)
3651800 0 0 - 0 - 0 - 0 - 0
3651800 8172062 0 8 0 0 0 ROHMAN D393546
3;JKN DR RIZKI; 5.2.2.201806040537 4 162617 1#0##0#0#0.0#2018-
08-10 14:12:22#0#12:00:00#12:00:00#12:00:00 2
6c553ea0aa24cca98e4f8ba515aaa226 0 0 378412 0 0
3905529 0 0 0 0 3888121 0 0 0 0 0
3201126 B 2 BS 1 22/03/2018 26/03/2018 01/01/1950 0 2
1 I50.0;I25.0;J90 89.52;87.44 - - None None None None I-4-
5968400 0 0 - 0 - 0 - 0 - 0
5968400 13630350 0 5 1 3 0 SALBIYAH, HJ
0000976208883 3;JKN DR RIZKI; 5.2.2.201806040537 4 164066
1#0##0#0#0.0#2018-08-10 14:46:45#0#12:00:00#12:00:00#12:00:00 2
8b9b4d11b23a81baacb73e3a0a81ddba 0 0 1176407 0 0
5724322 0 0 0 0 4353621 0 0 0 0
2376000
3201126 B 2 BS 1 26/03/2018 27/03/2018 04/03/1968 0 1
- 0 41590500 54398804 0 2 0 0 0 TUKIJO
0001718632991 3;JKN DR RIZKI; 5.2.0.201712280730 4 164789
1#0##0#0#0.0#2018-04-02 08:30:12#0#12:00:00#12:00:00#12:00:00 1
9b31c080f31647ad5123ccc716b3526f 0 8986000 2930600 0 0
33657204 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 09/03/2018 27/03/2018 07/08/1942 0 1
1 I50.0;E11.2;D68.9 38.95;39.95;99.04;93.19;87.44;93.94 - - None
0 - 0 - 0 - 0 27065300 54525731 0 19
1 6 0 NGISA D093581 75 27608 DR AGOES KOOSHARTORO SPPD-KKV
0138R01703180004619 0000060964312 3;JKN DR RIZKI; 5.2.0.201712280730
4 159429 1#0##0#0#0.0#2018-04-02
09:47:30#0#12:00:00#12:00:00#12:00:00 1 518f4a00efedbf3297ebb10af5dab597
0 18584000 9525675 0 0 18662806 0 0 0 0
2726250 0 0 0 0 5027000
3201126 B 3 BS 1 27/03/2018 27/03/2018 26/05/1973 0 1
0 - 0 - 0 - 0 - 0 10401900 3009539
0 1 0 0 0 BHIMA SISWO PUTRO, S.SI.T D097356 44
16376 DR DINI DANIATY 0138R01703180011992 0000204422027 3;JKN DR
RIZKI; 5.2.0.201712280730 4 165430 1#0##0#0#0.0#2018-04-05
16:32:15#0#12:00:00#12:00:00#12:00:00 1 0ccd2d152ba1b63d3dbea8a5777c2d30
0 0 936171 0 0 1587482 0 0 0 0 485886
0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 27/03/2018 11/10/1973 0 1
0 0 - 0 - 0 - 0 - 0 4202600
1758969 0 2 0 0 0 MULYADI D394252 44 16237
DR AHMAD HIBBAN A WRIYA 0138R01703180011723 0002293423953 3;JKN DR
RIZKI; 5.2.0.201712280730 4 165307 1#0##0#0#0.0#2018-04-06
09:54:22#0#12:00:00#12:00:00#12:00:00 1 6e6728db7dafbb484f6a7d2779aa61ad
0 0 378234 0 0 976662 0 0 0 0 404073
0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 27/03/2018 31/12/1947 0 1
- 0 - 0 - 0 - 0 4043000 2631977 0
1 0 0 0 SUMARSA D328626 70 25654 DR AHMAD HIBBAN A
WRIYA 0138R01703180012041 0001435563009 3;JKN DR RIZKI; 5.2.0.201712280730
4 165470 8#0##0#0#0.0#2018-04-06
09:56:09#0#12:00:00#12:00:00#00:00:00 1 8546d15768fd4f08ffcc769b015f5ad3
0 0 363870 0 0 1806922 0 0 0 0 461185
0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 27/03/2018 22/10/1950 0 1
0 - 0 - 0 - 0 - 0 4043000 1815884
0 1 0 0 0 ACHMAD SAIDUN ALI, SH D286409 67 24628
DR AHMAD HIBBAN A WRIYA 0138R01703180012116 0000043180378 3;JKN DR
RIZKI; 5.2.0.201712280730 4 165527 1#0##0#0#0.0#2018-04-06
09:57:01#0#12:00:00#12:00:00#00:00:00 1 09fd7a058e66d32cbc5447b41370024c
0 0 363870 0 0 1044218 0 0 0 0 407796
0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 27/03/2018 06/06/1944 0 1
1 R04.1 89.52 - - None None None None U-4-15-I None None
LAIN (RINGAN) 2961500 0 0 - 0 - 0 - 0 -
0 2961500 2404794 0 2 0 0 0 TOEKOEL
0000042658435 3;JKN DR RIZKI; 5.2.0.201712280730 4 165306
1#0##0#0#0.0#2018-04-06 10:32:23#0#12:00:00#12:00:00#12:00:00 2
c7bf1a0ad9da15963f248301cdf845e4 0 0 343809 0 0
1614662 0 0 0 0 446323 0 0 0 0 0
3201126 B 2 BS 1 24/03/2018 27/03/2018 16/12/2015 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4630862 0 4 0 0 0 ANINDYA ORLIN
0001961743948 3;JKN DR RIZKI; 5.2.0.201712280730 4 164534
1#0##0#0#0.0#2018-04-06 15:39:57#0#12:00:00#12:00:00#00:00:00 1
51e612827c781dbff5da78af7ea4a78a 0 0 338039 0 0
1433869 0 0 0 0 2348954 0 0 0 0 510000
3201126 B 2 BS 1 25/03/2018 27/03/2018 15/12/1994 0 2
10406400 0 0 - 0 - 0 - 0 - 0
10406400 13941232 0 3 0 0 0 ELISTA RAHMAWATI
0138R01703180011189 0001652417425 3;JKN DR RIZKI; 5.2.0.201712280730
4 164768 3#0##0#0#0.0#2018-04-06
15:57:02#0#12:00:00#12:00:00#12:00:00 1 1729ddaaccad6239338b7b400105e271
0 0 3041412 0 0 2001777 0 0 0 0
8753043 0 0 0 0 145000
3201126 B 3 BS 1 26/03/2018 27/03/2018 31/12/1958 0 1
- 0 45079800 52603089 0 2 0 0 0 ROIF DJUANDA
TN D389913 59 21635 DR AZRI NURIZAL SPPD KKV 12345678 1234 3;JKN
irene; 5.2.1.201802140120 4 165305 1#0##0#0#0.0#2018-04-10
09:49:43#0#17:11:15#17:11:15#00:00:00 2 8af5c7955511e9061affa8c58e866d78
0 0 52603089 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 24/03/2018 27/03/2018 19/05/1990 0 2
0 - 0 - 0 - 0 - 0 2344900 12190680
0 4 0 0 0 ELSA TIO FAULINA PURBA D372221 27 10171
DR NINING H, SPOG 0138R01703180010874 0001305852704 3;JKN DR RIZKI;
5.2.1.201802140120 4 164533 1#0##0#0#0.0#2018-04-10
13:49:48#0#12:00:00#12:00:00#12:00:00 2 6dcb3fb2a8cc2bc58a50f62e13894f40
0 0 12190680 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 25/03/2018 27/03/2018 20/11/1950 0 2
1 A09.9;E11.9;M54.56 - - - None None None None K-4-
17-I None None None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 6096060 0 3 0 0 0 ERIKA SIREGAR
0000060782714 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 165621
1#1#vvip#3#3690960#0.0#2018-05-02 10:29:06#0#18:16:34#18:16:34#12:00:00
1 f6b18866bbde9e8d3bdbc01a30701af6 0 0 631000 0 0
1454252 0 0 0 0 4010808 0 0 0 0 0
3201126 B 1 BS 1 25/03/2018 27/03/2018 24/03/2004 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4282779 0 3 0 0 0 RISTI D081387 14
5114 DR AD PASARIBU, SPA 0138R01703180011145 0001459629134 3;JKN
DR RIZKI; 5.2.1.201804062320 4 164761 1#0##0#0#0.0#2018-05-03
16:35:44#0#12:00:00#12:00:00#12:00:00 1 bb4b5e7d46b76c58ed69f78264076063
0 0 929825 0 0 703772 0 0 0 0
2649182 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 27/03/2018 31/12/1947 0 1
- 0 - 0 - 0 - 0 4043000 2631977 0
1 0 0 0 SUMARSA D328626 70 25654 DR BAMBANG
DWIPUTRA SPJP 0138R0170318V000025 0001435563009 3;JKN DR RIZKI;
5.2.2.201806040537 4 227353 1#0##0#0#0.0#2018-09-26
13:59:24#0#00:00:00#00:00:00#00:00:00 1 02f2fdfe65245de35e90fee579710cd9
0 0 363870 0 0 1806922 0 0 0 0 263000
0 0 198185 0 0
3201126 B 3 BS 1 27/03/2018 27/03/2018 22/10/1950 0 1
0 - 0 - 0 - 0 - 0 4043000 1815884
0 1 0 0 0 ACHMAD SAIDUN ALI, SH D286409 67 24628
DR BAMBANG DWIPUTRA SPJP 0138R0170318V000022 0000043180378 3;JKN
DR RIZKI; 5.2.2.201806040537 4 227397 1#0##0#0#0.0#2018-09-26
14:28:42#0#00:00:00#00:00:00#00:00:00 1 36221f33d7ef541cb61e858a96aca74b
0 0 363870 0 0 1044218 0 0 0 0 263000
0 0 118796 26000 0
3201126 B 1 BS 1 24/03/2018 27/03/2018 22/12/1974 0 2
1 O60.1;O62.4;O82.9;Z37.0;O99.0 74.0;99.04 - - None None None
None O-6-10-II None None None None None None OPERASI PEMBEDAHAN
CAESAR (SEDANG) 7567300 0 0 - 0 - 0 - 0 -
0 7567300 16158496 0 4 0 0 0 DESI SUSILOWATI
0002096844636 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 164535
1#0##0#0#0.0#2018-10-06 10:28:08#0#12:00:00#12:00:00#12:00:00 1
e7778331dc74c9c3e1b9856d70bf8baa 0 7789900 2746525 0 0
4444973 0 0 0 0 1108098 0 0 0 0 69000
3201126 B 3 BS 1 27/03/2018 28/03/2018 08/09/1975 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 6703431 0 2 0 0 0 AMIRRUDIN D379729
DR RIZKI; 5.2.0.201712280730 4 165622 15#0##0#0#0.0#2018-04-05
16:33:48#0#12:00:00#12:00:00#12:00:00 1 83d69456006fbdb7bac7086303777f4e
0 3062500 1311745 0 0 1765644 0 0 0 0
494542 0 0 0 0 69000
3201126 B 3 BS 1 26/03/2018 28/03/2018 16/09/1983 0 1
2646600 0 0 - 0 - 0 - 0 - 0
2646600 2991747 0 3 0 0 0 AGUS KURNAEN
0002089984836 3;JKN DR RIZKI; 5.2.0.201712280730 4 165119
8#0##0#0#0.0#2018-04-06 10:10:10#0#12:00:00#12:00:00#12:00:00 1
375cbdac7a00acfe565e5115614482f8 0 0 473155 0 0
1507870 0 0 0 0 1010722 0 0 0 0 0
3201126 B 3 BS 1 25/03/2018 28/03/2018 30/08/2013 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2710476 0 4 0 0 0 KHAIRUL ANNAM
D370908 4 1668 DR RASTRA, SPA 0138R01703180011074
0001771751891 3;JKN DR RIZKI; 5.2.0.201712280730 4 164757
1#0##0#0#0.0#2018-04-06 10:25:02#0#12:00:00#12:00:00#12:00:00 1
944a31941bfb4a3b9491c6a7f8bb8b2a 0 0 257183 0 0
1197972 0 0 0 0 1255321 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 28/03/2018 27/11/1953 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 15282093 0 2 0 0 0 POEDJADI
0001212186791 3;JKN DR RIZKI; 5.2.0.201712280730 4 165569
1#0##0#0#0.0#2018-04-06 10:27:36#0#12:00:00#12:00:00#12:00:00 1
7d9c2d212670f2750474644a421eea42 0 3062500 3866480 0 0
7262850 0 0 0 0 1055763 0 0 0 0 34500
3201126 B 1 BS 1 26/03/2018 28/03/2018 01/01/1973 0 1
1 N23;M54.59 87.71;88.76 - - None None None None N-4-13-I
None None None None None None BATU URIN (RINGAN) 4784600 0
0 - 0 - 0 - 0 - 0 4784600 5060958
0 3 0 0 0 SUGINO D394262 45 16520 DR ARU, SPPD
0138R01703180011725 0001126550463 3;JKN DR RIZKI; 5.2.0.201712280730
4 165308 1#0##0#0#0.0#2018-04-06
10:57:44#0#12:00:00#12:00:00#12:00:00 1 6f111512801cbf82fbdea454df79bc46
0 0 354482 0 0 2351885 0 0 0 0
2354591 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 28/03/2018 26/03/2018 3242 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2080849 0 3 0 0 0 BAYI NY. ERYANI
D394212 0 0 DR AWIDIYA, SPA 0138R01703180012710
0002444438272 3;JKN DR RIZKI; 5.2.0.201712280730 4 165907
18#0##0#0#0.0#2018-04-06 11:00:36#0#12:00:00#12:00:00#12:00:00 1
76e62d696b7900f159f2de0f048ece21 0 0 499620 0 0 126499
0 0 0 0 1454730 0 0 0 0 0
3201126 B 1 BS 1 27/03/2018 28/03/2018 16/11/1953 0 2
(SEDANG) 4615000 0 0 - 0 - 0 - 0 - 0
4615000 6420631 0 2 0 0 0 MURTINI D393707
DR RIZKI; 5.2.0.201712280730 4 165628 1#0##0#0#0.0#2018-04-06
11:02:49#0#12:00:00#12:00:00#12:00:00 1 50e469a7280af5bdaeb7992df72370c7
0 0 1345200 0 0 921390 0 0 0 0
2405041 0 0 0 0 1749000
3201126 B 1 BS 1 27/03/2018 28/03/2018 01/02/1961 0 1
1 E11.9;R55;G40.3;N39.9 87.03;87.44 - - None None None None
0 - 0 - 0 6852200 3375923 0 2 0 0
0 SUHADI S.SOS, MH D394318 57 20873 DR BETTY DWI L, SPPD
0138R01703180012072 0000060510429 3;JKN DR RIZKI; 5.2.0.201712280730
4 165476 1#0##0#0#0.0#2018-04-06
11:12:06#0#12:00:00#12:00:00#12:00:00 1 e1c6c30e0b210d863fef6d4e0e8c8e8e
0 0 669698 0 0 897370 0 0 0 0
1808855 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 28/03/2018 15/08/2016 0 1
(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 2881241 0 3 0 0 0 SALMAN AHSANUL FIRDAUS
0002213698724 3;JKN DR RIZKI; 5.2.0.201712280730 4 165309
1#0##0#0#0.0#2018-04-06 11:14:16#0#12:00:00#12:00:00#12:00:00 1
a6c6869b4042479683cb8e346ae3d939 0 0 387638 0 0 717111
0 0 0 0 1776492 0 0 0 0 0
3201126 B 1 BS 1 25/03/2018 28/03/2018 13/04/1974 0 2
(SEDANG) 7567300 0 0 - 0 - 0 - 0 - 0
7567300 15231501 0 4 0 0 0 ERYANI D325141
0001802014762 3;JKN DR RIZKI; 5.2.0.201712280730 4 164766
1#0##0#0#0.0#2018-04-06 11:17:21#0#12:00:00#12:00:00#12:00:00 1
534dd9784b824667f0285e15d0ff450d 0 7098900 3306939 0 0
3463209 0 0 0 0 1037453 0 0 0 0 325000
3201126 B 1 BS 1 24/03/2018 28/03/2018 19/03/1963 0 2
1 I50.0;J18.9;E10.6 87.44;90.59;89.52 - - None None None None
I-4-12-III None None None None None None KEGAGALAN JANTUNG (BERAT)
6963100 0 0 - 0 - 0 - 0 - 0
6963100 10628917 0 5 0 0 0 RR. RIKE PRIHANTINI
0001431733263 3;JKN DR RIZKI; 5.2.0.201712280730 4 164536
1#1#vvip#2#3665817#0.0#2018-04-06 11:20:31#0#12:00:00#12:00:00#12:00:00
1 0d59dbd71fdb1b9b3164eb31b5832414 0 0 776000 0 0
2708567 0 0 0 0 7144350 0 0 0 0 0
3201126 B 1 BS 1 27/03/2018 28/03/2018 09/05/1948 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 16751442 0 2 0 0 0 NURHASANAH D394299
69 25524 DR BENNY H T, SPOT 0138R01703180011947 0000060837186
3;JKN DR RIZKI; 5.2.0.201712280730 4 165388 1#0##0#0#0.0#2018-
04-06 11:25:44#0#12:00:00#12:00:00#12:00:00 1
b6e1500396ac3cff9deaef58ce893612 0 0 4092618 0 0
1578635 0 0 0 0 10935189 0 0 0 0 145000
3201126 B 2 BS 1 24/03/2018 28/03/2018 05/03/1956 0 1
1 E11.4;K29.7 87.03 - - None None None None G-4-17-I None
5397100 0 0 - 0 - 0 - 0 - 0
5397100 6682255 0 5 0 0 0 BAKRI D394051 62
DR RIZKI; 5.2.0.201712280730 4 164746 1#0##0#0#0.0#2018-04-06
16:00:59#0#12:00:00#12:00:00#12:00:00 1 32039cd3850a710a61f7ae4da8ef83d5
0 0 397356 0 0 3296742 0 0 0 0
2988157 0 0 0 0 0
3201126 B 2 BS 1 25/03/2018 28/03/2018 14/03/1993 0 1
1 J18.0;K29.7 87.44 - - None None None None J-4-16-I None
4335900 0 0 - 0 - 0 - 0 - 0
4335900 3506297 0 4 0 0 0 RANDI SETIAWAN
0000061099367 3;JKN DR RIZKI; 5.2.0.201712280730 4 164775
1#0##0#0#0.0#2018-04-06 16:09:55#0#12:00:00#12:00:00#12:00:00 1
795385961a1b839637bfa495956fc65a 0 0 746333 0 0 989580
0 0 0 0 1770384 0 0 0 0 0
3201126 B 2 BS 1 23/03/2018 28/03/2018 23/02/1953 0 2
15-III None None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL
(BERAT) 6870600 0 0 - 0 - 0 - 0 - 0
6870600 7602896 0 6 0 0 0 AISYAH D392327
3;JKN TANTIYO S;16137 5.2.0.201712280730 4 164527
1#0##0#0#0.0#2018-04-07 11:57:35#0#12:00:00#12:00:00#12:00:00 1
48e1fb6ae62bb43099f106ef89e1a59e 0 0 291535 0 0
4262975 0 0 0 0 3048386 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 28/03/2018 15/04/1974 0 1
None None None None INFEKSI BAKTERI SISTEM SARAF (RINGAN) 5315300
0 0 - 0 - 0 - 0 - 0 5315300
1865589 0 1 0 0 0 IMAN SUTA ATMAJA d394391 43
16053 DR ADITIA NATA KUSUMA 0138R01703180012376 0001128681112 3;JKN
TANTIYO S;16137 5.2.0.201712280730 4 165637 1#0##0#0#0.0#2018-
04-07 12:53:18#0#12:00:00#12:00:00#12:00:00 2
35dd7c138902fc6bf0747d57756198e2 0 0 398646 0 0 121317
999999 0 0 0 345627 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 28/03/2018 02/11/1964 0 2
1 J18.0;I10;J81 87.44 - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 2508120 0 1 0 0 0 ROSMAINI SIREGAR
0000038318319 3;JKN DR RIZKI; 5.2.1.201802140120 4 165711
1#0##0#0#0.0#2018-04-11 13:29:20#0#12:00:00#12:00:00#12:00:00 1
db7d0a069c6d28e6c3be7705ac5de651 0 0 577773 0 0
1477264 0 0 0 0 453083 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 28/03/2018 21/09/1958 0 2
1 E87.1;E87.6;R40.0;R33 87.03 - - None None None None E-4-
4504900 0 0 - 0 - 0 - 0 - 0
4504900 3140928 0 1 0 0 0 ALIAH D393434 59
21738 DR MUHAMMAD RIZKI YUWANA 0138R01703180013379 0002309296768
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166624
1#0##0#0#0.0#2018-04-12 08:29:25#0#12:00:00#12:00:00#12:00:00 1
73daf8d5d4d51e66ba6638a4c376777d 0 0 405441 0 0
2241006 0 0 0 0 468481 0 0 0 26000 0
3201126 B 2 BS 1 19/03/2018 28/03/2018 16/01/1989 0 1
1 A41.9;E14.7;J18.0;I10 87.44 - - None None None None A-4-
0 0 - 0 - 0 - 0 - 0 7006300
24450689 0 10 1 4 0 ADESYAH PUTRA D393411 29
irene; 5.2.1.201804062320 4 162060 1#0##0#0#0.0#2018-04-19
17:49:01#0#12:00:00#12:00:00#12:00:00 2 cc2599d7ca43b5735308a529e8a76069
0 0 741919 0 0 12643770 0 0 0 0
7243000 0 0 0 0 3822000
3201126 B 1 BS 1 23/03/2018 28/03/2018 15/11/1983 0 2
0 0 - 0 - 0 - 0 - 0 6981500
15674432 0 6 0 0 0 TITIS WAHYU SETIYOWATI D379000
34 12547 DR AFRA FONDA SPOG 0138R01703180010792 0000040615255
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 164512
1#0##0#0#0.0#2018-05-02 09:05:30#0#12:00:00#12:00:00#12:00:00 1
b9f8aa84271cdae3e43ea3d3ea2c5ed3 0 8480900 2676710 0 0
2515192 0 0 0 0 1121630 0 0 0 0 880000
3201126 B 2 BS 1 17/03/2018 28/03/2018 27/11/2017 0 2
2 Q31.5;I27.0;A41.9 96.72 - - None None None None J-1-02-III
None None None None None None VENTILASI MEKANIKAL LONG TERM TANPA
- 0 79597900 58199516 0 12 0 0 0 RAISYAH
PUTRI ADIVI D391299 0 110 DR NOVIK BUDIWARDHANA, SPA
0138R01703180007803 0002286096434 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 162017 1#0##0#0#0.0#2018-05-02
12:29:16#0#12:00:00#12:00:00#12:00:00 1 61d6bfc55d6b0329c5b7ad6e8fc66e82
0 0 7447805 0 0 26262711 0 0 0 0
12576000 0 0 0 0 11913000
3201126 B 3 BS 1 27/03/2018 28/03/2018 21/04/1978 0 1
1 T82.4;I12.0 88.67;38.95 - - None None None None N-1-12-II
- 0 8908800 13141826 0 2 0 0 0 MUHAMAD
SOLEH TN D332648 39 14585 DR DEDY PRATAMA SPBV 0138R01703180012127
0001455588617 3;JKN DR RIZKI; 5.2.2.201806040537 4 165548
1#0##0#0#0.0#2018-09-04 11:46:44#0#12:00:00#12:00:00#00:00:00 4
ba0574bf4b634ef1e32d23740e9dffaa 0 3062500 3866480 0 0
5228100 0 0 0 0 915746 0 0 0 0 69000
3201126 B 3 BS 1 28/03/2018 28/03/2018 02/11/1964 0 2
1 J22;I10;J81 87.44 - - None None None None J-4-21-III None
LAIN-LAIN (BERAT) 6291000 0 0 - 0 - 0 - 0 -
0 6291000 2055037 0 1 0 0 0 ROSMAINI SIREGAR
D334283 53 19504 DR IRVAN VERYADI 0138R0170318V000023
0000038318319 3;JKN DR RIZKI; 5.2.2.201806040537 4 227360
1#0##0#0#0.0#2018-09-26 14:25:31#0#00:00:00#00:00:00#12:00:00 1
e2055abdc77d2db45569f3f22b3db53e 0 0 577773 0 0
1477264 0 0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 29/03/2018 02/06/2016 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3952458 0 4 0 0 0 MUHAMMAD RIZKY ANWAR
0001728796577 3;JKN DR RIZKI; 5.2.0.201712280730 4 165085
10#0##0#0#0.0#2018-04-05 14:56:02#0#12:00:00#12:00:00#00:00:00 2
6c017ddedeceff28d0a31ad79bb906c1 0 0 325188 0 0
2290698 0 0 0 0 1336572 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 29/03/2018 14/10/1969 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 4921127 0 4 0 0 0 ANANG RUSDI
0001446446575 3;JKN DR RIZKI; 5.2.0.201712280730 4 165291
12#0##0#0#0.0#2018-04-05 15:49:48#0#12:00:00#12:00:00#12:00:00 1
3d7ecf67a71689ec3149bd6995682af2 0 0 433484 0 0
3087700 0 0 0 0 1399943 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 29/03/2018 02/09/1982 0 1
1 R07.4 89.52 - - None None None None I-4-20-I None None
0 0 - 0 - 0 - 0 - 0 4202600
3428734 0 3 0 0 0 ERIEK AULIA D394296 35 12990
DR ARU, SPPD 0138R01703180011765 0001144145799 3;JKN DR RIZKI;
5.2.0.201712280730 4 165313 1#0##0#0#0.0#2018-04-05
16:06:26#0#12:00:00#12:00:00#12:00:00 2 c5cef0e7ca0654942a059063b77bf356
0 0 431234 0 0 1958190 0 0 0 0
1039310 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 29/03/2018 31/12/1968 0 1
- 0 45079800 52008171 0 2 0 0 0 TOTONG
SUPRIATNA D391529 49 17984 DR AZRI NURIZAL SPPD KKV
0138R01703180012483 0000510580697 3;JKN DR RIZKI; 5.2.0.201712280730
4 165639 1#0##0#0#0.0#2018-04-05
16:23:11#0#12:00:00#12:00:00#12:00:00 1 d6037967ede31c85b456e10e878bb468
0 3062500 6870800 0 0 33749871 0 0 0 0
1256000 0 0 0 0 7069000
3201126 B 3 BS 1 23/03/2018 29/03/2018 07/04/1958 0 2
1 I61.9;G40.8;G81.9;I10 87.03;87.44 - - None None None None
0 - 0 5153300 6241316 0 7 0 0 0 NURUL
HUDA D393945 59 21900 DR NURUL KOMARI SPS 0138R01703180010845
0001267336653 3;JKN DR RIZKI; 5.2.0.201712280730 4 164528
3#0##0#0#0.0#2018-04-05 16:25:16#0#12:00:00#12:00:00#12:00:00 1
b1fe24efca9f8674e164668b22d18b2d 0 0 475198 0 0
3753808 0 0 0 0 2012310 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 29/03/2018 01/04/2003 0 2
1 A49.9;E10.9 - - - None None None None A-4-14-I None
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2729458 0 2 0 0 0 WIDYA APRILIANTI
D394392 14 5475 DR RASTRA, SPA 0138R01703180012370
0000512517508 3;JKN DR RIZKI; 5.2.0.201712280730 4 165636
17#0##0#0#0.0#2018-04-05 16:28:14#0#12:00:00#12:00:00#12:00:00 1
3e9b64653a4e0a8fca9c0ab53490844c 0 0 368243 0 0
1630652 0 0 0 0 730563 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 29/03/2018 24/10/2014 0 1
1 B34.9 93.94 - - None None None None A-4-13-I None None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2258535 0 3 0 0 0 ERSA OKTAVIANI NDRAHA
0002262235015 3;JKN DR RIZKI; 5.2.0.201712280730 4 165582
1#0##0#0#0.0#2018-04-06 08:25:10#0#12:00:00#12:00:00#12:00:00 1
6e9e22525d9f5c7a1db16b50de398879 0 0 378188 0 0 917592
0 0 0 0 962755 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 29/03/2018 14/06/1960 0 1
1 D29.1;R33;I10 60.29 - - None None None None V-1-14-I
(RINGAN) 8837900 0 0 - 0 - 0 - 0 - 0
8837900 17105342 0 4 0 0 0 ROHIMIN D388527
3;JKN DR RIZKI; 5.2.0.201712280730 4 164937 1#0##0#0#0.0#2018-
04-06 08:26:56#0#12:00:00#12:00:00#12:00:00 1
34f8ee9ba2c2f689fbe90667f5ce2f51 0 4773100 2562991 0 0
4492210 0 0 0 0 4740041 0 0 0 0 537000
3201126 B 3 BS 1 27/03/2018 29/03/2018 01/12/1945 0 2
1 K92.0;K92.1;D62;K29.6;A01.0;I10 99.04 - - None None None
None K-4-18-III None None None None None None GANGGUAN SISTEM
PENCERNAAN LAIN-LAIN (BERAT) 2941900 0 0 - 0 - 0 -
0 - 0 2941900 4336343 0 3 0 0 0 AMI
0000511897825 3;JKN DR RIZKI; 5.2.0.201712280730 4 165627
15#0##0#0#0.0#2018-04-06 08:51:36#0#12:00:00#12:00:00#12:00:00 1
5332d028318e7c28e5934805d5d1e138 0 0 273635 0 0
3227022 0 0 0 0 835686 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 29/03/2018 12/04/1971 0 1
1 I12.0;D63.8;J81;J18.0 99.04 - - None None None None N-4-
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 4827884 0 2 0 0 0 PRIJO DJATMIKO
HADISAPUTRO D329418 46 17152 DR SRI KUNMARTINI, SPPD 0138R01703180012549
0001272243453 3;JKN DR RIZKI; 5.2.0.201712280730 4 165700
20#0##0#0#0.0#2018-04-06 08:53:34#0#12:00:00#12:00:00#00:00:00 1
3816bc068b1ec7bc1dab9914fae16ee3 0 0 424889 0 0
2378902 0 0 0 0 2024093 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 29/03/2018 02/12/1934 0 2
1 I48 89.52 - - None None None None I-4-19-I None None
3914900 0 0 - 0 - 0 - 0 - 0
3914900 1990041 0 2 0 0 0 JUARIAH D373847
3;JKN DR RIZKI; 5.2.0.201712280730 4 166088 1#0##0#0#0.0#2018-
04-06 09:58:27#0#12:00:00#12:00:00#12:00:00 1
7f5766a66f1bd34634ece43a71a776ea 0 0 550017 0 0
1020834 0 0 0 0 419190 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 29/03/2018 12/08/1948 0 1
(SEDANG) 15287300 0 0 - 0 - 0 - 0 - 0
15287300 16578300 0 4 0 0 0 ENGKUS KUSWONO
0000061009773 3;JKN DR RIZKI; 5.2.0.201712280730 4 164874
8#0##0#0#0.0#2018-04-06 14:32:26#0#12:00:00#12:00:00#12:00:00 1
db7d0769876a6cb83831bcde8c000bd1 0 7027100 1392688 0 0
3135950 0 0 0 0 4485562 0 0 0 0 537000
3201126 B 1 BS 1 23/03/2018 29/03/2018 18/10/1953 0 2
1 M17.9;M23.63 81.54 - - YY01 RR04 None None M-1-04-I
None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI TUNGKAI
33538800 51253131 0 7 0 0 0 SULASTRI D170819
64 23532 DR BENNY H T, SPOT 0138R01703180010816 0002285147362
3;JKN DR RIZKI; 5.2.0.201712280730 4 164519 1#0##0#0#0.0#2018-
04-06 14:35:35#0#12:00:00#12:00:00#12:00:00 1
572d32708219ce350bafd8dbdb3e406c 0 0 6032261 0 0
31536270 0 0 0 0 13581100 0 0 0 0 103500
3201126 B 1 BS 1 27/03/2018 29/03/2018 17/01/1975 0 1
12140800 0 0 - 0 - 0 - 0 - 0
12140800 17235396 0 3 0 0 0 EKO HARYANTO
0001372399514 3;JKN DR RIZKI; 5.2.0.201712280730 4 165634
1#0##0#0#0.0#2018-04-06 14:37:53#0#12:00:00#12:00:00#12:00:00 1
d96002470d7861b0d2f2fa2012b9417d 0 9763300 4267240 0 0
1856307 0 0 0 0 1203549 0 0 0 0 145000
3201126 B 2 BS 1 24/03/2018 29/03/2018 08/02/1954 0 1
1 M84.42;D64.8;G20 99.04;93.53;87.44;87.03;88.27;88.24 - - None
None None None M-4-13-II None None None None None None TUMOR
MUSKULOSKLETAL,JARINGAN KONEKTIF DAN FRAKTUR PATOLOGIS (SEDANG) 8848200 0
0 - 0 - 0 - 0 - 0 8848200 9488551
0 6 0 0 0 NASIM UN D319296 64 23420 DR. ARU
5.2.0.201712280730 4 164529 1#0##0#0#0.0#2018-04-06
14:50:50#0#12:00:00#12:00:00#00:00:00 1 804a46af5cf4d658cdf4977e332529af
0 0 700097 0 0 5111708 0 0 0 0
3676746 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 29/03/2018 15/04/1943 0 1
0 0 - 0 - 0 - 0 - 0 14653000
13581079 0 2 0 0 0 MURSADI D341321 74 27376
DR RIZKI; 5.2.0.201712280730 4 165653 19#0##0#0#0.0#2018-04-06
15:35:12#0#12:00:00#12:00:00#12:00:00 1 1e6978006f0936e2217ad0feac819a9d
0 3555000 2930600 0 0 3953997 0 0 0 0
944482 0 0 0 0 2197000
3201126 B 2 BS 1 26/03/2018 29/03/2018 02/06/1952 0 1
I-4-16-II None None None None None None ATHEROSKLEROSIS (SEDANG)
4178900 0 0 - 0 - 0 - 0 - 0
4178900 4731674 0 4 0 0 0 T. FIRDAUS HUSEIN
0001257761068 3;JKN DR RIZKI; 5.2.0.201712280730 4 164784
7#0##0#0#0.0#2018-04-06 15:38:21#0#12:00:00#12:00:00#12:00:00 1
eb2565d7aad5ad10fea0b2fcf0d6c2e0 0 0 714738 0 0
1661387 0 0 0 0 2355549 0 0 0 0 0
3201126 B 2 BS 1 22/03/2018 29/03/2018 14/07/1963 0 2
1 R63.0;R63.8 88.76 - - None None None None E-4-10-I None
- 0 4203300 7633949 0 8 0 0 0 ENNY ROSMINI
D393824 54 19975 DR ARU, SPPD 0138R01703180010226
0001773460023 3;JKN DR RIZKI; 5.2.0.201712280730 4 164068
1#0##0#0#0.0#2018-04-06 15:43:02#0#12:00:00#12:00:00#12:00:00 2
18ab500d391b49d7662f452f3e02b6ca 0 0 372122 0 0
2903910 0 0 0 0 4357917 0 0 0 0 0
3201126 B 2 BS 1 24/03/2018 29/03/2018 23/06/1988 0 1
1 K51.9;K56.7;J18.0 45.23 - - None None None None K-4-13-III
PENYAKIT PERADANGAN USUS BESAR (BERAT) 9524200 0 0 - 0 -
0 - 0 - 0 9524200 13016415 0 6 0 0
0 RANGGA BAYU ADITYA d385229 29 10866 DR ARU, SPPD
0138R01703180010870 0001640248828 3;JKN DR RIZKI; 5.2.0.201712280730
4 164531 1#0##0#0#0.0#2018-04-06
15:58:59#0#12:00:00#12:00:00#12:00:00 1 937dba2291cd4da513f10f1265c48955
0 0 2815018 0 0 3892356 0 0 0 0
4560041 0 0 0 0 1749000
3201126 B 2 BS 1 26/03/2018 29/03/2018 09/08/2017 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3818718 0 4 0 0 0 ADIBA TSAQIFA AZZAHRA
D386555 0 229 DR HUDA, SPA 0138R01703180011629
0002436384194 3;JKN DR RIZKI; 5.2.0.201712280730 4 165211
1#0##0#0#0.0#2018-04-06 16:11:33#0#12:00:00#12:00:00#12:00:00 1
8e07a43474736fb0537364f816dcac40 0 0 350423 0 0 832472
0 0 0 0 2295823 0 0 0 0 340000
3201126 B 2 BS 1 25/03/2018 29/03/2018 11/03/1949 0 2
1 E10.6;J18.0;I10;R63.0;E87.6 87.49;90.59;99.17 - - None None
- 0 - 0 - 0 7515400 7506456 0 5 0
0 0 LISA ,NY D394102 69 25216 DR. ARU ARIADNO, SPPD
0138R01703180011069 0000060693052 3;JKN DR RIZKI; 5.2.0.201712280730
4 164756 1#0##0#0#0.0#2018-04-06
16:13:12#0#12:00:00#12:00:00#12:00:00 1 b3d9b8c3ba266cc17074d831cc729832
0 0 729386 0 0 3734993 0 0 0 0
3042077 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 29/03/2018 10/06/1967 0 2
- 0 8908800 9557341 0 2 0 0 0 NURWITA
0001212590226 3;JKN DR RIZKI; 5.2.1.201802140120 4 166078
1#0##0#0#0.0#2018-04-11 11:10:35#0#12:00:00#12:00:00#12:00:00 1
547274e66cd139be8af76c3e29531afc 0 0 2636552 0 0
2731742 0 0 0 0 4120047 0 0 0 0 69000
3201126 B 3 BS 1 27/03/2018 29/03/2018 13/07/1950 0 1
1 N18.5;J40;R60.0;T82.4 39.42 - - None None None None N-1-
- 0 - 0 19332400 11448234 0 3 0 0 0
IGNATIUS ANTONO ADJI d389824 67 24729 DR IRFIANSYAH LESMANA DR
SPBTKV 0138R01703180012344 0001463354684 3;JKN DR RIZKI;
5.2.1.201802140120 4 165630 1#0##0#0#0.0#2018-04-11
14:29:29#0#12:00:00#12:00:00#12:00:00 1 074b3ac75617ad49c81920c0959adc2e
0 3438800 3866480 0 0 3200004 0 0 0 0
804950 0 0 0 0 138000
3201126 B 2 BS 1 28/03/2018 29/03/2018 12/12/1960 0 1
- 0 10690500 13974343 0 2 0 0 0 SADUWAN D
0001095654431 3;JKN DR RIZKI; 5.2.1.201802140120 4 166077
1#0##0#0#0.0#2018-04-11 14:32:04#0#12:00:00#12:00:00#12:00:00 1
d9f0cebd2ba2c73312086a8daefb132f 0 0 3153245 0 0
4870789 0 0 0 0 5881309 0 0 0 0 69000
3201126 B 3 BS 1 28/03/2018 29/03/2018 21/07/2016 0 2
1 J18.0;R57.2;J80;Q90.9 87.44 - - None None None None J-4-
(SEDANG) 5077500 0 0 - 0 - 0 - 0 - 0
5077500 4190002 0 2 0 0 0 RORO JULIYA NEGARA
0001774326925 3;JKN DR RIZKI; 5.2.1.201802140120 4 166082
1#0##0#0#0.0#2018-04-11 14:37:48#0#12:00:00#12:00:00#12:00:00 1
8035e64e9d8c4d17fa4dead6cd8fc982 0 0 566190 0 0
2454700 0 0 0 0 581112 0 0 0 0 588000
3201126 B 3 BS 1 28/03/2018 29/03/2018 01/05/1996 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1218486 0 2 0 0 0 AHMAD RINALDI
D394463 21 8001 DR ARU, SPPD 0138R01703180012862
0000399076435 3;JKN DR RIZKI; 5.2.1.201802140120 4 166083
1#0##0#0#0.0#2018-04-12 14:42:28#0#12:00:00#12:00:00#12:00:00 1
c58b8b67215126b128a6cc16ba89a18e 0 0 183752 0 0 489520
0 0 0 0 545214 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 29/03/2018 23/03/2018 2500 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3527231 0 2 0 0 0 BAYI NY ANNISA SEKAR
PERTIWI D394439 0 5 DR DYAH HARINI, SPA 0138R01703180012712
0002443141473 3;JKN DR RIZKI; 5.2.1.201802140120 4 165913
1#0##0#0#0.0#2018-04-16 08:43:32#0#12:00:00#12:00:00#12:00:00 1
56c88d336d74dc7b9f4b9402a49d5251 0 0 447812 0 0 160666
0 0 0 0 1610753 0 0 0 0 1308000
3201126 B 3 BS 1 23/03/2018 29/03/2018 06/12/1977 0 2
- 0 - 0 - 0 - 0 3575600 3303332 0
7 0 0 0 IMAH D393891 40 14717 DR BAMBANG DWIPUTRA SPJP
0138R01703180010546 0000511515347 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 164411 1#0##0#0#0.0#2018-05-02
09:18:40#0#12:00:00#12:00:00#12:00:00 1 2b10c79f4e0aa7fcd0a8c9454054cd26
0 0 374804 0 0 845422 0 0 0 0
2083106 0 0 0 0 0
3201126 B 2 BS 1 27/03/2018 29/03/2018 31/12/1972 0 2
0 0 - 0 - 0 - 0 - 0 3545800
4511142 0 3 0 0 0 SUNARTI D394294 45 16522
S;16137 5.2.1.201804062320 4 165314 1#0##0#0#0.0#2018-05-02
09:59:40#0#12:00:00#12:00:00#12:00:00 1 9d9a98408a48693f47ae0d1d6368e8c5
0 0 372122 0 0 2302899 0 0 0 0
1836121 0 0 0 0 0
3201126 B 3 BS 1 28/03/2018 29/03/2018 01/03/1962 0 1
1 E10.2;J18.0;D63.8;I11.9 39.27;99.04;99.17 - - None None None
0 - 0 - 0 19332400 10360908 0 2 0 0
0 BASIMIN D388505 56 20481 SRI KUNMARTINI.DR,SPPD
0138R01703180012817 0000369507295 3;JKN DR RIZKI; 5.2.1.201804062320
4 166076 1#0##0#0#0.0#2018-05-04
08:46:03#0#12:00:00#12:00:00#12:00:00 1 2b647f892756e4d5735f9093fd119e05
0 3618800 2636552 0 0 3302740 0 0 0 0
733816 0 0 0 0 69000
3201126 B 2 BS 1 24/03/2018 29/03/2018 07/05/2000 0 1
1 N18.5;T82.4 90.59;87.49;38.95;88.40 - - None None None None
- 0 - 0 23198900 23687661 0 6 0 0 0
ADIDYA ISWAHYUDA D392079 17 6530 DR. ARU ARIADNO, SPPD
0138R01703180011047 0002063562041 3;JKN DR RIZKI; 5.2.1.201802140120
4 164753 1#0##0#0#0.0#2018-09-04
11:32:07#0#12:00:00#12:00:00#12:00:00 2 4fad07d7525bcf4fed3a46f76ea82ae9
0 6903600 2168028 0 0 9666783 0 0 0 0
2727250 0 0 0 0 2222000
3201126 B 2 BS 1 22/03/2018 29/03/2018 02/05/2015 0 1
1 D59.9;N39.0 99.04 - - None None None None D-4-13-II None
- 0 5073100 13968602 0 8 0 0 0 ARSAKHA
VIRENDRA SHAFWAN D308678 2 1055 DR VERA MUNA MANOE, SPA
0138R01703180010174 0001878426988 3;JKN DR RIZKI; 5.2.2.201806040537
4 164065 1#0##0#0#0.0#2018-09-05
15:20:40#0#12:00:00#12:00:00#12:00:00 3 dc153161de0e42439b6ba5dd655d8287
0 0 636968 0 0 4963300 0 0 0 0
6359334 0 0 0 0 2009000
3201126 B 1 BS 1 18/03/2018 30/03/2018 22/06/1949 0 2
1 C25.0;K80.8;B18.1 89.52;90.59 - - None None None None B-4-
11-II None None None None None None TUMOR SISTEM HEPATOBILLIARI DAN PANCREAS
(SEDANG) 9554800 0 0 - 0 - 0 - 0 - 0
9554800 31975587 0 13 0 0 0 SOEMIYATI D357463
3;JKN DR RIZKI; 5.2.0.201712280730 4 162051
1#1#vvip#13#22420787#0.0#2018-04-05 14:00:41#0#12:00:00#12:00:00#00:00:00
1 e7b343fe9431eeecb4320d3177689e4c 0 0 1557881 0 0
13891706 0 0 0 0 16526000 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 30/03/2018 01/04/2010 0 2
7792500 0 0 - 0 - 0 - 0 - 0
7792500 16704920 0 5 0 0 0 EPRIL NURLINA
0001818873189 3;JKN DR RIZKI; 5.2.0.201712280730 4 164904
1#0##0#0#0.0#2018-04-06 08:37:59#0#12:00:00#12:00:00#12:00:00 1
216690a2537e488be8db0aa2e8fb2926 0 3581500 5756685 0 0
6052890 0 0 0 0 1168845 0 0 0 0 145000
3201126 B 3 BS 1 25/03/2018 30/03/2018 07/11/1995 0 2
1 G43.9;M54.22 87.44 - - None None None None G-4-23-I
None None None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN)
2650100 0 0 - 0 - 0 - 0 - 0
2650100 3995825 0 6 0 0 0 AIKA ULANDARI
0002065500977 3;JKN DR RIZKI; 5.2.0.201712280730 4 164771
16#0##0#0#0.0#2018-04-06 08:41:54#0#22:56:51#22:56:51#12:00:00 1
f9af0e304aaa4d9886f836b3ebafb262 0 0 291509 0 0
2101907 0 0 0 0 1602409 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 30/03/2018 23/08/1975 0 1
1 J90;R18;R60.1 34.91;54.91 - - None None None None J-4-
20-II None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (SEDANG)
6429900 0 0 - 0 - 0 - 0 - 0
6429900 7051200 0 5 0 0 0 AL IHWAN D391267
0002296539382 3;JKN DR RIZKI; 5.2.0.201712280730 4 165120
1#0##0#0#0.0#2018-04-06 08:47:04#0#12:00:00#12:00:00#12:00:00 1
d40485a2bdde6142e2c6f7d91dfe0e0c 0 0 2642990 0 0
2587917 0 0 0 0 1820293 0 0 0 0 0
3201126 B 1 BS 1 23/03/2018 30/03/2018 05/05/1952 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 9251114 0 8 0 0 0 BADARI D370566
65 24063 DR ARU, SPPD 0138R01703180010494 0001309381841 3;JKN
DR RIZKI; 5.2.0.201712280730 4 164330 2#0##0#0#0.0#2018-04-06
10:44:39#0#12:00:00#12:00:00#00:00:00 1 33adfc96d9ba8a232072d112620be6ad
0 0 561265 0 0 1810636 0 0 0 0
6879213 0 0 0 0 0
3201126 B 1 BS 1 27/03/2018 30/03/2018 26/05/1958 0 2
1 N13.2;M17.9;N18.9;A01.0;E79.0 88.29;88.76 - - None None None
None N-4-13-III None None None None None None BATU URIN (BERAT)
9116900 0 0 - 0 - 0 - 0 - 0
9116900 4489977 0 4 0 0 0 NURMAWATI NASUTION
0000040857917 3;JKN DR RIZKI; 5.2.0.201712280730 4 165624
1#0##0#0#0.0#2018-04-06 10:50:03#0#12:00:00#12:00:00#12:00:00 1
8e1cee7aaf6025cec93e7cc37894d9c5 0 0 236051 0 0
1591189 0 0 0 0 2662737 0 0 0 0 0
3201126 B 1 BS 1 29/03/2018 30/03/2018 24/09/1970 0 2
1 I10;R63.0 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 2669400 3281548 0
2 0 0 0 GOLDA BENDEDE D015619 47 17353 DR. ARU
5.2.0.201712280730 4 166579 14#0##0#0#0.0#2018-04-06
10:53:01#0#12:00:00#12:00:00#00:00:00 1 c8d5a381b633e71d175fdf3f7a407160
0 0 494342 0 0 984525 0 0 0 0
1802681 0 0 0 0 0
3201126 B 1 BS 1 27/03/2018 30/03/2018 28/12/1944 0 1
1 I50.0;D29.1 87.44;89.52;88.76 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 5005900
6077999 0 4 0 0 0 INDRA SIREGAR D394284 73
RIZKI; 5.2.0.201712280730 4 165311 8#0##0#0#0.0#2018-04-06
11:09:19#0#12:00:00#12:00:00#12:00:00 1 9acb59c37f3eb027d3b781cf5c9dad76
0 0 575234 0 0 1955139 0 0 0 0
3547626 0 0 0 0 0
3201126 B 1 BS 1 25/03/2018 30/03/2018 05/05/1920 0 2
1 D64.9;R63.0 99.04 - - None None None None D-4-13-I None
- 0 4181800 7968057 0 6 0 0 0 CHAIRUNNISA
D322102 97 35753 DR ARU, SPPD 0138R01703180011216
0001454956468 3;JKN DR RIZKI; 5.2.0.201712280730 4 164778
1#0##0#0#0.0#2018-04-06 11:09:58#0#12:00:00#12:00:00#00:00:00 1
2cd334f210bd2049cf6ed3fa1638039f 0 0 429362 0 0
3914420 0 0 0 0 3624275 0 0 0 0 0
3201126 B 2 BS 1 24/03/2018 30/03/2018 05/05/1958 0 2
1 G50.0;G44.2;I64;G81.9;I10;R42 87.03 - - None None None None
G-4-17-III None None None None None None GANGUAN SARAF KRANIAL DAN
PERIFER (BERAT) 9167300 0 0 - 0 - 0 - 0 -
0 9167300 6152169 0 7 0 0 0 TITIN D382216
3;JKN DR RIZKI; 5.2.0.201712280730 4 164747 3#0##0#0#0.0#2018-
04-06 14:41:58#0#12:00:00#12:00:00#12:00:00 1
96b39ccaea434fe1d387e452bc8f2a2c 0 0 592710 0 0
1803481 0 0 0 0 3755978 0 0 0 0 0
3201126 B 2 BS 1 27/03/2018 30/03/2018 03/10/1955 0 2
- 0 9019700 14226811 0 4 0 0 0 DARNISAH
0001257190187 3;JKN DR RIZKI; 5.2.0.201712280730 4 165629
12#0##0#0#0.0#2018-04-06 14:44:22#0#12:00:00#12:00:00#12:00:00 1
06c12c586ff2a83d0bd26b34e5b0fbe0 0 5326100 2525516 0 0
4908469 0 0 0 0 1031726 0 0 0 0 435000
3201126 B 2 BS 1 27/03/2018 30/03/2018 26/09/2007 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2721861 0 4 0 0 0 ADINDA SEVIANA PUTRI
D394352 10 3835 DR RASTRA, SPA 0138R01703180012211
0001196873662 3;JKN DR RIZKI; 5.2.0.201712280730 4 165620
10#0##0#0#0.0#2018-04-06 14:46:53#0#12:00:00#12:00:00#12:00:00 1
9daf8e85d4284d15e08e913ed039530f 0 0 278711 0 0 724084
0 0 0 0 1719066 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 30/03/2018 08/12/1985 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 9990549 0 3 0 0 0 NURIN PRIYANDANI
0001191744595 3;JKN DR RIZKI; 5.2.0.201712280730 4 165697
1#0##0#0#0.0#2018-04-06 15:32:50#0#12:00:00#12:00:00#12:00:00 1
12d731377551c554556fec93458566d9 0 5251900 2027753 0 0
1779309 0 0 0 0 734587 0 0 0 0 197000
3201126 B 2 BS 1 28/03/2018 30/03/2018 08/04/1989 0 2
0 - 0 - 0 - 0 - 0 2009900 6495221
0 3 0 0 0 HANUM RAHMA UTAMI D373350 28 10581 DR
KARTIKA MAYA, SPOG 0138R01703180012759 0001631793532 3;JKN DR RIZKI;
5.2.1.201802140120 4 165999 1#0##0#0#0.0#2018-04-10
13:45:32#1#12:00:00#12:00:00#12:00:00 1 ae5ed9e895b037b4929afe1d324bc564
0 0 6495221 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 3 BS 1 30/03/2018 30/03/2018 17/11/1942 0 2
3 I11.0;S72.9 - - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 4144700 1883377
0 1 0 0 0 MURSINAH D331671 75 27527 DR DINI
DANIATY 0138R01703180013496 0001793558709 3;JKN DR RIZKI;
5.2.1.201802140120 4 166642 1#0##0#0#0.0#2018-04-11
14:40:22#0#12:00:00#12:00:00#12:00:00 1 2d9c73554c1967a5b167a64df6d3c6aa
0 0 373023 0 0 364142 0 0 0 0 430212
0 0 0 0 716000
3201126 B 3 BS 1 30/03/2018 30/03/2018 05/11/1978 0 1
1 I69.4;R56.8;E14.9 - - - None None None None G-4-26-II
LAIN (SEDANG) 4302200 0 0 - 0 - 0 - 0 -
0 4302200 2465449 0 1 0 0 0 RAHMAT NOVIAN
D394587 39 14390 DR DICKY KARUNDENG 0138R01703180013577
0001728497215 3;JKN DR RIZKI; 5.2.1.201802140120 4 166653
1#0##0#0#0.0#2018-04-11 14:42:54#0#12:00:00#12:00:00#12:00:00 1
eb0e6a2733638056f103d199a5604e30 0 0 305406 0 0
1709752 0 0 0 0 450291 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 30/03/2018 13/06/1971 0 1
(SEDANG) 7385300 0 0 - 0 - 0 - 0 - 0
7385300 4174087 0 3 0 0 0 ARIS MUNENDAR TN
0000045100124 3;JKN DR RIZKI; 5.2.1.201802140120 4 166089
1#0##0#0#0.0#2018-04-12 14:55:40#0#12:00:00#12:00:00#00:00:00 1
23decfc28d9a6e6922daecca2b77a61c 0 0 573641 0 0 583125
0 0 0 0 3017321 0 0 0 0 0
3201126 B 2 BS 1 26/03/2018 30/03/2018 18/08/1962 0 2
1 I25.0;I08.9;I50.0;I21.2;E11.2 88.55;36.07;99.04 - - YY02 None
0 - 0 - 0 51950600 58127845 0 5 1 0
2 TUTI MARYANI D394289 55 20309 DR AZRI NURIZAL SPPD KKV
0138R01703180011747 0001862317776 3;JKN DR RIZKI; 5.2.1.201802140120
4 165310 1#0##0#0#0.0#2018-04-12
14:58:45#0#12:00:00#12:00:00#12:00:00 2 ccdc1829024893ced4540c130fc4fdd4
0 7548000 6577840 0 0 34352005 0 0 0 0
1236000 0 0 0 0 8414000
3201126 B 2 BS 1 27/03/2018 30/03/2018 13/09/1977 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 12845765 0 4 0 0 0 MONA SHERLY JACKLINE.S
0001259076622 3;JKN DR RIZKI; 5.2.1.201802140120 4 165312
1#0##0#0#0.0#2018-04-12 15:09:13#0#12:00:00#12:00:00#12:00:00 2
eda713f6a496dc90cd75248b2b4f1267 0 5759100 2139241 0 0
3982047 0 0 0 0 896377 0 0 0 0 69000
3201126 B 1 BS 1 28/03/2018 30/03/2018 26/11/1994 0 1
2033900 0 0 - 0 - 0 - 0 - 0
2033900 3680156 0 3 0 0 0 CORNELEANS D394446
3;JKN DR RIZKI; 5.2.1.201802140120 4 165961 1#0##0#0#0.0#2018-
04-12 15:12:09#0#12:00:00#12:00:00#12:00:00 1
05a028b18fe6a67f39c529ed00be8ada 0 0 236051 0 0 834347
0 0 0 0 2609758 0 0 0 0 0
3201126 B 3 BS 1 29/03/2018 30/03/2018 09/01/1980 0 2
8672000 0 0 - 0 - 0 - 0 - 0
8672000 8770750 0 2 0 0 0 SITI MAEMUNAH
0002222192485 3;JKN DR RIZKI; 5.2.1.201802140120 4 166405
1#0##0#0#0.0#2018-04-12 15:23:59#0#12:00:00#12:00:00#12:00:00 1
489085d6f0ca0aa502535d1767e75bcd 0 3062500 2654600 0 0
2354863 0 0 0 0 629787 0 0 0 0 69000
3201126 B 2 BS 1 29/03/2018 30/03/2018 26/07/1973 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 2933758 0 2 0 0 0 SUMARTANA D369438
DR RIZKI; 5.2.1.201802140120 4 166542 22#0##0#0#0.0#2018-04-12
15:26:29#0#12:00:00#12:00:00#00:00:00 1 867fa81e8403303479cdae3c230c8f21
0 0 499265 0 0 1206565 0 0 0 0
1227928 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 30/03/2018 12/08/2016 0 2
1 J18.0;Q21.0 - - - None None None None J-4-16-II None
7108500 0 0 - 0 - 0 - 0 - 0
7108500 7931618 0 5 0 0 0 KEYZIA SHAQUEENA ALFIRA
SANTOSO D360546 1 591 DR SUPROHAITA, SPA 0138R01703180011478
0002254297656 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 165019
1#0##0#0#0.0#2018-04-26 16:49:44#0#12:00:00#12:00:00#12:00:00 1
954988c6952515dceb6d12c14f89244e 0 0 692765 0 0
2788962 0 0 0 0 4449891 0 0 0 0 0
3201126 B 2 BS 1 27/03/2018 30/03/2018 06/04/1980 0 2
0 - 0 - 0 - 0 - 0 2009900 10840138
0 4 0 0 0 PRIATMI PASKARINA D043658 37 13869 DR
AFRA FONDA SPOG 0138R01703180012140 0001623402999 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 165560 1#1#vip#1#2093675#75.0#2018-05-02
08:39:23#0#12:00:00#12:00:00#00:00:00 1 8f0d1461920935ed3ae0fa8be2398f71
0 7588700 756465 0 0 983805 0 0 0 0
836168 0 0 0 0 675000
3201126 B 2 BS 1 21/03/2018 30/03/2018 03/10/1969 0 2
1 I95.9;I63.9;J80;N18.5;D63.8 99.04;39.95 - - None None None
- 0 9767800 28636627 0 10 0 0 0 TRI LYDIA
OCTAVIANI NY D168182 48 17701 DR NURUL KOMARI SPS
0138R01703180009303 0001738873719 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 163146 1#0##0#0#0.0#2018-05-02
12:22:20#0#12:00:00#12:00:00#00:00:00 1 9226e5378161c5a7dd61b6ed047bd34e
0 0 698293 0 0 12246584 0 0 0 0
11952750 0 0 0 0 3739000
3201126 B 3 BS 1 29/03/2018 30/03/2018 02/03/1995 0 2
1 R18 - - - None None None None B-4-13-I None None
0 - 0 - 0 - 0 - 0 4204300 1991804
0 2 0 0 0 SITI ZAHRAH D394544 23 8428 DR TANTIYO
SETIYOWATI 0138R01703180013312 0001441467336 3;JKN irene;
5.2.1.201804062320 4 166630 1#0##0#0#0.0#2018-06-05
11:01:18#0#12:00:00#12:00:00#12:00:00 2 8a0e14a95c9b275d333070a3aae3b44f
0 0 378387 0 0 1194112 0 0 0 0 419305
0 0 0 0 0
3201126 B 1 BS 1 29/03/2018 30/03/2018 10/02/1964 0 1
1 N18.5;A49.9;J22;D63.8 99.21;38.95;99.04 - - None None None
0 - 0 - 0 12472300 12191774 0 2 0 0
0 MAIN D393429 54 19771 DR SRI KUNMARTINI, SPPD
0138R01703180012936 0000041305206 3;JKN DR RIZKI; 5.2.2.201806040537
4 166093 1#0##0#0#0.0#2018-08-15
10:52:03#0#12:00:00#12:00:00#12:00:00 2 709b1ab10a540493d16bcb1a9c0b599f
0 5896000 1815243 0 0 3557938 0 0 0 0
853593 0 0 0 0 69000
3201126 B 1 BS 1 26/03/2018 30/03/2018 14/08/1954 0 1
1 C78.2 34.91;89.52 - - None None None None J-4-14-I None
None None None None None TUMOR PARU (RINGAN) 6180400 0 0
- 0 - 0 - 0 - 0 6180400 9549361 0
5 0 0 0 ZAHIRMAN ARIFIN D394162 63 23235 DR MOHAMAD
NIZAM ERHAMZA SPP 0138R01703180011644 0000060493239 3;JKN DR RIZKI;
5.2.2.201806040537 4 165248 1#0##0#0#0.0#2018-09-04
11:28:24#0#12:00:00#12:00:00#12:00:00 2 f50c3bc59ae8f8f0c2baf8c13685f206
0 0 2032146 0 0 2961490 0 0 0 0
4555725 0 0 0 0 0
3201126 B 2 BS 1 29/03/2018 30/03/2018 14/08/2017 0 1
4 J96.0;I50.0;G93.4 96.05 - - None None None None J-4-11-III
None None None None None None KEGAGALAN PERNAFASAN (BERAT) 6158000
0 0 - 0 - 0 - 0 - 0 6158000
8260758 0 2 0 0 0 MUHAMMAD HAFIDZ PRATAMA D394569
0002275648806 3;JKN DR RIZKI; 5.2.2.201806040537 4 166638
1#0##0#0#0.0#2018-09-04 11:34:56#0#12:00:00#12:00:00#12:00:00 2
f0eb56c113d26dafa509283038bcf5e5 0 0 913377 0 0
5161958 0 0 0 0 2185423 0 0 0 0 0
3201126 B 3 BS 1 29/03/2018 30/03/2018 07/12/1962 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 4034350 0 2 0 0 0 KASONO TN D357931
3;JKN DR RIZKI; 5.2.2.201806040537 4 166635 1#0##0#0#0.0#2018-
09-25 18:41:55#0#12:00:00#12:00:00#00:00:00 2
4e3e0349c1dc9990ee3013cc3233eb27 0 0 424889 0 0
1723782 0 0 0 0 1885679 0 0 0 0 0
3201126 B 3 BS 1 30/03/2018 30/03/2018 05/11/1978 0 1
1 I69.4;R56.8;E14.9 - - - None None None None G-4-26-II
LAIN (SEDANG) 4302200 0 0 - 0 - 0 - 0 -
0 4302200 2465449 0 1 0 0 0 RAHMAT NOVIAN
D394587 39 14390 DR NURUL KOMARI SPS 0138R0170318V000026
0001728497215 3;JKN DR RIZKI; 5.2.2.201806040537 4 227334
1#0##0#0#0.0#2018-09-26 13:45:57#0#00:00:00#00:00:00#12:00:00 1
ee52666bea8cb08b43f6b7d688ece7ee 0 0 305406 0 0
1709752 0 0 0 0 289000 0 0 161291 0
0
3201126 B 2 BS 1 27/03/2018 30/03/2018 13/10/1988 0 2
12391500 0 0 - 0 - 0 - 0 - 0
12391500 17089358 0 4 0 0 0 MAULIDA ZAHROTUL IZZATI
D394348 29 10757 DR MAMAN H, SPOG 0138R01703180012187
0001643668975 3;JKN DR RIZKI; 5.2.2.201806040537 4 165598
1#0##0#0#0.0#2018-09-26 20:32:26#0#12:00:00#12:00:00#12:00:00 2
9f6b81098ef7789bb92496b1a8d5efab 0 5710500 5437940 0 0
4515423 0 0 0 0 1183995 0 0 0 0 241500
3201126 B 3 BS 1 30/03/2018 30/03/2018 17/11/1942 0 2
1 I11.0;S72.91 - - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 4973600
1883376 0 1 0 0 0 MURSINAH D331671 75 27527
DR DINI DANIATY 0138R0170318V000028 0001793558709 3;JKN DR RIZKI;
5.2.2.201806040537 4 228406 1#0##0#0#0.0#2018-09-28
16:10:46#0#00:00:00#00:00:00#12:00:00 1 03d6365b0675fbd34a5e00784a62ac64
0 0 373023 0 281000 364141 0 0 0 0
123212 0 0 716000 26000 0
3201126 B 3 BS 1 29/03/2018 30/03/2018 02/03/1995 0 2
0 - 0 - 0 - 0 - 0 4204300 1991804
0 2 0 0 0 SITI ZAHRAH D394544 23 8428 DR TANTIYO
SETIYOWATI 0138R0170318V000029 0001441467336 3;JKN DR RIZKI;
5.2.2.201806040537 4 228668 1#0##0#0#0.0#2018-10-01
09:16:06#0#00:00:00#00:00:00#12:00:00 1 08e3aaba2a1f526f2c5afde4938344c5
0 0 0 0 0 0 0 0 0 0 1991804 0
0 0 0 0
3201126 B 3 BS 1 28/03/2018 30/03/2018 17/03/1972 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2349922 0 3 0 0 0 ERLIYANI D393077
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 166086
1#0##0#0#0.0#2018-10-06 10:14:38#0#12:00:00#12:00:00#12:00:00 3
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3201126 B 1 BS 1 25/03/2018 31/03/2018 22/10/2008 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 11078923 0 7 0 0 0 HABIBI SAPUTRA
D182360 9 3441 DR RASTRA, SPA 0138R01703180011165
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1#0##0#0#0.0#2018-04-05 13:37:52#0#12:00:00#12:00:00#00:00:00 1
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4156630 0 0 0 0 6217793 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 31/03/2018 30/08/2017 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4513856 0 4 0 0 0 MUHAMMAD ARBANI AZIZ
D394453 0 210 DR RASTRA, SPA 0138R01703180012795
0002262776365 3;JKN DR RIZKI; 5.2.0.201712280730 4 166075
6#0##0#0#0.0#2018-04-05 13:39:53#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 1 BS 1 27/03/2018 31/03/2018 26/06/1958 0 1
1 I63.9;G81.9;R13;R47.0;I10 90.59;87.03;89.52 - - None None
- 0 - 0 - 0 9673300 7220878 0 5 0
0 0 BAHRUDIN D394290 59 21824 DR AL RASYID SPS
0138R01703180012097 0001425694375 3;JKN DR RIZKI; 5.2.0.201712280730
4 165508 1#0##0#0#0.0#2018-04-05
13:44:34#0#12:00:00#12:00:00#12:00:00 1 43285f3df106ed047e25df2ec0c371d6
0 0 655310 0 0 2162174 0 0 0 0
4403394 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 31/03/2018 23/09/1983 0 2
1 A15.3;J22;R63.0 87.44 - - None None None None J-4-15-I
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 4676233 0 4 0 0 0 WIDIA ASTUTI
0001195094867 3;JKN DR RIZKI; 5.2.0.201712280730 4 166087
8#0##0#0#0.0#2018-04-05 13:46:53#0#12:00:00#12:00:00#12:00:00 2
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1493046 0 0 0 0 2674922 0 0 0 0 0
3201126 B 1 BS 1 30/03/2018 31/03/2018 29/09/1969 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
0001273353625 3;JKN DR RIZKI; 5.2.0.201712280730 4 166663
10#0##0#0#0.0#2018-04-05 13:49:52#0#12:00:00#12:00:00#00:00:00 1
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1120397 0 0 0 0 2219260 0 0 0 0 0
3201126 B 1 BS 1 27/03/2018 31/03/2018 15/08/2014 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 8589266 0 5 0 0 0 AZZAM HADZIQ AFIF
D282789 3 1320 DR HUDA, SPA 0138R01703180012324
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4#1#vvip#5#5663366#0.0#2018-04-05 13:57:26#0#12:00:00#12:00:00#12:00:00
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1212351 0 0 0 0 6239915 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 31/03/2018 29/12/2004 0 2
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2993683 0 5 0 0 0 ADHINDA RAVIKA
D240772 13 4836 DR RASTRA, SPA 0138R01703180012029
0002065745013 3;JKN DR RIZKI; 5.2.0.201712280730 4 165469
1#0##0#0#0.0#2018-04-06 09:55:15#0#12:00:00#12:00:00#12:00:00 1
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1273083 0 0 0 0 1536848 0 0 0 0 0
3201126 B 2 BS 1 29/03/2018 31/03/2018 02/01/1985 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 9855969 0 3 0 0 0 SITTA TUN NADIYA CAMYLIA
D269427 33 12139 DR NOVI RESISTANTIE, SPOG 0138R01703180013441
0001369787049 3;JKN TANTIYO S;16137 5.2.0.201712280730 4 166634
1#0##0#0#0.0#2018-04-07 12:01:57#0#12:00:00#12:00:00#12:00:00 1
d42885ba3137531cba549e43c1d6f7e8 0 4854900 2287753 0 0
1904533 0 0 0 0 680783 0 0 0 0 128000
3201126 B 2 BS 1 25/03/2018 31/03/2018 27/02/1943 0 1
1 S07.9;I10 87.03 - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 3651800 6035674 0
7 0 0 0 SUMULE MARTINUS D394147 75 27420 DR AL RASYID
5.2.0.201712280730 4 164774 1#0##0#0#0.0#2018-04-07
12:03:54#0#23:51:03#23:51:03#12:00:00 1 92b22f9658322337a02baf527914091f
0 0 381662 0 0 2203155 0 0 0 0
3450857 0 0 0 0 0
3201126 B 2 BS 1 27/03/2018 31/03/2018 15/06/1947 0 2
0 0 - 0 - 0 - 0 - 0 12482300
5335416 0 5 0 0 0 KOMARIAH TJIK D347381 70
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3;JKN TANTIYO S;16137 5.2.0.201712280730 4 165631
1#0##0#0#0.0#2018-04-07 12:46:56#0#12:00:00#12:00:00#00:00:00 1
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2450726 0 0 0 0 2395046 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 31/03/2018 07/08/1981 0 2
- 0 - 0 - 0 - 0 2601900 4633711 0
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0138R01703180012847 0001463521465 3;JKN TANTIYO S;16137
5.2.0.201712280730 4 166079 1#0##0#0#0.0#2018-04-07
12:48:14#0#12:00:00#12:00:00#00:00:00 1 51e5b2560b1180b0af8eb8be98c2344b
0 0 287171 0 0 1997400 0 0 0 0
2349140 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 31/03/2018 15/03/1976 0 1
1 K80.1;K83.1;K66.0 51.22 - - None None None None B-1-12-II
(SEDANG) 9394800 0 0 - 0 - 0 - 0 - 0
9394800 18775877 0 4 0 0 0 HERI MARYANTO
D392787 42 15353 DR E SURYA POHAN DR SPB KBD 0138R0170318V000002
0002208255737 3;JKN DR RIZKI; 5.2.1.201802140120 4 169870
1#0##0#0#0.0#2018-04-10 13:41:35#1#00:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 28/03/2018 31/03/2018 24/02/2012 0 1
1 S06.40 87.03 - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 3043100 3632957 0
4 0 0 0 RAYHAN MUNGGARAN PRAHASTA D394450 6 2224
DR NURUL KOMARI SPS 0138R01703180013090 0001299930311 3;JKN
TANTIYO S;16137 5.2.1.201802140120 4 166160 1#0##0#0#0.0#2018-
04-11 08:43:01#0#12:00:00#12:00:00#12:00:00 1
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2086408 0 0 0 0 1052670 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 31/03/2018 03/02/1992 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 20722436 0 4 0 0 0 SARTIKA SARI
0001284741808 3;JKN DR RIZKI; 5.2.1.201802140120 4 170296
1#0##0#0#0.0#2018-04-11 10:55:14#1#10:05:49#10:05:49#00:00:00 1
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0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 30/03/2018 31/03/2018 26/02/1972 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6785045 0 2 0 0 0 NG TITY D005667
DR RIZKI; 5.2.1.201802140120 4 166657 1#0##0#0#0.0#2018-04-11
13:42:17#0#12:00:00#12:00:00#12:00:00 1 ba6ed42b34864d8fa49eb1e773eb3171
0 0 1194824 0 0 1539840 0 0 0 0
3977881 0 0 0 0 72500
3201126 B 1 BS 1 30/03/2018 31/03/2018 08/08/1954 0 1
1 H81.1;E11.9 87.44 - - None None None None U-4-11-I None
- 0 - 0 - 0 - 0 2124500 2555154 0
2 0 0 0 DHARMA BHAKTI D380480 63 23245 DR NURUL
5.2.1.201802140120 4 166664 1#0##0#0#0.0#2018-04-11
14:48:47#0#12:00:00#12:00:00#12:00:00 1 f709edbae333d8ff775a1342170056b7
0 0 384082 0 0 1196912 0 0 0 0 974160
0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 31/03/2018 28/03/2018 2542 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3349269 0 4 0 0 0 BY NY INGRID GREEN NEGO
D394482 0 0 DR KRISTY, SPA 0138R01703180013394
0002444976685 3;JKN DR RIZKI; 5.2.1.201802140120 4 166627
1#0##0#0#0.0#2018-04-11 14:53:45#0#12:00:00#12:00:00#12:00:00 1
1d581d275d1288d97f1f4dfdef91bb23 0 0 499620 0 0 89438
0 0 0 0 2760211 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 31/03/2018 28/03/2018 2673 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3349269 0 4 0 0 0 BY NY INGRID GREEN NEGO
1 D394481 0 0 DR KRISTY, SPA 0138R01703180013325
0002444977934 3;JKN DR RIZKI; 5.2.1.201802140120 4 166626
1#0##0#0#0.0#2018-04-11 14:54:39#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 29/03/2018 31/03/2018 29/03/2018 3135 1
4386800 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-04-12 08:40:36#0#13:34:56#13:34:56#00:00:00 1
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3201126 B 2 BS 1 29/03/2018 31/03/2018 23/11/1992 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10318399 0 3 0 0 0 UMU SALAMAH D394500
DR RIZKI; 5.2.1.201802140120 4 166091 1#0##0#0#0.0#2018-04-12
15:31:18#0#12:00:00#12:00:00#12:00:00 1 77264dfcb754bce7bfa78b68fbbb90b1
0 5269900 2090753 0 0 1984711 0 0 0 0
776035 0 0 0 0 197000
3201126 B 1 BS 1 29/03/2018 31/03/2018 29/05/2017 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3907834 0 3 0 0 0 MELODY EARLY RAMADHINA
D394529 0 304 DR RASTRA, SPA 0138R01703180013335
0002254492901 3;JKN DR RIZKI; 5.2.1.201802140120 4 166553
1#0##0#0#0.0#2018-04-13 16:16:30#0#12:00:00#12:00:00#12:00:00 1
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0 0 0 0 2624653 0 0 0 0 170000
3201126 B 2 BS 1 28/03/2018 31/03/2018 28/03/2018 2852 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1773044 0 4 0 0 0 BAYI NY NURIN PRIYANDANI
D394492 0 0 DR AD PASARIBU, SPA 0138R01703180013331
0002444936264 3;JKN DR RIZKI; 5.2.1.201802140120 4 166540
15#0##0#0#0.0#2018-04-16 08:42:36#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 2 BS 1 31/03/2018 31/03/2018 21/07/1995 0 2
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SPOG 0138R01703180013788 0002059136807 3;JKN DR RIZKI; 5.2.1.201802140120
4 167098 1#0##0#0#0.0#2018-04-16
08:59:13#0#12:00:00#12:00:00#12:00:00 1 1b3c89e420fde9b5d6167d63168d58c8
0 0 484171 0 0 219245 0 0 0 0 617409
0 0 0 0 0
3201126 B 1 BS 1 30/03/2018 31/03/2018 31/12/1968 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4279509 0 2 0 0 0 INDRAWAN RUSMAN
0001621275952 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 166658
1#0##0#0#0.0#2018-05-02 10:12:07#0#12:00:00#12:00:00#00:00:00 1
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1027150 0 0 0 0 2678718 0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 31/03/2018 01/01/1949 0 2
1 J91;J18.9;K21.9 93.94 - - None None None None J-4-20-III
None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (BERAT)
7771000 0 0 - 0 - 0 - 0 - 0
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0001740376001 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 165269
1#0##0#0#0.0#2018-05-02 10:16:21#0#12:00:00#12:00:00#12:00:00 1
5a3c6e5845f3078f254ba65e9ef648f6 0 0 470645 0 0
4347775 0 0 0 0 2053569 0 0 0 0 0
3201126 B 1 BS 1 29/03/2018 31/03/2018 07/01/1972 0 2
- 0 - 0 5576700 8440584 0 3 0 0 0
SRI PUDJI RAHAYU d393249 46 16883 DR BETTY DWI L, SPPD
0138R01703180013444 0001608772397 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 166636 1#0##0#0#0.0#2018-05-02
10:34:07#0#12:00:00#12:00:00#12:00:00 1 646c71712f40761c77689a1301c2a1f8
0 0 1614476 0 0 1592920 0 0 0 0
3408188 0 0 0 0 1825000
3201126 B 1 BS 1 28/03/2018 31/03/2018 20/01/1983 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 24778147 0 4 0 0 0 INGRID GREEN NEGO S
0001226778028 3;JKN DR RIZKI; 5.2.2.201806040537 4 165633
1#1#vvip#4#17210847#0.0#2018-08-15 11:02:24#0#12:00:00#12:00:00#12:00:00
3 51d8eb6a3bf2f2479804d1471cd37b80 0 10413600 9556000 0
0 2788547 0 0 0 0 1276000 0 0 744000
0 0
3201126 B 2 BS 1 27/03/2018 31/03/2018 01/03/2018 0 1
1 Q90.9;P03.4;P59.9;Q66.0;Q24.9;Q69.9 - - - None None None
None F-4-16-II None None None None None None GANGGUAN OTAK ORGANIK
LAIN-LAIN TERMASUK KETERBELAKANGAN MENTAL (SEDANG) 7885300 0 0 -
0 - 0 - 0 - 0 7885300 7711073 0 5
1 5 0 BAYI NY T.FLAVIA RINEKA DESTIA D394170 0 26
RIZKI; 5.2.2.201806040537 4 165625 1#0##0#0#0.0#2018-09-05
15:11:31#0#12:00:00#12:00:00#12:00:00 3 6bcdce0264866d69b0e5757ede912d38
0 0 560068 0 0 660042 0 0 0 0
4112963 0 0 0 0 2378000
3201126 B 1 BS 1 27/03/2018 31/03/2018 04/06/1946 0 1
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 6919060 0 5 0 0 0 SUWATDI BACHRUN,DRS
0000061044535 3;JKN DR RIZKI; 5.2.2.201806040537 4 165635
1#0##0#0#0.0#2018-09-25 18:39:37#0#12:00:00#12:00:00#12:00:00 2
999dfc64de8d930211d884df67d99410 0 0 878542 0 0
2437869 0 0 0 0 3602649 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 31/03/2018 01/12/1982 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 19804426 0 5 0 0 0 RULLY KURNIAWAN
0002304849947 3;JKN DR RIZKI; 5.2.2.201806040537 4 166730
1#0##0#0#0.0#2018-09-25 18:46:40#0#16:01:34#16:01:34#12:00:00 2
73ef4fd450bd6f6af50b48ffc5e9e0a8 0 8857200 2624525 0 0
6997701 0 0 0 0 1256000 0 0 0 0 69000
3201126 B 2 BS 1 29/03/2018 01/04/2018 21/08/1993 0 2
1 Z37.0;O82.9 74.0 - - None None None None O-6-10-I None
0 0 - 0 - 0 - 0 - 0 5984100
20421538 0 4 0 0 0 MURNI ASIH D377156 24 8986
DR FERRI SABARUDDIN SPOG 0138R01703180013137 0001455526618 3;JKN
TANTIYO S;16137 5.2.1.201802140120 4 166273
1#1#vvip#4#14437438#0.0#2018-04-10 09:23:48#0#12:00:00#12:00:00#12:00:00
1 d45ff9ad0d4968d9f3bcb19552fb752b 0 9464400 6551000 0
0 2953138 0 0 0 0 1256000 0 0 0 197000
0
3201126 B 2 BS 1 30/03/2018 01/04/2018 08/11/2016 0 1
- 0 - 0 - 0 - 0 3187000 2115401 0
3 0 0 0 MUHAMMAD ZIKRI ANSHORI d374495 1 507 DR
RASTRA, SPA 0138R01703180013614 0002227832133 3;JKN DR RIZKI;
5.2.1.201802140120 4 166661 13#0##0#0#0.0#2018-04-11
09:06:42#0#12:00:00#12:00:00#12:00:00 1 888ce58f6ae80fc420c7811afd905107
0 0 339830 0 0 303680 0 0 0 0
1471891 0 0 0 0 0
3201126 B 2 BS 1 27/03/2018 01/04/2018 27/01/2017 0 1
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 4033187 0 6 0 0 0 KHAYLA NURA QANITA
D394315 1 424 DR RASTRA, SPA 0138R01703180012135
0002300407953 3;JKN DR RIZKI; 5.2.1.201802140120 4 165555
1#0##0#0#0.0#2018-04-11 13:39:14#0#12:00:00#12:00:00#12:00:00 1
2a0f02a19b4b87240c913a14060ed0c6 0 0 238535 0 0 469799
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3201126 B 3 BS 1 29/03/2018 01/04/2018 30/10/1976 0 2
1 D64.8;K62.5;K30 99.04 - - None None None None D-4-13-I
0 - 0 2987000 3494355 0 4 0 0 0 ELLIZA
0001771628927 3;JKN DR RIZKI; 5.2.1.201802140120 4 166637
1#0##0#0#0.0#2018-04-11 13:40:57#0#12:00:00#12:00:00#12:00:00 1
9fb89bebcbd9a8445fda444206dc1d6a 0 0 321830 0 0
2128922 0 0 0 0 1043603 0 0 0 0 0
3201126 B 3 BS 1 31/03/2018 01/04/2018 15/04/1944 0 2
4 A15.3;J96.9;A41.9;R57.9 - - - None None None None J-4-
(BERAT) 6970400 0 0 - 0 - 0 - 0 - 0
6970400 5348416 0 2 0 0 0 HJ. SARI'AH D394675
TANTIYO S;16137 5.2.1.201802140120 4 166727 1#0##0#0#0.0#2018-
04-12 08:36:38#0#12:00:00#12:00:00#12:00:00 1
0b3cbe2c04e3e494b919757ad02c044c 0 0 627336 0 0
4082184 0 0 0 0 638896 0 0 0 0 0
3201126 B 3 BS 1 01/04/2018 01/04/2018 12/10/1955 0 1
1 I61.9;J43.9 - - - None None None None G-4-13-II None
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 2377828 0 1 0 0 0 M.SOBRI D394714
TANTIYO S;16137 5.2.1.201802140120 4 166741 1#0##0#0#0.0#2018-
04-12 11:44:25#0#12:00:00#12:00:00#12:00:00 1
8fd76a19428e16a0664c8fbe679333d8 0 0 439974 0 0
1365295 0 0 0 0 444559 0 0 0 0 128000
3201126 B 3 BS 1 31/03/2018 01/04/2018 21/08/1970 0 2
4 I63.9;R57.2;J18.9 - - - None None None None G-4-14-III
INFARK (BERAT) 8672200 0 0 - 0 - 0 - 0 -
0 8672200 6612900 0 2 0 0 0 ENY PURWATI
d385445 47 17389 DR WIDHI DEWANTA K AJI 0138R01703180013760
0001740422981 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166728
1#0##0#0#0.0#2018-04-12 13:04:49#0#12:00:00#12:00:00#12:00:00 1
f310dbe69cc7ef1b743c37e55ba9dae2 0 0 780498 0 0
5110782 0 0 0 0 721620 0 0 0 0 0
3201126 B 3 BS 1 30/03/2018 01/04/2018 12/10/1971 0 2
1 I64;H81.4 87.03 - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 2601368 0 3 0
0 0 MERY BERLIANTI D031182 46 16971 DR NURUL KOMARI SPS
0138R01703180013847 0001454732864 3;JKN DR RIZKI; 5.2.1.201802140120
4 167106 1#0##0#0#0.0#2018-04-12
13:30:34#0#12:00:00#12:00:00#12:00:00 1 a9c57d02ab8960aa4c7ff98b010d42ae
0 0 421658 0 0 1457527 0 0 0 0 722183
0 0 0 0 0
3201126 B 2 BS 1 27/03/2018 01/04/2018 02/08/1953 0 1
1 I61.9;I10;G81.9 87.03;87.44;89.52 - - None None None None
0 - 0 6183900 12787982 0 6 0 0 0 DJANI
HARDANI D394305 64 23613 DR NURUL KOMARI SPS 0138R01703180011946
0001873925482 3;JKN DR RIZKI; 5.2.1.201802140120 4 165356
1#0##0#0#0.0#2018-04-12 14:31:42#0#12:00:00#12:00:00#12:00:00 1
bd54c39fd86305b1930e60fe4e2953d7 0 0 425158 0 0
6778227 0 0 0 0 4996597 0 0 0 0 588000
3201126 B 1 BS 1 27/03/2018 01/04/2018 12/06/2015 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 12914487 0 6 0 0 0 RAAIQ AHMAD AR RASYID
D331430 2 1019 DR RASTRA, SPA 0138R01703180012316
0001881839542 3;JKN DR RIZKI; 5.2.1.201802140120 4 165623
1#1#vvip#6#9988587#0.0#2018-04-12 14:33:40#0#12:00:00#12:00:00#12:00:00
1 f380d1d777494f56eb77f7174c5c54c8 0 0 1408000 0 0
2796114 0 0 0 0 8710373 0 0 0 0 0
3201126 B 1 BS 1 30/03/2018 01/04/2018 23/03/1970 0 1
1 G40.3;I63.9;G81.9;E11.9;I10 87.03;87.44 - - None None None
None G-4-22-III None None None None None None SERANGAN KEJANG (BERAT)
5551000 0 0 - 0 - 0 - 0 - 0
5551000 3389579 0 3 0 0 0 MATTIAS WEMAY
0000206455162 3;JKN DR RIZKI; 5.2.1.201802140120 4 166665
1#0##0#0#0.0#2018-04-12 14:36:40#0#12:00:00#12:00:00#12:00:00 1
9e557a6fb362fae9b5f753b62e7e1213 0 0 923597 0 0 656234
0 0 0 0 1809748 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 01/04/2018 15/09/1947 0 1
4 J44.9;K21.9;I21.9;I50.0 87.44 - - None None None None J-4-
17-III None None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS
(BERAT) 8115800 0 0 - 0 - 0 - 0 - 0
8115800 6471902 0 5 0 0 0 MOH.CHAIDIR SAWIRUDIN
0001341310814 3;JKN DR RIZKI; 5.2.1.201802140120 4 166090
1#0##0#0#0.0#2018-04-12 14:52:39#0#12:00:00#12:00:00#12:00:00 1
8f7a954714fc072049ecf7fbbce65bf7 0 0 561265 0 0
2245242 0 0 0 0 3665395 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 01/04/2018 20/03/1994 0 2
1 N85.0;K66.0 54.11;54.59;87.44;89.52 - - None None None None
K-1-40-I None None None None None None PROSEDUR SISTEM PENCERNAAN
LAIN-LAIN (RINGAN) 9351000 0 0 - 0 - 0 - 0
- 0 9351000 14088009 0 5 0 0 0 SYARAFINA
NURFAZRINA D394236 24 8774 DR ARIS WAHJU, SPOG 0138R01703180012870
0000060521703 3;JKN DR RIZKI; 5.2.1.201802140120 4 166085
1#0##0#0#0.0#2018-04-12 15:06:00#0#12:00:00#12:00:00#12:00:00 1
257907549ea3ddf7494ee33217aca72b 0 5710500 2618280 0 0
4657584 0 0 0 0 1032645 0 0 0 0 69000
3201126 B 1 BS 1 27/03/2018 01/04/2018 01/04/1950 0 2
1 A91;H81.3;K29.7 87.44 - - None None None None A-4-13-I
(RINGAN) 2925900 0 0 - 0 - 0 - 0 - 0
2925900 8424051 0 6 0 0 0 EFRIDAWATI BATUBARA
D228053 67 24832 DR ARU, SPPD 0138R01703180011931
0001284473777 3;JKN DR RIZKI; 5.2.1.201802140120 4 165351
1#0##0#0#0.0#2018-04-12 15:28:15#0#12:00:00#12:00:00#00:00:00 1
117dfc45e295295737b0fff781eec579 0 0 424888 0 0
2736057 0 0 0 0 5263106 0 0 0 0 0
3201126 B 2 BS 1 29/03/2018 01/04/2018 29/03/2018 4083 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1426643 0 4 0 0 0 BAYI NY UMU SALAMAH
D394502 0 0 DR KRISTY, SPA 0138R01703180013196
0002444831188 3;JKN DR RIZKI; 5.2.1.201802140120 4 166371
1#0##0#0#0.0#2018-04-12 15:29:27#0#12:00:00#12:00:00#12:00:00 1
1d5709002f2187e12efc14d42e344a5a 0 0 433812 0 0 126499
0 0 0 0 866332 0 0 0 0 0
3201126 B 3 BS 1 29/03/2018 01/04/2018 18/11/2014 0 2
2667400 0 0 - 0 - 0 - 0 - 0
2667400 8095044 0 4 0 0 0 AFIFAH NOVI ANDRIANI
0001770782297 3;JKN DR RIZKI; 5.2.1.201802140120 4 166625
1#0##0#0#0.0#2018-04-13 16:05:57#0#12:00:00#12:00:00#12:00:00 1
04696d2abac01995c9e6e779aa130e23 0 0 341081 0 0
3088381 0 0 0 0 3149582 0 0 0 0
1516000
3201126 B 3 BS 1 26/03/2018 01/04/2018 27/05/2017 0 2
1 A16.1;D64.9 96.05;96.72;99.04;93.94 - - None None None None
J-1-02-II None None None None None None VENTILASI MEKANIKAL LONG TERM
TANPA TRAKEOSTOMI (SEDANG) 40168300 0 0 - 0 - 0 -
0 - 0 40168300 33398858 0 7 1 3 96 NAJLA
JELITA RAMADHANI D373793 0 303 DR NOVIK BUDIWARDHANA, SPA
0138R01703180011633 0002253682574 3;JKN DR RIZKI; 5.2.1.201802140120
4 165223 1#0##0#0#0.0#2018-04-13
16:12:55#0#12:00:00#12:00:00#00:00:00 1 78358cc653c924e8caa33f9fab04fa2e
0 0 6686160 0 0 12619382 0 0 0 0
7595316 0 0 0 0 6498000
3201126 B 2 BS 1 01/04/2018 01/04/2018 17/12/2011 0 2
0 - 0 - 0 - 0 - 0 4851400 1333036
0 1 0 0 0 NAILA ZHIFARAH WIDIYA D394725 6 2297
DR VERA MUNA MANOE, SPA 0138R01704180000005 0001654607169 3;JKN DR
RIZKI; 5.2.1.201802140120 4 166740 1#0##0#0#0.0#2018-04-13
16:14:18#0#12:00:00#12:00:00#12:00:00 1 22986ec5ccb66e23b438a0da07267585
0 0 489626 0 0 225202 0 0 0 0 618208
0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 01/04/2018 10/04/2016 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 1950707 0 3 0 0 0 ALLAN EZEQUIEL SASAMU
0002242171563 3;JKN ECHI; 5.2.1.201804062320 4 170822
1#0##0#0#0.0#2018-05-17 08:41:54#0#13:37:24#13:37:24#00:00:00 2
52b39d5668920e03bdd6155739d00371 0 0 288000 0 0 499091
0 0 0 0 1163616 0 0 0 0 0
3201126 B 2 BS 1 28/03/2018 01/04/2018 28/03/2018 3300 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 4740289 0 5 0 0 0 BAYI NY PRIATMI
PASKARINA D394394 0 0 DR KRISTY, SPA 0138R01703180013256
0002444774578 3;JKN DR RIZKI; 5.2.2.201806040537 4 166416
1#0##0#0#0.0#2018-08-16 11:14:07#0#12:00:00#12:00:00#12:00:00 2
66b40b5ce66c9e44c63b0aa961799afe 0 0 506812 0 0 557365
0 0 0 0 3336112 0 0 0 0 340000
3201126 B 2 BS 1 28/03/2018 01/04/2018 28/03/2018 3393 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 4740289 0 5 0 0 0 BAYI NY PRIATMI
PASKARINA D394394 0 0 DR KRISTY, SPA 0138R0170318V000006
0002444774578 3;JKN DR RIZKI; 5.2.2.201806040537 4 213867
1#0##0#0#0.0#2018-08-21 11:53:58#0#00:00:00#00:00:00#12:00:00 1
2da5173b3dd1e217be70aa2f96dbc7cb 0 0 506812 0 0 557365
0 0 0 0 3336112 0 0 340000 0 0
3201126 B 1 BS 1 31/03/2018 02/04/2018 10/12/1953 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5061334 0 3 0 0 0 HARDIMAN
D391256 64 23487 DR ARU, SPPD 0138R01703180013767
0001822536652 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166729
1#0##0#0#0.0#2018-04-11 08:39:28#0#12:00:00#12:00:00#12:00:00 1
7dd4161fd7715614a6adecad079cbe4b 0 0 573641 0 0
1787578 0 0 0 0 2700115 0 0 0 0 0
3201126 B 1 BS 1 01/04/2018 02/04/2018 26/12/1964 0 2
1 E10.2;I12.0 99.17;39.27 - - None None None None N-1-12-II
- 0 12472300 14006739 0 2 0 0 0 ERMIATI
TANJUNG D374992 53 19454 SRI KUNMARTINI.DR,SPPD 0138R01704180000037
0001292033079 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166747
1#0##0#0#0.0#2018-04-11 08:40:56#0#12:00:00#12:00:00#12:00:00 1
c54c545b02ac815ec6ea5a3eb7816168 0 6468200 3669967 0 0
2758243 0 0 0 0 972329 0 0 0 0 138000
3201126 B 1 BS 1 21/03/2018 02/04/2018 05/10/1958 0 1
1 I50.9;R57.0;I25.0;I08.9;I21.2 89.52;99.04 - - None None None
(BERAT) 6963100 0 0 - 0 - 0 - 0 - 0
6963100 27185369 0 13 1 9 0 DRS.H. JAJAT JATMIKA
0001454760562 3;JKN DR RIZKI; 5.2.1.201802140120 4 163533
1#0##0#0#0.0#2018-04-11 08:48:46#0#12:00:00#12:00:00#00:00:00 1
e07f7258ba6b3d65601f8d0e4979a8dc 0 0 1216097 0 0
8865272 0 0 0 0 11154000 0 0 0 0
5950000
3201126 B 1 BS 1 29/03/2018 02/04/2018 20/10/1968 0 2
1 E87.6;E13.1 - - - None None None None E-4-11-III None
8810600 0 0 - 0 - 0 - 0 - 0
8810600 11103487 0 5 0 0 0 SRI ROSILAH D394520
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166414
1#1#vvip#0#2292887#0.0#2018-04-11 08:58:17#0#12:00:00#12:00:00#12:00:00
1 3e48d94071de19822f09ab90029dafd0 0 0 1440668 0 0
3122923 0 0 0 0 6539896 0 0 0 0 0
3201126 B 2 BS 1 29/03/2018 02/04/2018 05/04/1960 0 1
1 D64.9;E11.9;I11.0;I64;R77.0 87.03;99.04;90.59;89.52 - - None
None None None D-4-13-III None None None None None None GANGGUAN SEL
DARAH MERAH SELAIN KRISIS ANEMIA SEL SICKLE (BERAT) 6488600 0 0 -
0 - 0 - 0 - 0 6488600 8854236 0 5
0 0 0 HIN BENG D391934 57 21177 DR AZRI NURIZAL SPPD KKV
0138R01703180013303 0002083681451 3;JKN DR RIZKI; 5.2.1.201802140120
4 166629 1#0##0#0#0.0#2018-04-11
09:00:28#0#12:00:00#12:00:00#12:00:00 1 9949405cf3f606a1a591e06cae282bb7
0 0 729386 0 0 5202101 0 0 0 0
2922749 0 0 0 0 0
3201126 B 3 BS 1 30/03/2018 02/04/2018 13/09/1975 0 2
1452800 0 0 - 0 - 0 - 0 - 0
1452800 3576105 0 4 0 0 0 FARIDA D394242
DR RIZKI; 5.2.1.201802140120 4 166646 1#0##0#0#0.0#2018-04-11
09:03:39#0#12:00:00#12:00:00#12:00:00 1 247b4a61f785f6229763058a688b6862
0 0 261764 0 0 2002390 0 0 0 0
1311951 0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 02/04/2018 26/10/1996 0 1
0 - 0 - 0 - 0 - 0 7892000 10451359
0 4 0 0 0 CLAUDINO LADIPA d389752 21 7825 DR
5.2.1.201802140120 4 166654 1#0##0#0#0.0#2018-04-11
09:12:52#0#12:00:00#12:00:00#12:00:00 1 9a78723c97183baca8ad136951e8c964
0 0 665336 0 0 3202989 0 0 0 0
6438034 0 0 0 0 145000
3201126 B 1 BS 1 31/03/2018 02/04/2018 16/01/1958 0 2
1 J02.9;R10.1;M79.1 - - - None None None None U-4-13-I
ISPA DAN LARINGOTRAKEITIS (RINGAN) 2772200 0 0 - 0 - 0
- 0 - 0 2772200 3808404 0 3 0 0 0
NY.MISDAR D313988 60 21989 DR ZULFAN, SPPD 0138R01703180013811
0001294322668 3;JKN DR RIZKI; 5.2.1.201802140120 4 166734
1#0##0#0#0.0#2018-04-11 10:40:28#0#12:00:00#12:00:00#12:00:00 1
1111b6c532baa62c422ec578585943c3 0 0 345275 0 0
1190481 0 0 0 0 2272648 0 0 0 0 0
3201126 B 3 BS 1 27/03/2018 02/04/2018 14/09/2017 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 5607429 0 7 0 0 0 ANANTA ALIF WIBOWO
d394333 0 194 DR RASTRA, SPA 0138R01703180012691
0002275842622 3;JKN DR RIZKI; 5.2.1.201802140120 4 165871
1#0##0#0#0.0#2018-04-11 11:01:10#0#12:00:00#12:00:00#12:00:00 1
2f3db915ea6957851813ced61c70bca4 0 0 378188 0 0
2995400 0 0 0 0 2233841 0 0 0 0 0
3201126 B 1 BS 1 28/03/2018 02/04/2018 07/06/1953 0 1
1 I64;I48;E14.9;G81.9;D29.1 87.03;90.59;89.52;93.19 - - None
None None None G-4-15-II None None None None None None KECEDERAAN
PEMBULUH DARAH OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (SEDANG)
6844000 0 0 - 0 - 0 - 0 - 0
6844000 10820911 0 6 0 0 0 MUHAJIR D338732
3;JKN DR RIZKI; 5.2.1.201802140120 4 166081 1#0##0#0#0.0#2018-
04-11 11:03:33#0#12:00:00#12:00:00#00:00:00 1
0fd842e4c5a52ffc74c800c4f5c3374f 0 0 1020330 0 0
4380671 0 0 0 0 5419910 0 0 0 0 0
3201126 B 3 BS 1 30/03/2018 02/04/2018 07/07/1951 0 2
1 J22;I11.9;I49.3 90.59;89.52 - - None None None None J-4-
0 - 0 6291000 3689180 0 4 0 0 0 AISAH
0001256916047 3;JKN DR RIZKI; 5.2.1.201802140120 4 166640
1#0##0#0#0.0#2018-04-11 11:05:41#0#12:00:00#12:00:00#12:00:00 1
ca489ec6aff55ff815c9eb6986585017 0 0 630773 0 0
1611059 0 0 0 0 1319348 0 0 0 0 128000
3201126 B 1 BS 1 29/03/2018 02/04/2018 29/02/1964 0 2
1 J18.0;I11.9 87.44 - - None None None None J-4-16-I None
5058500 0 0 - 0 - 0 - 0 - 0
5058500 6013107 0 5 0 0 0 YUYUN YUNINGSIH
0001521652713 3;JKN DR RIZKI; 5.2.1.201802140120 4 166633
1#0##0#0#0.0#2018-04-11 11:26:30#0#12:00:00#12:00:00#12:00:00 1
179c48b55de4dd85320ebf1e46e7dc69 0 0 508265 0 0 890461
0 0 0 0 4324381 0 0 0 0 290000
3201126 B 3 BS 1 29/03/2018 02/04/2018 04/05/1960 0 2
1 G20;R63.0 - - - None None None None G-4-11-I None
None None None None None TUMOR SISTEM SARAF & GANGGUAN DEGENERATIF
(RINGAN) 4571500 0 0 - 0 - 0 - 0 - 0
4571500 5396311 0 5 0 0 0 MASITOH D351186
57 21148 DR ARU, SPPD 0138R01703180013329 0001807108233 3;JKN
DR RIZKI; 5.2.1.201802140120 4 166632 1#0##0#0#0.0#2018-04-11
11:42:51#0#12:00:00#12:00:00#00:00:00 1 22ac6b00a60d0adbc301908b7a8f675e
0 0 517434 0 0 3271347 0 0 0 0
1607530 0 0 0 0 0
3201126 B 3 BS 1 01/04/2018 02/04/2018 11/08/1998 0 2
0 0 - 0 - 0 - 0 - 0 2954900
5523064 0 2 0 0 0 RIZKA ANINDYA MANJAYANI D394330
DR RIZKI; 5.2.1.201802140120 4 166752 1#0##0#0#0.0#2018-04-11
13:03:52#0#12:00:00#12:00:00#12:00:00 1 cc5208e7c0b4da8f06e06d3428fa00ef
0 0 880372 0 0 1237870 0 0 0 0
1655822 0 0 0 0 1749000
3201126 B 2 BS 1 30/03/2018 02/04/2018 25/11/1966 0 2
1 A09.9;R11 90.59 - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 3445326 0 4 0 0 0 BANIATUN D382738
DR RIZKI; 5.2.1.201802140120 4 166651 1#0##0#0#0.0#2018-04-11
13:33:41#0#12:00:00#12:00:00#12:00:00 1 f08b97b0aafa65c28be2dfef86727860
0 0 303524 0 0 870407 0 0 0 0
2271395 0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 02/04/2018 04/04/1952 0 2
1 K29.7;A09.9;M54.59 - - - None None None None K-4-
2783600 0 0 - 0 - 0 - 0 - 0
2783600 4984051 0 4 0 0 0 SITI ATIKAH D344282
DR RIZKI; 5.2.1.201802140120 4 166645 1#0##0#0#0.0#2018-04-11
14:46:33#0#12:00:00#12:00:00#00:00:00 1 c0cdffaa162a770ee9f7464a7c17d1a0
0 0 356524 0 0 2255468 0 0 0 0
2372059 0 0 0 0 0
3201126 B 1 BS 1 29/03/2018 02/04/2018 15/10/1982 0 1
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 6462513 0 5 0 0 0 JOVIALTA TARIGAN
D364977 35 12949 DR ARU, SPPD 0138R01703180013413
0001403754647 3;JKN DR RIZKI; 5.2.1.201802140120 4 166631
1#0##0#0#0.0#2018-04-11 14:47:32#0#12:00:00#12:00:00#00:00:00 1
2f1020a83c865d2df455f02939c1db6f 0 0 236050 0 0
2218182 0 0 0 0 4008281 0 0 0 0 0
3201126 B 1 BS 1 31/03/2018 02/04/2018 14/04/1982 0 2
(SEDANG) 7567300 0 0 - 0 - 0 - 0 - 0
7567300 12764704 0 3 0 0 0 INDRIYANI ASTUTI
D241097 35 13135 DR MAMAN HILMAN 0138R01703180013642
0000038331483 3;JKN DR RIZKI; 5.2.1.201802140120 4 166666
1#0##0#0#0.0#2018-04-11 14:51:57#0#12:00:00#12:00:00#12:00:00 1
3986f2c986d93505985c8239b16512ec 0 0 2482895 0 0
2059835 0 0 0 0 8024974 0 0 0 0 197000
3201126 B 1 BS 1 01/04/2018 02/04/2018 22/07/1942 0 1
- 0 12472300 12785127 0 2 0 0 0 NURHARYONO
0001257881196 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166748
1#0##0#0#0.0#2018-04-12 13:07:04#0#12:00:00#12:00:00#12:00:00 1
555296ad3fe6e78d15997920eb0e3e4f 0 6468200 2547460 0 0
2808057 0 0 0 0 892410 0 0 0 0 69000
3201126 B 3 BS 1 02/04/2018 02/04/2018 18/11/1959 0 1
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 3704605 0 1 0 0 0 ANDRI KARMA RIDWAN
D394814 58 21320 DR VINSENSIA NOVI KARTIKA 0138R01704180000493
0002207804591 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167032
1#0##0#0#0.0#2018-04-12 13:52:29#0#12:00:00#12:00:00#12:00:00 1
78fae9f0584809d052d0ec9e97957a90 0 0 621855 0 0
1963393 0 0 0 0 531357 0 0 0 0 588000
3201126 B 3 BS 1 01/04/2018 02/04/2018 29/06/1953 0 2
2 I50.0;R57.0;A49.9;E11.2;E87.5 89.52;87.44 - - None None None
(BERAT) 4973600 0 0 - 0 - 0 - 0 - 0
4973600 3894920 0 2 0 0 0 HJ.KURNIASIH
D394713 64 23652 DR RICO ADITYA 0138R01704180000007
0001834354495 3;JKN DR RIZKI; 5.2.1.201802140120 4 166742
1#0##0#0#0.0#2018-04-13 11:40:44#0#00:00:00#00:00:00#12:00:00 1
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2561992 0 0 0 0 543808 0 0 0 0 0
3201126 B 2 BS 1 01/04/2018 02/04/2018 14/04/1953 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 10720760 0 2 0 0 0 SITI KOMARIYAH
0138R01704180000045 0000060656646 3;JKN DR RIZKI; 5.2.1.201802140120
4 166745 1#0##0#0#0.0#2018-04-13
15:33:29#0#12:00:00#12:00:00#12:00:00 1 2f7abb03f47bad87d7412a0b20d9614c
0 0 2138100 0 0 2845202 0 0 0 0
5668458 0 0 0 0 69000
3201126 B 3 BS 1 26/03/2018 02/04/2018 01/03/1958 0 1
1 J18.0;D63.8;I11.0 34.91;99.04;93.94;87.44;88.73 - - None None
None None J-4-16-III None None None None None None SIMPLE PNEUMONIA &
WHOOPING COUGH (BERAT) 6419700 0 0 - 0 - 0 - 0
- 0 6419700 16030319 0 8 0 0 0 SAIFUL
D387312 60 21940 DR ARU, SPPD 0138R01703180011416
0001014240396 3;JKN DR RIZKI; 5.2.1.201802140120 4 165106
1#0##0#0#0.0#2018-04-16 08:25:10#0#12:00:00#12:00:00#12:00:00 1
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3201126 B 3 BS 1 29/03/2018 02/04/2018 05/12/1945 0 1
1 I21.2;J18.9;I48;I50.0;R57.0 88.55 - - None None None None
12210800 0 0 - 0 - 0 - 0 - 0
12210800 13247904 0 5 0 0 0 YAKUB SUPRIYADI
0000512874189 3;JKN DR RIZKI; 5.2.1.201802140120 4 166581
1#0##0#0#0.0#2018-04-17 08:50:50#0#12:00:00#12:00:00#12:00:00 1
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3421059 0 0 0 0 922685 0 0 0 0
2069000
3201126 B 1 BS 1 31/03/2018 02/04/2018 31/03/2018 2675 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2450213 0 3 0 0 0 BAYI NY INDRIYANI ASTUTI
d394626 0 0 DR DYAH HARINI, SPA 0138R01704180000277
0002445309235 3;JKN DR RIZKI; 5.2.2.201806040537 4 166879
1#0##0#0#0.0#2018-10-01 15:26:08#0#12:00:00#12:00:00#12:00:00 3
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3201126 B 3 BS 1 02/04/2018 02/04/2018 01/12/1990 0 1
4 E87.5;E87.2;R56.8 87.03;99.60;87.49;90.59;39.95 - - None None
None None E-4-11-II None None None None None None HIPOVOLEMIA &
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SAPUTRA D394846 27 9984 DR AHMAD HIBBAN A WRIYA 0138R01704180000560
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1#0##0#0#0.0#2018-11-02 16:07:37#0#12:00:00#12:00:00#12:00:00 5
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6633376 0 0 0 0 801947 0 0 0 0 0
3201126 B 3 BS 1 30/03/2018 03/04/2018 25/02/2015 0 2
1 D50.9;B34.9 - - - None None None None D-4-13-I None
- 0 2987000 2560481 0 5 0 0 0 SRIKANDITA
ALIMA PARAMITHA D351055 3 1129 DR RASTRA, SPA 0138R01703180013612
0002203926873 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166660
1#0##0#0#0.0#2018-04-12 08:31:49#0#12:00:00#12:00:00#00:00:00 1
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3201126 B 3 BS 1 01/04/2018 03/04/2018 04/06/1975 0 1
1 N18.5;D63.8;B18.9 38.95;99.04 - - None None None None N-1-
- 0 8908800 8083112 0 3 0 0 0 SUJIMAN
0138R01704180000044 0002134423337 3;JKN TANTIYO S;16137
5.2.1.201802140120 4 166744 1#0##0#0#0.0#2018-04-12
08:42:20#0#12:00:00#12:00:00#12:00:00 1 6a504ec003bca0680be22044112888f8
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644802 0 0 0 0 69000
3201126 B 2 BS 1 01/04/2018 03/04/2018 26/04/2016 0 1
1760800 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-04-12 11:21:18#0#12:00:00#12:00:00#12:00:00 1
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944532 0 0 0 0 372719 0 0 0 0 69000
3201126 B 3 BS 1 31/03/2018 03/04/2018 21/04/1978 0 1
(BERAT) 6077700 0 0 - 0 - 0 - 0 - 0
6077700 3615102 0 4 0 0 0 MUHAMAD SOLEH TN
0001455588617 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166731
1#0##0#0#0.0#2018-04-12 13:12:07#0#12:00:00#12:00:00#00:00:00 1
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0 0 0 0 2470752 0 0 0 0 0
3201126 B 2 BS 1 02/04/2018 03/04/2018 28/05/2012 0 2
None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH KULIT DAN
PAYUDARA (RINGAN) 5974200 0 0 - 0 - 0 - 0 -
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0001630426871 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 170273
1#0##0#0#0.0#2018-04-12 13:32:49#0#00:00:00#00:00:00#12:00:00 2
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414648 0 0 0 0 457079 0 0 0 0 72500
3201126 B 3 BS 1 02/04/2018 03/04/2018 01/08/2016 0 1
None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH KULIT DAN
PAYUDARA (RINGAN) 4978500 0 0 - 0 - 0 - 0 -
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D393487 1 609 DR CATUR S, SPB 0138R01704180000354
0002320954615 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166949
1#0##0#0#0.0#2018-04-12 13:34:37#0#12:00:00#12:00:00#12:00:00 1
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1348479 0 0 0 0 473218 0 0 0 0 72500
3201126 B 3 BS 1 02/04/2018 03/04/2018 19/01/1944 0 1
- 0 8908800 9881787 0 2 0 0 0 JUNED
0002219060891 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167014
1#0##0#0#0.0#2018-04-12 13:47:33#0#12:00:00#12:00:00#12:00:00 1
6544ac7f0c9965c7f01b0adcc59cadc2 0 3438800 2636552 0 0
3004963 0 0 0 0 732472 0 0 0 0 69000
3201126 B 3 BS 1 02/04/2018 03/04/2018 04/10/1979 0 2
1 I25.0;I11.0;N18.5 88.55;36.07 - - YY02 None None None I-1-
- 0 45079800 54293515 0 2 0 0 0 OKKY INDARTI
DEWI NY D328891 38 14060 DR AZRI NURIZAL SPPD KKV
0138R01704180000268 0001269336508 3;JKN TANTIYO S;16137
5.2.1.201802140120 4 167009 1#0##0#0#0.0#2018-04-12
14:51:05#0#12:00:00#12:00:00#00:00:00 1 2e717d63d7449b1840da6b9d2eba4738
0 7996000 6870800 0 0 30601715 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 3 BS 1 02/04/2018 03/04/2018 15/01/1966 0 2
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 5170166 0 2 0 0 0 SITI BAIDAH D379826
52 19070 DR ARIS WAHJU, SPOG 0138R01704180000731 0001014200831
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167164
1#0##0#0#0.0#2018-04-12 15:11:48#0#12:00:00#12:00:00#12:00:00 1
64b3cbaa0c6ef53d49e155a4edf5ead8 0 0 947168 0 0
1484263 0 0 0 0 2669735 0 0 0 0 69000
3201126 B 3 BS 1 03/04/2018 03/04/2018 01/12/1953 0 2
4 J18.0;I50.0;R57.0 - - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 6945883 0 1 0 0 0 BUDI SUHARTI NY
0000371888897 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167453
1#0##0#0#0.0#2018-04-12 16:07:31#0#14:40:24#14:40:24#00:00:00 1
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5029504 0 0 0 0 743404 0 0 0 0 716000
3201126 B 3 BS 1 01/04/2018 03/04/2018 08/04/1940 0 1
- 0 8908800 9732346 0 3 0 0 0 SOEWOJO
0001741041641 3;JKN DR RIZKI; 5.2.1.201802140120 4 166750
11#0##0#0#0.0#2018-04-13 15:35:21#0#12:00:00#12:00:00#12:00:00 1
9376e189ed1e0f81b9863f258a7eeb45 0 3611800 2636552 0 0
2722298 0 0 0 0 692696 0 0 0 0 69000
3201126 B 1 BS 1 31/03/2018 03/04/2018 28/10/2012 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3677698 0 4 0 0 0 MUHAMMAD DENIZ FARSHAD
0001307411144 3;JKN DR RIZKI; 5.2.1.201802140120 4 166733
1#0##0#0#0.0#2018-04-13 15:37:10#0#12:00:00#12:00:00#12:00:00 1
34d0f280cbd7a6c69cf07f7f65ba97e5 0 0 338858 0 0 729243
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3201126 B 1 BS 1 01/04/2018 03/04/2018 12/12/1952 0 1
1 E11.2;J90;D63.8;I25.0 99.04;38.95 - - None None None None
- 0 - 0 27065300 20076669 0 3 0 0 0
FRANS MARTINUS SAMUEL D111772 65 23851 DR SRI KUNMARTINI, SPPD
0138R01704180000074 0001318423162 3;JKN DR RIZKI; 5.2.1.201802140120
4 166749 1#0##0#0#0.0#2018-04-16
09:46:20#0#12:00:00#12:00:00#00:00:00 1 4c704712e9292a59688e987cdfd3ee3b
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7843000 0 0 0 0 69000
3201126 B 3 BS 1 25/03/2018 03/04/2018 03/02/1930 0 1
1 J44.1;I50.0 93.94 - - None None None None J-4-17-II None
None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (SEDANG)
4417400 0 0 - 0 - 0 - 0 - 0
4417400 8677483 0 10 0 0 0 BOY TANGKILISAN
0001311737545 3;JKN DR RIZKI; 5.2.1.201804062320 4 164759
3#0##0#0#0.0#2018-04-18 09:14:20#0#12:00:00#12:00:00#00:00:00 1
2202d67f49d65c2efa56c3a88733c538 0 0 503566 0 0
5213231 0 0 0 0 2960686 0 0 0 0 0
3201126 B 2 BS 1 31/03/2018 03/04/2018 31/10/2009 0 1
1 G40.9;G80.0 - - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 3187000 4386562
0 4 0 0 0 FACHRY ABDILLAH D193006 8 3073 DR
AWIDIYA, SPA 0138R01703180013792 0002103781814 3;JKN DR RIZKI;
5.2.1.201804062320 4 166781 2#0##0#0#0.0#2018-04-18
09:44:21#0#08:34:58#08:34:58#00:00:00 1 eb4c5a89cecdf936781913b99057e6c5
0 0 292031 0 0 2096560 0 0 0 0
1827971 0 0 0 0 170000
3201126 B 2 BS 1 29/03/2018 03/04/2018 03/08/1980 0 1
1 D01.0;D63.0 99.04 - - None None None None K-4-10-II None
0 - 0 - 0 - 0 - 0 8475400 8364882
0 6 0 0 0 AGUS D390328 37 13752 DR. ARU ARIADNO,
4 166413 5#0##0#0#0.0#2018-04-19
11:18:09#0#12:00:00#12:00:00#12:00:00 1 10be3d68c0ca080c31076b74d099d134
0 0 815786 0 0 3945861 0 0 0 0
3603235 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 03/04/2018 13/05/1973 0 2
0 0 - 0 - 0 - 0 - 0 5883600
1386491 0 2 0 0 0 MARGARETHA PURBA D269227 44
16395 DR ELISABETH DYAH NOVIANI 0138R01704180000719 0001456580619
3;JKN ECHI; 5.2.1.201804062320 4 167159 1#0##0#0#0.0#2018-05-17
08:13:12#0#12:00:00#12:00:00#12:00:00 2 af404866957c33d5a4ac3e0fd3ad1a0d
0 0 378234 0 0 628552 0 0 0 0 379705
0 0 0 0 0
3201126 B 3 BS 1 26/03/2018 03/04/2018 01/04/1960 0 1
1 I50.0;R57.0;J18.8 88.72;87.44 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 19602507 0 9 1 6 0 DAHLAN ISKANDAR
0001014451108 3;JKN DR RIZKI; 5.2.2.201806040537 4 164788
1#0##0#0#0.0#2018-09-26 19:40:49#0#12:00:00#12:00:00#12:00:00 3
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6255135 0 0 0 0 6887500 0 0 0 0
4956000
3201126 B 1 BS 1 31/03/2018 04/04/2018 21/10/1952 0 1
1 I63.8;E78.5 87.44;87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 7293436 0 5 0 0 0 YUSRIZAL
0001453970081 3;JKN DR RIZKI; 5.2.1.201802140120 4 166667
1#0##0#0#0.0#2018-04-11 15:01:13#0#12:00:00#12:00:00#12:00:00 1
06afe1d7c60b16a8db499b79cb83f31e 0 0 1117063 0 0
2549232 0 0 0 0 3627141 0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 04/04/2018 13/04/1984 0 1
1 A09.9;N18.5;D63.8 99.04 - - None None None None K-4-17-II
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
0001336724368 3;JKN DR RIZKI; 5.2.1.201802140120 4 166650
1#0##0#0#0.0#2018-04-11 15:03:44#0#12:00:00#12:00:00#12:00:00 1
7b4de7371e2cbfcc6734bfffd69f9cc0 0 0 236752 0 0
2107864 0 0 0 0 4671231 0 0 0 0 0
3201126 B 3 BS 1 01/04/2018 04/04/2018 10/05/1975 0 2
0 0 - 0 - 0 - 0 - 0 4144700
3099469 0 4 0 0 0 LILIS SURYANI D339258 42
3;JKN DR RIZKI; 5.2.1.201802140120 4 166739 1#0##0#0#0.0#2018-
04-11 15:05:58#0#12:00:00#12:00:00#00:00:00 1
81f714d5115605ac704516ab2eb15189 0 0 426022 0 0
1392678 0 0 0 0 1280769 0 0 0 0 0
3201126 B 3 BS 1 03/04/2018 04/04/2018 21/04/2010 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1325998 0 2 0 0 0 MOCHAMMAD FADILLAH
0001725323758 3;JKN DR RIZKI; 5.2.1.201802140120 4 167167
1#0##0#0#0.0#2018-04-11 15:07:46#0#12:00:00#12:00:00#12:00:00 1
f03dc31d9b947d57268f1c672c4969f9 0 0 257183 0 0 260067
0 0 0 0 638748 0 0 0 0 170000
3201126 B 3 BS 1 01/04/2018 04/04/2018 17/01/1951 0 2
1 E11.5 84.12;99.17;90.59 - - None None None None M-1-02-I
None None None None None None AMPUTASI (RINGAN) 9508900 0 0
- 0 - 0 - 0 - 0 9508900 14195887 0
4 0 0 0 JEANNE D394757 67 24546 DR ZULFAN, SPPD
0138R01704180000403 0001336662898 3;JKN DR RIZKI; 5.2.1.201802140120
4 167013 1#0##0#0#0.0#2018-04-12
12:42:24#0#12:00:00#12:00:00#12:00:00 1 eb4f382cde151e4160759df0f1cc31c6
0 3426500 6332558 0 0 3383126 0 0 0 0
984703 0 0 0 0 69000
3201126 B 1 BS 1 30/03/2018 04/04/2018 18/01/1982 0 2
1 M54.59;R42;R63.0 - - - None None None None M-4-17-I
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 7263070 0 6 0 0 0 MAULANI SRI KUSRINI
0001078080625 3;JKN DR RIZKI; 5.2.1.201802140120 4 166656
14#0##0#0#0.0#2018-04-12 12:45:37#0#12:00:00#12:00:00#00:00:00 1
b88a8aa35ded3b2cf1cf9d7c7f22752d 0 0 483616 0 0
1937800 0 0 0 0 4841654 0 0 0 0 0
3201126 B 2 BS 1 01/04/2018 04/04/2018 20/03/1969 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4392157 0 4 0 0 0 SUSI ANDAYANI
d044121 49 17909 DR SOEGIONO 0138R01704180000337 0001256826813
3;JKN DR RIZKI; 5.2.1.201802140120 4 166925 1#0##0#0#0.0#2018-
04-12 12:57:21#0#12:00:00#12:00:00#12:00:00 1
f2325906db16dea0902f8b3330aa1a31 0 0 238535 0 0
1820285 0 0 0 0 2333337 0 0 0 0 0
3201126 B 3 BS 1 02/04/2018 04/04/2018 06/08/1984 0 1
8041000 0 0 - 0 - 0 - 0 - 0
8041000 12651548 0 3 0 0 0 ABDUL WAHAB HSB
0001721276289 3;JKN DR RIZKI; 5.2.1.201802140120 4 166912
1#0##0#0#0.0#2018-04-12 12:59:06#0#12:00:00#12:00:00#12:00:00 1
728d1114abc706ce8e538abd70f7ac7f 0 3611800 2412300 0 0
2409277 0 0 0 0 4183671 0 0 0 0 34500
3201126 B 2 BS 1 30/03/2018 04/04/2018 21/08/2000 0 2
1 B17.8;R11 90.59;88.76 - - None None None None B-4-13-I
5045200 0 0 - 0 - 0 - 0 - 0
5045200 7774599 0 6 0 0 0 RHEKA AGUSTIAN
NURHADASARI D394580 17 6430 DR ARU, SPPD 0138R01703180013485
0001483889534 3;JKN DR RIZKI; 5.2.1.201802140120 4 166641
12#0##0#0#0.0#2018-04-12 13:04:40#0#12:00:00#12:00:00#12:00:00 1
63cbb4de77ebb3331cb02ff1536397f5 0 0 507070 0 0
3702910 0 0 0 0 3564619 0 0 0 0 0
3201126 B 1 BS 1 31/03/2018 04/04/2018 01/08/1939 0 1
1 M25.50;A41.9;E87.5;I48;I50.0;I64 89.52 - - None None None
None M-4-20-III None None None None None None TANDA, GEJALA &
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SUHARDJO M.A D394718 78 28732 DR ARU, SPPD
0138R01703180013836 0000044463982 3;JKN DR RIZKI; 5.2.1.201802140120
4 166735 1#0##0#0#0.0#2018-04-12
13:08:53#0#12:00:00#12:00:00#12:00:00 1 aa310f386690145159e041b98bb64b31
0 0 761100 0 0 4462775 0 0 0 0
3736171 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 04/04/2018 24/02/2011 0 1
2033900 0 0 - 0 - 0 - 0 - 0
2033900 4009126 0 3 0 0 0 SABQI ABWAB RIZQI
D394671 7 2594 DR RASTRA, SPA 0138R01704180000581
0000203228076 3;JKN DR RIZKI; 5.2.1.201802140120 4 167107
1#0##0#0#0.0#2018-04-12 13:11:49#0#12:00:00#12:00:00#12:00:00 1
860b73d3012df68b28a1d4e8a1b34b08 0 0 236051 0 0
1123796 0 0 0 0 2649279 0 0 0 0 0
3201126 B 2 BS 1 02/04/2018 04/04/2018 01/07/1989 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 9984660 0 3 0 0 0 ROFIQOH D376356
28 10502 DR RM DHENI DANARDHONO SPOG 0138R01704180000611
0000510774276 3;JKN DR RIZKI; 5.2.1.201802140120 4 167143
1#0##0#0#0.0#2018-04-12 13:19:20#0#12:00:00#12:00:00#12:00:00 1
fb0ddebb0e73cc10945eed3ebafe3de0 0 5269900 2090753 0 0
1687805 0 0 0 0 739202 0 0 0 0 197000
3201126 B 3 BS 1 02/04/2018 04/04/2018 06/07/1963 0 1
- 0 8908800 11582805 0 3 0 0 0 AGEN BANGUN
0001293936467 3;JKN DR RIZKI; 5.2.1.201802140120 4 167160
1#0##0#0#0.0#2018-04-12 13:22:07#0#12:00:00#12:00:00#12:00:00 1
e934d71cccd1512b3c5c352fd19b49c3 0 3062500 2636552 0 0
3879249 0 0 0 0 1970004 0 0 0 0 34500
3201126 B 1 BS 1 02/04/2018 04/04/2018 15/12/1990 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 26283388 0 3 0 0 0 THERESIA AMELIA VITALOKA
D057497 27 9970 DR ARJU A, SPOG 0138R01704180000408
0001195576154 3;JKN DR RIZKI; 5.2.1.201802140120 4 167016
1#1#vvip#3#19301888#0.0#2018-04-12 13:37:25#0#12:00:00#12:00:00#12:00:00
1 5b988a7ffe87f6ea233a897f4678c9b8 0 8973200 9305000 0
0 6369188 0 0 0 0 1311000 0 0 0 0
325000
3201126 B 2 BS 1 02/04/2018 04/04/2018 17/01/2016 0 1
1 A09.9;J06.9 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2545218 0 3 0 0 0 MOCHAMMAD DAWAUL HAYA
SURATMO D394704 2 806 DR AULIA TANGKARI, SPA 0138R01704180000543
0002038004469 3;JKN DR RIZKI; 5.2.1.201802140120 4 167082
1#0##0#0#0.0#2018-04-12 13:39:38#0#12:00:00#12:00:00#12:00:00 1
171ac8727e4383c872248d01d70359f9 0 0 238535 0 0 581173
0 0 0 0 1725510 0 0 0 0 0
3201126 B 2 BS 1 01/04/2018 04/04/2018 26/09/2003 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2365351 0 4 0 0 0 ZULFA AQILAH YUSFAIZA
D064404 14 5301 DR RASTRA, SPA 0138R01704180000125
0001264234588 3;JKN DR RIZKI; 5.2.1.201802140120 4 166760
1#0##0#0#0.0#2018-04-12 13:40:42#0#12:00:00#12:00:00#12:00:00 1
18aebe72230a6827d001a85e4ab7e09d 0 0 278711 0 0 390897
0 0 0 0 1695743 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 04/04/2018 11/06/1979 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5888081 0 3 0 0 0 SUPRIADI TN D346421
3;JKN DR RIZKI; 5.2.1.201802140120 4 167165 1#0##0#0#0.0#2018-
04-12 13:49:07#0#12:00:00#12:00:00#00:00:00 1
b956cb2227eaa2190132c8533acbce95 0 0 424889 0 0
2333740 0 0 0 0 3129452 0 0 0 0 0
3201126 B 2 BS 1 01/04/2018 04/04/2018 01/04/2018 3095 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437343 0 4 0 0 0 BAYI NY MARYATI
d394769 0 0 DR AD PASARIBU, SPA 0138R01704180000885
0002445316672 3;JKN DR RIZKI; 5.2.1.201802140120 4 167243
1#0##0#0#0.0#2018-04-12 13:50:05#0#12:00:00#12:00:00#12:00:00 1
41c0ad75a460e5ae8a09a99d2e906e2d 0 0 433812 0 0 88899
0 0 0 0 914632 0 0 0 0 0
3201126 B 2 BS 1 02/04/2018 04/04/2018 09/05/1995 0 2
- 0 - 0 - 0 - 0 4101100 3370723 0
3 0 0 0 DESI MAYANG SARI KARMIN D394774 22 8364 DR
5.2.1.201802140120 4 166759 1#0##0#0#0.0#2018-04-12
13:55:11#0#12:00:00#12:00:00#12:00:00 1 df4d7e15c64d1e2c242b4bed74b8520d
0 0 303524 0 0 1305684 0 0 0 0
1761515 0 0 0 0 0
3201126 B 2 BS 1 01/04/2018 04/04/2018 18/01/1988 0 2
(SEDANG) 6486300 0 0 - 0 - 0 - 0 - 0
6486300 18192690 0 4 0 0 0 MARYATI D394741
DR RIZKI; 5.2.1.201802140120 4 166743 1#0##0#0#0.0#2018-04-12
14:03:25#0#12:00:00#12:00:00#12:00:00 1 b8b810838e3a5e9becc208571c922a7b
0 6315400 2321342 0 0 7095272 0 0 0 0
1301176 0 0 0 0 1159500
3201126 B 1 BS 1 25/03/2018 04/04/2018 25/03/2018 2065 1
- 0 11976100 23112816 0 11 1 2 0 BAYI NY DESI
SUSILOWATI D394120 0 0 DR AULIA TANGKARI, SPA 0138R01703180011591
0002443359486 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 165143
1#0##0#0#0.0#2018-04-12 15:07:33#0#12:00:00#12:00:00#12:00:00 1
8c795cb8bbcd913fd6de613d6961bb0c 0 0 1197610 0 0
5667206 0 0 0 0 10940000 0 0 0 0
5308000
3201126 B 3 BS 1 03/04/2018 04/04/2018 21/08/1968 0 1
1 I12.0;K21.9 - - - None None None None N-4-10-I None
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 1653927 0 2 0 0 0 SUEDY SUKIA D365591
3;JKN DR RIZKI; 5.2.1.201802140120 4 167256
39#0##0#0#0.0#2018-04-12 15:48:39#0#12:00:00#12:00:00#00:00:00 1
430c1b17b4160ec794973a3b0ba3a954 0 0 424889 0 0 568837
0 0 0 0 660201 0 0 0 0 0
3201126 B 3 BS 1 03/04/2018 04/04/2018 01/08/1963 0 1
1 I12.0;B16.9 39.95;39.27 - - None None None None N-1-12-II
- 0 8908800 7626744 0 2 0 0 0 M. SOLEH
0138R01704180000749 0000511384307 3;JKN DR RIZKI; 5.2.1.201802140120
4 167556 1#0##0#0#0.0#2018-04-12
15:50:47#0#19:01:21#19:01:21#12:00:00 1 03d68700d38d3f1334f8185e05978c99
0 0 1870848 0 0 1727650 0 0 0 0
3993746 0 0 0 0 34500
3201126 B 3 BS 1 04/04/2018 04/04/2018 21/12/1942 0 1
4 I46.9;I67.9;N18.5;R40.1 99.60 - - None None None None I-4-
14-II None None None None None None CARDIAC ARREST, TIDAK DIKETAHUI (SEDANG)
3554400 0 0 - 0 - 0 - 0 - 0
3554400 2871739 0 1 0 0 0 D.SARING D394942
75 27498 DR MUHAMMAD RIZKI YUWANA 0138R0170418V000393
0002444407198 3;JKN DR RIZKI; 5.2.1.201802140120 4 167587
1#0##0#0#0.0#2018-04-12 15:55:14#0#06:40:52#06:40:52#00:00:00 2
32ba8e7ff8120ac5417c3d6107dd2f65 0 0 520896 0 0
1873972 0 0 0 0 476871 0 0 0 0 0
3201126 B 3 BS 1 04/04/2018 04/04/2018 13/07/1950 0 1
2 I64;E87.5;N18.5 - - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 4439417 0
1 0 0 0 IGNATIUS ANTONO ADJI d389824 67 24737 DR
ANGGA TOMALA PUTRA 0138R0170418V000786 0001463354684 3;JKN TANTIYO
S;16137 5.2.1.201802140120 4 168089 1#0##0#0#0.0#2018-04-12
15:55:15#0#16:27:30#16:27:30#12:00:00 1 0d83af36b47809f9e64031646000f120
0 0 588198 0 0 2683790 0 0 0 0 579429
0 0 0 0 588000
3201126 B 1 BS 1 26/03/2018 04/04/2018 10/08/1954 0 1
1 I21.3;I25.1;I63.9;A41.9 87.03 - - None None None None I-4-
14562700 0 0 - 0 - 0 - 0 - 0
14562700 24608292 0 10 1 2 0 GUN NURLETTE
D220387 63 23239 DR ARU, SPPD 0138R01703180011529
0000061141713 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 165122
1#0##0#0#0.0#2018-04-12 16:18:22#0#12:00:00#12:00:00#12:00:00 1
3399c4264c7bf5e5389c883c003e91bb 0 0 1509268 0 0
10799024 0 0 0 0 8867000 0 0 0 0
3433000
3201126 B 1 BS 1 03/04/2018 04/04/2018 27/11/1961 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3682668 0 2 0 0 0 NUNU HERIYANA TN
D114692 56 20581 SRI KUNMARTINI.DR,SPPD 0138R0170418V000377
0000060480268 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167577
1#0##0#0#0.0#2018-04-12 16:36:54#0#03:15:51#03:15:51#00:00:00 1
5fb708db47d271daf17374c541ab69f1 0 0 424889 0 0 272607
0 0 0 0 2985172 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 04/04/2018 28/03/2018 2695 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3497487 0 2 0 0 0 BY NY ANGGI DEWINTA
CHAIRANI D394948 0 6 DR DYAH HARINI, SPA 0138R0170418V000161
0002434436234 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167578
1#0##0#0#0.0#2018-04-12 16:48:54#0#03:20:44#03:20:44#00:00:00 1
2eba82b91d7255adf8e0769d2b4213c8 0 0 382013 0 0 160666
0 0 0 0 1816808 0 0 0 0 1138000
3201126 B 3 BS 1 30/03/2018 04/04/2018 23/04/2003 0 2
1452800 0 0 - 0 - 0 - 0 - 0
1452800 4238422 0 6 0 0 0 AZIZZAH WANDA SANUSI
D299801 14 5455 DR RASTRA, SPA 0138R01703180013845
0001455231789 3;JKN DR RIZKI; 5.2.1.201802140120 4 168128
8#0##0#0#0.0#2018-04-13 09:09:34#0#08:54:56#08:54:56#00:00:00 1
09ad4f2232afc3f3b3ae7bd0bd6d9a79 0 0 183752 0 0
2173390 0 0 0 0 1881280 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 04/04/2018 02/04/2018 2666 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3095128 0 3 0 0 0 BY NY THERESIA AMELIA
VITALOKA D394845 0 0 DR OTTY MITHA S, SPA 0138R0170418V000772
0002446452652 3;JKN DR RIZKI; 5.2.1.201802140120 4 168108
45#0##0#0#0.0#2018-04-13 11:18:47#0#20:54:59#20:54:59#00:00:00 1
b128cde62f46beb488def0e171adcb77 0 0 368013 0 0 88899
0 0 0 0 2638216 0 0 0 0 0
3201126 B 3 BS 1 04/04/2018 04/04/2018 22/03/1978 0 1
1 N18.5;I95.9 89.52 - - None None None None N-4-10-I None
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 3794109 0 1 0 0 0 ANDIKA K SIHALOHO
D373017 40 14623 DR AHMAD HIBBAN A WRIYA 0138R0170418V000368
0001089748686 3;JKN DR RIZKI; 5.2.1.201802140120 4 167573
1#0##0#0#0.0#2018-04-13 15:19:13#0#01:22:46#01:22:46#12:00:00 1
b76e571222b844708e926b8454e60fb8 0 0 298242 0 0
2071654 0 0 0 0 555213 0 0 0 0 869000
3201126 B 2 BS 1 02/04/2018 04/04/2018 09/08/1959 0 2
- 0 51950600 47707564 0 3 0 0 0 EMALIZA
D373588 58 21421 DR SUPONO 0138R01704180000717 0001263247233
3;JKN DR RIZKI; 5.2.1.201802140120 4 167156 1#0##0#0#0.0#2018-
04-16 09:38:58#0#12:00:00#12:00:00#12:00:00 1
02300ef2ce05d196012ca7c7d2a37a17 0 8986000 1089820 0 0
28806744 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 02/04/2018 04/04/2018 25/09/1953 0 1
1 I20.9;I25.0;I08.9;E14.9;I50.0 88.55;36.07 - - YY02 None None
0 - 0 - 0 46734600 57630554 0 3 0 0
0 BAMBANG HERMANTO BIN SUTOPO D354788 64 23565 DR SUPONO SPJP
0138R01704180000710 0000041751911 3;JKN DR RIZKI; 5.2.1.201802140120
4 167554 1#0##0#0#0.0#2018-04-16
10:14:52#0#18:55:51#18:55:51#00:00:00 1 0b331a57f059f328b943fd36a413ed9b
0 10062000 8914320 0 0 29829234 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 2 BS 1 02/04/2018 04/04/2018 24/03/1979 0 1
1 I25.0;I10 88.55 - - None None None None I-1-15-I None
0 - 0 - 0 - 0 - 0 5449100 16822765
0 3 0 0 0 INDRA WIJAKSANA d394775 39 14254 DR
5.2.1.201802140120 4 166900 1#0##0#0#0.0#2018-04-16
10:20:06#0#12:00:00#12:00:00#12:00:00 1 509963cb9b4c2343c512368e8ec2fbb5
0 3970000 3569720 0 0 6057490 0 0 0 0
1156555 0 0 0 0 2069000
3201126 B 3 BS 1 04/04/2018 04/04/2018 25/09/1988 0 1
1 G03.9 87.03;89.52;87.44 - - None None None None G-4-19-I
TERMASUK MENINGITIS VIRUS (RINGAN) 3695600 0 0 - 0 - 0
- 0 - 0 3695600 2797858 0 1 0 0 0
SUTRISWAN D395027 29 10783 DR ADITIA NATA KUSUMA
0138R0170418V000697 0002035554783 3;JKN DR RIZKI; 5.2.1.201802140120
4 167971 1#0##0#0#0.0#2018-04-17
09:38:52#0#14:16:27#14:16:27#00:00:00 1 4abb07871ff28184a2f4135a66f826e6
0 0 332604 0 0 1387217 0 0 0 0 490037
0 0 0 0 588000
3201126 B 2 BS 1 03/04/2018 04/04/2018 10/11/1954 0 1
9649200 0 0 - 0 - 0 - 0 - 0
9649200 14939774 0 2 0 0 0 SJAHRUDIN d392304
3;JKN DR RIZKI; 5.2.1.201804062320 4 167200 1#0##0#0#0.0#2018-
04-18 08:52:10#0#12:00:00#12:00:00#12:00:00 1
66a1f7f7ca9317be212c414e00a56aae 0 7031500 1264308 0 0
2241598 0 0 0 0 4333368 0 0 0 0 69000
3201126 B 1 BS 1 31/03/2018 04/04/2018 05/07/1955 0 1
1 I25.0;I05.9;I13.2;I48 88.55;36.07;89.52 - - YY02 None None
0 - 0 - 0 58821400 66968501 0 5 0 0
0 MUKHTADIN d368112 62 22915 DR AZRI NURIZAL SPPD KKV
0138R01703180013709 0000061088578 3;JKN DR RIZKI; 5.2.1.201804062320
4 166699 17#0##0#0#0.0#2018-04-19
09:46:54#0#12:00:00#12:00:00#00:00:00 1 c9c1c66cc00be25e0d5d9d42e05507f3
0 12225000 9672120 0 0 36246381 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 3 BS 1 04/04/2018 04/04/2018 08/02/1954 0 1
1 G20;R40.0;A49.9 - - - None None None None G-4-11-II
(SEDANG) 6072700 0 0 - 0 - 0 - 0 - 0
6072700 1920163 0 1 0 0 0 NASIM UN D319296
0001907401746 3;JKN DR RIZKI; 5.2.1.201804062320 4 167574
6#0##0#0#0.0#2018-04-19 10:40:12#0#00:00:00#06:10:00#00:00:00 1
ace34ffc26ec9147e3e2d488729c311e 0 0 546543 0 0 225002
0 0 0 0 432618 0 0 0 0 716000
3201126 B 1 BS 1 03/04/2018 04/04/2018 15/09/1962 0 2
1 M65.30 87.49;90.59;89.52;82.01;04.43 - - None None None
None M-1-80-I None None None None None None PROSEDUR ANGGOTA TUBUH
ATAS (RINGAN) 12140800 0 0 - 0 - 0 - 0 -
0 12140800 2000000 0 2 0 0 0 EUIS FATMAWATI
D337478 55 20289 DR BENNY H T, SPOT 0138R017418V000179
0001319983942 3;JKN ECHI; 5.2.1.201804062320 4 167582
1#0##0#0#0.0#2018-05-16 15:58:11#0#03:40:37#03:40:37#00:00:00 2
c9378b95a91c6cfe6dc16afeab7d9025 0 0 2000000 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 04/04/2018 21/02/1959 0 2
1 E11.2;A49.9;D63.8;I10 39.27;99.04 - - None None None None
- 0 - 0 12472300 4658636 0 2 0 0 0
ROSIYATI D384812 59 21591 DR SRI KUNMARTINI, SPPD
0138R01704180000741 0000044937145 3;JKN ECHI; 5.2.1.201804062320
4 167553 1#0##0#0#0.0#2018-05-16
16:00:36#0#18:50:29#18:50:29#12:00:00 2 69cb24489f26d2628dd15e2f654fc217
0 0 443645 0 0 1165970 0 0 0 0
3049021 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 04/04/2018 15/09/1962 0 2
1 M65.30 87.49;90.59;89.52;82.01;04.43 - - None None None
None M-1-80-I None None None None None None PROSEDUR ANGGOTA TUBUH
ATAS (RINGAN) 12140800 0 0 - 0 - 0 - 0 -
0 12140800 14541346 0 2 0 0 0 EUIS FATMAWATI
0001319983942 3;JKN DR RIZKI; 5.2.2.201806040537 4 170365
1#0##0#0#0.0#2018-08-21 10:40:39#0#00:00:00#00:00:00#00:00:00 1
dd201186cfbb61701af6fccf7a1a23d3 0 0 1555848 0 0
1977395 0 0 0 0 10790603 0 0 0 0 217500
3201126 B 3 BS 1 26/03/2018 04/04/2018 03/02/1964 0 1
1 N18.5;E87.6;E16.2;D63.8;R63.8 99.04;87.03;89.52;39.95 - - None
None None None N-4-10-II None None None None None None TUMOR GINJAL
& SALURAN URIN & GAGAL GINJAL (SEDANG) 4132100 0 0 - 0 -
0 - 0 - 0 4132100 20905204 0 10 1 4
0 SAPRIAT ROSTIADI D319745 54 19775 SRI KUNMARTINI.DR,SPPD
0138R01703180011542 0001740096775 3;JKN DR RIZKI; 5.2.2.201806040537
4 165121 1#0##0#0#0.0#2018-09-26
19:31:24#0#12:00:00#12:00:00#00:00:00 3 d152f70a26bc0792db7f6c1404d63c40
0 0 660770 0 0 9398684 0 0 0 0
9764750 0 0 0 0 1081000
3201126 B 1 BS 1 02/04/2018 04/04/2018 07/07/1937 0 2
1 D24;D63.0 99.04 - - None None None None L-4-14-II None
(SEDANG) 6190800 0 0 - 0 - 0 - 0 - 0
6190800 5290719 0 3 0 0 0 LIU NG FUNG D394805
80 29489 DR ARU, SPPD 0138R01704180000681 0001718053659 3;JKN
DR RIZKI; 5.2.2.201806040537 4 167148 1#0##0#0#0.0#2018-09-26
19:34:42#0#12:00:00#12:00:00#12:00:00 4 68557eebe9a58f0bb7dd8ddcba399ebb
0 0 672947 0 0 2170150 0 0 0 0
2447622 0 0 0 0 0
3201126 B 3 BS 1 02/04/2018 04/04/2018 24/04/1973 0 1
1 N21.0;N13.2 56.0;56.31 - - None None None None N-1-40-II
(SEDANG) 10919500 0 0 - 0 - 0 - 0 - 0
10919500 14200867 0 3 0 0 0 I S M A I L D393061
3;JKN DR RIZKI; 5.2.2.201806040537 4 166898 1#0##0#0#0.0#2018-
09-26 19:36:58#0#12:00:00#12:00:00#12:00:00 3
cc2c4f641763d12384aba29df5ad7f31 0 3611800 3037300 0 0
3152738 0 0 0 0 4330029 0 0 0 0 69000
3201126 B 3 BS 1 04/04/2018 04/04/2018 21/12/1965 0 1
1 I61.9;E14.9 87.03;87.44 - - None None None None G-4-13-I
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 7887654 0 1 0 0 0 HENJANG NURCAHYA BAYU
EDI D288905 52 19097 DR ADITIA NATA KUSUMA 0138R0170418V000380
0000036731428 3;JKN DR RIZKI; 5.2.2.201806040537 4 167586
1#0##0#0#0.0#2018-09-26 19:38:31#0#04:41:26#04:41:26#12:00:00 2
8c087ec37e39fe36ecd69db5c0724450 0 0 821982 0 0
5203657 0 0 0 0 823015 0 0 0 0
1039000
3201126 B 3 BS 1 30/03/2018 04/04/2018 27/03/2017 0 2
0 0 - 0 - 0 - 0 - 0 2392700
4002762 0 6 0 0 0 MAHILA ALONA MESSI D392406
DR RIZKI; 5.2.2.201806040537 4 166662 1#0##0#0#0.0#2018-09-29
12:27:42#0#12:00:00#12:00:00#12:00:00 2 f4470d59424f46ade667bc3106067620
0 0 300851 0 0 1759048 0 0 0 0
1602863 0 0 0 0 340000
3201126 B 2 BS 1 05/04/2018 05/04/2018 21/09/2014 0 1
1 Z09.8;F82 93.83 - - None None None None Z-4-12-I None
None None None None None FAKTOR-FAKTOR YANG MEMPENGARUHI STATUS
0 - 0 2252000 122000 0 1 0 0 0
MUHAMMAD SADAN D340806 3 1292 DR TITI SULARYO DR SPA
0138R0170418V001363 0001628833645 3;JKN VERA ARIESANDI;
5.2.1.201802140120 4 169509 1#0##0#0#0.0#2018-04-09
16:15:44#0#00:00:00#00:00:00#12:00:00 1 89917f81f44fc16873e0d862ff0224d7
0 0 0 0 0 0 0 0 0 122000 0 0
0 0 0 0
3201126 B 3 BS 1 01/04/2018 05/04/2018 01/04/1992 0 1
1 A15.2 90.59;93.94 - - None None None None J-4-15-I None
4336500 0 0 - 0 - 0 - 0 - 0
4336500 7286793 0 5 0 0 0 ADE MUKTI WARAN DELLA
0000512260571 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166746
1#0##0#0#0.0#2018-04-12 14:00:01#0#12:00:00#12:00:00#12:00:00 1
655fd0f70b74bd24a35bcb93296aa42d 0 0 443285 0 0
2320802 0 0 0 0 4522706 0 0 0 0 0
3201126 B 3 BS 1 30/03/2018 05/04/2018 01/04/2003 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 9748084 0 7 0 0 0 RIZAL MUTTAQIN
0001014224084 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166652
1#0##0#0#0.0#2018-04-12 14:48:34#0#12:00:00#12:00:00#12:00:00 1
55cef8e9015f25171538696242b62b8f 0 3908300 1626018 0 0
3431041 0 0 0 0 713725 0 0 0 0 69000
3201126 B 1 BS 1 31/03/2018 05/04/2018 08/12/1999 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 6878893 0 6 0 0 0 ANGELA FERGIE AGAVE
0001648377347 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166726
1#0##0#0#0.0#2018-04-12 15:18:00#0#12:00:00#12:00:00#12:00:00 1
06ea976c62a64695d3f032aae21d684d 0 0 316330 0 0
1400542 0 0 0 0 5162021 0 0 0 0 0
3201126 B 3 BS 1 02/04/2018 05/04/2018 11/10/1956 0 1
1 K40.3;N40 53.03 - - None None None None K-1-14-I None
5489000 0 0 - 0 - 0 - 0 - 0
5489000 7933836 0 4 0 0 0 KARDJI B.MARIDIN
0001743635878 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167161
1#0##0#0#0.0#2018-04-12 15:23:59#0#12:00:00#12:00:00#12:00:00 1
24dc99538c1b8a2f1532d1e72fe06bac 0 3611800 1536920 0 0
2141080 0 0 0 0 575036 0 0 0 0 69000
3201126 B 2 BS 1 02/04/2018 05/04/2018 25/05/1972 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3039644 0 4 0 0 0 EDY RUSLANY D112224
TANTIYO S;16137 5.2.1.201802140120 4 167146 1#0##0#0#0.0#2018-
04-12 15:43:03#0#12:00:00#12:00:00#00:00:00 1
9547359f93cc458cb191d818098effed 0 0 278711 0 0 723578
0 0 0 0 2037355 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 05/04/2018 03/04/2018 2564 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3011749 0 3 0 0 0 BAYI NY PUTRI PUSPITA
SARI D394973 0 0 DR AWIDIYA, SPA 0138R0170418V001162
0002436798745 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168191
1#0##0#0#0.0#2018-04-12 15:46:50#0#10:23:42#10:23:42#00:00:00 1
b7b361247ebac740994d3caaa0debb70 0 0 499620 0 0 126499
0 0 0 0 2385630 0 0 0 0 0
3201126 B 2 BS 1 03/04/2018 05/04/2018 25/01/1958 0 2
1 M54.59;K80.2;R63.0 - - - None None None None M-4-
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 3699107 0 3 0 0 0 RODIAH D154678
60 21983 DR ARU, SPPD 0138R0170418V000213 0001456655938 3;JKN
DR RIZKI; 5.2.1.201802140120 4 167583 1#0##0#0#0.0#2018-04-12
15:58:18#0#03:42:41#03:42:41#00:00:00 1 0be1304c42f4825f572ce3138eba9375
0 0 384902 0 0 1738707 0 0 0 0
1575498 0 0 0 0 0
3201126 B 3 BS 1 03/04/2018 05/04/2018 31/08/2016 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1626502 0 3 0 0 0 MUHAMMAD IKHSAN FADILLAH
D394915 1 580 DR RASTRA, SPA 0138R0170418V000235
0002090801845 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167561
1#0##0#0#0.0#2018-04-12 16:09:11#0#20:19:34#20:19:34#00:00:00 1
2320ed47380b1f093f5270a908e598cc 0 0 257183 0 0 534412
0 0 0 0 834907 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 05/04/2018 22/03/1993 0 2
1 O82.1;O41.0 74.0 - - None None None None O-6-10-I None
0 0 - 0 - 0 - 0 - 0 6981500
19399505 0 3 0 0 0 PUTRI PUSPITA SARI D372414
25 9143 DR KARTIKA MAYA, SPOG 0138R01704180000888 0001655711199
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167247
1#1#vvip#3#12418005#0.0#2018-04-12 16:23:00#0#12:00:00#12:00:00#12:00:00
1 8edb50351a24b1d54a86ce91db8b987a 0 8271400 6605000 0
0 3015105 0 0 0 0 1311000 0 0 0 0
197000
3201126 B 3 BS 1 02/04/2018 05/04/2018 12/05/1954 0 2
1 I50.9;J18.9;E10.9;E87.6 90.59;89.52;99.17 - - None None None
(BERAT) 4973600 0 0 - 0 - 0 - 0 - 0
4973600 6345830 0 4 0 0 0 NURAIDA D394783
0002222571341 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166964
1#0##0#0#0.0#2018-04-12 16:30:43#0#12:00:00#12:00:00#12:00:00 1
9176db7877a507d132b7cb8ef3a2544a 0 0 777923 0 0
4074759 0 0 0 0 1493148 0 0 0 0 0
3201126 B 2 BS 1 02/04/2018 05/04/2018 09/10/1970 0 2
1 E10.6;H81.3 87.49;90.59 - - None None None None E-4-10-I
0 - 0 4203300 5770624 0 4 0 0 0 SRI
WAHYUNINGSIH D389514 47 17342 DR ARU, SPPD 0138R01704180000128
0002075843283 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166757
1#0##0#0#0.0#2018-04-12 16:42:46#0#12:00:00#12:00:00#12:00:00 1
f4fda61a3fcdd679631682528d3c770c 0 0 431297 0 0
2915810 0 0 0 0 2423517 0 0 0 0 0
3201126 B 3 BS 1 02/04/2018 05/04/2018 17/03/2010 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 4616059 0 4 0 0 0 ALFATHIRA
KRISYANTO D392584 8 2938 DR VERA MUNA MANOE, SPA 0138R01704180000728
0001265724505 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167163
1#0##0#0#0.0#2018-04-12 16:46:32#0#12:00:00#12:00:00#12:00:00 1
33d46bd12e7315df35760c39a3e8ebbc 0 0 268830 0 0
3230244 0 0 0 0 1116985 0 0 0 0 0
3201126 B 2 BS 1 04/04/2018 05/04/2018 13/12/1971 0 2
1 N93.9;O99.0 99.04 - - None None None None W-4-12-II None
LAIN-LAIN (SEDANG) 4628500 0 0 - 0 - 0 - 0
- 0 4628500 3040271 0 2 0 0 0 NINUK SRI
PINUNTUN D395023 46 16914 DR ERDIYAN, SPOG 0138R0170418V000561
0001154652489 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167744
1#0##0#0#0.0#2018-04-12 16:47:50#0#10:26:13#10:26:13#00:00:00 1
b62c3e35724cf858733d8e39e29780b1 0 0 522565 0 0
1282810 0 0 0 0 1234896 0 0 0 0 0
3201126 B 3 BS 1 04/04/2018 05/04/2018 12/04/1964 0 2
1 E11.9;I69.4 89.52 - - None None None None E-4-10-I None
- 0 3502700 2411747 0 2 0 0 0 DEWI WINARNI
D395085 53 19715 DR DICKY KARUNDENG 0138R0170418V000955
0001258335977 3;JKN DR RIZKI; 5.2.1.201802140120 4 168115
1#0##0#0#0.0#2018-04-13 15:27:52#0#23:11:11#23:11:11#00:00:00 1
7f3713803bebaec7c6db7dd97c625e0f 0 0 387198 0 0 963771
0 0 0 0 464778 0 0 0 0 596000
3201126 B 1 BS 1 02/04/2018 05/04/2018 17/03/2007 0 1
- 0 - 0 - 0 - 0 5424200 11555054 0
4 0 0 0 ADINATA NAUFAL AL FATHIN D131572 11 4034
DR CATUR SUZANTARA 0138R01704180000371 0001468061368 3;JKN DR
RIZKI; 5.2.1.201802140120 4 166988 1#0##0#0#0.0#2018-04-13
15:58:18#0#12:00:00#12:00:00#12:00:00 1 9b42bb59c2644846ba97e2ec5d536180
0 7243000 1572776 0 0 1824840 0 0 0 0
841938 0 0 0 0 72500
3201126 B 3 BS 1 01/04/2018 05/04/2018 25/04/2004 0 2
1 A91;R57.1;H11.3 99.05 - - None None None None A-4-13-III
(BERAT) 3200900 0 0 - 0 - 0 - 0 - 0
3200900 9511812 0 5 0 0 0 CHORRUNIS SHALSHA BILA
PUTRI D394768 13 5089 DR NOVIK BUDIWARDHANA, SPA 0138R01704180000098
0001014205252 3;JKN DR RIZKI; 5.2.1.201802140120 4 166753
1#0##0#0#0.0#2018-04-13 16:00:57#0#12:00:00#12:00:00#12:00:00 1
e48579b4051b663ada4ec6f3045dc672 0 0 399066 0 0
3921478 0 0 0 0 3505268 0 0 0 0
1686000
3201126 B 2 BS 1 04/04/2018 05/04/2018 10/11/1960 0 2
- 0 10690500 11137880 0 2 0 0 0 NANI
MARDIYANTI D391261 57 20964 SRI KUNMARTINI.DR,SPPD 0138r0170418v000943
0001730363848 3;JKN DR RIZKI; 5.2.1.201802140120 4 168106
1#0##0#0#0.0#2018-04-16 09:43:24#0#20:51:24#20:51:24#12:00:00 1
386f720b299bc702b4101d5a9360751d 0 4721600 2636552 0 0
2956082 0 0 0 0 754646 0 0 0 0 69000
3201126 B 3 BS 1 04/04/2018 05/04/2018 01/09/1988 0 1
- 0 8908800 11060393 0 2 0 0 0 WAHYUDIN TN
D395069 29 10807 DR SRI KUMARTINI 0138R0170418V000925
0000385500341 3;JKN DR RIZKI; 5.2.1.201802140120 4 168100
28#0##0#0#0.0#2018-04-16 09:50:24#0#19:35:27#19:35:27#00:00:00 1
dc8587f3c370b7ac87fee290efc46043 0 0 2636552 0 0
4611264 0 0 0 0 3743577 0 0 0 0 69000
3201126 B 3 BS 1 05/04/2018 05/04/2018 09/09/1959 0 2
1 I48;I25.2 89.52 - - None None None None I-4-19-I None
3914900 0 0 - 0 - 0 - 0 - 0
3914900 2939574 0 1 0 0 0 HAMIDAH D323673
58 21393 DR YOHANNES DWINANDA 0138R0170418V001216 0001470066614
3;JKN DR RIZKI; 5.2.1.201802140120 4 168278
10#0##0#0#0.0#2018-04-16 10:25:05#0#11:44:47#11:44:47#00:00:00 1
2c2bcd90b3aa0ab2cc0edbfe676720e5 0 0 649737 0 0
1220528 0 0 0 0 481309 0 0 0 0 588000
3201126 B 3 BS 1 05/04/2018 05/04/2018 15/01/1940 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2349796 0 1 0 0 0 MINIH D375696 78
28570 DR DICKY KARUNDENG 0138R0170418V000968 0001730202873 3;JKN
DR RIZKI; 5.2.1.201802140120 4 168120 3#0##0#0#0.0#2018-04-17
09:22:14#0#00:00:00#01:20:53#12:00:00 1 fb9c85735b20d6e2ab2b74922a7c54c8
0 0 371889 0 0 1535182 0 0 0 0 442725
0 0 0 0 0
3201126 B 1 BS 1 04/04/2018 05/04/2018 31/01/1978 0 1
1 S22.40 - - - None None None None J-4-13-I None
None None None None None TRAUMA DADA (RINGAN) 5779100 0 0
- 0 - 0 - 0 - 0 5779100 3480877 0
2 0 0 0 ALEX RASANDI ANIRUN D244833 40 14673 DR
IRFIANSYAH LESMANA DR SPBTKV 0138R0170418000363 0001616142036 3;JKN
TANTIYO S;16137 5.2.1.201802140120 4 167569 1#0##0#0#0.0#2018-
04-17 16:05:56#0#00:12:26#00:12:26#00:00:00 1
033fa31de8783465ae390a07020175a2 0 0 405611 0 0
1241545 0 0 0 0 1833721 0 0 0 0 0
3201126 B 1 BS 1 04/04/2018 05/04/2018 22/04/1966 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4676530 0 2 0 0 0 JOHN TUA TN D148895
51 18975 SRI KUNMARTINI.DR,SPPD 0138R0170418V000864 0001423898605
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168098
1#0##0#0#0.0#2018-04-17 16:13:04#0#18:04:29#18:04:29#00:00:00 1
edd8b49a9ab1a33e9b585c8a1a55fb3f 0 0 371889 0 0
1761950 0 0 0 0 2542691 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 05/04/2018 07/08/2014 0 1
- 0 - 0 - 0 - 0 3718200 2814939 0
3 0 0 0 KEVAN RAFANDRA D283074 3 1335 DR RASTRA,
SPA 0138R0170418V000285 0001839667667 3;JKN DR RIZKI; 5.2.1.201804062320
4 167585 5#0##0#0#0.0#2018-04-18
08:54:52#0#03:48:59#03:48:59#00:00:00 1 3e67d00d3740c0b959d8be4d6bb5d932
0 0 292031 0 0 297253 0 0 0 0
2225655 0 0 0 0 0
3201126 B 2 BS 1 02/04/2018 05/04/2018 11/05/1950 0 1
1743400 0 0 - 0 - 0 - 0 - 0
1743400 3705515 0 4 0 0 0 HERY GERNA D382725
DR RIZKI; 5.2.1.201804062320 4 167056 20#0##0#0#0.0#2018-04-18
08:56:00#0#12:00:00#12:00:00#12:00:00 1 dab79bbe9307ed71e0151d976e911cd8
0 0 209906 0 0 1207192 0 0 0 0
2288417 0 0 0 0 0
3201126 B 2 BS 1 04/04/2018 05/04/2018 02/07/1957 0 2
1 E14.7;D63.8;I11.9 99.04 - - None None None None E-4-10-II
0 - 0 5873300 4541812 0 2 0 0 0
MUHAYATI NY D331924 60 22191 SRI KUNMARTINI.DR,SPPD
0138R0170418V000712 0001293884651 3;JKN DR RIZKI; 5.2.1.201804062320
4 168005 25#0##0#0#0.0#2018-04-18
08:58:57#0#14:51:49#14:51:49#00:00:00 1 7957b3646a388f4ab974c7a448ea6bb7
0 0 424889 0 0 1627545 0 0 0 0
2489378 0 0 0 0 0
3201126 B 3 BS 1 03/04/2018 05/04/2018 19/03/1949 0 1
1 I63.9;E87.2;N18.5 99.04;38.95;96.05;39.95 - - None None None
0 - 0 - 0 8908800 20703888 0 3 0 0
0 SUMIRAT ATJE D053750 69 25217 DR NIKEN PRABHA DUHITA
0138R01704180000736 0001305871659 3;JKN DR RIZKI; 5.2.1.201804062320
4 167166 1#0##0#0#0.0#2018-05-05
10:10:26#0#12:00:00#12:00:00#00:00:00 1 deb93c314c835d24bc2d4577f0474600
0 0 2124848 0 0 9499440 0 0 0 0
8422600 0 0 0 0 657000
3201126 B 1 BS 1 02/04/2018 05/04/2018 10/12/2004 0 2
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 6127968 0 4 0 0 0 MUTIA AZZAHRA
ANJANI D080562 13 4861 DR VERA MUNA MANOE, SPA 0138R0170418V000045
0001262504057 3;JKN ECHI; 5.2.1.201804062320 4 171511
1#0##0#0#0.0#2018-05-16 15:38:02#0#00:00:00#00:00:00#00:00:00 2
4206b18699a37f4f3655e21f61bdfbd4 0 0 321830 0 0 0
0 0 3036243 0 2769895 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 05/04/2018 28/04/2006 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 5008753 0 4 0 0 0 GALIH WISESA AN
D394889 11 4357 DR VERA MUNA MANOE, SPA 0138R0170418V000020
0001262504327 3;JKN irene; 5.2.1.201804062320 4 167575
1#0##0#0#0.0#2018-06-05 12:50:31#0#02:58:35#02:58:35#00:00:00 2
1b8d7b4a2e07d01bace6922da4483e10 0 0 429362 0 0
1882716 0 0 0 0 2696675 0 0 0 0 0
3201126 B 3 BS 1 04/04/2018 05/04/2018 04/04/1959 0 1
1 I21.2;I11.0 89.52;87.44 - - None None None None I-4-10-III
0 0 - 0 - 0 - 0 - 0 10401900
4385334 0 2 0 0 0 DARMUDI D335486 59 21550
DR DINI DANIATY 0138R0170418V000949 0001834926884 3;JKN DR RIZKI;
5.2.2.201806040537 4 168113 1#0##0#0#0.0#2018-08-20
09:18:27#0#21:15:59#21:15:59#00:00:00 2 eeb94b9a46be1afbf9ea330388f480e4
0 0 936171 0 0 1969272 0 0 0 0 593891
0 0 0 0 886000
3201126 B 3 BS 1 05/04/2018 05/04/2018 12/04/1964 0 2
- 0 3502700 2411747 0 1 0 0 0 DEWI WINARNI
0001258335977 3;JKN DR RIZKI; 5.2.2.201806040537 4 218976
1#0##0#0#0.0#2018-09-04 12:09:00#0#00:00:00#00:00:00#00:00:00 1
5750967278ec85f7d3a6a60835d15ec6 0 0 387198 0 0 963771
0 0 0 0 464778 0 0 596000 0 0
3201126 B 3 BS 1 04/04/2018 05/04/2018 12/09/1960 0 2
2 I64;R40.2;I50.0 - - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 4742768 0
2 0 0 0 TINY LEANDER D033035 57 21023 DR DICKY
KARUNDENG 0138R0170418V000946 0001257784931 3;JKN DR RIZKI;
5.2.2.201806040537 4 168773 1#0##0#0#0.0#2018-09-04
12:22:26#0#15:06:04#15:06:04#00:00:00 2 f4d2fcfe41550c7255fc84000b2369c7
0 0 561609 0 0 2694884 0 0 0 0 617275
0 0 0 0 869000
3201126 B 3 BS 1 04/04/2018 05/04/2018 28/11/1951 0 2
1 I25.1;I11.9 88.55;36.07;89.52 - - YY02 None None None I-1-
40-I None None YY-02-III None None None PROSEDUR KARDIOVASKULAR PERKUTAN
(RINGAN) 10725800 0 0 PCI 10725800 - 0 - 0 -
0 21451600 58685484 0 2 0 0 0 THAI DJI KHIUN
D386590 66 24234 DR AZRI NURIZAL SPPD KKV 0138R0170418V000502
0001388641331 3;JKN irvan; 5.2.2.201806040537 4 167639
1#0##0#0#0.0#2018-09-26 16:26:00#0#09:05:20#09:05:20#12:00:00 2
859d896204044c4758a6c5374b22e8aa 0 7996000 6870800 0 0
34993684 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 23/03/2018 05/04/2018 03/10/1944 0 2
1 I63.9;J18.9;G81.9 90.59;89.52 - - None None None None G-4-
- 0 12141100 36795351 0 14 0 0 0 SRI SULASIH
SUPOMO D375246 73 26834 DR MAYSAM I., SPS 0138R01703180010277
0000045081404 3;JKN DR RIZKI; 5.2.2.201806040537 4 164077
1#1#vvip#14#24654251#0.0#2018-09-26 19:19:53#0#12:00:00#12:00:00#12:00:00
2 288f24c5eec83c512ce59cf9c5788b4c 0 0 4190000 0 0
10629351 0 0 0 0 20526000 0 0 0 0
1450000
3201126 B 3 BS 1 04/04/2018 05/04/2018 06/03/1947 0 2
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 54838924 0 2 0 0 0 JAENAH
0000511736624 3;JKN DR RIZKI; 5.2.2.201806040537 4 167599
1#0##0#0#0.0#2018-09-26 19:25:11#0#08:12:18#08:12:18#12:00:00 4
8ba82f5b72a4e07c6916ed200193b427 0 7996000 6870800 0 0
31147124 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 04/04/2018 05/04/2018 04/03/1986 0 1
1 I11.0;R57.9 - - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 4144700 2868641
0 2 0 0 0 IMAM BUKHORI D383268 32 11719 DR
DINI DANIATY 0138R0170418V000948 0001460622936 3;JKN DR RIZKI;
5.2.2.201806040537 4 168112 1#0##0#0#0.0#2018-09-26
19:26:46#0#21:11:46#21:11:46#12:00:00 2 138390ba07f98f058816584dbd96d726
0 0 754893 0 0 1637080 0 0 0 0 476668
0 0 0 0 0
3201126 B 1 BS 1 27/03/2018 05/04/2018 11/01/1961 0 1
4 A15.3;A41.9 96.72;99.08;93.94 - - None None None None J-1-
- 0 92864200 77489587 0 10 1 5 100 OMAY TRI
KOMARA D195893 57 20894 DR SUKAMTO SPPD 0138R01703180012359
0000045767294 3;JKN DR RIZKI; 5.2.2.201806040537 4 165632
1#0##0#0#0.0#2018-09-26 19:28:48#0#12:00:00#12:00:00#12:00:00 3
9f028eb49c49fe495d3a4796e6da4ae6 0 0 10547093 0 0
47279494 0 0 0 0 11978000 0 0 0 0
7685000
3201126 B 2 BS 1 03/04/2018 05/04/2018 16/10/2017 0 1
1 S09.9;B34.9 - - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 3651800 1958963 0
3 0 0 0 AZKA GALEN PRATAMA D395002 0 169 DR
OTTY MITHA S, SPA 0138R0170418V000352 0001733941067 3;JKN DR RIZKI;
5.2.2.201806040537 4 167564 1#0##0#0#0.0#2018-09-29
12:25:41#0#21:31:02#21:31:02#00:00:00 2 cfa7b6d333bbea9445340ac5e976782c
0 0 381662 0 0 243145 0 0 0 0
1164156 0 0 0 0 170000
3201126 B 3 BS 1 06/04/2018 06/04/2018 16/07/1969 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 252000 0 1 0 0 0 ACHMAD WINARNO YASA
D388359 48 17796 DR ADRIAN HANDARU 0138R0170418V001675
0001730288035 3;JKN ikwalni; 5.2.1.201802140120 4 169843
2#0##0#0#0.0#2018-04-11 14:36:21#0#00:00:00#00:00:00#12:00:00 1
8b50a86efffb26ae2dde561a37f8dbb3 200000 0 40000 0 0 0
0 0 0 0 0 0 0 0 12000 0
3201126 B 1 BS 1 04/04/2018 06/04/2018 19/12/1941 0 1
1 D29.1;N02.8;N13.3 - - - None None None None V-4-11-II
- 0 6936800 4308542 0 3 0 0 0 DANIEL DE
FRETES D031016 76 27865 DR SIDDHI ANDIKA, SPU 0138R0170418V001127
0001321520747 3;JKN DR RIZKI; 5.2.1.201802140120 4 168156
11#0##0#0#0.0#2018-04-12 15:38:39#0#09:42:55#09:42:55#12:00:00 1
67b6597104f9161312430d6397c47a2c 0 0 498941 0 0
1939734 0 0 0 0 1869867 0 0 0 0 0
3201126 B 3 BS 1 03/04/2018 06/04/2018 18/08/1965 0 1
0 - 0 - 0 - 0 - 0 3575600 4361344
0 4 0 0 0 AGUS MARAFDI D394869 52 19221 DR
5.2.1.201802140120 4 170900 1#0##0#0#0.0#2018-04-12
15:44:55#0#00:00:00#00:00:00#00:00:00 1 70b1614256f5eb62f29f6c65fe3a84a4
0 0 1061522 0 0 1790500 0 0 0 0
1381322 0 0 0 0 128000
3201126 B 3 BS 1 03/04/2018 06/04/2018 23/07/2012 0 1
1 A91;R10.4 90.59 - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2041582 0 4 0 0 0 MARIO STEVANUS NABABAN
D394689 5 2080 DR RASTRA, SPA 0138R0170418V000354
0001268668203 3;JKN DR RIZKI; 5.2.1.201802140120 4 167565
33#0##0#0#0.0#2018-04-12 15:45:53#0#21:50:20#21:50:20#00:00:00 1
e79aebdda3bcd4359ef8a0c26d58b44e 0 0 241100 0 0 505921
0 0 0 0 954561 0 0 0 0 340000
3201126 B 2 BS 1 02/04/2018 06/04/2018 28/03/1941 0 1
1 A41.9;J18.0;N18.3;K21.9;T82.4 90.59;87.49 - - None None None
7006300 0 0 - 0 - 0 - 0 - 0
7006300 12667788 0 5 0 0 0 ETJE WARTA D316048
3;JKN DR RIZKI; 5.2.1.201802140120 4 167025
1#1#vvip#5#5661488#0.0#2018-04-12 15:53:53#0#12:00:00#12:00:00#12:00:00
1 888bcb4e5982d969a6a8751121aac31b 0 0 1408000 0 0
3340054 0 0 0 0 7919734 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 06/04/2018 03/11/1943 0 1
1 D29.1;G20;I10 60.29 - - None None None None V-1-14-II
(SEDANG) 17977700 0 0 - 0 - 0 - 0 - 0
17977700 18412443 0 5 0 0 0 ASSER LOLOTAN
0000060704368 3;JKN DR RIZKI; 5.2.1.201802140120 4 166761
1#0##0#0#0.0#2018-04-12 15:57:02#0#12:00:00#12:00:00#12:00:00 1
e7720ed4cd9719c3ab666e83c3ebd5e3 0 8541200 3835661 0 0
4665582 0 0 0 0 1301000 0 0 0 0 69000
3201126 B 3 BS 1 02/04/2018 06/04/2018 20/01/1970 0 2
1 I11.0;E11.5;I67.9 86.22 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4144700
10781609 0 5 0 0 0 ANIH D388414 48 17604 DR
5.2.1.201802140120 4 166758 18#0##0#0#0.0#2018-04-13
09:02:10#0#12:00:00#12:00:00#12:00:00 1 020e81b501bfbda0dc4452d966523268
0 3581500 1834199 0 0 4535571 0 0 0 0
761339 0 0 0 0 69000
3201126 B 3 BS 1 04/04/2018 06/04/2018 02/06/1959 0 1
None None None None None None PROSEDUR HERNIA INGUINAL DAN FEMORAL
(RINGAN) 5489000 0 0 - 0 - 0 - 0 - 0
5489000 7220806 0 3 0 0 0 ATTA SUKINTA
d364277 58 21491 DR E SURYA POHAN DR SPB KBD 0138R0170418V000538
0001740110016 3;JKN DR RIZKI; 5.2.1.201802140120 4 167695
1#0##0#0#0.0#2018-04-13 09:04:22#0#09:42:45#09:42:45#00:00:00 1
d0ed569bb9868ace83ffa25acab4477a 0 3611800 961912 0 0
2029705 0 0 0 0 548389 0 0 0 0 69000
3201126 B 3 BS 1 03/04/2018 06/04/2018 04/08/1954 0 2
- 0 7516400 13964011 0 4 0 0 0 HJ. MASENAH
D389516 63 23253 RACHMAWATI DR,SPB(K)ONK 0138R0170V000067
0001739620686 3;JKN DR RIZKI; 5.2.1.201802140120 4 167566
1#0##0#0#0.0#2018-04-13 09:12:31#0#22:54:20#22:54:20#12:00:00 1
aefca096c4d20adde960b3d0783b8da2 0 5219300 2895732 0 0
4641946 0 0 0 0 989533 0 0 0 0 217500
3201126 B 3 BS 1 04/04/2018 06/04/2018 10/11/2006 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1656458 0 3 0 0 0 LUQMAN ATHA D395010
11 4163 DR AWIDIYA, SPA 0138R0170418V000365 0001455111944 3;JKN
DR RIZKI; 5.2.1.201802140120 4 167571 1#0##0#0#0.0#2018-04-13
10:57:53#0#00:51:26#00:51:26#00:00:00 1 3dfc48ff337932bce81cb6e2dca8e386
0 0 241100 0 0 321992 0 0 0 0 923366
0 0 0 0 170000
3201126 B 2 BS 1 04/04/2018 06/04/2018 06/03/1994 0 2
- 0 - 0 - 0 - 0 2601900 2870129 0
3 0 0 0 EUIS ELISKA D310634 24 8795 DR AFRA FONDA SPOG
0138r0170418v000908 0001766468081 3;JKN DR RIZKI; 5.2.1.201802140120
4 168105 1#0##0#0#0.0#2018-04-13
11:11:34#0#20:49:10#20:49:10#00:00:00 1 8fde6925185805b0303dffbd8b93ea4e
0 0 248147 0 0 1082717 0 0 0 0
1539265 0 0 0 0 0
3201126 B 1 BS 1 04/04/2018 06/04/2018 28/03/2018 2500 2
0 - 0 - 0 - 0 - 0 5886000 4493364
0 3 0 0 0 BY NY INGRID GREEN NEGO D394482 0 7
DR KRISTY, SPA 0138R0170418V000880 0002444976685 3;JKN DR RIZKI;
5.2.1.201802140120 4 168111 32#0##0#0#0.0#2018-04-13
11:14:08#0#21:00:40#21:00:40#12:00:00 1 01fcef3221ee3bec3f1b78146df09c0c
0 0 529740 0 0 160666 0 0 0 0
2350958 0 0 0 0 1452000
3201126 B 1 BS 1 04/04/2018 06/04/2018 28/03/2018 2400 2
0 - 0 - 0 - 0 - 0 5886000 4493364
0 3 0 0 0 BY NY INGRID GREEN NEGO 1 D394481 0
7 DR KRISTY, SPA 0138R0170418V000878 0002444977934 3;JKN DR
RIZKI; 5.2.1.201802140120 4 168110 31#0##0#0#0.0#2018-04-13
11:15:18#0#20:59:18#20:59:18#12:00:00 2 17376a88281a1e51cf75b6e4177eec2c
0 0 529740 0 0 160666 0 0 0 0
2350958 0 0 0 0 1452000
3201126 B 2 BS 1 23/03/2018 06/04/2018 23/03/2018 1945 2
1 P22.0;P07.3;P07.1;P59.0 96.05;96.72 - - None None None None
0 - 0 - 0 36098300 37761024 0 15 1 5
0 BAYI NY SISKA FARADILLA KUMALA SARI D393918 0 0 DR KHARNINA,
SPA 0138R01703180011555 0002443265201 3;JKN DR RIZKI; 5.2.1.201802140120
4 165175 14#0##0#0#0.0#2018-04-13
11:36:58#0#12:00:00#12:00:00#12:00:00 1 30d896aaa139c629809d3da847722c5f
0 0 3810826 0 0 7297198 0 0 0 0
13656000 0 0 0 0 12997000
3201126 B 3 BS 1 06/04/2018 06/04/2018 08/12/1976 0 1
1 K21.9;I25.0;K80.2 89.52 - - None None None None K-4-12-I
0 0 - 0 - 0 - 0 - 0 2954900
1303171 0 1 0 0 0 SUPRI JAYADI D338883 41
15094 DR DICKI PRATAMA 0138R0170418V001521 0001725615382 3;JKN DR
RIZKI; 5.2.1.201802140120 4 168472 1#0##0#0#0.0#2018-04-13
15:09:19#0#00:00:00#04:45:00#12:00:00 1 4a68a251287035e8793057e41d2a197d
0 0 368937 0 0 559980 0 0 0 0 374254
0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 06/04/2018 29/01/1956 0 1
1 I11.0;J22 89.52 - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 5005900 4950449
0 5 0 0 0 KARYANTO D344004 62 22709 DR SUPONO
SPJP 0138R01704180000708 0000041115633 3;JKN DR RIZKI; 5.2.1.201802140120
4 167150 1#0##0#0#0.0#2018-04-13
15:12:54#0#12:00:00#12:00:00#00:00:00 1 be23a90e2a105ce2ece6b9c3db740ea8
0 0 450530 0 0 590558 0 0 0 0
3909361 0 0 0 0 0
3201126 B 2 BS 1 01/04/2018 06/04/2018 12/03/1951 0 2
1 I64;I50.0 88.72 - - None None None None G-4-15-II None
- 0 - 0 - 0 5866300 7672967 0 6 0
0 0 MUINAH D394724 67 24492 DR HARDI PRANATA SPS
0138R01704180000004 0000172689142 3;JKN DR RIZKI; 5.2.1.201802140120
4 166738 1#0##0#0#0.0#2018-04-13
15:23:04#0#12:00:00#12:00:00#12:00:00 1 247a720cee830f0dfef97085f31ce941
0 0 1316954 0 0 2798043 0 0 0 0
3557970 0 0 0 0 0
3201126 B 2 BS 1 05/04/2018 06/04/2018 24/10/1983 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
0001638965226 3;JKN DR RIZKI; 5.2.1.201802140120 4 168464
1#0##0#0#0.0#2018-04-13 15:24:35#0#20:40:12#20:40:12#00:00:00 1
814c89f1cc61caf0413da726690dfdec 0 0 424889 0 0
1357554 0 0 0 0 2248454 0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 06/04/2018 18/08/1975 0 2
- 0 4203300 8294044 0 8 0 0 0 HADIJAH
0001266002684 3;JKN DR RIZKI; 5.2.1.201802140120 4 166644
1#0##0#0#0.0#2018-04-16 08:30:47#0#12:00:00#12:00:00#12:00:00 2
673bb7b1c8f498b18c5639a0ce07085f 0 0 409013 0 0
3276430 0 0 0 0 4608601 0 0 0 0 0
3201126 B 1 BS 1 30/03/2018 06/04/2018 20/10/1945 0 1
1 I64;I10;I50.0;E14.9 87.03;90.59;89.52 - - None None None
6844000 0 0 - 0 - 0 - 0 - 0
6844000 15959811 0 8 0 0 0 ZAINUDDIN IDRIS ,H
0000061057787 3;JKN DR RIZKI; 5.2.1.201802140120 4 166648
1#1#vvip#8#9115811#0.0#2018-04-16 08:55:52#0#12:00:00#12:00:00#00:00:00
1 5237bc40376a068080127b62ee18b779 0 0 2390161 0 0
3287550 0 0 0 0 10282100 0 0 0 0 0
3201126 B 2 BS 1 05/04/2018 06/04/2018 04/04/2013 0 2
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9807250 0 2 0 0 0 LAINA ANIDA D394466
5 1827 DR CATUR SUZANTARA 0138R0170418V001274 0001337049303
3;JKN DR RIZKI; 5.2.1.201802140120 4 168306 1#0##0#0#0.0#2018-
04-16 10:26:50#0#13:29:01#13:29:01#12:00:00 1
36624feee61d13636b53d535cac3a5c0 0 4933300 1907276 0 0
2154078 0 0 0 0 667596 0 0 0 0 145000
3201126 B 1 BS 1 04/04/2018 06/04/2018 07/08/1949 0 1
- 0 58821400 63505191 0 3 0 0 0 DJAMALIS TN
0001304476918 3;JKN DR RIZKI; 5.2.1.201802140120 4 168099
26#0##0#0#0.0#2018-04-16 10:38:19#0#19:15:33#19:15:33#00:00:00 1
4c019fbbcb972efc012a2a9f867dfc04 0 9377500 6923800 0 0
38378891 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 04/04/2018 06/04/2018 29/09/1965 0 1
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 3518915 0 3 0 0 0 BUDI SETIAWAN
D395045 52 19180 DR HARDI PRANATA SPS 0138R0170418V000821
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1#0##0#0#0.0#2018-04-16 10:53:56#0#09:44:41#09:44:41#00:00:00 1
1b1a717079a1c8ab85c73e6a84eff0ed 0 0 684656 0 0 235050
0 0 0 0 2599209 0 0 0 0 0
3201126 B 1 BS 1 05/04/2018 06/04/2018 12/10/2014 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 10614577 0 2 0 0 0 ANDREW TUWANAKOTTA
d284428 3 1271 DR CATUR S, SPB 0138R0170418V001231
0002324952314 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168291
1#0##0#0#0.0#2018-04-17 11:53:08#0#12:09:28#12:09:28#00:00:00 1
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1733545 0 0 0 0 750412 0 0 0 0 34500
3201126 B 2 BS 1 05/04/2018 06/04/2018 06/07/1951 0 2
- 0 10690500 11339436 0 2 0 0 0 EKA SUKAESIH
0000043949226 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168460
1#0##0#0#0.0#2018-04-17 15:40:10#0#19:22:39#19:22:39#00:00:00 1
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3638952 0 0 0 0 5029432 0 0 0 0 34500
3201126 B 3 BS 1 05/04/2018 06/04/2018 01/09/1988 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 4965619 0 2 0 0 0 FARISA BUDI ANGGRAENI
D381703 29 10808 DR DEDY PRATAMA SPBV 0138R0170418V001322
0001740585126 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168343
1#0##0#0#0.0#2018-04-17 15:41:53#0#14:23:19#14:23:19#12:00:00 1
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0 0 0 0 3443354 0 0 0 0 69000
3201126 B 2 BS 1 04/04/2018 06/04/2018 04/04/2018 3484 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437343 0 3 0 0 0 BY NY DINA FAZRIA
D395056 0 0 DR HANDARMI, SPA 0138R0170418V001854
0002446689317 3;JKN DR RIZKI; 5.2.1.201804062320 4 171071
1#0##0#0#0.0#2018-04-18 08:46:27#0#00:00:00#00:00:00#00:00:00 1
6f3840744f34719e4d418ea79771490c 0 0 433812 0 0 88899
0 0 0 0 914632 0 0 0 0 0
3201126 B 1 BS 1 04/04/2018 06/04/2018 04/04/2018 2780 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1899798 0 3 0 0 0 BY NY CITRA RESMI
0002446907354 3;JKN DR RIZKI; 5.2.1.201804062320 4 168532
8#0##0#0#0.0#2018-04-18 09:08:33#0#09:22:20#09:22:20#00:00:00 1
953886cc62a4ceaafb7b1eac2e46874d 0 0 368013 0 0 88899
0 0 0 0 1442886 0 0 0 0 0
3201126 B 2 BS 1 05/04/2018 06/04/2018 02/11/2011 0 2
0 - 0 - 0 - 0 7145100 9733616 0 2
0 0 0 HAYATUN NAZIRA D395114 6 2346 DR CATUR S, SPB
0138R0170418V000965 0002093976134 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176156 1#0##0#0#0.0#2018-05-03
16:19:35#0#00:00:00#00:00:00#00:00:00 1 d964e75a90a1076d5364a74a289aaeb5
0 4397500 2196530 0 0 2404307 0 0 0 0
662779 0 0 0 0 72500
3201126 B 2 BS 1 05/04/2018 06/04/2018 28/03/1973 0 1
- 0 10690500 11129174 0 2 0 0 0 FAHRUDIN
0001898374364 3;JKN ECHI; 5.2.1.201804062320 4 168463
1#0##0#0#0.0#2018-05-16 15:28:31#0#20:14:04#20:14:04#00:00:00 2
4635ffc1da3bd2bf29eef0bbf3d3e5ed 0 0 2636552 0 0
3407945 0 0 0 0 5015677 0 0 0 0 69000
3201126 B 1 BS 1 03/04/2018 06/04/2018 21/05/2002 0 1
1 C41.9;K12.1 - - - None None None None M-4-13-II None
None None None None None TUMOR MUSKULOSKLETAL,JARINGAN KONEKTIF DAN
FRAKTUR PATOLOGIS (SEDANG) 10322900 0 0 - 0 - 0 -
0 - 0 10322900 7524500 0 4 0 0 0
ARVANDY YUSTICIO D393239 15 5796 DR OTTY MITHA S, SPA
0138R0170418V000342 0000126245801 3;JKN ECHI; 5.2.1.201804062320
4 167924 1#1#vvip#4#0#0.0#2018-05-17
10:37:22#0#13:19:25#13:19:25#12:00:00 2 523383e584b7a13dbe7be928e81abc44
0 0 866000 0 0 1895243 0 0 0 0
4763257 0 0 0 0 0
3201126 B 3 BS 1 04/04/2018 06/04/2018 01/03/1992 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 7528489 0 3 0 0 0 DINA FAZRIA D395025
26 9530 DR ARIS WAHJU, SPOG 0138R0170418V000570 0001306766373
3;JKN ECHI; 5.2.1.201804062320 4 167777 1#0##0#0#0.0#2018-06-06
11:03:36#0#10:52:40#10:52:40#00:00:00 2 23134ae94c3e8a4193c148efe11675c2
0 3534500 1708644 0 0 1632827 0 0 0 0
583518 0 0 0 0 69000
3201126 B 3 BS 1 05/04/2018 06/04/2018 29/10/2008 0 2
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6616904 0 2 0 0 0 AFIFA WARDA D393748*
9 3445 DR CATUR SUZANTARA 0138R0170418V001034 0001725323938
3;JKN ECHI; 5.2.1.201804062320 4 168122 1#0##0#0#0.0#2018-06-06
11:03:56#0#07:40:12#07:40:12#00:00:00 2 e9d325cd64fa76665ed7da8ef90f6198
0 3062500 1599920 0 0 1396602 0 0 0 0
488882 0 0 0 0 69000
3201126 B 1 BS 1 04/04/2018 06/04/2018 01/12/1982 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12943547 0 3 0 0 0 CITRA RESMI D281661
35 12908 DR BAGUS T, SPOG 0138R0170418V000364 0002233786184 3;JKN
DR RIZKI; 5.2.2.201806040537 4 167570 1#0##0#0#0.0#2018-08-18
13:53:04#0#00:37:08#00:37:08#00:00:00 2 5128d6972a569713d8897d515ddb2aca
0 7098900 2419895 0 0 2166978 0 0 0 0
932774 0 0 0 0 325000
3201126 B 2 BS 1 05/04/2018 06/04/2018 24/05/1997 0 1
1 I12.0;D63.8;A41.9 99.21;99.04;38.95 - - None None None None
- 0 - 0 23198900 16735104 0 2 0 0 0
MUHAMMAD IQBAL HIDAYATULLAH D395196 20 7621 DR. ARU ARIADNO, SPPD
0138R0170418V001515 0001214834444 3;JKN DR RIZKI; 5.2.2.201806040537
4 168470 1#0##0#0#0.0#2018-08-20
09:49:10#0#00:37:55#00:37:55#00:00:00 2 64885bed8c860301b220c5cc02d460c3
0 0 6780681 0 0 4710503 0 0 0 0
5174920 0 0 0 0 69000
3201126 B 3 BS 1 03/04/2018 06/04/2018 04/08/1954 0 2
- 0 7516400 13964011 0 4 0 0 0 HJ. MASENAH
0001739620686 3;JKN DR RIZKI; 5.2.2.201806040537 4 167566
1#0##0#0#0.0#2018-08-21 10:37:35#0#22:54:20#22:54:20#12:00:00 2
2fd3535bfaee9fcbde093a45cafb7ae9 0 5219300 2895732 0 0
4641946 0 0 0 0 989533 0 0 0 0 217500
3201126 B 3 BS 1 06/04/2018 06/04/2018 08/08/2017 0 2
1 E44.1;J18.9 87.44 - - None None None None E-4-10-III None
METABOLIK (BERAT) 6262900 0 0 - 0 - 0 - 0 -
0 6262900 2573444 0 1 0 0 0 HAURA NAZHIFA
KHAIRUNISA D395208 0 241 DR DICKI PRATAMA 0138R0170418V001668
0002274296005 3;JKN DR RIZKI; 5.2.2.201806040537 4 168545
1#0##0#0#0.0#2018-09-26 19:13:57#0#09:31:10#09:31:10#00:00:00 2
b3f30cc09df3c1d63094bab724a396b0 0 0 325188 0 0
1790900 0 0 0 0 457356 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 06/04/2018 13/03/1955 0 1
1 N40;I11.9;R31 60.29 - - None None None None V-1-14-I
(RINGAN) 12373100 0 0 - 0 - 0 - 0 - 0
12373100 47267487 0 12 1 3 0 NONO KARSONO
d379611 63 23024 DR SIDDHI ANDIKA, SPU 0138R01703180011231
0001146718225 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 164786
1#0##0#0#0.0#2018-10-05 16:14:31#0#12:00:00#12:00:00#12:00:00 4
74d128fe325b5cd0d39f89cd274d4a2b 0 19100400 4641047 0 0
14136751 0 0 0 0 8485289 0 0 0 0 904000
3201126 B 2 BS 1 04/04/2018 07/04/2018 09/08/1989 0 2
0 0 - 0 - 0 - 0 - 0 5984100
18955051 0 4 0 0 0 MELISA AMELIA RIANTI NY D394939
28 10465 DR ERDIYAN, SPOG 0138R0170418V000750 0001306570083 3;JKN
DR RIZKI; 5.2.1.201802140120 4 168097
1#1#vvip#4#12970951#0.0#2018-04-12 13:47:45#0#17:57:57#17:57:57#00:00:00
3 80757de79d9e7e7ba101c3102e25ff52 0 12520051 6435000 0
0 0 0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 01/04/2018 07/04/2018 13/03/1966 0 1
1 I63.9;G81.9;E11.9 87.03;90.59;89.52 - - None None None None
0 - 0 9673300 9514265 0 7 0 0 0 LIBER
SIBORO D354920 52 19012 DR AL RASYID SPS 0138R01704180000122
0000037362082 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166754
1#0##0#0#0.0#2018-04-13 11:15:52#0#12:00:00#12:00:00#00:00:00 1
fa4a095dab45b6adfbecd618c4e82bcd 0 0 1407262 0 0
2772574 0 0 0 0 5334429 0 0 0 0 0
3201126 B 2 BS 1 06/04/2018 07/04/2018 25/04/1952 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 2993877 0 2 0 0 0 DIDI SUHENDRI
D321683 65 24087 DR. ARU ARIADNO, SPPD 0138R0170418V002106
0001459026955 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168873
1#0##0#0#0.0#2018-04-13 11:25:23#0#21:45:34#21:45:34#00:00:00 1
6ddd6769b246e29ea68e87a048bd443f 0 0 371889 0 0
1579627 0 0 0 0 1042361 0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 07/04/2018 30/03/1940 0 2
1 I48;I21.9;N18.9;I50.0 - - - None None None None I-4-
(BERAT) 8754900 0 0 - 0 - 0 - 0 - 0
8754900 22091675 0 9 0 0 0 DJUNAENGSIH, NY
0000061007681 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166655
1#0##0#0#0.0#2018-04-13 11:40:00#0#12:00:00#12:00:00#00:00:00 1
99668dcc79e7d8428a219fc02ff97e07 0 0 1184579 0 0
10046096 0 0 0 0 7599000 0 0 0 0
3262000
3201126 B 1 BS 1 04/04/2018 07/04/2018 17/09/1960 0 1
1 K40.3;E11.9 53.61 - - None None None None K-1-12-I None
None None None None None PROSEDUR HERNIA TIDAK TERMASUK INGUINAL &
FEMORAL (RINGAN) 4809500 0 0 - 0 - 0 - 0 -
0 4809500 19456607 0 4 0 0 0 SUYANTO
D394966 57 21018 DR HENDRIEK S, SPB 0138R0170418V000367
0001336236737 3;JKN DR RIZKI; 5.2.1.201802140120 4 167572
1#1#vvip#4#14647107#0.0#2018-04-16 08:38:48#0#00:56:04#00:56:04#00:00:00
1 ecc6e3e5d251e837ba1b0e83290e29ef 0 10547900 2746320 0
0 4817387 0 0 0 0 1276000 0 0 0 0
69000
3201126 B 2 BS 1 04/04/2018 07/04/2018 04/04/2018 3583 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3219535 0 4 0 0 0 MELISA AMELIA RIANTI BY
NY D395089 0 0 DR HANDARMI, SPA 0138R0170418V001462
0002446987454 3;JKN DR RIZKI; 5.2.1.201802140120 4 168458
1#0##0#0#0.0#2018-04-16 09:02:02#0#18:13:12#18:13:12#00:00:00 1
e1f1a654ee6ef9aa0db6a482edb135b4 0 0 433812 0 0 434099
0 0 0 0 2351624 0 0 0 0 0
3201126 B 3 BS 1 07/04/2018 07/04/2018 08/05/1960 0 1
2 I60.9;K27.3;J80 89.52;87.03;96.05 - - None None None None
0 - 0 5153300 4985074 0 1 0 0 0 SATORI
D395305 57 21153 DR. SUKMARINI 0138R0170418V002202
0000060527608 3;JKN DR RIZKI; 5.2.1.201802140120 4 169019
1#0##0#0#0.0#2018-04-16 10:52:07#0#10:43:10#10:43:10#00:00:00 1
fccede2fdd44ea92bde0432484c6089d 0 0 368658 0 0
3267290 0 0 0 0 633126 0 0 0 0 716000
3201126 B 1 BS 1 04/04/2018 07/04/2018 06/11/1967 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3469512 0 4 0 0 0 SLAMET SANTOSO
0000038963079 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168117
1#0##0#0#0.0#2018-04-17 11:44:07#0#23:33:23#23:33:23#00:00:00 1
6ac58f3c0fd469eac25cd8fcf27b7434 0 0 404801 0 0 468734
0 0 0 0 2595977 0 0 0 0 0
3201126 B 2 BS 1 30/03/2018 07/04/2018 01/01/1950 0 2
1 I21.9;I50.0;R57.0 - - - None None None None I-4-10-III
0 0 - 0 - 0 - 0 - 0 12482300
25805648 0 9 0 0 0 SALBIYAH, HJ D373699 68
3;JKN TANTIYO S;16137 5.2.1.201802140120 4 166647
1#0##0#0#0.0#2018-04-17 14:22:13#0#12:00:00#12:00:00#12:00:00 1
657ada23a497f9893d7e77a7d9283a64 0 0 932102 0 0
9924546 0 0 0 0 8715000 0 0 0 0
6234000
3201126 B 1 BS 1 05/04/2018 07/04/2018 14/02/1950 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 17390064 0 3 0 0 0 HARRY HERMANSYAH
d393208 68 24887 DR H TEDDY H DJUNAEDI SPB 0138R0170418V000983
0000038226688 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 168121
1#1#vvip#3#9705564#0.0#2018-04-17 14:34:06#0#06:31:36#06:31:36#12:00:00
1 84e9fb24fc56b67bde030e05a9acf0b4 0 9372900 2777486 0
0 3937010 0 0 0 0 1233668 0 0 0 0
69000
3201126 B 3 BS 1 04/04/2018 07/04/2018 31/12/1949 0 1
1 I25.0;I48;N18.5;I44.1;I11.0 88.55;36.07 - - YY02 None None
0 - 0 - 0 45079800 63130719 0 4 0 0
0 SAMIN HS D389095 68 24931 DR AZRI NURIZAL SPPD KKV
0138R0170418V000504 0001459427095 3;JKN TANTIYO S;16137
5.2.1.201802140120 4 167633 1#0##0#0#0.0#2018-04-17
15:23:07#0#08:56:10#08:56:10#12:00:00 1 9dd5121e86bd7def3b5577f0ee329bb6
0 10532000 5144120 0 0 36841599 0 0 0 0
1256000 0 0 0 0 9357000
3201126 B 3 BS 1 06/04/2018 07/04/2018 29/10/1992 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7363126 0 2 0 0 0 REZA ANDENI P
0002444706112 3;JKN DR RIZKI; 5.2.1.201802140120 4 168870
24#0##0#0#0.0#2018-04-17 15:24:57#0#20:32:16#20:32:16#00:00:00 1
3105f9c5f508b040382ad44886f58cbe 0 2994000 1311745 0 0
2450681 0 0 0 0 537700 0 0 0 0 69000
3201126 B 2 BS 1 05/04/2018 07/04/2018 02/05/1950 0 1
1 T87.4;E14.5 39.50 - - None None None None I-1-20-II None
(SEDANG) 23032500 0 0 - 0 - 0 - 0 - 0
23032500 14381405 0 3 0 0 0 SUDARNO D393327
67 24810 DEDY PRATAMA,SPBV 0138R0170418V001163 0000060929774 3;JKN
TANTIYO S;16137 5.2.1.201802140120 4 168195 1#0##0#0#0.0#2018-
04-17 15:26:09#0#10:25:05#10:25:05#12:00:00 1
0e46b27a585f8cb825da24e7c1a1d394 0 3970000 3891760 0 0
3453805 0 0 0 0 996840 0 0 0 0
2069000
3201126 B 3 BS 1 06/04/2018 07/04/2018 17/03/1972 0 2
1 N18.5;D63.8;D69.6 99.04;39.42 - - None None None None N-1-
- 0 8908800 13017348 0 2 0 0 0 ERLIYANI
0001264472122 3;JKN DR RIZKI; 5.2.1.201802140120 4 168878
1#0##0#0#0.0#2018-04-17 15:26:41#0#00:36:30#00:36:30#12:00:00 1
56a8b645a43849fa24d989a725e95192 0 3438800 5619202 0 0
2962744 0 0 0 0 927602 0 0 0 0 69000
3201126 B 1 BS 1 28/03/2018 07/04/2018 28/12/1937 0 2
1 I95.9;I48;I13.2;R00.1;K30 - - - None None None None
- 0 11395800 22090751 0 11 1 2 0 M. AMINAH
0000044916197 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 165954
1#0##0#0#0.0#2018-04-17 15:29:50#0#12:00:00#12:00:00#12:00:00 1
bce00ae45554c460694f1fea45bec48d 0 0 1078621 0 0
8854130 0 0 0 0 9588000 0 0 0 0
2570000
3201126 B 1 BS 1 03/04/2018 07/04/2018 13/12/1950 0 1
1 I63.9;N39.0 87.03 - - None None None None G-4-14-II None
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 7409239 0 5 0 0 0 SETYO SOESANTO
0000041413061 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167580
1#0##0#0#0.0#2018-04-17 15:34:39#0#03:28:38#03:28:38#00:00:00 1
03bf8c659744c242a8d1a80a8cadadc5 0 0 743950 0 0
2249572 0 0 0 0 4415717 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 07/04/2018 04/06/1946 0 1
1 E11.5;L97;I64;G81.9 86.22 - - None None None None I-4-
LAIN (SEDANG) 8537100 0 0 - 0 - 0 - 0 -
0 8537100 15918756 0 5 0 0 0 SUWATDI
BACHRUN,DRS D239273 71 26236 DEDY PRATAMA,SPBV 0138R01704180000887
0000061044535 3;JKN TANTIYO S;16137 5.2.1.201802140120 4 167246
1#0##0#0#0.0#2018-04-17 15:38:51#0#12:00:00#12:00:00#12:00:00 1
d877eeb2868cc3718df7a7a746386e91 0 7969000 2614130 0 0
4169212 0 0 0 0 1097414 0 0 0 0 69000
3201126 B 1 BS 1 31/03/2018 07/04/2018 21/05/1947 0 1
1 J44.9;E14.9;I51.7;D29.1 87.44 - - None None None None J-4-
17-I None None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (RINGAN)
5164300 0 0 - 0 - 0 - 0 - 0
5164300 32295986 0 8 0 0 0 SYAHRIZAL MISHAR,DR
0000060897036 3;JKN DR RIZKI; 5.2.1.201802140120 4 166687
17#1#vvip#8#27131686#0.0#2018-04-17 16:05:52#0#12:00:00#12:00:00#12:00:00
1 bceafac6b3365e079b3a4b59c7829ee8 0 0 2245120 0 0
18581866 0 0 0 0 11469000 0 0 0 0 0
3201126 B 3 BS 1 07/04/2018 07/04/2018 05/04/1943 0 1
1 R90.0 87.03 - - None None None None G-4-26-I None None
3587300 0 0 - 0 - 0 - 0 - 0
3587300 1682536 0 1 0 0 0 RIIH N.NELAN
D324093 75 27396 DR RICO ADITYA 0138R0170418V002132
0000511843533 3;JKN DR RIZKI; 5.2.1.201804062320 4 168882
1#0##0#0#0.0#2018-04-19 14:31:29#0#03:38:27#03:38:27#12:00:00 1
d69988b9a7d10bdf5c09c8c41a5a8426 0 0 322857 0 0 226607
0 0 0 0 417072 0 0 0 0 716000
3201126 B 3 BS 1 07/04/2018 07/04/2018 17/05/1958 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2603675 0 1 0 0 0 ROSMIYATI D382439
59 21875 DR RICO ADITYA 0138R0170418V002219 0001447717882 3;JKN
DR RIZKI; 5.2.1.201804062320 4 169068 1#0##0#0#0.0#2018-04-19
14:35:10#0#11:26:21#11:26:21#12:00:00 1 0acdbc89c674df0ef63fc74a8b676d20
0 0 371889 0 0 1038452 0 0 0 0 477334
0 0 0 0 716000
3201126 B 1 BS 1 05/04/2018 07/04/2018 09/10/2017 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2532015 0 3 0 0 0 AL AZRIL REZKYAN MAULANA
0002275653374 3;JKN DR RIZKI; 5.2.1.201804062320 4 168465
26#0##0#0#0.0#2018-04-20 15:17:00#0#20:44:24#20:44:24#00:00:00 1
2619ed85d6a7e7cfc597c443a621f08a 0 0 257183 0 0 521186
0 0 0 0 1753646 0 0 0 0 0
3201126 B 3 BS 1 05/04/2018 07/04/2018 15/05/1953 0 1
1 H81.3;L27.1;R63.0 - - - None None None None U-4-11-II
0 - 0 - 0 - 0 - 0 2207000 2500371
0 3 0 0 0 SOPIAN D395148 64 23701 DR ARU, SPPD
0138R0170418V001376 0000385772409 3;JKN DR RIZKI; 5.2.1.201804062320
4 168437 20#0##0#0#0.0#2018-04-20
15:18:16#0#16:09:17#16:09:17#00:00:00 1 42aa2ee58b4ff76943e4044eee20e32e
0 0 251630 0 0 1270165 0 0 0 0 978576
0 0 0 0 0
3201126 B 1 BS 1 07/04/2018 07/04/2018 21/12/2007 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 4321805 0 1 0 0 0 IQBAL MARLOPO
PURNAMASIDI C240998 10 3760 DR VERA MUNA MANOE, SPA 0138R0170418V002171
0001335363658 3;JKN DR RIZKI; 5.2.1.201804062320 4 168939
8#0##0#0#0.0#2018-04-20 15:19:19#0#09:03:30#09:03:30#12:00:00 1
59fef20b135a40894bc250cb06eae429 0 0 376362 0 0
2855708 0 0 0 0 1089735 0 0 0 0 0
3201126 B 1 BS 1 06/04/2018 07/04/2018 19/12/1949 0 1
1 K92.1;K29.6;K26.1 45.16 - - None None None None K-4-18-I
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 5907346 0 2 0 0 0 TJIPTADI D021182
68 24945 DR. ARU ARIADNO, SPPD 0138R0170418V002096 0000061053603
3;JKN DR RIZKI; 5.2.1.201804062320 4 168867 1#0##0#0#0.0#2018-
05-04 10:42:05#0#20:13:59#20:13:59#00:00:00 2
b78540df886f72d24884637ab055e61d 0 0 459784 0 0
1109100 0 0 0 0 2589462 0 0 0 0
1749000
3201126 B 2 BS 1 04/04/2018 07/04/2018 16/04/2011 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3758810 0 4 0 0 0 SHAQUILLE I'ZAZ SAVERO
D395017 6 2545 DR OTTY MITHA S, SPA 0138R0170418V000624
0002052235855 3;JKN ECHI; 5.2.1.201804062320 4 167905
1#0##0#0#0.0#2018-05-14 17:24:45#0#12:07:18#12:07:18#00:00:00 2
62f74f71b8d86573311b6fa9471d63c6 0 0 278711 0 0
1018196 0 0 0 0 2291903 0 0 0 0 170000
3201126 B 1 BS 1 03/04/2018 07/04/2018 22/06/1972 0 2
None None None None None LIGASI DAN STRIPPING PEMBULUH DARAH VENA
(RINGAN) 19082700 0 0 - 0 - 0 - 0 - 0
19082700 16258362 0 5 0 0 0 FIRDA ANIWAHYUNI
D388970 45 16721 DEDY PRATAMA,SPBV 0138R0170418V000065
0001449264723 3;JKN ECHI; 5.2.1.201804062320 4 167579
1#0##0#0#0.0#2018-05-16 15:06:21#0#03:23:20#03:23:20#12:00:00 2
2c5702bdcf9d952319749c9161f667a5 0 0 5403676 0 0
1692555 0 0 0 0 7969000 0 0 103500 26000
1063631
3201126 B 1 BS 1 03/04/2018 07/04/2018 30/04/1962 0 1
(RINGAN) 7018400 0 0 - 0 - 0 - 0 - 0
7018400 6039767 0 5 0 0 0 MISNARA PULUNGAN
0000036621178 3;JKN DR RIZKI; 5.2.2.201806040537 4 167568
1#0##0#0#0.0#2018-08-20 08:59:28#0#23:36:12#23:36:12#00:00:00 2
df84a17ffaa10c505e7b3eecb022d52a 0 0 754840 0 0
1739802 0 0 0 0 3545125 0 0 0 0 0
3201126 B 2 BS 1 06/04/2018 07/04/2018 22/06/1960 0 1
0 0 - 0 - 0 - 0 - 0 2783600
5480690 0 2 0 0 0 SURYADINATA D390310 57 21107
DR ARU, SPPD 0138R0170418V002108 0001815193067 3;JKN DR RIZKI;
5.2.2.201806040537 4 168874 1#0##0#0#0.0#2018-09-05
18:32:16#0#22:18:47#22:18:47#12:00:00 2 e48d517dc67b8f715275a0b7f2b9687b
0 0 832408 0 0 1177232 0 0 0 0
1722050 0 0 0 0 1749000
3201126 B 2 BS 1 04/04/2018 07/04/2018 27/11/2002 0 1
1 M86.56;T93.1 78.65 - - None None None None M-1-40-II
None None None None None None EKSISI LOKAL DAN PENGANGKATAN ALAT
FIKSASI INTERNAL (SEDANG) 9184300 0 0 - 0 - 0 -
0 - 0 9184300 15885481 0 4 0 0 0
YOHANES D394382 15 5607 DR MARQUEE KENNY TUMBELAKA SPOT
0138R0170418V000945 0001734507246 3;JKN DR RIZKI; 5.2.2.201806040537
4 168102 1#0##0#0#0.0#2018-09-07
16:13:57#0#20:44:49#20:44:49#12:00:00 3 3ca1f06b3ff4e69fd24c0071b61e9b29
0 0 3146368 0 0 3258876 0 0 0 0
9335237 0 0 0 0 145000
3201126 B 1 BS 1 06/04/2018 07/04/2018 22/11/2016 0 2
1 Q38.1 25.92 - - None None None None U-4-14-I None None
0 - 0 - 0 - 0 - 0 5163500 8407066
0 2 0 0 0 ARSENIO GHAISAN ADIYATMA D350744* 1
500 DR CATUR SUZANTARA 0138R0170418V002099 0002252657351 3;JKN
DR RIZKI; 5.2.2.201806040537 4 168871 1#0##0#0#0.0#2018-09-26
18:20:04#0#20:42:28#20:42:28#12:00:00 2 950714fd0698b3ad74d308deb1b366fd
0 6150700 1032696 0 0 578675 0 0 0 0
575995 0 0 0 0 69000
3201126 B 3 BS 1 06/04/2018 07/04/2018 08/09/1975 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7430001 0 2 0 0 0 AMIRRUDIN D379729
42 15551 DR IRFIANSYAH LESMANA DR SPBTKV 0138R0170418V001993
0001266283269 3;JKN DR RIZKI; 5.2.2.201806040537 4 168869
1#0##0#0#0.0#2018-09-26 18:26:23#0#20:29:02#20:29:02#12:00:00 2
023f5694e530f48c9b308f12926ce31c 0 3438800 931100 0 0
2449026 0 0 0 0 542075 0 0 0 0 69000
3201126 B 3 BS 1 04/04/2018 07/04/2018 20/03/1981 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 12881543 0 4 0 0 0 RIKSON NABABAN
D393418 37 13529 DR HENDRIEK SP B 0138R0170418V000604
0002440631327 3;JKN DR RIZKI; 5.2.2.201806040537 4 167849
1#0##0#0#0.0#2018-09-26 18:40:24#0#11:39:41#11:39:41#00:00:00 2
d70020dd6679b09c10c2fcc56c43ce25 0 0 4555910 0 0
3543115 0 0 0 0 4713518 0 0 0 0 69000
3201126 B 3 BS 1 07/04/2018 08/04/2018 06/12/1955 0 1
- 0 8908800 9439332 0 2 0 0 0 SAAR SATIM
d395345 62 22768 SRI KUNMARTINI.DR,SPPD 0138R0170418V002264
0001740039028 3;JKN DR RIZKI; 5.2.1.201802140120 4 169204
23#0##0#0#0.0#2018-04-13 15:31:18#0#16:02:28#16:02:28#00:00:00 1
3f1dc79ce07e19feec2e9db7887af6f8 0 3438800 2583552 0 0
2674454 0 0 0 0 673526 0 0 0 0 69000
3201126 B 2 BS 1 06/04/2018 08/04/2018 13/04/1984 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
D388984 33 12411 DR SRI KUN, SPPD 0138R0170418V001560
0001336724368 3;JKN DR RIZKI; 5.2.1.201802140120 4 168473
1#0##0#0#0.0#2018-04-16 08:40:25#0#07:14:54#07:14:54#12:00:00 2
e06c9596b538ac983fa7194a57de1f28 0 0 310183 0 0
2048940 0 0 0 0 3051196 0 0 0 0 0
3201126 B 1 BS 1 26/03/2018 08/04/2018 26/03/2018 1900 1
1 P07.3;P07.1;P01.1;P59.0 99.82 - - None None None None P-8-
12-II None None None None None None NEONATAL, BBL 1500 - 1999 GR TANPA
- 0 15568900 27753737 0 14 1 6 0 MUHAMMAD
RAZQA ABQARY D394216 0 0 DR KHARINA CHATAR SPA
0138R01703180012713 0002444216995 3;JKN DR RIZKI; 5.2.1.201802140120
4 165911 1#0##0#0#0.0#2018-04-16
09:10:18#0#12:00:00#12:00:00#12:00:00 1 ff8361a84f3b99b35534fba69ed17dc1
0 0 1556882 0 0 3787855 0 0 0 0
13658000 0 0 0 0 8751000
3201126 B 3 BS 1 05/04/2018 08/04/2018 05/04/1994 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8786280 0 4 0 0 0 SITI MASLUROH
D392409 24 8766 DR FERRI SABARUDDIN SPOG 0138R0170418V001469
0001260256498 3;JKN DR RIZKI; 5.2.1.201802140120 4 171455
1#0##0#0#0.0#2018-04-16 09:58:42#0#00:00:00#00:00:00#00:00:00 1
7c4eb7b7e507b29195e713529b150325 0 3621000 1761644 0 0
2580833 0 0 0 0 625803 0 0 0 0 197000
3201126 B 3 BS 1 08/04/2018 08/04/2018 06/02/1959 0 2
0 - 0 - 0 - 0 - 0 2168700 897822
0 1 0 0 0 WARTI D379236 59 21611 DR DICKY KARUNDENG
0138R0170418V002402 0001740085424 3;JKN DR RIZKI; 5.2.1.201802140120
4 169230 1#0##0#0#0.0#2018-04-16
10:04:09#0#18:52:25#18:52:25#12:00:00 1 5dfd155427cfa3e2e2c9f7944500d5a0
0 0 378234 0 0 171852 0 0 0 0 347736
0 0 0 0 0
3201126 B 3 BS 1 05/04/2018 08/04/2018 04/01/2017 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 9495211 0 4 0 0 0 MUHAMMAD ARSYA ABDILLAH
D361067 1 456 DR ASRI RAHMAWATI SPB 0138R0170418V001412
0002201856884 3;JKN DR RIZKI; 5.2.1.201802140120 4 168457
1#0##0#0#0.0#2018-04-16 10:06:54#0#16:44:42#16:44:42#12:00:00 1
9c38cdf5357df496e9d0566d4510db08 0 3408500 1705920 0 0
3538609 0 0 0 0 697182 0 0 0 0 145000
3201126 B 3 BS 1 06/04/2018 08/04/2018 06/05/1986 0 2
1 I12.0;M32.9;J18.0;D63.8 39.27;99.04 - - None None None None
- 0 - 0 19332400 9530310 0 3 0 0 0
SITI AMALIA D353116 31 11658 SRI KUNMARTINI.DR,SPPD
0138R0170418V002086 0002196827987 3;JKN DR RIZKI; 5.2.1.201802140120
4 168864 30#0##0#0#0.0#2018-04-16
10:29:53#0#19:16:21#19:16:21#12:00:00 1 93bb9451d8fd8cae8f1779b62841a4df
0 0 2636552 0 0 2772980 0 0 0 0
4051778 0 0 0 0 69000
3201126 B 1 BS 1 07/04/2018 08/04/2018 07/04/1969 0 1
1 S92.20;S92.30 78.68 - - None None None None M-1-40-I
FIKSASI INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 -
0 - 0 6041900 9034890 0 2 0 0 0 BAGUS
TRI TN D138633 48 17897 DR BENNY H T, SPOT 0138R0170418V002174
0000061058575 3;JKN DR RIZKI; 5.2.1.201802140120 4 168953
1#0##0#0#0.0#2018-04-16 10:32:27#0#09:12:33#09:12:33#00:00:00 1
58e7809dabcbead26ccde7e59f54a66c 0 5777200 1261368 0 0
1204254 0 0 0 0 647068 0 0 0 0 145000
3201126 B 1 BS 1 06/04/2018 08/04/2018 17/10/1950 0 1
1 I25.0;I08.9;I11.0;E11.9 88.55;36.07 - - None None None None
I-1-40-III None None None None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (BERAT) 48095600 0 0 - 0 - 0 - 0 -
0 48095600 63159733 0 3 0 0 0 SUSENO
D355961 67 24643 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170418V001590
0001390833911 3;JKN DR RIZKI; 5.2.1.201802140120 4 168475
9#0##0#0#0.0#2018-04-16 10:41:12#0#07:54:18#07:54:18#00:00:00 1
129d52bf0eca6cf7004283ad2ec35276 0 10753000 9619120 0 0
34061613 0 0 0 0 1226000 0 0 0 0
7500000
3201126 B 1 BS 1 06/04/2018 08/04/2018 07/05/1953 0 1
1 I25.0;I08.9;I50.0;I48 88.55;36.07 - - YY02 None None None
- 0 46734600 54046785 0 3 0 0 0 MOH
TOHIR,H,SKM d381473 64 23710 DR AGOES KOOSHARTORO SPPD
0138R0170418V001737 0000157502362 3;JKN DR RIZKI; 5.2.1.201802140120
4 168682 1#0##0#0#0.0#2018-04-16
10:44:34#0#11:15:06#11:15:06#12:00:00 1 744e8c12d779960c8885d5f488ce456a
0 10753000 5144120 0 0 29393665 0 0 0 0
1256000 0 0 0 0 7500000
3201126 B 3 BS 1 06/04/2018 08/04/2018 13/06/2013 0 1
0 - 0 - 0 - 0 - 0 5331600 6539882
0 3 0 0 0 MUHAMMAD HASAN ASRORI D394460 4 1758
DR CATUR SUZANTARA 0138R0170418V002087 0001302772961 3;JKN DR
RIZKI; 5.2.1.201802140120 4 168868 1#0##0#0#0.0#2018-04-16
10:47:03#0#20:27:04#20:27:04#12:00:00 1 367bf4d01708c9f2c3ae7811e46290df
0 3140800 1492848 0 0 1277391 0 0 0 0
483843 0 0 0 0 145000
3201126 B 3 BS 1 07/04/2018 08/04/2018 05/06/1969 0 2
1 E14.2 39.27;99.17 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8680998 0 2 0 0 0 MARIYAM
0002198424982 3;JKN DR RIZKI; 5.2.1.201802140120 4 169203
1#0##0#0#0.0#2018-04-16 11:13:30#0#15:46:15#15:46:15#16:48:56 1
e5b1565c34030c73827720cf5a8c5f88 0 3438800 2636552 0 0
1912730 0 0 0 0 623916 0 0 0 0 69000
3201126 B 3 BS 1 07/04/2018 08/04/2018 27/12/1967 0 2
- 0 8908800 8446219 0 2 0 0 0 MULYATI
0138R0170418V002207 0001322482408 3;JKN DR RIZKI; 5.2.1.201802140120
4 169023 15#0##0#0#0.0#2018-04-16
11:32:54#0#10:47:46#10:47:46#12:00:00 1 7ec1aa8f14e35285a6bd9895dbf79227
0 3438800 1870848 0 0 2459015 0 0 0 0
608556 0 0 0 0 69000
3201126 B 2 BS 1 07/04/2018 08/04/2018 03/03/1944 0 2
0 0 - 0 - 0 - 0 - 0 14653000
11862031 0 2 0 0 0 GUPILAH D318033 74 27063
DR AGOES KOOSHARTORO SPPD-KKV 0138R0170418V002186 0000042514942 3;JKN
DR RIZKI; 5.2.1.201802140120 4 168972 11#0##0#0#0.0#2018-04-17
08:48:31#0#09:41:29#09:41:29#00:00:00 1 783dbd9dcca11098f5f99e2f76eccf9a
0 3555000 1521920 0 0 3884090 0 0 0 0
832021 0 0 0 0 2069000
3201126 B 1 BS 1 05/04/2018 08/04/2018 21/04/1954 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 5774707 0 4 0 0 0 YOHUSUA SOMALAY
0000061063457 3;JKN DR RIZKI; 5.2.1.201802140120 4 168433
22#0##0#0#0.0#2018-04-17 09:17:32#0#15:58:01#15:58:01#00:00:00 1
b5cb758029005659e2f53bed0f7dc350 0 0 416852 0 0
2175570 0 0 0 0 3182285 0 0 0 0 0
3201126 B 2 BS 1 07/04/2018 08/04/2018 11/08/1958 0 1
8448000 0 0 - 0 - 0 - 0 - 0
8448000 2201322 0 2 0 0 0 BAMBANG WASITO.S
0001262321201 3;JKN DR RIZKI; 5.2.1.201802140120 4 168883
1#0##0#0#0.0#2018-04-17 09:19:18#0#06:40:59#06:40:59#12:00:00 1
eb11a23ff45e08fd65d2e2f5cd6023e1 0 0 760320 0 0 260990
0 0 0 0 1180012 0 0 0 0 0
3201126 B 1 BS 1 07/04/2018 08/04/2018 22/07/1954 0 2
- 0 46734600 13381714 0 2 0 0 0 YVONNE
JONATHANS D208301 63 23270 DR AGOES KOOSHARTORO SPPD
0138R0170418V002192 0001380155861 3;JKN DR RIZKI; 5.2.1.201802140120
4 168993 1#0##0#0#0.0#2018-04-17
09:58:20#0#10:03:11#10:03:11#12:00:00 1 a6c944e9681f126fb4f7de95333b540d
0 4777000 1775560 0 0 3828715 0 0 0 0
931439 0 0 0 0 2069000
3201126 B 1 BS 1 07/04/2018 08/04/2018 24/01/1943 0 1
- 0 12472300 11003596 0 2 0 0 0 ZAINURUDIN
0000042969352 3;JKN DR RIZKI; 5.2.1.201802140120 4 169206
31#0##0#0#0.0#2018-04-17 10:01:30#0#19:27:24#19:27:24#00:00:00 1
5494cc4d67d5f43abbd7bd939309f8e1 0 6122700 1815243 0 0
2220792 0 0 0 0 775861 0 0 0 0 69000
3201126 B 1 BS 1 07/04/2018 08/04/2018 06/06/1963 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 11006114 0 2 0 0 0 RIANTO SAPARI
0138R0170418V002199 0002069457928 3;JKN DR RIZKI; 5.2.1.201802140120
4 168995 1#0##0#0#0.0#2018-04-17
10:05:33#0#10:07:48#10:07:48#00:00:00 1 d176fe15e75c901d7d37a4fe5e8d00a1
0 6468200 1762243 0 0 1935645 0 0 0 0
771026 0 0 0 0 69000
3201126 B 3 BS 1 07/04/2018 08/04/2018 16/12/1972 0 1
- 0 8908800 9133393 0 2 0 0 0 SUDIYONO
0002339319183 3;JKN DR RIZKI; 5.2.1.201802140120 4 169207
1#0##0#0#0.0#2018-04-17 10:10:46#0#20:41:29#20:41:29#00:00:00 1
a566b3eb2cb022252a6946b7405c032b 0 2889500 2636552 0 0
2884829 0 0 0 0 653512 0 0 0 0 69000
3201126 B 2 BS 1 05/04/2018 08/04/2018 09/04/1990 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10150412 0 4 0 0 0 APRILIA DEVITA D082925 27
10223 DR MAMAN H, SPOG 0138R0170418V001510 0001099789323 3;JKN DR
RIZKI; 5.2.1.201802140120 4 168469 3#0##0#0#0.0#2018-04-17
15:05:16#0#00:35:55#00:35:55#12:00:00 1 09aff551a8cafdf03382a882e18a4935
0 5269900 2090753 0 0 1892713 0 0 0 0
700046 0 0 0 0 197000
3201126 B 2 BS 1 04/04/2018 08/04/2018 10/10/1989 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3328363 0 5 0 0 0 AMELIYA D395093
28 10403 DR ARU, SPPD 0138R0170418V000953 0001743487931 3;JKN
DR RIZKI; 5.2.1.201802140120 4 168114 37#0##0#0#0.0#2018-04-17
15:07:38#0#22:54:43#22:54:43#00:00:00 1 fd61d816d06730dc53d87af0d056663a
0 0 241100 0 0 823520 0 0 0 0
2263743 0 0 0 0 0
3201126 B 3 BS 1 05/04/2018 08/04/2018 13/08/1993 0 2
1 N18.5;C56;E87.5 38.95;39.95;88.76;87.44 - - None None None
0 - 0 - 0 8908800 15685757 0 4 0 0
0 ASSYIFA NUR AZIZAH D390946 24 9001 DR. ARU ARIADNO, SPPD
0138R0170418V001134 0001150160657 3;JKN DR RIZKI; 5.2.1.201802140120
4 168165 13#0##0#0#0.0#2018-04-17
15:10:08#0#10:04:05#10:04:05#12:00:00 1 bce7290b182da0ddbdafd063946fbb8b
0 3408500 2725640 0 0 7278696 0 0 0 0
2238421 0 0 0 0 34500
3201126 B 3 BS 1 05/04/2018 08/04/2018 18/09/1975 0 2
1 D09.3 06.4 - - None None None None E-1-20-I None None
- 0 7516400 12740722 0 4 0 0 0 ROHIDA
0001283278555 3;JKN DR RIZKI; 5.2.1.201802140120 4 168466
36#0##0#0#0.0#2018-04-17 15:13:49#0#21:00:12#21:00:12#12:00:00 1
225139ae95e1b00fc413ed8f9173c27c 0 3791800 2104592 0 0
5789825 0 0 0 0 909505 0 0 0 0 145000
3201126 B 2 BS 1 05/04/2018 08/04/2018 23/03/1960 0 1
1 A09.9;E11.9 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 3139610 0 4 0 0 0 ADE ABDULLAH
D342483 58 21197 DR ZULFAN, SPPD 0138R0170418V001249
0000165551376 3;JKN DR RIZKI; 5.2.1.201802140120 4 168351
19#0##0#0#0.0#2018-04-17 15:22:55#0#14:31:34#14:31:34#00:00:00 1
5fa0a53c88d82c6b5776a3e9e1c0a99c 0 0 207620 0 0 680595
0 0 0 0 2251395 0 0 0 0 0
3201126 B 1 BS 1 06/04/2018 08/04/2018 01/03/2012 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 4765649 0 3 0 0 0 AQMARUL IKHSAN
0001274835126 3;JKN DR RIZKI; 5.2.1.201802140120 4 168866
1#0##0#0#0.0#2018-04-17 15:23:44#0#19:34:36#19:34:36#00:00:00 1
8c58bfd02360a0085295bf9d8fdc217e 0 0 376362 0 0
2346966 0 0 0 0 2042321 0 0 0 0 0
3201126 B 1 BS 1 07/04/2018 08/04/2018 31/08/1964 0 2
1 J45.9;R63.0 - - - None None None None J-4-18-I None
0 0 - 0 - 0 - 0 - 0 3116300
4419816 0 2 0 0 0 ELIS TIAHESARA,DR. D016018
53 19577 DR ARU, SPPD 0138R0170418V002127 0000059276632 3;JKN
DR RIZKI; 5.2.1.201802140120 4 168881
5#1#vvip#2#1303516#0.0#2018-04-17 15:34:06#0#01:35:49#01:35:49#00:00:00
1 2bcc1487a54a624d7229c890c3a464b2 0 0 373339 0 0
1181330 0 0 0 0 2865147 0 0 0 0 0
3201126 B 1 BS 1 07/04/2018 08/04/2018 04/07/1975 0 1
0 0 - 0 - 0 - 0 - 0 8877800
14033404 0 2 0 0 0 RIANTO D389685 42 15618
DR RIZKI; 5.2.1.201802140120 4 169208
1#1#vvip#2#5155604#0.0#2018-04-17 15:43:11#0#20:54:37#20:54:37#12:00:00
2 ecfc22f1ca064591375a6eefdc7442c0 0 4950000 2219455 0
0 3826876 0 0 0 0 968073 0 0 0 0
2069000
3201126 B 1 BS 1 26/03/2018 08/04/2018 09/07/1937 0 1
1 I63.9;R40.1;J18.0;G30.9 87.44;87.03 - - None None None None
0 - 0 12141100 54453729 0 14 0 0 0
YUSTIAN YUSUF H D394157 80 29480 DR AL RASYID SPS
0138R01703180011221 0000061065731 3;JKN DR RIZKI; 5.2.1.201802140120
4 164780 17#1#vvip#14#42312629#0.0#2018-04-17
15:54:10#0#12:00:00#12:00:00#12:00:00 1 5d2acd6eea0c3fdaa5df8bb2c4254412
0 0 2588669 0 0 32584060 0 0 0 0
19281000 0 0 0 0 0
3201126 B 2 BS 1 05/04/2018 08/04/2018 05/06/1972 0 2
(RINGAN) 5984100 0 0 - 0 - 0 - 0 - 0
5984100 20309072 0 4 0 0 0 VERONIKA TATI ROHATI
D160695 45 16740 DR NINING H, SPOG 0138R0170418V000962
0001259731416 3;JKN DR RIZKI; 5.2.1.201802140120 4 168459
1#1#vvip#4#14324972#0.0#2018-04-17 16:13:30#0#18:51:56#18:51:56#00:00:00
1 72cebc54d27dad2e3d279131474d43a6 0 8876900 6749807 0
0 3313365 0 0 0 0 1241000 0 0 0 0
128000
3201126 B 3 BS 1 06/04/2018 08/04/2018 04/09/1982 0 2
- 0 - 0 - 0 - 0 2168300 1962661 0
3 0 0 0 SAFIATIN D375494 35 12998 DR ERDIYAN, SPOG
0138R0170418V001955 0001771691692 3;JKN DR RIZKI; 5.2.1.201802140120
4 168840 25#0##0#0#0.0#2018-04-17
16:19:41#0#16:26:52#16:26:52#12:00:00 1 f84636728af5f593d3046ddd99451422
0 0 501812 0 0 603951 0 0 0 0 856898
0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 08/04/2018 08/05/1976 0 1
1 A41.9;E16.2;N17.9 89.52 - - None None None None A-4-10-III
0 - 0 - 0 - 0 - 0 5838600 4837343
0 1 0 0 0 EKO ANDHOKO D286693 41 15310 DR RENDRA
RAMADYA 0138R0170418V002333 0001453740142 3;JKN DR RIZKI;
5.2.1.201804062320 4 169219 6#0##0#0#0.0#2018-04-20
15:07:06#0#03:23:42#03:23:42#00:00:00 1 46f68e80c2be403d3e5dc161944de513
0 0 563661 0 0 2934220 0 0 0 0 623462
0 0 0 0 716000
3201126 B 1 BS 1 06/04/2018 08/04/2018 27/07/1963 0 1
- 0 12472300 13983982 0 3 0 0 0 NURJAMAN
0001662640255 3;JKN DR RIZKI; 5.2.1.201804062320 4 168755
20#0##0#0#0.0#2018-04-20 15:08:38#0#14:45:34#14:45:34#00:00:00 1
0c0194a0e4ebdb13018c31b65aa63c86 0 7339200 1181530 0 0
4403412 0 0 0 0 990840 0 0 0 0 69000
3201126 B 1 BS 1 06/04/2018 08/04/2018 15/06/2016 0 1
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 2849460 0 3 0 0 0 ARSYAD ABINAYA FAEYZA
IRZALDI D336281 1 660 DR KRISTON SILITONGA, SPA
0138R0170418V002076 0002065531195 3;JKN DR RIZKI; 5.2.1.201804062320
4 168863 1#0##0#0#0.0#2018-04-20
15:21:18#0#18:40:11#18:40:11#12:00:00 1 80b8f54299be3270428dd515eb33924a
0 0 207620 0 0 431927 0 0 0 0
2209913 0 0 0 0 0
3201126 B 3 BS 1 06/04/2018 08/04/2018 01/05/2013 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1250560 0 3 0 0 0 ICHIKA AKBAR DINATA
0001466709772 3;JKN DR RIZKI; 5.2.1.201804062320 4 169561
2#0##0#0#0.0#2018-04-20 15:21:59#0#00:00:00#00:00:00#00:00:00 1
3c06e56b496366f89d3519f5861b1e1d 0 0 241100 0 0 357648
0 0 0 0 651812 0 0 0 0 0
3201126 B 2 BS 1 06/04/2018 08/04/2018 06/04/2018 3387 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1445048 0 3 0 0 0 BAYI NY APRILIA DEVITA
D395227 0 0 DR GUNAWAN S, SPA 0138R0170418V002653
0002447697879 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 169514
24#0##0#0#0.0#2018-04-21 09:31:00#0#16:17:52#16:17:52#00:00:00 1
169a94bf04ef921b3319da9d4f699c7d 0 0 441013 0 0 88899
0 0 0 0 915136 0 0 0 0 0
3201126 B 2 BS 1 06/04/2018 08/04/2018 28/09/2012 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2545175 0 3 0 0 0 ZAKILA AMELIA PUTRI
D395212 5 2016 DR RASTRA, SPA 0138R0170418V001520
0001644519734 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 168471
4#0##0#0#0.0#2018-05-03 09:23:00#0#01:02:32#01:02:32#00:00:00 1
92d849b163e620fe49192c86e57e95ad 0 0 298025 0 0 539643
0 0 0 0 1707507 0 0 0 0 0
3201126 B 3 BS 1 06/04/2018 08/04/2018 29/04/2015 0 1
1 J20.9;B94.1 - - - None None None None J-4-21-II None
LAIN-LAIN (SEDANG) 4508300 0 0 - 0 - 0 - 0
- 0 4508300 1905443 0 3 0 0 0 ALEXANDER
INGGIL FILIP POTIRAY D395203 2 1073 DR RASTRA, SPA
0138R0170418V001678 0002204916524 3;JKN DR RIZKI; 5.2.1.201804062320
4 168746 1#0##0#0#0.0#2018-05-04
10:48:54#0#14:36:54#14:36:54#00:00:00 1 5f4bc9a802251c9ab98488ac4b09c43c
0 0 231209 0 0 564579 0 0 0 0 939655
0 0 0 0 170000
3201126 B 1 BS 1 07/04/2018 09/04/2018 16/12/2016 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5821507 0 3 0 0 0 EFROSINA IVAH WIJAYA
D353029 1 477 DR AULIA TANGKARI, SPA 0138R0170418V002167
0002208881261 3;JKN DR RIZKI; 5.2.1.201802140120 4 168908
1#1#vvip#3#2895607#0.0#2018-04-16 09:11:56#0#08:45:38#08:45:38#00:00:00
1 8c23016f286da4485547c41ca9355c78 0 0 513829 0 0
1075832 0 0 0 0 4231846 0 0 0 0 0
3201126 B 1 BS 1 08/04/2018 09/04/2018 17/06/2012 0 1
0 - 0 2772200 5058377 0 2 0 0 0 AZZAM
ZAIDAN P D246365 5 2121 DR OTTY MITHA S, SPA 0138R0170418V002342
0001197153303 3;JKN DR RIZKI; 5.2.1.201802140120 4 169221
1#1#vvip#2#2286177#0.0#2018-04-16 09:54:53#0#08:03:27#08:03:27#00:00:00
1 9e7bec8099dfbd2c5d27361b8cc84f45 0 0 342000 0 0
773455 0 0 0 0 3942922 0 0 0 0 0
3201126 B 2 BS 1 08/04/2018 09/04/2018 14/04/1953 0 2
- 0 10690500 11352806 0 2 0 0 0 SITI
KOMARIYAH D392764 64 23735 DR. ARU ARIADNO, SPPD 0138R0170418V002380
0000060656646 3;JKN DR RIZKI; 5.2.1.201802140120 4 169225
4#0##0#0#0.0#2018-04-16 10:22:12#0#14:45:03#14:45:03#12:00:00 1
a0a01f57498924f7d278b7b2f453eade 0 4911100 3153245 0 0
2420754 0 0 0 0 798707 0 0 0 0 69000
3201126 B 1 BS 1 08/04/2018 09/04/2018 15/05/1945 0 2
0 - 0 - 0 - 0 - 0 4136800 5318803
0 2 0 0 0 KAMUSIA D394836 72 26626 DR ZULFAN,
SPPD 0138R0170418V002399 0000060801557 3;JKN DR RIZKI; 5.2.1.201802140120
4 169231 7#0##0#0#0.0#2018-04-16
10:36:13#0#18:57:18#18:57:18#12:00:00 1 119d1de280889f9f7478e36e21b8cd85
0 0 622492 0 0 648852 0 0 0 0
2332959 0 0 0 0 1714500
3201126 B 2 BS 1 06/04/2018 09/04/2018 12/07/1991 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4577995 0 4 0 0 0 YULIA N MAIWA
0001635556127 3;JKN DR RIZKI; 5.2.1.201802140120 4 168862
1#0##0#0#0.0#2018-04-17 09:23:22#0#18:28:17#18:28:17#00:00:00 1
397aec33f6f77f61e294560728b138a4 0 0 154620 0 0
2267380 0 0 0 0 2155995 0 0 0 0 0
3201126 B 1 BS 1 07/04/2018 09/04/2018 26/03/1948 0 2
1 T82.4;N18.5;I13.1;I25.0 39.42;99.04 - - None None None None
- 0 - 0 12472300 17364123 0 3 0 0 0
SURARTINI SURYOSURARSO D395350 70 25579 DEDY PRATAMA,SPBV
0138R0170418V002650 0001718879657 3;JKN DR RIZKI; 5.2.1.201802140120
4 169447 5#1#vvip#3#4891823#0.0#2018-04-17
09:37:34#0#15:03:08#15:03:08#00:00:00 2 6d1949191b9d51cbb89122a6a2698b60
0 0 3271000 0 0 9646152 0 0 0 0
4377971 0 0 0 0 69000
3201126 B 3 BS 1 30/03/2018 09/04/2018 26/02/1949 0 1
1 S72.00;E14.9;I10;I69.4 81.51 - - YY01 RR04 None None M-1-
04-I None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI TUNGKAI
28912800 43729464 0 11 0 0 0 SUHADA HALIMI
0001461593193 3;JKN DR RIZKI; 5.2.1.201802140120 4 166639
1#0##0#0#0.0#2018-04-17 09:55:08#0#12:00:00#12:00:00#12:00:00 1
a6a3b0f738dca83c4f0bee0c15e13b25 0 5593600 14203494 0 0
22552870 0 0 0 0 1276000 0 0 0 0 103500
3201126 B 2 BS 1 05/04/2018 09/04/2018 05/01/1991 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3900533 0 5 0 0 0 INDRA YAHDI PUTRA
0001261533565 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 168467
1#0##0#0#0.0#2018-04-19 15:42:28#0#21:13:42#21:13:42#00:00:00 1
ad2fc76a58dfc64c049e1afeabc2af85 0 0 241100 0 0
1358258 0 0 0 0 2301175 0 0 0 0 0
3201126 B 2 BS 1 08/04/2018 09/04/2018 04/04/1993 0 2
- 0 10690500 13447339 0 2 0 0 0 DWI AVIVIANI
0001901163069 3;JKN DR RIZKI; 5.2.1.201804062320 4 169228
1#0##0#0#0.0#2018-04-20 14:49:26#0#17:23:39#17:23:39#00:00:00 1
34016097e3651b84db4ed880313bb661 0 4439100 3153245 0 0
4884762 0 0 0 0 935732 0 0 0 0 34500
3201126 B 3 BS 1 08/04/2018 09/04/2018 07/03/1955 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 7695984 0 2 0 0 0 ROHAYAH NY
0138R0170418V002371 0002061697645 3;JKN DR RIZKI; 5.2.1.201804062320
4 169223 1#0##0#0#0.0#2018-04-20
14:59:24#0#13:00:44#13:00:44#00:00:00 1 15ee67c6c367c7567f7e7f976857bb66
0 3438800 921100 0 0 2707608 0 0 0 0
559476 0 0 0 0 69000
3201126 B 2 BS 1 08/04/2018 09/04/2018 31/12/1952 0 2
- 0 10690500 11692970 0 2 0 0 0 SITI
HARTIDJAH D395438 65 23839 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V002391 0000166686221 3;JKN DR RIZKI; 5.2.1.201804062320
4 169226 1#0##0#0#0.0#2018-04-20
15:00:23#0#17:08:29#17:08:29#00:00:00 1 2f4a8b5a50a0eb2af0659aaa746a82ff
0 4231600 3153245 0 0 3452664 0 0 0 0
820961 0 0 0 0 34500
3201126 B 3 BS 1 09/04/2018 09/04/2018 15/03/1952 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1689869 0 1 0 0 0 HANAPI D359663
66 24131 DR VINSENSIA NOVI KARTIKA 0138R0170418V002702
0001459392322 3;JKN DR RIZKI; 5.2.1.201804062320 4 169415
3#0##0#0#0.0#2018-04-20 15:01:30#0#00:00:00#00:00:00#00:00:00 1
daee614fa4fb3bd7fc5f1f8def6bdce8 0 0 204183 0 0 650134
0 0 0 0 417552 0 0 0 0 418000
3201126 B 1 BS 1 07/04/2018 09/04/2018 24/11/1961 0 1
2 I46.9;I50.0;N18.5 39.95;99.60;87.44 - - None None None None
I-4-14-II None None None None None None CARDIAC ARREST, TIDAK
DIKETAHUI (SEDANG) 4976100 0 0 - 0 - 0 - 0
- 0 4976100 7183394 0 3 0 0 0 NOVIANDRIE
POERBOSOESILO TN D324836 56 20588 DR. ARU ARIADNO, SPPD
0138R0170418V002273 0001484943434 3;JKN DR RIZKI; 5.2.1.201804062320
4 169205 13#1#vvip#3#2207294#0.0#2018-04-20
15:14:54#0#17:08:41#17:08:41#00:00:00 1 fb8b25edeed4dd3cf04d989f77cad566
0 0 595000 0 0 382202 0 0 0 0
6206192 0 0 0 0 0
3201126 B 1 BS 1 06/04/2018 09/04/2018 02/05/1972 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3640477 0 4 0 0 0 RENI UMBARASARI
D006282 45 16775 DR BETTY DWI L, SPPD 0138R0170418V002954
0001472091063 3;JKN DR RIZKI; 5.2.1.201804062320 4 170047
1#0##0#0#0.0#2018-04-23 11:22:47#0#00:00:00#00:00:00#00:00:00 1
632dce0ce0e9ed189f529758ba8c01a8 0 0 338858 0 0 694457
0 0 0 0 2607162 0 0 0 0 0
3201126 B 2 BS 1 07/04/2018 09/04/2018 24/02/2016 0 1
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2528775 0 3 0 0 0 AHMAD RAFKY ARASI
D331320 2 773 DR RASTRA, SPA 0138R0170418V002252
0002278604597 3;JKN DR RIZKI; 5.2.1.201804062320 4 169972
1#0##0#0#0.0#2018-04-28 10:40:24#0#00:00:00#00:00:00#12:00:00 1
1bfeac45b70e861e5a52d89c11d3b1ee 0 0 291535 0 0 530806
0 0 0 0 1706434 0 0 0 0 0
3201126 B 1 BS 1 03/04/2018 09/04/2018 03/04/2018 2129 1
- 0 11976100 10272904 0 7 0 0 0 BY NY LENY
NORMALISA D394979 0 0 DR AULIA TANGKARI, SPA 0138R0170418V000730
0002446447419 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 169953
1#0##0#0#0.0#2018-05-03 08:44:24#0#00:00:00#00:00:00#00:00:00 1
dedb83eb75aa3daa8d8bb07af8806890 0 0 690930 0 0
1388415 0 0 0 0 5799559 0 0 0 0
2394000
3201126 B 1 BS 1 07/04/2018 09/04/2018 10/10/1943 0 1
1 I64;E87.1;G20;N17.9 - - - None None None None G-4-
- 0 - 0 - 0 - 0 9659700 6133748 0
3 0 0 0 TEUKU ZOELFICAR BITEH H D071745 74 27208 DR
MAYSAM I., SPS 0138R0170418V002261 0001382953926 3;JKN DR RIZKI;
5.2.2.201806040537 4 169201 1#0##0#0#0.0#2018-08-20
09:57:39#0#15:04:45#15:04:45#00:00:00 2 706f0d484e7a18892d2e88b4eb9998cf
0 0 920220 0 0 2443255 0 0 0 0
2770273 0 0 0 0 0
3201126 B 3 BS 1 06/04/2018 09/04/2018 23/06/2017 0 1
1 J06.9;A09.9 - - - None None None None U-4-13-I None
0 - 0 1980100 2846961 0 4 0 0 0 BAYI
NY ROSELLI SITEPU D384164 0 287 DR AULIA TANGKARI, SPA
0138R0170418V001975 0002260863562 3;JKN DR RIZKI; 5.2.2.201806040537
4 168829 1#0##0#0#0.0#2018-09-26
16:15:16#0#16:19:19#16:19:19#12:00:00 3 83b09f64a057cfa8377f88e50d6ec815
0 0 207620 0 0 614591 0 0 0 0
2024750 0 0 0 0 0
3201126 B 3 BS 1 09/04/2018 10/04/2018 14/07/1956 0 1
- 0 45079800 63319795 0 2 0 0 0 ZULKIFLI
EFENDI D295579 61 22549 DR AZRI NURIZAL SPPD KKV
0138R0170418V002534 0001089735129 3;JKN DR RIZKI; 5.2.1.201804062320
4 169240 9#0##0#0#0.0#2018-04-19
09:43:14#0#08:08:17#08:08:17#00:00:00 1 fdf2afe744439e4b9633d8fa04c924d5
0 7996000 6870800 0 0 39662495 0 0 0 0
1256000 0 0 0 0 7534500
3201126 B 3 BS 1 09/04/2018 10/04/2018 01/01/1977 0 1
1 I64;R63.0 - - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 2054373 0 2 0
0 0 DENY MIHARJA D395529 41 15073 DR ARU, SPPD
0138R0170418V003025 0000511434268 3;JKN DR RIZKI; 5.2.1.201804062320
4 169578 3#0##0#0#0.0#2018-04-19
10:29:07#0#00:00:00#00:00:00#00:00:00 1 8ab70dd493465ce604ef1af565d90bb7
0 0 424889 0 0 1206086 0 0 0 0 423398
0 0 0 0 0
3201126 B 3 BS 1 10/04/2018 10/04/2018 05/05/1950 0 1
2955200 0 0 - 0 - 0 - 0 - 0
2955200 4234365 0 1 0 0 0 A. CHOLIK D395586
67 24812 DR NIKEN PRABHA DUHITA 0138R0170418V003037 0001439073551
3;JKN DR RIZKI; 5.2.1.201804062320 4 169585 5#0##0#0#0.0#2018-
04-19 14:36:45#0#00:00:00#00:00:00#00:00:00 1
9a5f3ef84953959abb75f303f1411f09 0 0 368658 0 0
2565692 0 0 0 0 584015 0 0 0 0 716000
3201126 B 2 BS 1 05/04/2018 10/04/2018 28/12/1959 0 1
1 E14.4 99.17;90.59 - - None None None None G-4-17-I None
5397100 0 0 - 0 - 0 - 0 - 0
5397100 6790515 0 6 0 0 0 YOHANES MARYONO
0001377205975 3;JKN DR RIZKI; 5.2.1.201804062320 4 168438
22#0##0#0#0.0#2018-04-20 14:26:57#0#16:10:41#16:10:41#12:00:00 1
7dbe8655a0208ff7675e6f7d7c5c5d88 0 0 431297 0 0
2858979 0 0 0 0 3500239 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 10/04/2018 07/08/1944 0 1
1 A41.9;I50.0;J18.0;R63.0;D29.1 87.44 - - None None None None
8174100 0 0 - 0 - 0 - 0 - 0
8174100 27646618 0 9 0 0 0 MARTUA RAJA HALOMOAN
GULTOM D394761 73 26901 DR ARU, SPPD 0138R01704180000127
0001447777563 3;JKN DR RIZKI; 5.2.1.201804062320 4 166756
16#1#vvip#6#19472518#0.0#2018-04-20 14:30:46#0#12:00:00#12:00:00#12:00:00
1 be174ca8b6e406cd1598d8be159b3c3f 0 0 2047265 0 0
11547353 0 0 0 0 10289000 0 0 0 0
3763000
3201126 B 2 BS 1 03/04/2018 10/04/2018 24/04/1937 0 2
1 S72.00;D64.9;I10 81.51;99.04 - - YY01 RR04 None None M-1-
04-II None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI TUNGKAI
BAWAH (SEDANG) 17829300 0 0 HIP REPLACEMENT / KNEE REPLACEMENT
35177000 40359857 0 8 0 0 0 NURBAITI,NY D151936
80 29564 DR BENNY H T, SPOT 0138R0170418V000306 0000060998141
3;JKN DR RIZKI; 5.2.1.201804062320 4 167562
27#0##0#0#0.0#2018-04-20 14:41:00#0#20:23:24#20:23:24#00:00:00 2
f6b2827255cd163a7928c1785a6f8a58 0 0 10388605 0 0
20980252 0 0 0 0 8624000 0 0 0 0 367000
3201126 B 1 BS 1 06/04/2018 10/04/2018 13/01/1955 0 2
1 D12.7;D12.6;K92.1 45.23 - - None None None None K-4-18-I
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 13579070 0 5 0 0 0 NUR PANGESTUTI
0000041025791 3;JKN DR RIZKI; 5.2.1.201804062320 4 168861
1#0##0#0#0.0#2018-04-20 14:44:13#0#17:37:32#17:37:32#12:00:00 2
93c97d00a9eeab10c2666929d21bf09f 0 0 3163755 0 0
3539965 0 0 0 0 5126350 0 0 0 0
1749000
3201126 B 3 BS 1 10/04/2018 10/04/2018 07/06/1965 0 2
0 0 - 0 - 0 - 0 - 0 3333000
2257625 0 1 0 0 0 NANA HASANAH D395587 52
19300 DR NIKEN PRABHA DUHITA 0138R0170418V003033 0002087013183 3;JKN
DR RIZKI; 5.2.1.201804062320 4 169580 4#0##0#0#0.0#2018-04-20
15:16:04#0#00:00:00#00:00:00#00:00:00 2 05a5a835e4014e8e858ecbaf4d9e9699
0 0 299970 0 0 1520960 0 0 0 0 436695
0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 10/04/2018 04/03/1942 0 1
1 F03;I67.9 - - - None None None None F-4-16-I None
None None None None None GANGGUAN OTAK ORGANIK LAIN-LAIN TERMASUK
KETERBELAKANGAN MENTAL (RINGAN) 5651700 0 0 - 0 - 0
- 0 - 0 5651700 4904805 0 3 0 0 0
MAJA D395413 76 27794 DR ARU, SPPD 0138R0170418V002325
0001771666705 3;JKN DR RIZKI; 5.2.1.201804062320 4 169216
1#0##0#0#0.0#2018-04-20 15:36:17#0#01:04:15#01:04:15#00:00:00 1
320c9dbb2dd84b84721b30860a6b9d89 0 0 920220 0 0
2848710 0 0 0 0 1135875 0 0 0 0 0
3201126 B 3 BS 1 10/04/2018 10/04/2018 18/02/2001 0 1
1 G03.9;A41.9;J96.0 96.05 - - None None None None G-4-19-III
- 0 - 0 8201200 5928617 0 1 0 0 0
RAFLIUDIN TN D395593 17 6260 DR WIDHI DEWANTA K AJI
0138R0170418V003262 0000513202432 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 169832 13#0##0#0#0.0#2018-04-21
11:51:13#0#11:55:30#11:55:30#00:00:00 1 0fe2d370356cd581bc563a696f43c612
0 0 1120108 0 0 4131656 0 0 0 0 676853
0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 10/04/2018 08/04/2018 3204 2
3655700 0 0 - 0 - 0 - 0 - 0
3655700 959268 0 3 0 0 0 RIZKY RAHAYAU BY NY
D395448 0 0 DR KRISTY, SPA 0138R0170418V002657
0002447707948 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 169350
18#0##0#0#0.0#2018-04-21 12:30:18#0#13:06:00#13:06:00#00:00:00 2
3d56f7977c52fdd364ea9f8bb72fe802 0 0 368013 0 0 156499
0 0 0 0 434756 0 0 0 0 0
3201126 B 3 BS 1 01/04/2018 10/04/2018 15/06/1959 0 2
1 J22;H81.3;L27.0;K30 90.59;89.52 - - None None None None
0 - 0 - 0 4508300 11401952 0 10 0 0
0 MUIDAH D393564 58 21475 DR. ARU ARIADNO, SPPD
0138R01704180000123 0001739618853 3;JKN DR RIZKI; 5.2.1.201804062320
4 166755 1#0##0#0#0.0#2018-04-23
08:52:07#0#12:00:00#12:00:00#12:00:00 1 a7c90b5ab0f08ade5640fa54c92b188c
0 0 687090 0 0 2706940 0 0 0 0
8007922 0 0 0 0 0
3201126 B 3 BS 1 29/03/2018 10/04/2018 23/09/1951 0 1
1 I61.9;G81.9;J18.9 96.05;96.71;87.44 - - None None None None
J-1-20-III None None None None None None PROSEDUR SISTEM PERNAFASAN
NON-KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0
- 0 29135800 46020491 0 13 1 10 48 SAPIIH
0000511046087 3;JKN DR RIZKI; 5.2.1.201804062320 4 166092
14#0##0#0#0.0#2018-04-23 11:21:46#0#12:00:00#12:00:00#12:00:00 1
8549d0779dc378825b1b03abd20c1cda 0 0 4192553 0 0
22624938 0 0 0 0 10745000 0 0 0 0
8458000
3201126 B 2 BS 1 09/04/2018 10/04/2018 07/04/1950 0 1
4 I64;I46.9 99.60 - - None None None None G-4-15-III None
- 0 - 0 - 0 8279800 5138658 0 2 0
0 0 MAXI MEIRUNTU D395462 68 24839 DR ARU, SPPD
0138R0170418V002928 0001971796138 3;JKN DR RIZKI; 5.2.1.201804062320
4 169563 23#0##0#0#0.0#2018-04-23
11:37:30#0#17:22:35#17:22:35#00:00:00 1 b621b0821050e3395855bb8d159a5b9a
0 0 1301230 0 0 2465254 0 0 0 0
1372174 0 0 0 0 0
3201126 B 1 BS 1 09/04/2018 10/04/2018 15/12/1954 0 1
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 65546815 0 2 0 0 0 EDISON NAINGGOLAN
0000041209053 3;JKN DR RIZKI; 5.2.1.201804062320 4 169238
1#0##0#0#0.0#2018-04-23 11:40:54#0#06:37:34#06:37:34#00:00:00 1
263c56168f740ef3acbafb9ca0e13620 0 10062000 7201760 0 0
39492555 0 0 0 0 1256000 0 0 0 0
7534500
3201126 B 3 BS 1 07/04/2018 10/04/2018 24/03/1992 0 2
1 N39.0;K58.9 - - - None None None None N-4-12-I None
2392700 0 0 - 0 - 0 - 0 - 0
2392700 3012901 0 4 0 0 0 ANITA MARISKA
D364123 26 9510 DR ARU, SPPD 0138R0170418V002310
0001739957578 3;JKN DR RIZKI; 5.2.1.201804062320 4 169210
28#0##0#0#0.0#2018-04-23 11:42:54#0#21:41:43#21:41:43#00:00:00 1
3e34a6e66f2506fe87491d92ee510cf0 0 0 268343 0 0
1732452 0 0 0 0 1012106 0 0 0 0 0
3201126 B 1 BS 1 07/04/2018 10/04/2018 18/05/1966 0 1
1 I13.1;R63.0;E14.9 39.95;89.52 - - None None None None N-4-
GINJAL (RINGAN) 4639400 0 0 - 0 - 0 - 0 -
0 4639400 9143757 0 4 0 0 0 SULISTYARTO
WIDAGDO H097931 51 18952 DR ARU, SPPD 0138R0170418V002257
0001642474719 3;JKN DR RIZKI; 5.2.1.201804062320 4 169194
19#0##0#0#0.0#2018-04-23 11:54:48#0#14:12:42#14:12:42#00:00:00 1
0bd07ff37312d853807a54ed86073676 0 0 818792 0 0
3105525 0 0 0 0 5219440 0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 10/04/2018 23/06/1993 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8048533 0 3 0 0 0 RIZKI RAHAYU NY
D395442 24 9055 DR RACHMADSYAH, SPOG 0138R0170418V002366
0001014200842 3;JKN DR RIZKI; 5.2.1.201804062320 4 169222
17#0##0#0#0.0#2018-04-23 12:02:42#0#12:39:28#12:39:28#00:00:00 1
0e1ac4a70a41383459f00f52c91cb87f 0 3534500 1815644 0 0
1863849 0 0 0 0 637540 0 0 0 0 197000
3201126 B 3 BS 1 07/04/2018 10/04/2018 25/04/2009 0 2
0 0 - 0 - 0 - 0 - 0 2392700
2751739 0 4 0 0 0 NUR LAILA ZULFA D395357 8
3269 DR OTTY MITHA S, SPA 0138R0170418V002266 0001771696686 3;JKN
DR RIZKI; 5.2.1.201804062320 4 170218 1#0##0#0#0.0#2018-04-28
09:32:45#0#00:00:00#00:00:00#00:00:00 1 c7443bea44cd242f3b5a0f35822a58f4
0 0 268343 0 0 1311876 0 0 0 0
1171520 0 0 0 0 0
3201126 B 2 BS 1 08/04/2018 10/04/2018 26/12/2014 0 2
1 J02.9;R11 - - - None None None None U-4-13-I None
0 - 0 2376200 2173655 0 3 0 0 0 SOPHIA
HAFIDZAH FAUSTINE D294820 3 1199 DR AWIDIYA, SPA 0138R0170418V002409
0001634040911 3;JKN DR RIZKI; 5.2.1.201804062320 4 169232
1#0##0#0#0.0#2018-04-28 09:35:22#0#19:12:36#19:12:36#00:00:00 1
6e94b2ca1a8fa31066aaa48e5a2f87a2 0 0 266858 0 0 472595
0 0 0 0 1434202 0 0 0 0 0
3201126 B 3 BS 1 09/04/2018 10/04/2018 27/05/1980 0 2
INTERNAL (RINGAN) 4315600 0 0 - 0 - 0 - 0 -
0 4315600 6851237 0 2 0 0 0 DESSY HARYANI
D391328 37 13831 DR RAY HENDRY, SPOT 0138R0170418V002749
0001721030804 3;JKN DR RIZKI; 5.2.1.201804062320 4 169502
1#0##0#0#0.0#2018-04-28 09:47:47#0#16:04:42#16:04:42#12:00:00 1
3f83c8e72ccec792f99560ab01ff6a9f 0 0 1208368 0 0
1587457 0 0 0 0 3910412 0 0 0 0 145000
3201126 B 2 BS 1 09/04/2018 10/04/2018 21/02/1958 0 1
0 0 - 0 - 0 - 0 - 0 2783600
5615882 0 2 0 0 0 DARSONO D310836 60 21962
5.2.1.201804062320 4 169503 1#0##0#0#0.0#2018-04-28
09:48:52#0#16:05:29#16:05:29#00:00:00 1 476cd144bdcce962c31d91e8dac73bf0
0 0 832408 0 0 708580 0 0 0 0
2325894 0 0 0 0 1749000
3201126 B 1 BS 1 08/04/2018 10/04/2018 27/08/1971 0 2
1 I64;I49.3;G81.9;E78.5 87.03 - - None None None None G-4-
- 0 - 0 - 0 - 0 9659700 4898124 0
3 0 0 0 ERMAWATY D395446 46 17026 DR NURUL KOMARI
SPS 0138R0170418V002397 0000040419808 3;JKN DR RIZKI; 5.2.1.201804062320
4 169229 1#0##0#0#0.0#2018-04-28
10:09:00#0#18:15:26#18:15:26#00:00:00 1 f079be26a4adffa35be835a5bdd1cf5d
0 0 1267109 0 0 1287077 0 0 0 0
2343938 0 0 0 0 0
3201126 B 2 BS 1 04/04/2018 10/04/2018 07/10/1968 0 1
1 I50.0;N17.9;R33;N39.0;D29.1 87.44 - - None None None None
5968400 0 0 - 0 - 0 - 0 - 0
5968400 9407512 0 7 0 0 0 ANTONO D395071
49 18076 DR ARU, SPPD 0138R0170418V000959 0001271974634 3;JKN
DR RIZKI; 5.2.1.201804062320 4 168116 1#0##0#0#0.0#2018-04-28
10:37:01#0#23:25:49#23:25:49#00:00:00 1 e9c9b68f91ad3c78c59d011e1ad97cab
0 0 591384 0 0 5144683 0 0 0 0
3671445 0 0 0 0 0
3201126 B 1 BS 1 06/04/2018 10/04/2018 30/12/1959 0 2
1 S06.90;S00.9;I10 88.38 - - None None None None G-4-24-I
None None None None None None TRAUMA KEPALA (RINGAN) 4260400 0
0 - 0 - 0 - 0 - 0 4260400 5845771
0 5 0 0 0 INGAN PULUNG SINULINGGA D395216 58 21282
DR MAYSAM I., SPS 0138R0170418V001693 0000040660209 3;JKN DR RIZKI;
5.2.1.201804062320 4 168615 1#0##0#0#0.0#2018-04-28
10:43:33#0#10:23:03#10:23:03#00:00:00 1 a35bcf317081dd59f5ffe338f7802417
0 0 379879 0 0 3724458 0 0 0 0
1741434 0 0 0 0 0
3201126 B 2 BS 1 08/04/2018 10/04/2018 29/07/1969 0 1
1 E14.9;D72.9 - - - None None None None E-4-10-I None
- 0 4203300 3812038 0 3 0 0 0 YUDI ALFONS
SOEDIRA D094932 48 17785 DR. ARU ARIADNO, SPPD 0138R0170418V002330
0001453469736 3;JKN DR RIZKI; 5.2.1.201804062320 4 169218
1#0##0#0#0.0#2018-05-04 10:45:43#0#02:23:56#02:23:56#00:00:00 1
f227faaa12a19ce9857a9c032a8607ba 0 0 431297 0 0
1590355 0 0 0 0 1790386 0 0 0 0 0
3201126 B 2 BS 1 03/04/2018 10/04/2018 03/10/2016 0 2
1 E87.2;R57.1;E87.8;A41.9;A09.9 - - - None None None None
ELEKROLIT (BERAT) 7552000 0 0 - 0 - 0 - 0 -
0 7552000 20051074 0 8 1 3 0 SAUFA ADZKIA
KHOIRUNNISA D394901 1 547 DR NOVIK BUDIWARDHANA, SPA
0138R01704180000742 0002277534093 3;JKN DR RIZKI; 5.2.1.201804062320
4 168709 1#0##0#0#0.0#2018-05-05
09:33:02#0#12:00:00#12:00:00#12:00:00 1 5f8d21a4a0e1766cd3ca175116defad5
0 0 520676 0 0 11766898 0 0 0 0
6214500 0 0 0 0 1549000
3201126 B 3 BS 1 08/04/2018 10/04/2018 11/01/1993 0 2
- 0 - 0 - 0 - 0 2168300 3401656 0
3 0 0 0 SRI HARTATI D395452 25 9218 DR ERDIYAN, SPOG
0138R0170418V002413 0001014462022 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 169233 1#0##0#0#0.0#2018-05-11
09:10:44#1#19:40:08#19:40:08#00:00:00 1 1475087a8f38bf562a8e12c586d3a9d2
1000000 0 389320 0 0 0 0 0 0 0
1552140 0 0 0 460196 0
3201126 B 3 BS 1 04/04/2018 10/04/2018 09/02/2008 0 1
1 D65;G93.4;E87.6;A91 99.06 - - None None None None D-4-
11-III None None None None None None GANGGUAN PEMBEKUAN DARAH (BERAT)
10288700 0 0 - 0 - 0 - 0 - 0
10288700 20476145 0 7 0 0 0 MUHAMMAD TEGAR ABDUL
AZIZ D395053 10 3707 DR NOVIK BUDIWARDHANA, SPA 0138R0170418V000685
0002215417454 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 167957
1#0##0#0#0.0#2018-05-31 11:37:29#0#14:02:27#14:02:27#00:00:00 1
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10613662 0 0 0 0 6559500 0 0 0 0
2324000
3201126 B 2 BS 1 08/04/2018 10/04/2018 08/04/2018 3033 2
None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-5 DENGAN
SINDROMA DISTRES PERNAFASAN (RINGAN) 5066300 0 0 - 0 -
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0 TITI NURHAYATI BY NY D395425 0 0 DR KRISTY, SPA
0138R0170418V003167 0002448114129 3;JKN DR RIZKI; 5.2.2.201806040537
4 169809 1#0##0#0#0.0#2018-08-20
10:07:35#0#11:36:10#11:36:10#00:00:00 2 950b79633cc728458727f792a8b8dffc
0 0 368013 0 0 719259 0 0 0 0 881819
0 0 0 0 0
3201126 B 2 BS 1 10/04/2018 10/04/2018 20/01/1959 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 2991026 0 1 0 0 0 MOKH. MASKUR
0001882347118 3;JKN DR RIZKI; 5.2.2.201806040537 4 169579
1#0##0#0#0.0#2018-09-07 16:17:51#0#00:37:06#00:37:06#12:00:00 2
b26ffdc1e8f51633693b3c7f9eb51c07 0 0 499265 0 0
1765086 0 0 0 0 726675 0 0 0 0 0
3201126 B 2 BS 1 07/04/2018 10/04/2018 25/11/1965 0 1
1 E87.1;I11.0 88.76;87.44 - - None None None None E-4-11-III
7552000 0 0 - 0 - 0 - 0 - 0
7552000 6716590 0 4 0 0 0 MUSTARI D384697
52 19126 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170418V002655
0002257349275 3;JKN DR RIZKI; 5.2.2.201806040537 4 169250
1#0##0#0#0.0#2018-09-07 16:21:45#0#08:43:24#08:43:24#12:00:00 2
34480f7ac44b65a4ddb29b2c693d7e08 0 0 813365 0 0
3922822 0 0 0 0 1980403 0 0 0 0 0
3201126 B 2 BS 1 08/04/2018 10/04/2018 28/07/1992 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 10945845 0 3 0 0 0 TITI NURHAYATI
D392792 25 9385 DR ATJANG S, SPOG 0138R0170418V002326
0001770777617 3;JKN DR RIZKI; 5.2.2.201806040537 4 169217
1#0##0#0#0.0#2018-09-07 16:24:11#0#01:21:26#01:21:26#12:00:00 2
4426b0542972c1bd3cef9cd8fa6d7422 0 5684900 2090753 0 0
2156109 0 0 0 0 817083 0 0 0 0 197000
3201126 B 2 BS 1 05/04/2018 10/04/2018 21/07/1982 0 1
1 J18.0;F03;J45.9 93.94 - - None None None None J-4-16-II
(SEDANG) 6093000 0 0 - 0 - 0 - 0 - 0
6093000 5871515 0 6 0 0 0 FADHLIYAH RASYID
0001719223751 3;JKN DR RIZKI; 5.2.2.201806040537 4 173436
1#0##0#0#0.0#2018-09-10 10:06:03#0#00:00:00#00:00:00#00:00:00 2
9fcf752029ea3fc88309ceb337e09ced 0 0 759167 0 0
2177230 0 0 0 0 2935118 0 0 0 0 0
3201126 B 3 BS 1 10/04/2018 11/04/2018 01/04/1944 0 2
- 0 36446400 62196035 0 2 0 0 0 MAIMUNAH
d391112 74 27037 DR AZRI NURIZAL SPPD KKV 0138R0170418V003315
0000511776639 3;JKN DR RIZKI; 5.2.1.201804062320 4 169948
18#0##0#0#0.0#2018-04-19 09:36:51#0#14:18:54#14:18:54#12:00:00 2
075db58ebe438207f54d0a9d01f7396b 0 7996000 5144120 0 0
40161915 0 0 0 0 1256000 0 0 0 0
7638000
3201126 B 1 BS 1 10/04/2018 11/04/2018 28/03/1954 0 1
- 0 58821400 60426410 0 2 0 0 0 NAZARIUS
MULYADI D378222 64 23389 DR AZRI NURIZAL SPPD KKV
0138R0170418V003322 0001466484311 3;JKN DR RIZKI; 5.2.1.201804062320
4 169938 1#0##0#0#0.0#2018-04-19
09:49:11#0#14:16:06#14:16:06#12:00:00 1 65ea74dd2c9ee973430f1e4bdbd07e0d
0 10062000 9619120 0 0 31920290 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 3 BS 1 07/04/2018 11/04/2018 28/02/2018 0 1
1 J18.0;A41.9 87.44;93.94 - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 7471149 0 5 1 3 0 MUHAMMAD BILAL AUFAR AN
D394864 0 38 DR NOVIK BUDIWARDHANA, SPA 0138R0170418V002228
0002446917996 3;JKN DR RIZKI; 5.2.1.201804062320 4 169154
12#0##0#0#0.0#2018-04-19 10:44:50#0#13:26:47#13:26:47#00:00:00 1
3e4a7a40bd5f7bda1ca4b219a85284d4 0 0 630773 0 0
2550109 0 0 0 0 3780267 0 0 0 0 510000
3201126 B 2 BS 1 10/04/2018 11/04/2018 19/02/1984 0 2
0 - 0 - 0 - 0 - 0 3545800 5902811
0 2 0 0 0 RIPA PADILA D394539 34 12469 DR ZULFAN,
4 170144 1#0##0#0#0.0#2018-04-19
11:15:07#0#23:41:15#23:41:15#12:00:00 1 9cea59f0e3a7a7c8056ed30844016845
0 0 1108824 0 0 880322 0 0 0 0
2164665 0 0 0 0 1749000
3201126 B 1 BS 1 10/04/2018 11/04/2018 16/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 4136800
7155041 0 2 0 0 0 NY.MISDAR D313988 60 21999
DR ZULFAN, SPPD 0138R0170418V003433 0001294322668 3;JKN DR RIZKI;
5.2.1.201804062320 4 170101 1#0##0#0#0.0#2018-04-19
14:43:33#0#16:19:02#16:19:02#12:00:00 1 4297145e3c2d4788e5343fdec2051350
0 0 1679204 0 0 928250 0 0 0 0
2798587 0 0 0 0 1749000
3201126 B 2 BS 1 07/04/2018 11/04/2018 28/04/2017 0 1
6093000 0 0 - 0 - 0 - 0 - 0
6093000 5944709 0 5 0 0 0 BY NY NUR HASANAH
0002245762067 3;JKN DR RIZKI; 5.2.1.201804062320 4 169212
29#0##0#0#0.0#2018-04-19 14:54:42#0#22:23:01#22:23:01#00:00:00 1
aa9782b8f3ec70d04c66bf9468b4d07c 0 0 562975 0 0
2436828 0 0 0 0 2434906 0 0 0 0 510000
3201126 B 1 BS 1 09/04/2018 11/04/2018 09/04/2018 3336 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3237947 0 3 0 0 0 BRYANT MATTHEW
0002354868011 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170559
1#1#vvip#3#0#0.0#2018-04-21 11:16:29#0#15:04:43#15:04:43#00:00:00 1
a88041ac103e973a20feeb44d6d8da4f 0 0 499620 0 0 88899
0 0 0 0 2649428 0 0 0 0 0
3201126 B 2 BS 1 09/04/2018 11/04/2018 17/04/2017 0 1
1 D18.1;R56.0 - - - None None None None D-4-14-II None
LAIN-LAIN (SEDANG) 6294200 0 0 - 0 - 0 - 0
- 0 6294200 3006699 0 3 0 0 0 GUIZA
RAFISQY N D395498 0 357 DR OTTY MITHA S, SPA 0138R0170418V002736
0002286699153 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 169364
1#0##0#0#0.0#2018-04-21 11:25:11#0#13:27:47#13:27:47#00:00:00 1
542997d553182be3f6742dc52fa75cc6 0 0 321830 0 0 607169
0 0 0 0 1737700 0 0 0 0 340000
3201126 B 2 BS 1 10/04/2018 11/04/2018 29/09/2008 0 1
(RINGAN) 3536800 0 0 - 0 - 0 - 0 - 0
3536800 7596066 0 2 0 0 0 MUHAMMAD ERHAN
D155501 9 3480 DR BENNY H TUMBELAKA 0138R0170418V003420
0001188207606 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170133
25#0##0#0#0.0#2018-04-21 11:29:52#0#18:34:35#18:34:35#00:00:00 1
cec74c1cb44b6b16234fa7ff9c941d07 0 4715200 1194672 0 0
988255 0 0 0 0 552939 0 0 0 0 145000
3201126 B 2 BS 1 07/04/2018 11/04/2018 16/03/2002 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3653994 0 5 0 0 0 IVY ALAMANDA PASYA
0001191755733 3;JKN DR RIZKI; 5.2.1.201804062320 4 169209
1#0##0#0#0.0#2018-04-24 12:09:01#0#21:26:51#21:26:51#00:00:00 1
596ae37c32ce0b8e02b5b150584c6879 0 0 209906 0 0 861542
0 0 0 0 2582546 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 11/04/2018 05/10/1957 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 16092778 0 2 0 0 0 LENNY ZAKHRONI
0002294946516 3;JKN DR RIZKI; 5.2.1.201804062320 4 169950
1#0##0#0#0.0#2018-04-24 12:11:14#0#14:19:29#14:19:29#12:00:00 1
3f2e0dbf398354405c8fc2a8fc230f43 0 9763300 4024424 0 0
1031255 0 0 0 0 1128799 0 0 0 0 145000
3201126 B 2 BS 1 09/04/2018 11/04/2018 05/05/1991 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 25509636 0 3 0 0 0 EKA SHINTA KUSUMAWATI
D373886 26 9836 ENDANG TRI KURNIADEWI DR SPOG 0138R0170418V002641
0002273631906 3;JKN DR RIZKI; 5.2.1.201804062320 4 169456
1#1#vvip#3#19525536#0.0#2018-04-25 15:04:37#0#15:13:02#15:13:02#00:00:00
1 fb18dbabfbb0c22673bbc9108d99a5ca 0 8973200 9306000 0
0 5402436 0 0 0 0 1296000 0 0 0 0
532000
3201126 B 3 BS 1 10/04/2018 11/04/2018 12/06/2017 0 1
1467400 0 0 - 0 - 0 - 0 - 0
1467400 4059485 0 2 0 0 0 ASRAF ZAHIRUL RAMAZAN
NASUTION D394456 0 302 DR CATUR SUZANTARA 0138R0170418V003184
0002248735285 3;JKN DR RIZKI; 5.2.1.201804062320 4 169707
1#0##0#0#0.0#2018-04-28 09:05:32#0#10:17:44#10:17:44#12:00:00 1
6897ce6554d7138af487cdddcebcacc1 0 2362000 410872 0 0
820039 0 0 0 0 321574 0 0 0 0 145000
3201126 B 2 BS 1 10/04/2018 11/04/2018 02/09/2014 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4779978 0 2 0 0 0 KAHFI IKHSAN KAMIL AN
D395102 3 1316 DR CATUR SUZANTARA 0138R0170418V003202
0001431918033 3;JKN DR RIZKI; 5.2.1.201804062320 4 169763
1#0##0#0#0.0#2018-04-28 09:10:51#0#11:01:06#11:01:06#00:00:00 1
27e9db2c55706f6ce9e27dd6f48b0c86 0 2846000 410872 0 0
1009397 0 0 0 0 368709 0 0 0 0 145000
3201126 B 1 BS 1 09/04/2018 11/04/2018 28/08/1958 0 2
1 I10;R63.0;I69.4;E14.9 87.44 - - None None None None I-4-
0 - 0 - 0 - 0 - 0 2669400 6157276
0 3 0 0 0 NY.KUSNANI PUJOGIRI D258422 59 21774
DR. ARU ARIADNO, SPPD 0138R0170418V002983 0000036145001 3;JKN DR
RIZKI; 5.2.1.201804062320 4 169572 1#1#vvip#3#3487876#0.0#2018-
04-28 09:13:17#0#00:00:00#00:00:00#12:00:00 1
2fbcb4cdefd872dd8fb74c50dcb05aa5 0 0 1548336 0 0 942628
0 0 0 0 3666312 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 11/04/2018 31/12/1938 0 2
FIKSASI INTERNAL (BERAT) 15298900 0 0 - 0 - 0 -
0 - 0 15298900 15687578 0 2 0 0 0
SUHARTI,HJ D195978 79 28955 DR BENNY H T, SPOT
0138R0170418V003294 0000060975584 3;JKN DR RIZKI; 5.2.1.201804062320
4 169932 1#0##0#0#0.0#2018-04-28
09:15:05#0#14:13:49#14:13:49#00:00:00 1 931ced8ccbcbd467d42ca73a6998a5cd
0 0 2693008 0 0 1983980 0 0 0 0
10865590 0 0 0 0 145000
3201126 B 3 BS 1 10/04/2018 11/04/2018 27/11/1953 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 5427892 0 2 0 0 0 POEDJADI
0001212186791 3;JKN DR RIZKI; 5.2.1.201804062320 4 170391
1#0##0#0#0.0#2018-04-28 09:25:59#0#00:00:00#00:00:00#12:00:00 1
e31603dcdee5250ecd6ca7d781bdfa1b 0 3080500 868100 0 0
1033696 0 0 0 0 411096 0 0 0 0 34500
3201126 B 2 BS 1 10/04/2018 11/04/2018 01/08/1958 0 1
1 N18.5;I50.0 39.95;99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 6587320 0 2 0 0 0 SUNARDI
D391467 59 21802 DR ARU, SPPD 0138R0170418V003035
0001607940213 3;JKN DR RIZKI; 5.2.1.201804062320 4 169581
1#0##0#0#0.0#2018-04-28 09:29:05#0#01:52:43#01:52:43#12:00:00 1
21db73805f68df70338051aa1526d651 0 0 552265 0 0
3411859 0 0 0 0 2623196 0 0 0 0 0
3201126 B 3 BS 1 10/04/2018 11/04/2018 17/09/1961 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2701198 0 2 0 0 0 BAMBANG SETIAWAN
0001740406904 3;JKN DR RIZKI; 5.2.1.201804062320 4 170139
1#0##0#0#0.0#2018-04-28 09:52:16#0#19:57:55#19:57:55#12:00:00 1
1c6d61d9482157a46d9db5920615ab36 0 0 424889 0 0
1634095 0 0 0 0 642214 0 0 0 0 0
3201126 B 1 BS 1 09/04/2018 11/04/2018 08/10/1959 0 2
- 0 4903800 3634921 0 3 0 0 0 YEANNE SRI
MASTUTI D395471 58 21368 DR SOEGIONO, SPPD 0138R0170418V002876
0000040876007 3;JKN DR RIZKI; 5.2.1.201804062320 4 169504
1#0##0#0#0.0#2018-04-28 11:00:10#0#16:05:34#16:05:34#00:00:00 1
1c1949371727ee7a74ebb7c0da57e043 0 0 494342 0 0 533780
0 0 0 0 2606799 0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 11/04/2018 17/04/1961 0 2
4199800 0 0 - 0 - 0 - 0 - 0
4199800 3283852 0 4 0 0 0 NGUI TJHIN MOI
D395453 56 20810 DR ZULFAN 0138R0170418V002421 0002047655057
3;JKN DR RIZKI; 5.2.1.201804062320 4 169234 1#0##0#0#0.0#2018-
04-28 11:01:44#0#22:03:44#22:03:44#00:00:00 1
5cf1df48b63d1667be1dd10946add915 0 0 430982 0 0
1646539 0 0 0 0 1206331 0 0 0 0 0
3201126 B 2 BS 1 09/04/2018 11/04/2018 23/07/1989 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10396917 0 3 0 0 0 EVA YULI VARAYA AFNI
D200760 28 10487 DR ERDIYAN, SPOG 0138R0170418V002597
0001639973081 3;JKN DR RIZKI; 5.2.1.201804062320 4 169276
1#0##0#0#0.0#2018-04-28 13:50:09#0#09:29:56#09:29:56#00:00:00 1
52248ea9f11b7aa52c250f5f7071c9fc 0 5269900 2090753 0 0
2083092 0 0 0 0 756172 0 0 0 0 197000
3201126 B 1 BS 1 09/04/2018 11/04/2018 22/09/1961 0 2
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 4245437 0 3 0 0 0 YETI SUHAYATI
D395495 56 20653 DR SOEGIONO, SPPD 0138R0170418V002937
0000061107287 3;JKN DR RIZKI; 5.2.1.201804062320 4 169564
1#0##0#0#0.0#2018-04-28 13:59:04#0#17:41:26#17:41:26#00:00:00 1
ac2b675d161ade8f6b8d896f637d1e6f 0 0 644066 0 0 954632
0 0 0 0 2646739 0 0 0 0 0
3201126 B 3 BS 1 07/04/2018 11/04/2018 17/09/1945 0 1
1 J44.9;E14.9 87.03 - - None None None None J-4-17-I None
3688800 0 0 - 0 - 0 - 0 - 0
3688800 3988390 0 5 0 0 0 MUSA SARMILIH
D395411 72 26500 DR MOHAMAD NIZAM ERHAMZA SPP 0138R0170418V002317
0001089734422 3;JKN DR RIZKI; 5.2.1.201804062320 4 169213
1#0##0#0#0.0#2018-04-28 14:00:52#0#23:03:11#23:03:11#00:00:00 1
64aa4305853e5730f28330c9faebbe99 0 0 437992 0 0
2211475 0 0 0 0 1338923 0 0 0 0 0
3201126 B 2 BS 1 10/04/2018 11/04/2018 05/09/1977 0 1
0 - 0 - 0 - 0 - 0 2783600 5801110
0 2 0 0 0 HARRY TJAHJANA D360674 40 14827 DR.
ARU ARIADNO, SPPD 0138R0170418V003171 0001460228859 3;JKN DR RIZKI;
5.2.1.201804062320 4 169667 1#0##0#0#0.0#2018-04-28
14:02:56#0#09:32:13#09:32:13#12:00:00 1 4dd3fe4f978bafd03450661bfdd25c6c
0 0 702488 0 0 1191610 0 0 0 0
2158012 0 0 0 0 1749000
3201126 B 2 BS 1 11/04/2018 11/04/2018 11/04/1996 0 2
- 0 - 0 - 0 - 0 2601900 1522081 0
1 0 0 0 NIVI SEPTI ASMAN NY d395699 21 8035 DR
ERDIYAN, SPOG 0138R0170418V003749 0002216263667 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176267 3#0##0#0#0.0#2018-05-03
08:47:41#0#00:00:00#00:00:00#00:00:00 1 414dec92110e64209c4125a7adc26dbf
0 0 248147 0 0 428359 0 0 0 0 648575
0 0 0 0 197000
3201126 B 2 BS 1 04/04/2018 11/04/2018 31/08/1978 0 1
0 - 0 - 0 - 0 - 0 4973600 7198934
0 8 0 0 0 NIKO HARI WIBOWO d374482 39 14461 DR
BAMBANG DWIPUTRA SPJP 0138R0170418V000881 0001775498681 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 168109 1#0##0#0#0.0#2018-05-03
11:38:41#0#20:58:17#20:58:17#12:00:00 1 77695f19c60740babc65fca7181f3a24
0 0 374804 0 0 2494672 0 0 0 0
4329458 0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 11/04/2018 01/07/1968 0 2
1 I72.1;D63.8;T82.4 99.04;39.52;39.43 - - None None None None
I-1-20-III None None None None None None PROSEDUR SISTIM PEREDARAN
- 0 20176600 15332683 0 4 0 0 0 JUMROH
0138R0170418V002393 0002065855386 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 169227 1#0##0#0#0.0#2018-05-03
16:23:59#0#17:21:10#17:21:10#12:00:00 1 a200c917313b1dc4520f33d09e6e208b
0 3784800 6052980 0 0 4465830 0 0 0 0
1029073 0 0 0 0 0
3201126 B 2 BS 1 10/04/2018 11/04/2018 05/01/1952 0 1
1 N18.5;E79.9 39.43 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 6245216 0 2 0 0 0 A. SOPIANSYAH
0001480417492 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 169605
1#0##0#0#0.0#2018-05-15 10:47:57#0#08:52:14#08:52:14#00:00:00 1
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3201126 B 1 BS 1 08/04/2018 11/04/2018 17/01/1977 0 2
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1#1#vvip#4#21622864#0.0#2018-06-05 12:50:54#0#23:40:51#23:40:51#12:00:00
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197000
3201126 B 1 BS 1 09/04/2018 11/04/2018 09/04/2018 3375 1
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1#0##0#0#0.0#2018-08-20 10:09:52#0#13:51:45#13:51:45#00:00:00 2
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3201126 B 2 BS 1 09/04/2018 11/04/2018 09/04/2018 2754 1
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NY D395554 0 0 DR OTTY MITHA S, SPA 0138R0170418V003720
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1#0##0#0#0.0#2018-08-20 10:18:15#0#09:49:01#09:49:01#00:00:00 2
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3201126 B 1 BS 1 10/04/2018 11/04/2018 19/05/1953 0 1
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RIZKI; 5.2.1.201804062320 4 169944 1#0##0#0#0.0#2018-09-10
10:11:12#0#14:17:51#14:17:51#12:00:00 2 9db622daef6597ee54f18284d91b082e
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3201126 B 1 BS 1 09/04/2018 11/04/2018 03/01/1984 0 2
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7567300 0 0 - 0 - 0 - 0 - 0
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1#1#vip#3#3783650#50.0#2018-09-10 10:11:49#0#08:56:25#08:56:25#00:00:00
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197000
3201126 B 2 BS 1 10/04/2018 11/04/2018 13/04/2016 0 1
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0002046517255 3;JKN DR RIZKI; 5.2.2.201806040537 4 169777
1#0##0#0#0.0#2018-09-10 10:13:17#0#11:13:21#11:13:21#00:00:00 2
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3201126 B 3 BS 1 11/04/2018 12/04/2018 01/09/1988 0 1
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0000385500341 3;JKN DR RIZKI; 5.2.1.201804062320 4 170432
12#0##0#0#0.0#2018-04-18 11:53:34#0#12:18:17#12:18:17#00:00:00 1
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3201126 B 1 BS 1 11/04/2018 12/04/2018 02/02/1961 0 1
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15#0##0#0#0.0#2018-04-19 09:07:24#0#13:55:56#13:55:56#00:00:00 1
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7569000
3201126 B 2 BS 1 11/04/2018 12/04/2018 15/06/1947 0 2
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TJIK D347381 70 25868 DR AGOES KOOSHARTORO SPPD 0138R0170418V003765
0001258382518 3;JKN DR RIZKI; 5.2.1.201804062320 4 170422
11#0##0#0#0.0#2018-04-19 09:16:07#0#11:55:47#11:55:47#00:00:00 1
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39945745 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 08/04/2018 12/04/2018 01/01/1953 0 1
1 I63.9;G81.9;E14.9 87.44;87.03 - - None None None None G-4-
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-04-19 10:21:58#0#08:40:17#08:40:17#00:00:00 1
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3201126 B 1 BS 1 09/04/2018 12/04/2018 27/09/2016 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 11284331 0 4 0 0 0 CALON BAYI NY.RESTU
MURDIYANTI D349133 1 559 DR ASRI RAHMAWATI SPB 0138R0170418V002977
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23#0##0#0#0.0#2018-04-19 10:37:59#0#18:36:45#18:36:45#00:00:00 1
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3201126 B 1 BS 1 09/04/2018 12/04/2018 12/03/1949 0 1
1 L27.0;E14.9;A41.9 87.44 - - None None None None L-4-14-III
None None None None None None GANGGUAN PADA KULIT & PAYUDARA LAIN-LAIN
(BERAT) 8726700 0 0 - 0 - 0 - 0 - 0
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69 25230 DR ARU, SPPD 0138R0170418V002892 0001256033237 3;JKN
DR RIZKI; 5.2.1.201804062320 4 169529 20#0##0#0#0.0#2018-04-19
10:49:39#0#16:25:04#16:25:04#00:00:00 1 a1a8cd3175368e446edb942658e47376
0 0 838403 0 0 2247990 0 0 0 0
3586548 0 0 0 0 0
3201126 B 3 BS 1 11/04/2018 12/04/2018 01/04/1963 0 2
1 E11.2;D63.8;J18.0;J90;I25.0 39.27;99.04 - - None None None
0 - 0 - 0 19332400 13309505 0 2 0 0
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0138R0170418V003752 0000368760791 3;JKN DR RIZKI; 5.2.1.201804062320
4 170436 13#0##0#0#0.0#2018-04-19
11:03:57#0#12:26:49#12:26:49#12:00:00 1 850afca4fdf43f028516dcfd95e27f55
0 3438800 5659396 0 0 3215594 0 0 0 0
926715 0 0 0 0 69000
3201126 B 1 BS 1 08/04/2018 12/04/2018 25/10/2017 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 5297262 0 5 0 0 0 MUHAMMAD SYAHIR
D379998 0 165 DR TRI LESTARI, SPA 0138R0170418V002790
0002301807442 3;JKN DR RIZKI; 5.2.1.201804062320 4 169490
19#0##0#0#0.0#2018-04-19 11:26:19#0#15:48:26#15:48:26#12:00:00 1
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1141141 0 0 0 0 3496550 0 0 0 0 340000
3201126 B 3 BS 1 10/04/2018 12/04/2018 01/09/1997 0 2
4665300 0 0 - 0 - 0 - 0 - 0
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20 7526 DR ARI KUSUMA JANUARTO, DR. SPOG 0138R0170418V003358
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18#0##0#0#0.0#2018-04-19 11:57:32#0#14:41:57#14:41:57#00:00:00 2
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1566901 0 0 0 0 516677 0 0 0 0 69000
3201126 B 3 BS 1 09/04/2018 12/04/2018 16/04/1955 0 1
1 I50.0;I48;J18.0;K30;N39.0 87.44 - - None None None None
4973600 0 0 - 0 - 0 - 0 - 0
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0001266993156 3;JKN DR RIZKI; 5.2.1.201804062320 4 169278
1#0##0#0#0.0#2018-04-19 14:29:21#0#09:31:04#09:31:04#00:00:00 1
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1335436 0 0 0 0 1276762 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 12/04/2018 15/10/1965 0 1
1 C20 45.23 - - None None None None K-4-10-I None None
None None None None TUMOR PENCERNAAN (RINGAN) 6881700 0 0
- 0 - 0 - 0 - 0 6881700 8418451 0
3 0 0 0 HASAN BADRI D395152 52 19170 DR ZULFAN, SPPD
0138R0170418V003276 0000039636156 3;JKN DR RIZKI; 5.2.1.201804062320
4 169864 1#0##0#0#0.0#2018-04-19
14:32:51#0#12:43:50#12:43:50#00:00:00 1 fd4c7da77b37d3c1dc7d2312a37686f6
0 0 1231324 0 0 1865887 0 0 0 0
3572240 0 0 0 0 1749000
3201126 B 2 BS 1 10/04/2018 12/04/2018 15/07/1970 0 2
1743400 0 0 - 0 - 0 - 0 - 0
1743400 6009624 0 3 0 0 0 YUVY LIANA D393831
3;JKN DR RIZKI; 5.2.1.201804062320 4 170134
24#0##0#0#0.0#2018-04-19 14:41:21#0#18:49:38#18:49:38#12:00:00 1
a6fb238c571ca7c70d95e78e840df554 0 0 541152 0 0
1336819 0 0 0 0 2379153 0 0 0 0
1752500
3201126 B 1 BS 1 08/04/2018 12/04/2018 14/10/1993 0 1
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 5857131 0 5 0 0 0 ADI DWI JANARKO
D352394 24 8942 DR ARU, SPPD 0138R0170418V002321
0001453747228 3;JKN DR RIZKI; 5.2.1.201804062320 4 169214
5#0##0#0#0.0#2018-04-19 14:48:35#0#00:03:33#00:03:33#00:00:00 1
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1281190 0 0 0 0 4314177 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 12/04/2018 14/11/1974 0 2
0 0 - 0 - 0 - 0 - 0 3247500
6790862 0 3 0 0 0 ELFINUR ZETHA RAHMAN D121118
43 15853 DR ARU, SPPD 0138R0170418V003558 0001462949008 3;JKN
DR RIZKI; 5.2.1.201804062320 4 170143 1#0##0#0#0.0#2018-04-19
14:58:22#0#22:50:34#22:50:34#00:00:00 1 4f6cde86742f9b8d8a0319bd84c27866
0 0 962300 0 0 1159300 0 0 0 0
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3201126 B 1 BS 1 07/04/2018 12/04/2018 23/10/1974 0 1
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0 - 0 - 0 - 0 - 0 6062400 17449775
0 6 0 0 0 HADI ALHADAR D395309 43 15872 DR.
5.2.1.201804062320 4 169190 17#0##0#0#0.0#2018-04-19
15:05:27#0#14:08:40#14:08:40#00:00:00 1 7a4d12f95ad76b99107def212ef33c6d
0 0 934060 0 0 7262141 0 0 0 0
6221574 0 0 0 0 3032000
3201126 B 1 BS 1 09/04/2018 12/04/2018 06/02/1985 0 2
0 - 0 - 0 - 0 - 0 5886000 5641427
0 4 0 0 0 ENDANG HASTARINI WIDOWATI D334749 33
12115 DR. ARU ARIADNO, SPPD 0138R0170418V002912 0000204015813 3;JKN
DR RIZKI; 5.2.1.201804062320 4 169562 1#0##0#0#0.0#2018-04-19
15:13:47#0#17:00:49#17:00:49#00:00:00 1 28c13f6858e670e549636b234b35017e
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3173565 0 0 0 0 0
3201126 B 3 BS 1 10/04/2018 12/04/2018 17/08/1967 0 2
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GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 4496733 0 3 0 0 0 SRI AGUSTINA NY
0001458266444 3;JKN DR RIZKI; 5.2.1.201804062320 4 170135
25#0##0#0#0.0#2018-04-19 15:15:41#0#19:01:07#19:01:07#00:00:00 1
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1892915 0 0 0 0 2178929 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 12/04/2018 12/09/1958 0 2
1 E14.5 - - - None None None None I-4-15-I None None
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 7853306 0 3 0 0 0 SITI KIPTIAH
D311964 59 21760 DR ARU, SPPD 0138R0170418V003038
0001812320223 3;JKN DR RIZKI; 5.2.1.201804062320 4 169586
3#0##0#0#0.0#2018-04-19 15:17:56#0#00:00:00#00:00:00#00:00:00 1
4b8d636a2a20565775605551b53e31e7 0 0 870410 0 0
4100128 0 0 0 0 2882768 0 0 0 0 0
3201126 B 2 BS 1 10/04/2018 12/04/2018 05/01/1970 0 2
2061500 0 0 - 0 - 0 - 0 - 0
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0002092129187 3;JKN DR RIZKI; 5.2.1.201804062320 4 169583
2#0##0#0#0.0#2018-04-19 15:21:56#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1732013 0 0 0 0 0
3201126 B 3 BS 1 11/04/2018 12/04/2018 26/03/2007 0 1
8672000 0 0 - 0 - 0 - 0 - 0
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0138R0170418V003755 0001257830695 3;JKN DR RIZKI; 5.2.1.201804062320
4 170349 10#0##0#0#0.0#2018-04-19
15:23:51#0#11:04:37#11:04:37#00:00:00 1 4f8a08d15a1680d11263ae1f10e5a119
0 3766600 8904600 0 0 2907249 0 0 0 0
1181961 0 0 0 0 145000
3201126 B 3 BS 1 12/04/2018 12/04/2018 03/07/1980 0 1
1 I47.1;I20.0;K21.9 - - - None None None None I-4-19-II
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 2756670 0 1 0 0 0 CAROLUS T YULIAN DEWANTO
0000209420267 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170607
6#0##0#0#0.0#2018-04-21 11:38:36#0#01:53:06#01:53:06#00:00:00 1
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0 0 0 0 487343 0 0 0 0 844000
3201126 B 3 BS 1 11/04/2018 12/04/2018 15/01/1950 0 1
- 0 8908800 15806699 0 2 0 0 0 NAWAWI
0001281921309 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170294
9#0##0#0#0.0#2018-04-21 11:55:57#0#10:05:05#10:05:05#00:00:00 1
1dab005c2e4329023a03532f5b86c08e 0 3062500 2636552 0 0
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3201126 B 3 BS 1 11/04/2018 12/04/2018 03/07/1957 0 1
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0 - 0 - 0 - 0 - 0 3043100 1671746
0 2 0 0 0 RD KUSNAEDY D122722 60 22197 DR RENDRA
RAMADYA 0138R0170418V004190 0001314702145 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 171490 4#0##0#0#0.0#2018-04-21
11:58:35#0#00:00:00#00:00:00#00:00:00 1 38ef27747f24d2475815dbd579c1fc86
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3201126 B 2 BS 1 11/04/2018 12/04/2018 12/12/1960 0 1
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D394441 57 20939 DR ARU, SPPD 0138R0170418V003942
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22#0##0#0#0.0#2018-05-03 09:22:06#0#17:02:25#17:02:25#12:00:00 1
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3201126 B 3 BS 1 09/04/2018 12/04/2018 21/04/1952 0 1
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0 0 - 0 - 0 - 0 - 0 4973600
2909137 0 4 0 0 0 ASELI Q059660 65 24094 DR
S;16137 5.2.1.201804062320 4 176149 1#0##0#0#0.0#2018-05-03
11:35:01#0#00:00:00#00:00:00#00:00:00 1 3909e18ca62e49607b40d92c12e6747e
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1268317 0 0 0 0 0
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3;JKN TANTIYO S;16137 5.2.1.201804062320 4 169235
1#0##0#0#0.0#2018-05-03 11:41:12#0#22:37:42#22:37:42#12:00:00 1
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1764000
3201126 B 2 BS 1 07/04/2018 12/04/2018 02/06/1980 0 1
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- 0 - 0 4434700 6982167 0 6 0 0 0
TOMI ANOM D289166 37 13823 DR HARDI PRANATA SPS
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5.2.1.201804062320 4 168876 1#0##0#0#0.0#2018-05-03
15:56:29#0#00:31:17#00:31:17#00:00:00 1 50c30e337c07594126d9dc536fd30d43
0 0 505123 0 0 2946267 0 0 0 0
3530777 0 0 0 0 0
3201126 B 3 BS 1 12/04/2018 12/04/2018 19/10/1957 0 1
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0 1 0 0 0 SUTOMO d343226 60 22090 DR DICKI
PRATAMA 0138R0170418V004020 0000049363323 3;JKN DR RIZKI;
5.2.1.201804062320 4 170604 1#0##0#0#0.0#2018-05-14
15:48:38#0#00:56:53#00:56:53#00:00:00 1 0a0d9496cd96f70bc10c4c94d85c187e
0 0 607248 0 0 2728785 0 0 0 0 542752
0 0 0 0 0
3201126 B 1 BS 1 08/04/2018 12/04/2018 18/03/1951 0 1
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INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-05-16 14:45:52#0#14:00:21#14:00:21#00:00:00 2
8609908ca5b0f77896ff6d420fbf7d1d 0 0 684656 0 0
1099063 0 0 0 0 1559730 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 12/04/2018 11/09/2008 0 1
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3 0 0 0 ABDURRAHMAN NAUFAL RAMADHAN D394468 9 3498
DR CATUR S, SPB 0138R0170418V003174 0001474674827 3;JKN irene;
5.2.1.201804062320 4 169673 1#0##0#0#0.0#2018-06-05
12:51:12#0#09:42:28#09:42:28#00:00:00 2 2dd383b2a48e9d7a14f748d4544c181a
0 7187200 1084832 0 0 3069012 0 0 0 0
863943 0 0 0 0 145000
3201126 B 1 BS 1 09/04/2018 12/04/2018 22/11/2016 0 2
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D350744* 1 503 DR KRISTON SILITONGA, SPA 0138R0170418V003030
0002252657351 3;JKN DR RIZKI; 5.2.2.201806040537 4 169584
1#0##0#0#0.0#2018-08-20 10:05:19#0#00:00:00#00:00:00#12:00:00 2
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0 0 0 0 2622168 0 0 0 0 170000
3201126 B 1 BS 1 10/04/2018 12/04/2018 04/09/1950 0 2
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50-I None None None None None None PROSEDUR PADA PAYUDARA (RINGAN)
9150100 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.2.201806040537 4 170136 1#0##0#0#0.0#2018-
08-21 11:39:33#0#19:31:59#19:31:59#00:00:00 2
38425758b1bcc6e431c68fb6d4acc896 0 9101600 2653529 0 0
4825005 0 0 0 0 1316279 0 0 0 0 145000
3201126 B 3 BS 1 12/04/2018 13/04/2018 13/10/1963 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2736836 0 2 0 0 0 SITI CHASIDAH
0000511209819 3;JKN DR RIZKI; 5.2.1.201804062320 4 170668
14#0##0#0#0.0#2018-04-18 11:46:23#0#11:07:10#11:07:10#00:00:00 1
210d3bff853547f6702bf48db93d226a 0 0 424889 0 0
1580902 0 0 0 0 731045 0 0 0 0 0
3201126 B 3 BS 1 12/04/2018 13/04/2018 21/05/1994 0 1
- 0 8908800 13599000 0 2 0 0 0 ISMAIL
0001233775078 3;JKN DR RIZKI; 5.2.1.201804062320 4 170612
1#0##0#0#0.0#2018-04-18 11:48:19#0#08:12:09#08:12:09#00:00:00 1
5a080b9b0739a9ec5babe37c2be2404b 0 3438800 5659396 0 0
3486150 0 0 0 0 945654 0 0 0 0 69000
3201126 B 3 BS 1 12/04/2018 13/04/2018 16/05/1957 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 9254638 0 2 0 0 0 NAMI 395836 60
22246 DR IRFIANSYAH LESMANA DR SPBTKV 0138R0170418V004442
0001338440207 3;JKN DR RIZKI; 5.2.1.201804062320 4 173086
6#0##0#0#0.0#2018-04-19 08:26:45#0#00:00:00#00:00:00#00:00:00 1
c113ad7371889c85adfa28e242b22ef2 0 3174000 1834760 0 0
3549934 0 0 0 0 661444 0 0 0 0 34500
3201126 B 2 BS 1 12/04/2018 13/04/2018 20/09/1992 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 9217536 0 2 0 0 0 YUDI SETIAWAN
0138R0170418V004331 0001868283246 3;JKN DR RIZKI; 5.2.1.201804062320
4 170905 17#0##0#0#0.0#2018-04-19
08:28:53#0#14:28:22#14:28:22#12:00:00 1 9d546ba72c8a48d6613d9d69e513ea5b
0 4911100 1041720 0 0 2536700 0 0 0 0
659016 0 0 0 0 69000
3201126 B 2 BS 1 10/04/2018 13/04/2018 17/06/1957 0 1
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 4885832 0 4 0 0 0 YOHANES ADNAN
D395574 60 22212 DR MAYSAM I., SPS 0138R0170418V003036
0002269700728 3;JKN DR RIZKI; 5.2.1.201804062320 4 169582
2#0##0#0#0.0#2018-04-19 08:31:34#0#00:00:00#00:00:00#00:00:00 1
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1865618 0 0 0 0 2365634 0 0 0 0 0
3201126 B 1 BS 1 12/04/2018 13/04/2018 05/02/1969 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 10415043 0 2 0 0 0 M YUNUS D395655
49 17963 DR DEDY PRATAMA SPBV 0138R0170418V004438 0001457654657
3;JKN DR RIZKI; 5.2.1.201804062320 4 171555
19#0##0#0#0.0#2018-04-19 08:33:10#0#17:10:52#17:10:52#00:00:00 1
144097d5e4dff17fe3cf2b7def3e6321 0 6122700 2494460 0 0
991525 0 0 0 0 737358 0 0 0 0 69000
3201126 B 2 BS 1 12/04/2018 13/04/2018 02/02/1963 0 2
- 0 10690500 11933711 0 2 0 0 0 PURBONINGSIH
D395835 55 20158 DR ARU, SPPD 0138R0170418V004402
0001294463902 3;JKN DR RIZKI; 5.2.1.201804062320 4 170950
18#0##0#0#0.0#2018-04-19 08:36:05#0#15:44:24#15:44:24#00:00:00 1
41420eb4b3662d04eb14cd922267d71b 0 0 3153245 0 0
3435656 0 0 0 0 5275810 0 0 0 0 69000
3201126 B 1 BS 1 11/04/2018 13/04/2018 04/04/1959 0 1
- 0 58821400 68928967 0 3 0 0 0 MAMUN
0000061100796 3;JKN DR RIZKI; 5.2.1.201804062320 4 170444
16#0##0#0#0.0#2018-04-19 09:12:52#0#13:11:17#13:11:17#00:00:00 1
e1bd96c1c66385918b473f4ecc361125 0 10753000 6870800 0 0
42480167 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 3 BS 1 11/04/2018 13/04/2018 27/12/1986 0 2
0 - 0 - 0 - 0 - 0 4986800 8491034
0 3 0 0 0 DEBI ANGGRAENI D392330 31 11428 DR
5.2.1.201804062320 4 170602 1#0##0#0#0.0#2018-04-21
10:04:20#0#00:08:12#00:08:12#00:00:00 1 fd477ed0c1f5c9021c953c6976ce84c0
0 3361500 1761644 0 0 2529402 0 0 0 0
641488 0 0 0 0 197000
3201126 B 3 BS 1 11/04/2018 13/04/2018 28/04/2008 0 1
8672000 0 0 - 0 - 0 - 0 - 0
8672000 16178533 0 3 0 0 0 MOSESFERDYANTA TARIGAN
0138R0170418V004003 0002091715547 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 170594 22#0##0#0#0.0#2018-04-21
10:13:52#0#19:59:59#19:59:59#00:00:00 1 f325c5e4f4e652f760d1594d84d5d41e
0 0 5494259 0 0 3664365 0 0 0 0
6874909 0 0 0 0 145000
3201126 B 3 BS 1 11/04/2018 13/04/2018 05/07/1978 0 2
0 - 0 - 0 - 0 - 0 4986800 8004551
0 3 0 0 0 NILA SARI D395701 39 14525 DR MAMAN H,
SPOG 0138R0170418V003576 0001727462564 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 170156 5#0##0#0#0.0#2018-04-21
11:33:17#0#00:00:00#00:00:00#00:00:00 1 7f3c6dc81fc961f2d4e2596a25fc8fbe
0 3534500 1814644 0 0 1740745 0 0 0 0
589662 0 0 0 0 325000
3201126 B 2 BS 1 11/04/2018 13/04/2018 03/09/1994 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 12442604 0 3 0 0 0 RENI TRI SEPTIANI
0002076162715 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170147
3#0##0#0#0.0#2018-04-21 11:57:11#0#00:00:00#00:00:00#00:00:00 1
1997655e409c6ac3efd48e8c6df70f5d 0 5269900 2090753 0 0
3727949 0 0 0 0 900002 0 0 0 0 454000
3201126 B 2 BS 1 12/04/2018 13/04/2018 27/10/2017 0 2
0 - 0 - 0 - 0 - 0 6397900 8267824
0 2 0 0 0 ARUNA SACHI KANAYA d395097* 0 167
DR CATUR S, SPB 0138R0170418V004182 0002289814997 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 170666 1#0##0#0#0.0#2018-04-21
12:15:33#0#09:36:47#09:36:47#00:00:00 1 7f84bdfbb24ef994de917f025730b060
0 4397500 1545848 0 0 1562590 0 0 0 0
616886 0 0 0 0 145000
3201126 B 1 BS 1 12/04/2018 13/04/2018 05/09/2014 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5404588 0 2 0 0 0 DAFFIN NICKELTON NUGROHO
d373507 3 1315 DR CATUR SUZANTARA 0138R0170418V004139
0002034031961 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170634
1#0##0#0#0.0#2018-04-21 12:17:33#0#08:29:38#08:29:38#12:00:00 1
687e23968121b43bd30b9536d5eaa5ec 0 3398000 410872 0 0
1041145 0 0 0 0 409571 0 0 0 0 145000
3201126 B 1 BS 1 11/04/2018 13/04/2018 17/03/1951 0 1
1 I25.0;N18.5;I11.0 88.55;36.07 - - YY02 None None None I-1-
- 0 58821400 60370700 0 3 0 0 0 EKA UTOYO
0001809227406 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170198
12#0##0#0#0.0#2018-04-21 12:18:51#0#08:51:23#08:51:23#12:00:00 1
fba776c8051e60f56a8fabe711d1fed5 0 10753000 6870800 0 0
33921900 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 08/04/2018 13/04/2018 06/07/1952 0 2
0 - 0 - 0 - 0 - 0 4290800 4429724
0 6 0 0 0 HJ.MUJENAH D378196 65 24017 DR PRIYO
SUNARTO , SPJP 0138R0170418V002340 0001338885022 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 169220 9#0##0#0#0.0#2018-04-21
12:20:49#0#06:46:19#06:46:19#12:00:00 1 83bdb9c74f335bf06cd00e108308f068
0 0 429099 0 0 636830 0 0 0 0
3363795 0 0 0 0 0
3201126 B 2 BS 1 11/04/2018 13/04/2018 05/04/2018 2910 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 4251621 0 3 0 0 0 BAYI NY NINA WATI
0002447227978 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170153
4#0##0#0#0.0#2018-05-03 08:37:53#0#00:00:00#00:00:00#00:00:00 1
77622d2afb143e1347bcfb1ead77448c 0 0 447812 0 0 160666
0 0 0 0 2335143 0 0 0 0 1308000
3201126 B 2 BS 1 11/04/2018 13/04/2018 11/04/2018 3250 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1848330 0 3 0 0 0 BAYI NY RENI TRI
SEPTIANI D395741 0 0 DR AULIA TANGKARI, SPA 0138R0170418V004461
0002448956968 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177395
7#0##0#0#0.0#2018-05-03 10:31:39#0#00:00:00#00:00:00#00:00:00 1
9b0223685ec936d794073f532161332f 0 0 1848330 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 12/04/2018 13/04/2018 12/01/1957 0 2
1 E10.2;I15.9 38.95;99.17 - - None None None None N-1-12-I
- 0 6076700 14126111 0 2 0 0 0 ANAH
D395839 61 22370 DR ARU, SPPD 0138R0170418V004430
0001257026297 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171027
21#0##0#0#0.0#2018-05-03 10:45:58#0#17:56:52#17:56:52#00:00:00 1
1896e25009e542547a65dbf7f0df779c 0 5640500 3669967 0 0
3796506 0 0 0 0 950138 0 0 0 0 69000
3201126 B 2 BS 1 12/04/2018 13/04/2018 13/09/1962 0 1
1 T82.4;E11.2;N18.5;D63.8 39.42;38.95;99.04 - - None None None
0 - 0 - 0 10690500 17204610 0 2 0 0
0 DJOKO SUPRIYANTO D395828 55 20300 DR. ARU ARIADNO, SPPD
0138R0170418V004253 0001226677116 3;JKN DR RIZKI; 5.2.1.201804062320
4 170714 1#0##0#0#0.0#2018-05-03
15:28:59#0#11:40:00#11:40:00#00:00:00 1 3642e706f91c702177093282d0b64927
0 4911100 6780681 0 0 4262294 0 0 0 0
1181535 0 0 0 0 69000
3201126 B 2 BS 1 06/04/2018 13/04/2018 06/04/2018 1873 2
MAYOR (RINGAN) 11607000 0 0 - 0 - 0 - 0 -
0 11607000 16504827 0 8 0 0 0 BY NY VERONIKA
TATI ROHATI D395223 0 0 DR AULIA TANGKARI, SPA 0138R0170418V001858
0002447321962 3;JKN DR RIZKI; 5.2.1.201804062320 4 168741
1#0##0#0#0.0#2018-05-15 16:10:06#0#14:25:18#14:25:18#00:00:00 1
8a707afee63ea4cf78f03e650c0c9513 0 0 1044626 0 0
3276446 0 0 0 0 8112755 0 0 0 0
4071000
3201126 B 1 BS 1 10/04/2018 13/04/2018 14/11/1989 0 2
0 0 - 0 - 0 - 0 - 0 6981500
19838291 0 4 0 0 0 YUNITA LIA MARYANI D395686
28 10374 DR NINING H, SPOG 0138R0170418V003553 0001812410403 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 170141 1#0##0#0#0.0#2018-
05-15 18:19:34#0#22:09:40#22:09:40#00:00:00 1
30bead4630d4d9b1203d6fdcb2deef3d 0 0 6078750 0 0
3987141 0 0 0 0 9575400 0 0 0 0 197000
3201126 B 3 BS 1 13/04/2018 13/04/2018 07/10/1968 0 1
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 2300606 0 1 0 0 0 ANTONO D395071
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172250
1#0##0#0#0.0#2018-05-15 18:45:08#0#00:00:00#00:00:00#00:00:00 1
c609d44151e98bcd5fb1cd4c4d2ddc60 0 0 245189 0 0 411494
0 0 0 0 355198 0 0 0 1288725 0
3201126 B 3 BS 1 13/04/2018 13/04/2018 10/06/1956 0 1
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 3518162 0 1 0 0 0 HABIB WARACHMAN
D384587 61 22587 DR VINSENSIA NOVI KARTIKA 0138R0170418V004817
0000040201953 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171553
1#0##0#0#0.0#2018-05-15 18:51:48#0#16:37:17#16:37:17#12:00:00 1
4e7c8e480cc1c78909af3b1a5ebbe02d 0 0 621855 0 0
2377147 0 0 0 0 519160 0 0 0 0 0
3201126 B 3 BS 1 09/04/2018 13/04/2018 26/03/1954 0 2
4336500 0 0 - 0 - 0 - 0 - 0
4336500 4940454 0 5 0 0 0 EULIS PRAWATI
0000165112738 3;JKN ECHI; 5.2.1.201804062320 4 169576
1#0##0#0#0.0#2018-05-17 09:33:01#0#00:00:00#00:00:00#00:00:00 2
b5d3386acc52f3e0d5562086a2bc548f 0 0 920180 0 0
1651067 0 0 0 0 2369207 0 0 0 0 0
3201126 B 3 BS 1 11/04/2018 13/04/2018 28/03/2016 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2683426 0 3 0 0 0 M ARKAN AN D395690
2 744 DR CATUR S, SPB 0138R0170418V003759 0002037281927 3;JKN
DR RIZKI; 5.2.2.201806040537 4 170364 1#0##0#0#0.0#2018-08-20
10:21:24#0#11:11:56#11:11:56#00:00:00 2 993d5548992c8e38c17bd952ad44fc9b
0 0 224800 0 0 1468075 0 0 0 0 990551
0 0 0 0 0
3201126 B 3 BS 1 12/04/2018 13/04/2018 14/07/1959 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3910547 0 2 0 0 0 SARJANI D339833
58 21457 DR SOEGIONO, SPPD 0138R0170418V004448 0001317938231 3;JKN
DR RIZKI; 5.2.2.201806040537 4 171038 1#0##0#0#0.0#2018-08-20
10:31:58#0#23:36:45#23:36:45#00:00:00 2 9631a3992d5ad31606012c0b0b509a23
0 0 499265 0 0 1710202 0 0 0 0
1701080 0 0 0 0 0
3201126 B 1 BS 1 11/04/2018 13/04/2018 17/03/1951 0 1
- 0 58821400 60370700 0 3 0 0 0 EKA UTOYO
0001809227406 3;JKN DR RIZKI; 5.2.2.201806040537 4 170198
1#0##0#0#0.0#2018-08-21 11:00:52#0#08:51:23#08:51:23#12:00:00 2
179708e0be42c3fc2a295d3a52415b1d 0 10753000 6870800 0 0
33921900 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 1 BS 1 09/04/2018 13/04/2018 30/11/1965 0 2
1 N85.1 68.9;65.49 - - None None None None W-1-20-I None
None None None None None PROSEDUR PADA RAHIM & ADNEKSA (RINGAN)
11569900 0 0 - 0 - 0 - 0 - 0
11569900 16162498 0 5 0 0 0 DRA. TIURIDA TOBING
d393614 52 19123 DR ARIS WAHJU, SPOG 0138R0170418V003002
0000061068846 3;JKN DR RIZKI; 5.2.2.201806040537 4 169573
1#0##0#0#0.0#2018-09-10 10:15:02#0#20:28:37#20:28:37#12:00:00 2
fae964f733396c57c74bfb2f2ed1560e 0 7787000 4280863 0 0
2882275 0 0 0 0 1143360 0 0 0 0 69000
3201126 B 1 BS 1 10/04/2018 13/04/2018 30/04/1935 0 2
1 A41.9;J22;F00.9 - - - None None None None A-4-10-I
0 - 0 - 0 - 0 - 0 3548600 7558467
0 4 0 0 0 H PEGGY SJATHA BAX D395628 82 30296
DR NURUL KOMARI SPS 0138R0170418V003554 0001889971738 3;JKN DR
RIZKI; 5.2.2.201806040537 4 170142 1#1#vvip#4#4009867#0.0#2018-
09-10 10:16:59#0#22:14:52#22:14:52#00:00:00 2
343ad9d80ce80718817c5ce47ed4ca9c 0 0 674004 0 0
2518984 0 0 0 0 4365479 0 0 0 0 0
3201126 B 2 BS 1 09/04/2018 13/04/2018 23/12/1979 0 2
8447200 0 0 - 0 - 0 - 0 - 0
8447200 17423935 0 5 0 0 0 DESY TRIANY NATALIA
SIAGIAN d393247 38 13987 DR E SURYA POHAN DR SPB KBD
0138R0170418V002604 0001457847617 3;JKN DR RIZKI; 5.2.2.201806040537
4 171558 1#0##0#0#0.0#2018-09-25
10:12:28#0#17:19:25#17:19:25#12:00:00 2 53e75f0e49ba26fa7cd6d9595db29d3f
0 6156100 2428216 0 0 681000 0 0 0 0
1139884 0 0 0 7018735 0
3201126 B 1 BS 1 12/04/2018 13/04/2018 28/02/1970 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 13078628 0 2 0 0 0 TUAH ROBERT. S
D392183 48 17575 DR ARU, SPPD 0138R0170418V004396
0001725341049 3;JKN DR RIZKI; 5.2.2.201806040537 4 170965
1#0##0#0#0.0#2018-09-25 12:43:58#0#15:55:51#15:55:51#12:00:00 2
452be5aa22ded6f4ac3e7a29114cae86 0 0 3669967 0 0
2532050 0 0 0 0 6807611 0 0 0 0 69000
3201126 B 3 BS 1 09/04/2018 13/04/2018 10/05/2004 0 1
- 0 - 0 - 0 - 0 3874400 13587534 0
5 0 0 0 ASLAM AZIZAN D395199 13 5082 DR OTTY
MITHA S, SPA 0138R0170418V002603 0001719804802 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 169284 1#0##0#0#0.0#2018-09-28
13:28:45#0#09:35:33#09:35:33#00:00:00 2 6f38278fabfaa520614396ab1074ecfd
0 3957800 2780375 0 0 5414455 0 0 0 0
974904 0 0 0 0 460000
3201126 B 2 BS 1 12/04/2018 13/04/2018 12/07/1970 0 1
- 0 10690500 12584869 0 2 0 0 0 EDI SAIDI
0138R0170418V004363 0001298221211 3;JKN DR RIZKI; 5.2.2.201806040537
4 170924 1#0##0#0#0.0#2018-09-29
15:01:58#0#15:03:23#15:03:23#00:00:00 3 f97affe3ce20d45e026827527f3ee33b
0 4929100 2245005 0 0 4561455 0 0 0 0
849309 0 0 0 0 0
3201126 B 3 BS 1 11/04/2018 14/04/2018 10/02/2018 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4035107 0 4 0 0 0 EZRA ADSKHAN DHIA
PRATAMA D395670 0 60 DR AULIA TANGKARI, SPA 0138R0170418V003562
0002439034571 3;JKN DR RIZKI; 5.2.1.201804062320 4 173060
1#0##0#0#0.0#2018-04-18 11:50:39#0#00:00:00#00:00:00#00:00:00 1
65e973866d44f2d6efb669b1586cffdc 0 0 378188 0 0
1804940 0 0 0 0 1341979 0 0 0 0 510000
3201126 B 1 BS 1 10/04/2018 14/04/2018 28/02/1950 0 1
1 I63.9;E14.9;G81.9 87.03;87.44 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 6947150 0 5 0 0 0 DICKY MOCH SADIKIN
0001462580267 3;JKN DR RIZKI; 5.2.1.201804062320 4 170137
18#0##0#0#0.0#2018-04-18 11:55:38#0#19:44:02#19:44:02#00:00:00 1
42253903c7db1eaab7e8a1f5f6aec384 0 0 825024 0 0
2082140 0 0 0 0 4039986 0 0 0 0 0
3201126 B 3 BS 1 09/04/2018 14/04/2018 12/10/1991 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 6015684 0 6 0 0 0 DWI ARIF BUDIARDI
d395480 26 9676 DR. ARU ARIADNO, SPPD 0138R0170418V002687
0001379939624 3;JKN DR RIZKI; 5.2.1.201804062320 4 169331
9#0##0#0#0.0#2018-04-18 11:58:03#0#12:23:51#12:23:51#00:00:00 1
cc2034103adcd5643f4a58c71fabebf3 0 0 300851 0 0
3717284 0 0 0 0 1997549 0 0 0 0 0
3201126 B 2 BS 1 12/04/2018 14/04/2018 25/01/1954 0 2
0 - 0 2376200 2701783 0 3 0 0 0
SUNDARI D337669 64 23453 DR. ARU ARIADNO, SPPD
0138R0170418V004435 0000036784675 3;JKN DR RIZKI; 5.2.1.201804062320
4 171029 17#0##0#0#0.0#2018-04-18
12:00:57#0#19:00:25#19:00:25#00:00:00 1 c70fcf352edb5794d9231b2df2c3666c
0 0 278711 0 0 912820 0 0 0 0
1510252 0 0 0 0 0
3201126 B 1 BS 1 11/04/2018 14/04/2018 18/08/1961 0 2
1 C73;I15.9 06.4 - - None None None None E-1-20-I None
None None None None None PROSEDUR PADA TIROID, PARATIROID DAN SALURAN
- 0 10523000 20739780 0 4 0 0 0 MUJI RAHAYU
0000198227024 3;JKN DR RIZKI; 5.2.1.201804062320 4 170592
19#0##0#0#0.0#2018-04-19 08:44:55#0#19:52:37#19:52:37#12:00:00 1
a2e35546ff855dcdc2084c2b6c6bdfe8 0 10156100 2946440 0 0
6046240 0 0 0 0 1301000 0 0 0 0 290000
3201126 B 2 BS 1 13/04/2018 14/04/2018 11/06/1995 0 2
1 K30;B34.9 - - - None None None None K-4-18-I None
1743400 0 0 - 0 - 0 - 0 - 0
1743400 1814244 0 2 0 0 0 NANDA AYU FADILLAH
D356123 22 8342 DR ARU, SPPD 0138R0170418V004834
0001228973679 3;JKN DR RIZKI; 5.2.1.201804062320 4 171562
14#0##0#0#0.0#2018-04-19 09:14:15#0#17:59:27#17:59:27#00:00:00 1
d5fe912c09f77afe167598bb2d7f94f1 0 0 298025 0 0 361530
0 0 0 0 1154689 0 0 0 0 0
3201126 B 3 BS 1 12/04/2018 14/04/2018 05/03/1975 0 2
4199800 0 0 - 0 - 0 - 0 - 0
4199800 2940549 0 3 0 0 0 ALIYAH NY D395798
43 15744 DR BETTY DWI L, SPPD 0138R0170418V004024 0000510898331
3;JKN DR RIZKI; 5.2.1.201804062320 4 170606 4#0##0#0#0.0#2018-
04-19 09:20:18#0#01:38:28#01:38:28#00:00:00 1
2a39e27bf532182ea987aa4c02a3d97e 0 0 430982 0 0
1484195 0 0 0 0 1025372 0 0 0 0 0
3201126 B 2 BS 1 11/04/2018 14/04/2018 17/10/1970 0 2
1 A01.0;H81.1;D25.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 3377335 0 4 0 0 0 MERIANTO BP
SINURAT D395792 47 17343 DR BETTY DWI L, SPPD 0138R0170418V004018
0002315518334 3;JKN DR RIZKI; 5.2.1.201804062320 4 170600
22#0##0#0#0.0#2018-04-19 09:25:11#0#23:56:14#23:56:14#00:00:00 1
364a15b9c05f45d75f5e7bb72afea689 0 0 291356 0 0
1324032 0 0 0 0 1761947 0 0 0 0 0
3201126 B 2 BS 1 12/04/2018 14/04/2018 18/09/1982 0 1
1 E14.7;E87.6;N39.0;I10 99.17 - - None None None None E-4-
0 - 0 5873300 4599338 0 3 0 0 0
PURWANTO D366349 35 12990 DR BETTY DWI L, SPPD
0138R0170418V004455 0001805823382 3;JKN DR RIZKI; 5.2.1.201804062320
4 171040 3#0##0#0#0.0#2018-04-19
09:52:24#0#01:31:35#01:31:35#00:00:00 1 90e82295f42274208c6c34b66e91772d
0 0 581597 0 0 2662850 0 0 0 0
1354891 0 0 0 0 0
3201126 B 3 BS 1 13/04/2018 14/04/2018 10/07/1950 0 2
1 D64.8;K30 99.04 - - None None None None D-4-13-I None
- 0 2987000 2840183 0 2 0 0 0 ASMANAH
0000510952847 3;JKN DR RIZKI; 5.2.1.201804062320 4 171564
16#0##0#0#0.0#2018-04-19 09:54:41#0#18:35:06#18:35:06#00:00:00 1
802386f1751c7cccf42b352d6287e1c1 0 0 321830 0 0
1867047 0 0 0 0 651306 0 0 0 0 0
3201126 B 3 BS 1 12/04/2018 14/04/2018 19/04/2016 0 1
0 - 0 2334400 1794904 0 3 0 0 0 RAFFI
AHMAD SAIFUDDIN AN d395820 1 723 DR KRISTON SILITONGA, SPA
0138R0170418V004333 0002047416028 3;JKN DR RIZKI; 5.2.1.201804062320
4 170895 11#0##0#0#0.0#2018-04-19
09:56:10#0#14:12:55#14:12:55#00:00:00 1 bd062f9a5362dc8f1893931a3632bb6f
0 0 292031 0 0 570449 0 0 0 0 932424
0 0 0 0 0
3201126 B 2 BS 1 12/04/2018 14/04/2018 16/11/1950 0 2
1 M75.0;E14.9 81.92 - - None None None None M-4-21-I None
None None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
0 - 0 3543000 3615051 0 3 0 0 0
NY.CHAMISMARWATI D305396 67 24619 DR NURUL KOMARI SPS
0138R0170418V004449 0000060827679 3;JKN DR RIZKI; 5.2.1.201804062320
4 171035 21#0##0#0#0.0#2018-04-19
10:00:03#0#22:59:07#22:59:07#00:00:00 1 a2bd966fe358ba56965a6ae0d331a7da
0 0 594422 0 0 1730130 0 0 0 0
1290499 0 0 0 0 0
3201126 B 1 BS 1 12/04/2018 14/04/2018 17/11/1965 0 1
1 I63.9;I10;E11.9 87.03;87.44 - - None None None None G-4-
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 7040402 0 3 0 0 0 SRI YANTI SULIDI
NY D395794 52 19139 DR MAYSAM I., SPS 0138R0170418V004022
0001456508619 3;JKN DR RIZKI; 5.2.1.201804062320 4 170605
2#0##0#0#0.0#2018-04-19 10:01:58#0#01:20:13#01:20:13#00:00:00 1
44dfa554dcd3ddec8de2cf355ee8065e 0 0 1117063 0 0
3093752 0 0 0 0 2829587 0 0 0 0 0
3201126 B 2 BS 1 11/04/2018 14/04/2018 16/12/2015 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3132296 0 4 0 0 0 ANINDYA ORLIN
0001961743948 3;JKN DR RIZKI; 5.2.1.201804062320 4 170520
1#0##0#0#0.0#2018-05-02 11:59:20#0#14:34:15#14:34:15#00:00:00 1
9dbdfaa9c570af1d59b6987e1b7465bc 0 0 257183 0 0 454196
0 0 0 0 2250917 0 0 0 0 170000
3201126 B 2 BS 1 13/04/2018 14/04/2018 09/03/1960 0 1
1 G56.0;M65.34 04.43;82.01 - - None None None None M-1-
80-I None None None None None None PROSEDUR ANGGOTA TUBUH ATAS (RINGAN)
10406400 0 0 - 0 - 0 - 0 - 0
10406400 8706036 0 2 0 0 0 IVAN SATIVA. W
0001961243458 3;JKN DR RIZKI; 5.2.1.201804062320 4 171170
1#0##0#0#0.0#2018-05-02 12:02:17#0#10:10:53#10:10:53#00:00:00 1
6c752c83bc039953aa600ffda5d703ff 0 5180500 500192 0 0
2330790 0 0 0 0 625554 0 0 0 0 69000
3201126 B 3 BS 1 13/04/2018 14/04/2018 22/03/2015 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6707487 0 2 0 0 0 ADRIANSYAH AL HASYIM
0002096723812 3;JKN DR RIZKI; 5.2.1.201804062320 4 171191
1#0##0#0#0.0#2018-05-02 12:23:46#0#10:33:30#10:33:30#12:00:00 1
eb5da1b89e5bf8fe3958d0ca1815ea99 0 3462900 1536920 0 0
1047859 0 0 0 0 514808 0 0 0 0 145000
3201126 B 3 BS 1 13/04/2018 14/04/2018 31/12/1957 0 2
- 0 8908800 9441077 0 2 0 0 0 AINUN
D395910 60 22018 DR ARU, SPPD 0138R0170418V004842
0001298342362 3;JKN DR RIZKI; 5.2.1.201804062320 4 171563
1#0##0#0#0.0#2018-05-02 14:08:39#0#18:18:08#18:18:08#00:00:00 1
82ac9ece396fd69e4f2bfc0a17d12bbe 0 0 2636552 0 0
3098384 0 0 0 0 3706141 0 0 0 0 0
3201126 B 3 BS 1 13/04/2018 14/04/2018 22/03/2004 0 2
1 Q21.1 - - - None None None None I-4-18-I None None
None None None None PENYAKIT JANTUNG KONGENITAL DAN KATUP JANTUNG
(RINGAN) 4057700 0 0 - 0 - 0 - 0 - 0
4057700 783821 0 2 0 0 0 MUHAMMAD RHIDO ABDILLAH
D380766 14 5135 DR DINI DANIATY 0138R0170418V004840
0001335822906 3;JKN DR RIZKI; 5.2.1.201804062320 4 171561
1#0##0#0#0.0#2018-05-02 14:13:38#0#17:34:21#17:34:21#12:00:00 1
4a64339a9e0db94101aa0be5b2e4ca74 0 0 365193 0 0 78350
0 0 0 0 340278 0 0 0 0 0
3201126 B 1 BS 1 12/04/2018 14/04/2018 17/08/1959 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 11019440 0 3 0 0 0 AGUS PANJAITAN
0001299474257 3;JKN DR RIZKI; 5.2.1.201804062320 4 171126
1#0##0#0#0.0#2018-05-02 15:05:21#0#09:38:30#09:38:30#12:00:00 2
dba28502eb655abda07b04d41549ca54 0 6486200 984100 0 0
2733242 0 0 0 0 746898 0 0 0 0 69000
3201126 B 3 BS 1 10/04/2018 14/04/2018 25/04/2015 0 1
1 A41.9;G05.8;R56.0;A09.9 - - - None None None None A-4-
0 0 - 0 - 0 - 0 - 0 5838600
11350581 0 5 0 0 0 HANIF ABBAD FAHSYA D395616
2 1081 DR NOVIK BUDIWARDHANA, SPA 0138R0170418V003548
0001739964598 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170140
20#0##0#0#0.0#2018-05-03 09:09:16#0#20:23:38#20:23:38#00:00:00 1
a8e7284634618adc39f3fbb55c2c3e7e 0 0 281492 0 0
4918528 0 0 0 0 3947561 0 0 0 0
2203000
3201126 B 2 BS 1 13/04/2018 14/04/2018 28/03/1973 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8818245 0 2 0 0 0 FAHRUDIN D395164
0001898374364 3;JKN DR RIZKI; 5.2.1.201804062320 4 171212
1#0##0#0#0.0#2018-05-03 15:20:57#0#10:45:46#10:45:46#00:00:00 1
1806bbf5f641a79d268e4e18eddbc53f 0 4911100 931100 0 0
2373150 0 0 0 0 602895 0 0 0 0 0
3201126 B 3 BS 1 13/04/2018 14/04/2018 16/08/1973 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 6927662 0 2 0 0 0 MAMAN D395594 44
16311 DR IRFIANSYAH LESMANA DR SPBTKV 0138R0170418V004559
0001771853758 3;JKN DR RIZKI; 5.2.1.201804062320 4 171198
1#0##0#0#0.0#2018-05-15 16:36:48#0#10:38:33#10:38:33#00:00:00 1
88950a853c4b180ec71e7089467f10ce 0 0 868100 0 0
1876550 0 0 0 0 3986012 0 0 0 0 197000
3201126 B 1 BS 1 13/04/2018 14/04/2018 23/11/1953 0 2
- 0 25741900 48113244 0 2 0 0 0 DERITA BR
SIMANJUNTAK D323013 64 23517 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170418V004619 0000061082493 3;JKN DR RIZKI; 5.2.2.201806040537
4 171235 1#0##0#0#0.0#2018-09-10
10:19:57#0#10:59:17#10:59:17#00:00:00 2 eaacd2c677957400985806aa42294c95
0 10062000 3419040 0 0 25807204 0 0 0 0
1256000 0 0 0 0 7569000
3201126 B 3 BS 1 13/04/2018 14/04/2018 03/08/1938 0 1
4 G31.9;I21.3 87.03 - - None None None None G-4-11-III None
(BERAT) 8922900 0 0 - 0 - 0 - 0 - 0
8922900 1934817 0 2 0 0 0 KASNADI D395935
0000061019471 3;JKN DR RIZKI; 5.2.2.201806040537 4 171554
1#0##0#0#0.0#2018-09-10 10:25:51#0#17:07:08#17:07:08#00:00:00 2
ef3ac7bdd223b2c2dd8004ab669e0fd6 0 0 780498 0 0 738742
0 0 0 0 415577 0 0 0 0 0
3201126 B 1 BS 1 13/04/2018 14/04/2018 18/05/2001 0 2
1 I12.0;R60.1 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 16601831 0 2 0 0 0 DHENISWARI H PUTRI
0138R0170418V004689 0001421988772 3;JKN DR RIZKI; 5.2.2.201806040537
4 171344 1#0##0#0#0.0#2018-09-25
14:07:17#0#13:41:04#13:41:04#12:00:00 2 f7abae83e2f536524202375afcc2b8a5
0 6468200 1300230 0 0 7622300 0 0 0 0
1142101 0 0 0 0 69000
3201126 B 2 BS 1 13/04/2018 14/04/2018 02/05/1964 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8889556 0 2 0 0 0 SUKEN RINI , S.PD ,MM
D183622 53 19704 DR ARU, SPPD 0138R0170418V004872
0001633805886 3;JKN DR RIZKI; 5.2.2.201806040537 4 171568
1#0##0#0#0.0#2018-09-26 12:06:59#0#00:00:00#00:00:00#12:00:00 2
bef8a8bfd3efa2ec30a92fec487a031b 0 4496100 1563494 0 0
2153402 0 0 0 0 607560 0 0 0 0 69000
3201126 B 1 BS 1 13/04/2018 15/04/2018 03/07/2011 0 1
1 R11;E86 - - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 2689461 0 3 0 0 0 M BIRRU BANUA PUTRA
BUDIMAN D211389 6 2476 DR RASTRA, SPA 0138R0170418V005209
0001844311667 3;JKN DR RIZKI; 5.2.1.201804062320 4 171884
1#0##0#0#0.0#2018-05-02 09:06:40#0#10:29:00#10:29:00#00:00:00 1
75123d7c25dd444a818c028413be6598 0 0 269458 0 0 220557
0 0 0 0 2199446 0 0 0 0 0
3201126 B 1 BS 1 14/04/2018 15/04/2018 23/11/2014 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2368077 0 2 0 0 0 ALFATHIR ZHAFRAN ADITAMA
0001868223903 3;JKN DR RIZKI; 5.2.1.201804062320 4 171572
1#0##0#0#0.0#2018-05-02 09:07:30#0#00:00:00#00:00:00#00:00:00 1
52e76a725c2748da3a33ecb76cf0804b 0 0 269459 0 0 355697
0 0 0 0 1742921 0 0 0 0 0
3201126 B 3 BS 1 15/04/2018 15/04/2018 02/07/2003 0 2
1 Q21.1;L97;I70.2;A41.9;R57.9 - - - None None None None
I-4-18-III None None None None None None PENYAKIT JANTUNG KONGENITAL
DAN KATUP JANTUNG (BERAT) 8387700 0 0 - 0 - 0 -
0 - 0 8387700 4132197 0 1 0 0 0 KARINA
ASRI ANGELLINA F237358 14 5401 DR DINI DANIATY 0138R0170418V004962
0001768511248 3;JKN DR RIZKI; 5.2.1.201804062320 4 171603
1#0##0#0#0.0#2018-05-02 14:12:49#0#00:00:00#00:00:00#00:00:00 1
6a60ff40fed3c4ba9a7865905d0a1b39 0 0 754893 0 0
2799973 0 0 0 0 577331 0 0 0 0 0
3201126 B 3 BS 1 13/04/2018 15/04/2018 17/03/1961 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 11115760 0 3 0 0 0 FATIMAH BT KADUM
0138R0170418V004860 0001390997485 3;JKN DR RIZKI; 5.2.1.201804062320
4 171565 1#0##0#0#0.0#2018-05-02
14:59:42#0#20:12:12#20:12:12#00:00:00 1 8b941a755586ee5c8f1bffc5828377fc
0 3149000 4253128 0 0 2861433 0 0 0 0
783199 0 0 0 0 69000
3201126 B 2 BS 1 11/04/2018 15/04/2018 08/09/2017 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4238241 0 5 0 0 0 M SYAMIL HUDA AN
D395713 0 215 DR RASTRA, SPA 0138R0170418V003768
0002309851877 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170416
6#0##0#0#0.0#2018-05-03 09:15:58#0#11:52:16#11:52:16#00:00:00 1
7b054e45ac5200865c964b878844bd72 0 0 313620 0 0 926353
0 0 0 0 2828268 0 0 0 0 170000
3201126 B 1 BS 1 11/04/2018 15/04/2018 07/10/1950 0 2
1 K80.4;J18.0;R11;R16.1 - - - None None None None B-4-
(BERAT) 9188400 0 0 - 0 - 0 - 0 - 0
9188400 7718976 0 5 0 0 0 ZUBAEDAH D098359
67 24658 DR ARU, SPPD 0138R0170418V003567 0001338748817 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 170151 1#0##0#0#0.0#2018-
05-03 09:21:12#0#00:00:00#00:00:00#00:00:00 1
2bfc328314fa4bb72ed213be76c64a04 0 0 879956 0 0
2403040 0 0 0 0 4435980 0 0 0 0 0
3201126 B 1 BS 1 13/04/2018 15/04/2018 04/05/1952 0 2
1 A01.0;H81.1;K30 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 2964263 0 3 0 0 0 ADE MARYATI
0002217612115 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171570
2#0##0#0#0.0#2018-05-03 09:24:40#0#00:00:00#00:00:00#12:00:00 1
383467b934f9cbda5259fb9baee321b7 0 0 338858 0 0 843481
0 0 0 0 1781924 0 0 0 0 0
3201126 B 2 BS 1 14/04/2018 15/04/2018 10/03/1982 0 1
1 S62.61 79.64;79.24;78.10 - - None None None None M-1-
0 - 0 9584600 12950833 0 2 0 0 0
ASWANDI BORDA D395961 36 13184 DR BENNY H TUMBELAKA
0138R0170418V004882 0002249475625 3;JKN DR RIZKI; 5.2.1.201804062320
4 171573 1#0##0#0#0.0#2018-05-03
14:55:41#0#00:00:00#00:00:00#00:00:00 1 cedb4caadb1c12663910eac6799aac91
0 5180500 5079612 0 0 1642470 0 0 0 0
903251 0 0 0 0 145000
3201126 B 2 BS 1 14/04/2018 15/04/2018 03/04/1947 0 1
1 I12.0;R00.1 39.27;87.44 - - None None None None N-1-12-II
- 0 10690500 10760830 0 2 0 0 0 YOYADJI
PRIBADI D395817 71 25944 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V004913 0001268820549 3;JKN DR RIZKI; 5.2.1.201804062320
4 171589 1#0##0#0#0.0#2018-05-03
15:15:10#0#12:01:21#12:01:21#00:00:00 1 e7981af50d95aa31e349e6aa31551438
0 4911100 2245005 0 0 2775745 0 0 0 0
759980 0 0 0 0 69000
3201126 B 2 BS 1 14/04/2018 15/04/2018 05/08/1989 0 2
1 O14.1;O35.9 75.32 - - None None None None W-4-16-II None
0 - 0 - 0 - 0 - 0 3479400 3445798
0 2 0 0 0 SILVI MAHARANI D220288 28 10479 DR
ERDIYAN, SPOG 0138R0170418V004887 0001959587032 3;JKN DR RIZKI;
5.2.1.201804062320 4 171575 1#0##0#0#0.0#2018-05-15
16:47:01#0#00:00:00#00:00:00#12:00:00 1 a5f05ecdded4af0e40325367cf3fba78
0 0 572146 0 0 1323226 0 0 0 0
1294426 0 0 0 0 256000
3201126 B 3 BS 1 15/04/2018 15/04/2018 19/12/1941 0 1
4 I21.3;I44.7;E87.2;A49.9;N18.3;E87.5;R00.1;R57.0 99.60 - - None
None None None I-4-10-III None None None None None None INFARK
MYOKARD AKUT (BERAT) 10401900 0 0 - 0 - 0 - 0
- 0 10401900 6046600 0 1 0 0 0 DANIEL DE
FRETES D031016 76 27876 DR ANGGA TOMALA PUTRA 0138R0170418V004986
0001321520747 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171636
1#0##0#0#0.0#2018-05-15 18:38:34#0#00:00:00#00:00:00#12:00:00 1
3c3f4c464f1ada2ee6191850f0c1e17f 0 0 936171 0 0
4425857 0 0 0 0 684572 0 0 0 0 0
3201126 B 2 BS 1 13/04/2018 15/04/2018 13/07/1968 0 1
(BERAT) 3965700 0 0 - 0 - 0 - 0 - 0
3965700 2545041 0 3 0 0 0 AHMAD GHOZALI
0001458773605 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171566
1#0##0#0#0.0#2018-05-15 19:09:54#0#20:40:32#20:40:32#00:00:00 1
222ae061127e0b3d0a74027f3bcec255 0 0 409913 0 0 427630
0 0 0 0 1707498 0 0 0 0 0
3201126 B 2 BS 1 12/04/2018 15/04/2018 02/08/1989 0 2
0 0 - 0 - 0 - 0 - 0 5984100
9645139 0 4 0 0 0 KARINA EKA KOMARUDIN NY D373674
28 10480 ENDANG TRI KURNIADEWI DR SPOG 0138R0170418V004460
0001373402946 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171037
1#0##0#0#0.0#2018-05-17 09:17:22#0#23:35:31#23:35:31#00:00:00 1
d4ff276ed46cb6c43ea15af9de7b64a7 0 5251900 1708644 0 0
1943605 0 0 0 0 671990 0 0 0 0 69000
3201126 B 3 BS 1 12/04/2018 15/04/2018 27/11/1962 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1796846 0 4 0 0 0 RUSILAH NY D395875
TANTIYO S;16137 5.2.1.201804062320 4 171036 1#0##0#0#0.0#2018-
05-17 09:22:39#0#23:30:24#23:30:24#00:00:00 1
da70df38cb5b5bfcc5a428c40159d88a 0 0 207620 0 0 656675
0 0 0 0 932551 0 0 0 0 0
3201126 B 3 BS 1 08/04/2018 15/04/2018 17/01/1951 0 2
1 E13.5;A41.9 93.57 - - None None None None I-4-15-III None
(BERAT) 7317500 0 0 - 0 - 0 - 0 - 0
7317500 5446123 0 8 0 0 0 JEANNE D394757
67 24553 DR ZULFAN, SPPD 0138R0170418V002426 0001336662898 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 181181 1#0##0#0#0.0#2018-
05-17 09:31:52#0#00:00:00#00:00:00#12:00:00 1
2aee93dcd37aeac1afbf57f052ae6d88 0 0 723765 0 0
2499070 0 0 0 0 0 0 0 0 2223288 0
3201126 B 1 BS 1 12/04/2018 15/04/2018 11/01/1954 0 2
1 I50.0;I48 - - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 5802600 4221288
0 4 0 0 0 SUMIRAH D377765 64 23467 DR AGOES
KOOSHARTORO SPPD-KKV 0138R0170418V00446 0000164586227 3;JKN ECHI;
5.2.1.201804062320 4 171123 1#0##0#0#0.0#2018-05-17
11:44:52#0#09:36:58#09:36:58#12:00:00 2 d9e8b647086c3e7713f69b9ac13ea693
0 0 575234 0 0 1000895 0 0 0 0
2645159 0 0 0 0 0
3201126 B 3 BS 1 15/04/2018 15/04/2018 21/12/1959 0 1
0 0 - 0 - 0 - 0 - 0 4202600
2135627 0 1 0 0 0 AMIRUDDIN D388887 58 21300
DR DINI DANIATY 0138R0170418V004958 0001874438695 3;JKN irene;
5.2.1.201804062320 4 171604 1#0##0#0#0.0#2018-05-18
12:46:56#0#00:00:00#00:00:00#12:00:00 2 035f278aff41594616a2dd63caf692d3
0 0 378234 0 0 142530 0 415000 0 0
345683 0 0 0 854180 0
3201126 B 1 BS 1 13/04/2018 15/04/2018 13/04/2018 3298 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2484667 0 3 0 0 0 BY NY KARINA EKA
KOMARUDIN D395903 0 0 DR KRISTON SILITONGA, SPA
0138R0170418V004627 002449446873 3;JKN DR RIZKI; 5.2.2.201806040537
4 171242 1#0##0#0#0.0#2018-08-20
10:36:45#0#11:02:46#11:02:46#00:00:00 2 7aa6ae2ccee918e1a068dea59c8b0d8d
0 0 499620 0 0 88899 0 0 0 0 1896148
0 0 0 0 0
3201126 B 2 BS 1 13/04/2018 15/04/2018 08/04/2018 3303 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3341051 0 3 1 1 0 TITI NURHAYATI BY NY
D395425 0 5 DR KRISTY, SPA 0138R0170418V004682
0002448114129 3;JKN DR RIZKI; 5.2.2.201806040537 4 171335
1#0##0#0#0.0#2018-08-20 12:05:10#0#13:13:04#13:13:04#00:00:00 2
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0 0 0 0 2275573 0 0 0 0 510000
3201126 B 1 BS 1 12/04/2018 15/04/2018 11/01/1954 0 2
1 I50.0;I48 - - - None None None None I-4-12-II None
0 - 0 - 0 - 0 - 0 5802600 4221288
0 4 0 0 0 SUMIRAH D377765 64 23467 DR AGOES
KOOSHARTORO SPPD-KKV 0138R0170418V004446 0000164586227 3;JKN DR RIZKI;
5.2.2.201806040537 4 171123 1#0##0#0#0.0#2018-08-21
10:51:12#0#09:36:58#09:36:58#12:00:00 3 a016bab9e146577178d5dc9511e2624f
0 0 575234 0 0 1000895 0 0 0 0
2645159 0 0 0 0 0
3201126 B 1 BS 1 13/04/2018 15/04/2018 06/01/1957 0 1
1 I25.0;I10;E11.9 36.07;88.55 - - YY02 None None None I-1-
(RINGAN) 15016100 0 0 PCI 10725800 - 0 - 0 -
0 25741900 60211004 0 3 0 0 0 ADJI ANGGORO
0001261249582 3;JKN DR RIZKI; 5.2.2.201806040537 4 171551
1#0##0#0#0.0#2018-09-10 10:49:37#0#16:27:50#16:27:50#00:00:00 2
a830135fcb3d4c30aafb7e77402229a1 0 10753000 9619120 0 0
31043884 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 3 BS 1 13/04/2018 15/04/2018 31/05/1946 0 2
1 I25.0;I11.9;E14.9 88.55 - - None None None None I-1-15-I
0 0 - 0 - 0 - 0 - 0 4540900
12738898 0 3 0 0 0 HALIMAH D131833 71 26250
DR RIZKI; 5.2.2.201806040537 4 171412 1#0##0#0#0.0#2018-09-10
11:03:42#0#14:34:51#14:34:51#00:00:00 2 873c30248d458c5d67ecf70684cfdb14
0 2594000 3195478 0 0 4021034 0 0 0 0
859386 0 0 0 0 2069000
3201126 B 3 BS 1 14/04/2018 15/04/2018 03/01/1946 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 8216864 0 2 0 0 0 SITI D396028 72
DR RIZKI; 5.2.2.201806040537 4 171594 1#0##0#0#0.0#2018-09-25
11:20:18#0#15:55:58#15:55:58#00:00:00 2 3a609658611ec0a112a5cb46a75146b3
0 3438800 1834760 0 0 2280752 0 0 0 0
593552 0 0 0 0 69000
3201126 B 3 BS 1 14/04/2018 15/04/2018 19/02/1968 0 2
1 A09.9;D84.9 - - - None None None None K-4-17-II None
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 3165065 0 2 0 0 0 PURI HANDAYANI
D333316 50 18317 DR ARU, SPPD 0138R0170418V004883
0001470804052 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 171583
1#0##0#0#0.0#2018-10-05 16:13:05#0#06:08:05#06:08:05#00:00:00 3
27cc24efbb0b24c4d27dde831b3a30a1 0 0 1355093 0 0
1050912 0 0 0 0 759060 0 0 0 0 0
3201126 B 1 BS 1 16/04/2018 16/04/2018 31/10/1977 0 2
None None None None TUMOR PAYUDARA (RINGAN) 5011800 0 0 -
0 - 0 - 0 - 0 5011800 4073480 0 1
0 0 0 INDAH SUSHANTY D381833 40 14777 RACHMAWATI
DR,SPB(K)ONK 0138R0170418V005335 0001716416109 3;JKN DR RIZKI;
5.2.1.201804062320 4 172180 1#0##0#0#0.0#2018-05-02
09:09:02#0#14:12:38#14:12:38#12:00:00 1 ae4b97c651541466a705840016cda188
0 0 1002360 0 0 1997631 0 0 0 0
1073489 0 0 0 0 0
3201126 B 2 BS 1 14/04/2018 16/04/2018 05/05/2015 0 2
1 A16.2;E46 87.44 - - None None None None J-4-15-I None
5203800 0 0 - 0 - 0 - 0 - 0
5203800 3056888 0 3 0 0 0 KIRANA TSABITHA ACHMAD
0001857149616 3;JKN DR RIZKI; 5.2.1.201804062320 4 171597
1#0##0#0#0.0#2018-05-02 09:14:52#0#16:34:11#16:34:11#00:00:00 1
8ceb3b8410b107cc92c9e20eabd8ead2 0 0 338039 0 0 977866
0 0 0 0 1740983 0 0 0 0 0
3201126 B 3 BS 1 16/04/2018 16/04/2018 30/12/1959 0 1
1 I63.9;R47.0;E11.9;J18.0;I21.2 87.03;87.44;99.60 - - None None
0 - 0 - 0 8672200 3994286 0 1 0 0
0 ANWAR RAKHMAN D368665 58 21292 DR MUHAMMAD RIZKI YUWANA
0138R0170418V005367 0001288232853 3;JKN DR RIZKI; 5.2.1.201804062320
4 172239 1#0##0#0#0.0#2018-05-02
11:26:46#0#14:58:37#14:58:37#00:00:00 2 3a381ee5e5e5a7aab02237a52c4faaaf
0 0 1011498 0 0 1716480 0 0 0 0 550308
0 0 0 0 716000
3201126 B 3 BS 1 14/04/2018 16/04/2018 21/06/2016 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1631354 0 3 0 0 0 KHIAR RAIHAN RAMADHAN
0002053937698 3;JKN DR RIZKI; 5.2.1.201804062320 4 171598
1#0##0#0#0.0#2018-05-02 12:06:39#0#00:00:00#00:00:00#00:00:00 1
b9a154c5cbd57bbeda4896de0426f015 0 0 207620 0 0 588510
0 0 0 0 835224 0 0 0 0 0
3201126 B 3 BS 1 14/04/2018 16/04/2018 12/08/2015 0 2
- 0 - 0 - 0 - 0 2655900 3070146 0
3 0 0 0 FAYOLA NUR ARROZAK D395994 2 976 DR
OTTY MITHA S, SPA 84N505000140418 3276055208150005 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 172368 8#0##0#0#0.0#2018-05-02
14:16:27#0#09:40:09#09:40:09#00:00:00 1 2c9d302082b1c4139a32106b4930bf98
0 0 3070146 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 3 BS 1 16/04/2018 16/04/2018 06/09/2017 0 2
1 A09.9;E86 96.05;99.60 - - None None None None K-4-17-I
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 6698641 0 1 0 0 0 ADZKIYA ZAHRA
D396098 0 222 DR ADITIA NATA KUSUMA 0138R0170418V005148
0002283973929 3;JKN DR RIZKI; 5.2.1.201804062320 4 171736
1#0##0#0#0.0#2018-05-02 14:42:44#0#09:10:27#09:10:27#00:00:00 1
d7af85930d56383566ab8da21a9a2254 0 0 357080 0 0
5614332 0 0 0 0 727229 0 0 0 0 0
3201126 B 1 BS 1 14/04/2018 16/04/2018 16/07/1951 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 14324481 0 3 0 0 0 TATO MUJIHARTO
0000042203452 3;JKN DR RIZKI; 5.2.1.201804062320 4 171574
1#0##0#0#0.0#2018-05-02 15:14:56#0#00:00:00#00:00:00#00:00:00 1
8e21c1e032174490cb7f49f67db662c5 0 7159200 2344505 0 0
3738660 0 0 0 0 1013116 0 0 0 0 69000
3201126 B 1 BS 1 11/04/2018 16/04/2018 24/12/1953 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 18382735 0 6 0 0 0 JEANNE CHRISTINE WAYONG
0002438004519 3;JKN DR RIZKI; 5.2.1.201804062320 4 170574
1#0##0#0#0.0#2018-05-02 15:16:49#0#16:08:14#16:08:14#00:00:00 1
81bef93208b5640cdfa81ab850de80e3 0 8660000 3740750 0 0
4560985 0 0 0 0 1276000 0 0 0 0 145000
3201126 B 3 BS 1 14/04/2018 16/04/2018 01/06/1957 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3164194 0 3 0 0 0 PONIAH d373295
60 22232 DR ARU, SPPD 0138R0170418V004935 0001014272234 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 171596 3#0##0#0#0.0#2018-
05-03 10:16:05#0#00:00:00#00:00:00#12:00:00 1
390629902c64f07b7eb2e5862d6ded43 0 0 424889 0 0
1717302 0 0 0 0 1022003 0 0 0 0 0
3201126 B 3 BS 1 14/04/2018 16/04/2018 30/12/1988 0 2
0 - 0 - 0 3013600 5920216 0 3 0 0
0 NENNI D395998 29 10697 DR AFRA FONDA SPOG
0138R0170418V004910 0001221533583 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 171587 9#0##0#0#0.0#2018-05-03
10:17:26#0#11:13:51#11:13:51#00:00:00 1 e64f94b176ae65554f3e4096ee9ee212
0 0 655720 0 0 2603592 0 0 0 0
2463904 0 0 0 0 197000
3201126 B 3 BS 1 14/04/2018 16/04/2018 14/04/1965 0 2
1 K51.9;N39.0;I84.0;K63.5 45.23 - - None None None None K-4-
0 - 0 - 0 5152700 7086038 0 3 0 0
0 EMI D395022 52 19358 DR BETTY DWI L, SPPD
0138R0170418V004946 0001336403744 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 171601 5#0##0#0#0.0#2018-05-03
10:18:36#0#00:00:00#00:00:00#00:00:00 1 edda360f62cf845b11ebabc2df73cd27
0 0 1495756 0 0 2065209 0 0 0 0
1776073 0 0 0 0 1749000
3201126 B 3 BS 1 13/04/2018 16/04/2018 17/03/1972 0 2
1 N18.5;D63.8;J81;E16.2 99.04;39.95 - - None None None None
- 0 6077700 9498054 0 4 0 0 0 ERLIYANI
0001264472122 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171585
6#0##0#0#0.0#2018-05-03 10:21:58#0#06:10:10#06:10:10#12:00:00 1
8e91456293024bb7da79219f726ff252 0 0 599993 0 0
5063943 0 0 0 0 3834118 0 0 0 0 0
3201126 B 3 BS 1 14/04/2018 16/04/2018 19/08/1981 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 5195334 0 3 0 0 0 IIN SUPRIATIN
D385388 36 13387 DR ARU, SPPD 0138R0170418V004929
0002282454371 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171592
2#0##0#0#0.0#2018-05-03 10:22:54#0#00:00:00#00:00:00#12:00:00 1
4463abe6bcd22555c1f38c344c288f07 0 0 424889 0 0
3325563 0 0 0 0 1154882 0 0 0 0 290000
3201126 B 2 BS 1 14/04/2018 16/04/2018 29/09/1979 0 1
1 S66.6;I77.2 83.01 - - None None None None M-1-50-II None
None None None None None PROSEDUR JARINGAN LUNAK (SEDANG) 10617200
0 0 - 0 - 0 - 0 - 0 10617200
12545115 0 3 0 0 0 ACHIRUDDIN D302431 38 14077
DR HENDRIEK S, SPB 0138R0170418V004926 0001132158352 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 171591
11#0##0#0#0.0#2018-05-03 10:26:04#0#13:15:42#13:15:42#00:00:00 1
f267cccc6f1383299e82cf9aaf83d11f 0 5326100 3131988 0 0
3065319 0 0 0 0 876708 0 0 0 0 145000
3201126 B 2 BS 1 14/04/2018 16/04/2018 20/01/2000 0 2
1 A01.0;K30 90.59 - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2813983 0 3 0 0 0 GITTA DAMAIYANTI
0001840914641 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171588
10#0##0#0#0.0#2018-05-03 10:33:00#0#11:29:26#11:29:26#00:00:00 1
fbad56c1b2c1244b41b12f11cfdafd6c 0 0 298025 0 0 790866
0 0 0 0 1725092 0 0 0 0 0
3201126 B 1 BS 1 10/04/2018 16/04/2018 03/10/1930 0 1
1 G31.9;J18.0;F02.3 87.49;90.59;89.52 - - None None None None
G-4-11-III None None None None None None TUMOR SISTEM SARAF & GANGGUAN
DEGENERATIF (BERAT) 12492100 0 0 - 0 - 0 - 0
- 0 12492100 21396136 0 7 0 0 0 HARDIN
HUTABARAT D395623 87 31966 DR NURUL KOMARI SPS 0138R0170418V003541
0002097183892 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170138
1#1#vvip#6#8904036#0.0#2018-05-03 10:54:21#0#19:45:07#19:45:07#00:00:00
1 e5df7a49d640329cccd37f1b26317586 0 0 2365000 0 0
6467136 0 0 0 0 11984000 0 0 0 0 580000
3201126 B 1 BS 1 15/04/2018 16/04/2018 18/12/1940 0 1
- 0 4903800 2763303 0 2 0 0 0 SUGIARTO
0000082206281 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177459
1#0##0#0#0.0#2018-05-03 11:07:38#0#00:00:00#00:00:00#00:00:00 1
8f98dd8ef5356cdef5008ae959349b39 0 0 2763303 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 30/03/2018 16/04/2018 06/04/1947 0 2
1 J81;L10.9;K92.1;I63.9 99.04;93.94;99.06 - - None None None
None J-4-21-III None None None None None None GEJALA, TANDA DAN
DIAGNOSIS SISTEM PERNAFASAN LAIN-LAIN (BERAT) 8807500 0 0 - 0
- 0 - 0 - 0 8807500 62810636 0 18 0
0 0 ALIFA ARBIE D048514 70 25926 DR SUKAMTO SPPD
0138R01703180013561 0002059434303 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 166649 1#1#vvip#18#54003136#0.0#2018-05-03
11:12:34#0#12:00:00#12:00:00#12:00:00 1 19beaa8e1aafcbf7d8b161ffadb0f512
0 0 1940396 0 0 34992740 0 0 0 0
22845500 0 0 0 0 3032000
3201126 B 2 BS 1 11/04/2018 16/04/2018 01/01/1950 0 2
1 I50.0;R57.0;I25.0;L03.9 89.52 - - None None None None I-4-
5968400 0 0 - 0 - 0 - 0 - 0
5968400 11863206 0 6 1 4 0 SALBIYAH, HJ
0000976208883 3;JKN DR RIZKI; 5.2.1.201804062320 4 170215
1#0##0#0#0.0#2018-05-03 14:58:57#0#09:06:59#09:06:59#12:00:00 1
fbaf2ebc5c0a68055282b811c0411305 0 0 880847 0 0
2016261 0 0 0 0 5322098 0 0 0 0
3644000
3201126 B 2 BS 1 14/04/2018 16/04/2018 04/06/1958 0 2
1 C18.9;D63.0 99.04 - - None None None None K-4-10-II None
0 - 0 - 0 - 0 - 0 8475400 3890896
0 3 0 0 0 ELISABETH ELLEN.T. LH D363093 59 21864
5.2.1.201804062320 4 171600 1#0##0#0#0.0#2018-05-08
15:44:10#0#00:00:00#00:00:00#00:00:00 1 97598a0eca4481095946f43d7d49927f
0 0 458817 0 0 2141534 0 0 0 0
1036000 0 0 0 254545 0
3201126 B 3 BS 1 12/04/2018 16/04/2018 01/07/1950 0 1
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 8805991 0 5 0 0 0 ENDANG KOSWARA
0138R0170418V004610 0001274248304 3;JKN DR RIZKI; 5.2.1.201804062320
4 171175 1#0##0#0#0.0#2018-05-15
16:49:45#0#10:14:34#10:14:34#12:00:00 1 94cf607b0dbfc4689154af95c44ebf43
0 3426500 1870848 0 0 2837550 0 0 0 0
602093 0 0 0 0 69000
3201126 B 3 BS 1 15/04/2018 16/04/2018 19/09/1965 0 1
1 I63.9;E87.3;E87.6;J18.0;A41.9 - - - None None None None
0 - 0 8672200 4042610 0 2 0 0 0 TRI
SUDARMANTO D264043 52 19201 DR WIDHI DEWANTA K AJI 0138R0170418V004991
0001893377744 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171619
1#0##0#0#0.0#2018-05-15 18:54:29#0#00:00:00#00:00:00#12:00:00 1
c0ebf85e1cf2fd908e5d7aaf42d622b1 0 0 780498 0 0
2708642 0 0 0 0 553470 0 0 0 0 0
3201126 B 1 BS 1 12/04/2018 16/04/2018 23/04/2015 0 1
11257400 0 0 - 0 - 0 - 0 - 0
11257400 15418743 0 5 0 0 0 AYDIN AL AYYUBI
D317387 2 1085 DR CATUR S, SPB 0138R0170418V004214
0001840133981 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170667
1#0##0#0#0.0#2018-05-15 19:04:39#0#10:22:01#10:22:01#00:00:00 1
10f27fa26eb13117d889979b26922968 0 8569200 2251480 0 0
3368360 0 0 0 0 1084703 0 0 0 0 145000
3201126 B 3 BS 1 13/04/2018 16/04/2018 17/03/1972 0 2
1 N18.5;D63.8;J81;E16.2 99.04;39.95 - - None None None None
- 0 6077700 9498054 0 4 0 0 0 ERLIYANI
0001264472122 3;JKN irene; 5.2.1.201804062320 4 171585
1#0##0#0#0.0#2018-05-15 19:04:41#0#06:10:10#06:10:10#12:00:00 2
16fc12fbb3b644663bd2f0288f15f8a8 0 0 599993 0 0
5063943 0 0 0 0 3834118 0 0 0 0 0
3201126 B 1 BS 1 15/04/2018 16/04/2018 10/02/1980 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6354152 0 2 0 0 0 TRI HARTATI NY
D296159 38 13944 DR RACHMADSYAH, SPOG 0138R0170418V004981
0001376361753 3;JKN DR RIZKI; 5.2.2.201806040537 4 171616
1#0##0#0#0.0#2018-08-20 12:07:55#0#11:47:32#11:47:32#00:00:00 3
f427cf824e6c43223cb78ab1ce157d7c 0 0 1330824 0 0
1183636 0 0 0 0 3839692 0 0 0 0 0
3201126 B 3 BS 1 14/04/2018 16/04/2018 14/04/2018 3539 2
3655700 0 0 - 0 - 0 - 0 - 0
3655700 1005011 0 3 0 0 0 NENNI BY NY D396025
0 0 DR TRI LESTARI, SPA 0138R0170418V005403 0002438021744
3;JKN DR RIZKI; 5.2.2.201806040537 4 172303 1#0##0#0#0.0#2018-
08-20 12:11:30#0#15:57:53#15:57:53#00:00:00 2
6a314d03cd1303b26ea98c564d941b6a 0 0 363224 0 0 136439
0 0 0 0 505348 0 0 0 0 0
3201126 B 1 BS 1 02/04/2018 16/04/2018 20/02/1950 0 2
1 I63.9;R47.0;G81.9;J22;I11.0 87.03;90.59;89.52 - - None None
0 - 0 - 0 12141100 40903313 0 15 1 4
0 IYUS RISNAWATI D394830 68 24878 DR MAYSAM I., SPS
0138R01704180000645 0000062888534 3;JKN DR RIZKI; 5.2.2.201806040537
4 167147 1#0##0#0#0.0#2018-09-10
11:08:28#0#12:00:00#12:00:00#12:00:00 2 1f2eba8aaa29835a6ac9dbfbe76ed7f7
0 0 2226064 0 0 21578249 0 0 0 0
13309000 0 0 0 0 3790000
3201126 B 3 BS 1 16/04/2018 16/04/2018 12/10/1946 0 2
1 I64;R45.3;E14.9 87.03 - - None None None None G-4-15-I
- 0 - 0 - 0 - 0 4096200 1855743 0
1 0 0 0 ONGENG TJENG D367737 71 26119 DR LIDYA
SANTALIA 0138R0170418V005303 0001458680376 3;JKN DR RIZKI;
5.2.2.201806040537 4 172080 1#0##0#0#0.0#2018-09-26
18:42:03#0#13:20:23#13:20:23#12:00:00 2 777361957ea9930c59023700ea396493
0 0 621855 0 0 823484 0 0 0 0 410404
0 0 0 0 0
3201126 B 2 BS 1 11/04/2018 16/04/2018 02/06/1957 0 2
- 0 - 0 - 0 11410700 20860082 0 6 0
0 0 YUYUN YULAEHA D395667 60 22228 DR HENDRIEK S, SPB
0138R0170418V004007 0001450867779 3;JKN DR RIZKI; 5.2.2.201806040537
4 170596 1#0##0#0#0.0#2018-09-26
18:43:30#0#21:15:04#21:15:04#00:00:00 2 4a77a2fee6e4153e02380887b9564115
0 8119100 6020570 0 0 5350412 0 0 0 0
1301000 0 0 0 0 69000
3201126 B 2 BS 1 15/04/2018 17/04/2018 24/09/1996 0 2
LAIN-LAIN (SEDANG) 4628500 0 0 - 0 - 0 - 0
- 0 4628500 5231600 0 3 0 0 0 ROSLIANIE
STEFANY D269364 21 7873 DR ERDIYAN, SPOG 0138R0170418V005153
0001631116056 3;JKN DR RIZKI; 5.2.1.201804062320 4 171724
1#0##0#0#0.0#2018-04-30 15:27:00#0#09:06:32#09:06:32#12:00:00 1
b1bbfe8add9d8462fb23ec14115c418d 0 0 322596 0 0
3007750 0 0 0 0 1901254 0 0 0 0 0
3201126 B 3 BS 1 15/04/2018 17/04/2018 14/05/1970 0 2
1 D05.9;D63.0 99.04 - - None None None None L-4-11-II None
None None None None None TUMOR PAYUDARA (SEDANG) 4920200 0 0
- 0 - 0 - 0 - 0 4920200 8777684 0
3 0 0 0 RANITI D391895 47 17503 RACHMAWATI
5.2.1.201804062320 4 171614 1#0##0#0#0.0#2018-05-02
14:06:31#0#00:00:00#00:00:00#12:00:00 1 24a2ff003e3196e7f0c05ae284626e32
0 0 984040 0 0 6404403 0 0 0 0
1389241 0 0 0 0 0
3201126 B 3 BS 1 11/04/2018 17/04/2018 16/06/1960 0 1
1 I50.0;J22 87.44 - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 3575600 6567203
0 7 0 0 0 WAGIMIN D395734 57 21118 DR. ARU
ARIADNO, SPPD 0138R0170418V003988 0001739955947 3;JKN DR RIZKI;
5.2.1.201804062320 4 170590 1#0##0#0#0.0#2018-05-02
14:56:50#0#18:26:12#18:26:12#00:00:00 1 561189c83960f282225b67e15e19de88
0 0 696608 0 0 2500465 0 0 0 0
2210130 0 0 0 0 1160000
3201126 B 1 BS 1 14/04/2018 17/04/2018 21/11/1997 0 2
1 K21.9;A01.0;J02.9 - - - None None None None K-4-12-III
0 0 - 0 - 0 - 0 - 0 9494200
5130954 0 4 0 0 0 NOVIANTI PRATIWI NN D396040
3;JKN DR RIZKI; 5.2.1.201804062320 4 171599 1#0##0#0#0.0#2018-
05-02 15:19:57#0#20:56:22#20:56:22#00:00:00 1
8c2e4dd8de12847be912db7c9e98ab39 0 0 907478 0 0
1518806 0 0 0 0 2704670 0 0 0 0 0
3201126 B 1 BS 1 15/04/2018 17/04/2018 12/03/1946 0 1
1 K74.6;E87.5;K72.9;B18.2;D64.9 90.59;89.52;87.49;99.04 - - None
None None None B-4-13-II None None None None None None GANGGUAN
HATI LAIN-LAIN (SEDANG) 6857000 0 0 - 0 - 0 - 0
- 0 6857000 6078303 0 3 0 0 0 SUGIMAN A
KASDURI D393402 72 26332 DR BETTY DWI L, SPPD 0138R0170418V005001
0000060883053 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171626
5#0##0#0#0.0#2018-05-03 09:29:55#0#19:21:53#19:21:53#12:00:00 1
20e9fa3bbc2fe868ce497ecfddd595ba 0 0 670130 0 0
2987027 0 0 0 0 2421146 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 17/04/2018 12/06/1987 0 2
0 0 - 0 - 0 - 0 - 0 2379000
5931737 0 2 0 0 0 DEVI JUNIARSIH d396095 30
11266 DR ARI KUSUMA JANUARTO, DR. SPOG 0138R0170418V005257
0001297696522 3;JKN DR RIZKI; 5.2.1.201804062320 4 172017
1#0##0#0#0.0#2018-05-03 15:22:55#0#11:29:52#11:29:52#00:00:00 1
8c1d7347294c429860bd670640e56948 0 0 475800 0 0
2217179 0 0 0 0 3110758 0 0 0 0 128000
3201126 B 2 BS 1 13/04/2018 17/04/2018 12/02/1950 0 2
0 - 0 - 0 - 0 - 0 5449100 12830001
0 5 0 0 0 SRI MASRINGAH D307890 68 24897 DR
AGOES KOOSHARTORO SPPD-KKV 0138R0170418V004562 0000061044142 3;JKN DR
RIZKI; 5.2.1.201804062320 4 171091 1#0##0#0#0.0#2018-05-03
15:36:13#0#09:11:29#09:11:29#00:00:00 1 1d99f29fd246df44b983586b9276094c
0 3970000 2442160 0 0 3423495 0 0 0 0
925346 0 0 0 0 2069000
3201126 B 2 BS 1 06/04/2018 17/04/2018 24/05/1974 0 1
1 I50.0;E14.2;I25.0;K30 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4973600
18767887 0 12 1 4 0 EVIKSON PARDAMEAN SIMAMORA
0001096020257 3;JKN DR RIZKI; 5.2.1.201804062320 4 168872
1#0##0#0#0.0#2018-05-03 15:51:22#0#21:02:58#21:02:58#12:00:00 2
a6a7e16852668f762fba8254f3bdd403 0 0 1563758 0 0
7435129 0 0 0 0 8593000 0 0 0 0
1176000
3201126 B 3 BS 1 11/04/2018 17/04/2018 25/08/1949 0 1
1 D64.9;E11.9;I64;F03 99.04;87.03;87.49;99.17 - - None None
None None D-4-13-III None None None None None None GANGGUAN SEL DARAH
MERAH SELAIN KRISIS ANEMIA SEL SICKLE (BERAT) 5407200 0 0 - 0
- 0 - 0 - 0 5407200 15297151 0 7 1
2 0 SUGIYANTO D354985 68 25066 DR. ARU ARIADNO, SPPD
0138R0170418V004015 0000060883266 3;JKN DR RIZKI; 5.2.1.201804062320
4 170597 1#0##0#0#0.0#2018-05-04
11:10:56#0#00:00:00#00:00:00#00:00:00 1 5025ee79635eda7561acf22469cd4924
0 0 738220 0 0 9558183 0 0 0 0
3824748 0 0 0 0 1176000
3201126 B 3 BS 1 16/04/2018 17/04/2018 18/08/1965 0 1
0 - 0 - 0 - 0 - 0 12210800 16050861
0 2 0 0 0 AGUS MARAFDI D394869 52 19234 DR
AZRI NURIZAL SPPD KKV 0138R0170418V005125 0000511016163 3;JKN DR RIZKI;
5.2.1.201804062320 4 171663 1#0##0#0#0.0#2018-05-14
15:02:49#0#08:40:38#08:40:38#00:00:00 2 394d0f6da642f9f7d1c8616928538383
0 2439000 6870800 0 0 3566005 0 0 0 0
1106056 0 0 0 0 2069000
3201126 B 1 BS 1 16/04/2018 17/04/2018 10/12/1953 0 1
4 I46.9;I21.2;N18.5 89.52;99.60 - - None None None None I-4-
14-III None None None None None None CARDIAC ARREST, TIDAK DIKETAHUI
(BERAT) 8461500 0 0 - 0 - 0 - 0 - 0
8461500 5244984 0 2 0 0 0 HARDIMAN D391256
64 23503 DR ARU, SPPD 0138R0170418V005462 0001822536652 3;JKN
DR RIZKI; 5.2.1.201804062320 4 172335 1#0##0#0#0.0#2018-05-15
16:23:49#0#20:09:21#20:09:21#12:00:00 1 5a3ca685a3d790642b6d7d71120512a9
0 0 351242 0 0 3216112 0 0 0 0
1677630 0 0 0 0 0
3201126 B 3 BS 1 16/04/2018 17/04/2018 07/07/1951 0 2
0 0 - 0 - 0 - 0 - 0 4540900
12129773 0 2 0 0 0 AISAH D394574 66 24390 DR
5.2.1.201804062320 4 171633 1#0##0#0#0.0#2018-05-15
16:56:54#0#07:53:31#07:53:31#12:00:00 1 545f0612c4cfd359fb7acfc79a78c1a1
0 2439000 2442160 0 0 4074076 0 0 0 0
849537 0 0 0 0 2325000
3201126 B 1 BS 1 07/04/2018 17/04/2018 08/03/2018 0 1
1 Q43.1;D64.9 46.10;99.04 - - None None None None K-1-20-II
None None None None None None PROSEDUR INTESTINAL KOMPLEKS (SEDANG)
23807200 0 0 - 0 - 0 - 0 - 0
23807200 50651138 0 11 0 0 0 BAYI NY THERESIA
OKTARIANA SITORUS D392518 0 30 DR CATUR SUZANTARA
0138R0170418V002119 0002437966743 3;JKN irene; 5.2.1.201804062320
4 168877 1#0##0#0#0.0#2018-08-11
13:39:04#0#00:34:04#00:34:04#12:00:00 3 b72ccaf0bb8464aa90bbb80c03f21d30
0 0 14252010 0 0 13321228 0 0 0 0
19821400 0 0 0 0 3256500
3201126 B 1 BS 1 13/04/2018 17/04/2018 08/05/2017 0 1
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4560252 0 5 0 0 0 MUHAMMAD DZIKRI ALDEN
D395969 0 340 DR RASTRA, SPA 0138R0170418V004878
0002428814441 3;JKN DR RIZKI; 5.2.2.201806040537 4 171569
1#0##0#0#0.0#2018-08-20 10:46:42#0#00:00:00#00:00:00#00:00:00 2
8631d67659d6ddb311f936b9ce777811 0 0 269459 0 0 842459
0 0 0 0 3448334 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 17/04/2018 05/07/1974 0 2
1 I13.2;A41.9 38.95 - - None None None None N-1-12-III None
DIALISIS (BERAT) 23198900 0 0 - 0 - 0 - 0 -
0 23198900 16324704 0 2 0 0 0 KARTINI
0001258749393 3;JKN DR RIZKI; 5.2.2.201806040537 4 172336
1#0##0#0#0.0#2018-09-26 18:47:25#0#22:41:06#22:41:06#00:00:00 3
71d319838406d6f5d203f86c64ea8ec6 0 4231600 6780681 0 0
2943202 0 0 0 0 2300221 0 0 0 0 69000
3201126 B 2 BS 1 15/04/2018 17/04/2018 02/07/1943 0 1
- 0 - 0 - 0 - 0 4290800 3476210 0
3 0 0 0 M SOLEH D234638 74 27316 DR AGOES
5.2.2.201806040537 4 174799 1#0##0#0#0.0#2018-09-26
18:53:39#0#00:00:00#00:00:00#00:00:00 2 3d643d3d7d2b2d8495f5f4392f2e3e06
0 0 439172 0 0 1268622 0 0 0 0
1768416 0 0 0 0 0
3201126 B 2 BS 1 11/04/2018 17/04/2018 01/03/1949 0 1
1 I11.9;K30;G44.2;M54.2 89.52 - - None None None None I-4-
0 - 0 - 0 - 0 - 0 2288000 6680795
0 7 0 0 0 MAKMUR YUNUS D300813 69 25243 DR
5.2.2.201806040537 4 170603 1#0##0#0#0.0#2018-09-26
18:55:59#0#00:12:33#00:12:33#00:00:00 2 259e6fcdb98550557e78a871e7efec89
0 0 374804 0 0 2812930 0 0 0 0
3493061 0 0 0 0 0
3201126 B 3 BS 1 09/04/2018 17/04/2018 01/03/1949 0 2
1 I80.2;A41.9;I11.9 88.77;87.44 - - None None None None I-4-
13-III None None None None None None THROMBOPHLEBITIS PADA PEMBULUH
DARAH VENA (BERAT) 9361700 0 0 - 0 - 0 - 0
- 0 9361700 19646051 0 9 0 0 0 PONIRAH
0001014199953 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 169577
1#0##0#0#0.0#2018-10-06 14:13:30#0#00:00:00#00:00:00#00:00:00 4
d4ac5bc23f069a1d8c839b6847578d4c 0 0 1464930 0 0
10852121 0 0 0 0 5507000 0 0 0 0
1822000
3201126 B 1 BS 1 15/04/2018 18/04/2018 06/01/1965 0 2
1 G45.0;E78.5;K30 87.44;87.03 - - None None None None G-4-
16-I None None None None None None ISKEMIK TRANSIENT (RINGAN) 4727400
0 0 - 0 - 0 - 0 - 0 4727400
7997900 0 4 0 0 0 NARTI RAHYUNI D118068 53
19457 DR MAYSAM I., SPS 0138R0170418V004954 0001640398443 3;JKN DR
RIZKI; 5.2.1.201804062320 4 171602 1#0##0#0#0.0#2018-04-28
14:13:14#0#00:00:00#00:00:00#00:00:00 1 1b96fe403998c13475405033ce218768
0 0 249403 0 0 4075270 0 0 0 0
3673227 0 0 0 0 0
3201126 B 1 BS 1 15/04/2018 18/04/2018 28/12/1955 0 2
1 K80.1 87.44;88.76 - - None None None None B-4-14-I None
5879800 0 0 - 0 - 0 - 0 - 0
5879800 8430591 0 4 0 0 0 RUMSIAH,NY D396052
62 22754 DR SURYA POHAN SPB 0138R0170418V004967 0000060631323
3;JKN DR RIZKI; 5.2.1.201804062320 4 171606 1#0##0#0#0.0#2018-
04-30 08:21:33#0#00:00:00#00:00:00#00:00:00 1
63f7e04dda08c13db5a89b3a6b8b745b 0 0 640980 0 0
4088077 0 0 0 0 3701534 0 0 0 0 0
3201126 B 1 BS 1 11/04/2018 18/04/2018 05/10/1951 0 2
1 M81.68;G82.2 93.39;87.23 - - None None None None M-4-
18-II None None None None None None PENYAKIT TULANG DAN SENDI LAIN-LAIN
(SEDANG) 5881100 0 0 - 0 - 0 - 0 - 0
5881100 10436609 0 8 0 0 0 INARYATUN A119363
66 24295 DR HARDI PRANATA SPS 0138R0170418V003565 0000044803089
3;JKN DR RIZKI; 5.2.1.201804062320 4 170150 1#0##0#0#0.0#2018-
04-30 08:24:56#0#01:19:26#01:19:26#00:00:00 1
1ffabad8eca26de7485754faf3a6413f 0 0 847310 0 0
2632530 0 0 0 0 6956769 0 0 0 0 0
3201126 B 1 BS 1 17/04/2018 18/04/2018 20/06/1946 0 1
None None None None None None GANGGUAN ESOFAGUS (SEDANG) 5739000
0 0 - 0 - 0 - 0 - 0 5739000
5812879 0 2 0 0 0 H.SYAFE I IBRAHIM D395731 71
26234 DR ZULFAN, SPPD 0138R0170418V005946 0001472363616 3;JKN DR
RIZKI; 5.2.1.201804062320 4 172836 1#0##0#0#0.0#2018-04-30
08:28:06#0#20:12:06#20:12:06#00:00:00 1 862fb0c80e0ea76f73c9f9264f105917
0 0 880372 0 0 818225 0 0 0 0
2365282 0 0 0 0 1749000
3201126 B 1 BS 1 17/04/2018 18/04/2018 26/06/1962 0 2
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 7958382 0 2 0 0 0 JUNIAR SIHOTANG
0000037682458 3;JKN DR RIZKI; 5.2.1.201804062320 4 172844
1#0##0#0#0.0#2018-04-30 08:46:10#0#22:18:51#22:18:51#12:00:00 1
8dc2d9e2b164d22856bc77d51eec2b23 0 5777200 1215340 0 0
300200 0 0 0 0 596642 0 0 0 0 69000
3201126 B 3 BS 1 17/04/2018 18/04/2018 11/04/1979 0 2
5405200 0 0 - 0 - 0 - 0 - 0
5405200 8002046 0 2 0 0 0 HENI SUNARTI
0002442602338 3;JKN DR RIZKI; 5.2.1.201804062320 4 172411
1#0##0#0#0.0#2018-04-30 14:47:16#0#10:56:09#10:56:09#00:00:00 1
9ed950e5219978bf4cb2c71f66114bf1 0 3361500 1708644 0 0
1997404 0 0 0 0 609498 0 0 0 0 325000
3201126 B 3 BS 1 17/04/2018 18/04/2018 05/10/1981 0 1
1 T87.5 84.3 - - None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 5331600 7846891
0 2 0 0 0 ROY D384547 36 13343 DR BENNY H
TUMBELAKA 0138R0170418V005735 0001733462763 3;JKN DR RIZKI;
5.2.1.201804062320 4 172536 1#0##0#0#0.0#2018-04-30
14:52:44#0#13:00:15#13:00:15#12:00:00 1 83fcd6b5b03e907045f001eba7521b26
0 0 2180848 0 0 1165095 0 0 0 0
4355948 0 0 0 0 145000
3201126 B 3 BS 1 17/04/2018 18/04/2018 18/07/1958 0 2
1 N18.5;D63.8;A41.9 38.95;99.04 - - None None None None N-1-
- 0 - 0 19332400 12899648 0 2 0 0 0
SUWARNI D391032 59 21823 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V005742 0001481969856 3;JKN DR RIZKI; 5.2.1.201804062320
4 172540 1#0##0#0#0.0#2018-04-30
14:54:28#0#13:12:09#13:12:09#12:00:00 1 df105b8911c9bf76c5b3c8452fa2d9aa
0 0 4059804 0 0 4432142 0 0 0 0
4338702 0 0 0 0 69000
3201126 B 3 BS 1 14/04/2018 18/04/2018 14/02/2018 0 1
5077500 0 0 - 0 - 0 - 0 - 0
5077500 5308652 0 5 0 0 0 BAYI NY SITI JUBAEDAH II
d390452 0 59 DR AULIA TANGKARI, SPA 0138R0170418V004984
0002430203376 3;JKN DR RIZKI; 5.2.1.201804062320 4 171617
1#0##0#0#0.0#2018-04-30 14:55:42#0#14:54:53#14:54:53#12:00:00 1
88ebea38b579e75be37d96200e516e44 0 0 509975 0 0
2940382 0 0 0 0 1688295 0 0 0 0 170000
3201126 B 2 BS 1 17/04/2018 18/04/2018 15/06/1960 0 2
- 0 10690500 10245304 0 2 0 0 0 SUNDARI
HARTATI D068054 57 21125 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V005801 0000042653237 3;JKN DR RIZKI; 5.2.1.201804062320
4 172657 1#0##0#0#0.0#2018-04-30
14:57:43#0#14:48:13#14:48:13#00:00:00 1 c5bea15e447b3d26f47260a55993957f
0 4911100 2138100 0 0 2380850 0 0 0 0
746254 0 0 0 0 69000
3201126 B 2 BS 1 15/04/2018 18/04/2018 11/10/1988 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3693312 0 4 0 0 0 KOSASIH D396075
3;JKN DR RIZKI; 5.2.1.201804062320 4 171861 1#0##0#0#0.0#2018-
04-30 15:22:11#0#10:15:39#10:15:39#00:00:00 1
b540b57d3668579cac44b9b56f4a8056 0 0 278711 0 0
1334482 0 0 0 0 2080119 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 18/04/2018 17/06/1962 0 1
1 I50.0;E14.9;R18 99.17;90.59;89.52 - - None None None None
4973600 0 0 - 0 - 0 - 0 - 0
4973600 4499582 0 3 0 0 0 HALOMAN LUBIS
D374133 55 20392 DR ARU, SPPD 0138R0170418V005011
0001807165506 3;JKN DR RIZKI; 5.2.1.201804062320 4 171630
1#0##0#0#0.0#2018-04-30 15:36:46#0#01:55:02#01:55:02#12:00:00 1
15f99151eddf28d96004c6eb5293a74b 0 0 581597 0 0
2082620 0 0 0 0 1835365 0 0 0 0 0
3201126 B 2 BS 1 17/04/2018 18/04/2018 25/11/1966 0 2
0 0 - 0 - 0 - 0 - 0 3545800
5945182 0 2 0 0 0 BANIATUN D382738 51 18771
5.2.1.201804062320 4 172835 1#0##0#0#0.0#2018-04-30
15:37:49#0#19:18:39#19:18:39#12:00:00 1 829b3e423fb8ed3ca8ed1689687b33ab
0 0 1045824 0 0 1170421 0 0 0 0
1979937 0 0 0 0 1749000
3201126 B 2 BS 1 17/04/2018 18/04/2018 26/06/1987 0 2
9649200 0 0 - 0 - 0 - 0 - 0
9649200 13385946 0 2 0 0 0 MURTININGRUM, S.IKOM
D273693 30 11253 DR HERY TIERA, SPU 0138R0170418V005571
0001301793658 3;JKN DR RIZKI; 5.2.1.201804062320 4 172349
1#0##0#0#0.0#2018-05-02 11:34:06#0#08:16:24#08:16:24#12:00:00 1
132266650cdbdc5fdefccfeaeba79982 0 4911100 2451308 0 0
1821822 0 0 0 0 4201716 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 18/04/2018 05/05/1979 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10357632 0 3 0 0 0 IRMAWATY D396122
38 14226 DR FERRI SABARUDDIN SPOG 0138R0170418V005199
0002050593838 3;JKN DR RIZKI; 5.2.1.201804062320 4 171881
1#0##0#0#0.0#2018-05-02 11:41:25#0#10:28:26#10:28:26#00:00:00 1
7550f4b1f4cba2c8ac7b335a462b32a3 0 5269900 2147435 0 0
1920695 0 0 0 0 763602 0 0 0 0 256000
3201126 B 3 BS 1 17/04/2018 18/04/2018 01/08/2000 0 1
0 - 0 - 0 - 0 - 0 3575600 1724180
0 2 0 0 0 ALDI D396255 17 6468 DR ERTY MASIHAT
0138R0170418V005960 0000510498145 3;JKN DR RIZKI; 5.2.1.201804062320
4 172845 1#0##0#0#0.0#2018-05-02
12:15:32#0#00:00:00#00:00:00#00:00:00 1 205dadd84d91e134e65240a6ca6f9c2c
0 0 373023 0 0 513360 0 0 0 0 419797
0 0 0 0 418000
3201126 B 3 BS 1 17/04/2018 18/04/2018 12/09/1960 0 2
1 I63.9;G93.4 87.03 - - None None None None G-4-14-III None
(BERAT) 8672200 0 0 - 0 - 0 - 0 - 0
8672200 1389393 0 2 0 0 0 TINY LEANDER
0001257784931 3;JKN DR RIZKI; 5.2.1.201804062320 4 172841
1#0##0#0#0.0#2018-05-02 12:27:39#0#21:30:25#21:30:25#00:00:00 1
97934fbe5f3f753c8f762e1829265b37 0 0 780498 0 0 229000
0 0 0 0 379895 0 0 0 0 0
3201126 B 1 BS 1 11/04/2018 18/04/2018 21/04/1957 0 2
4 T82.4;A41.9;E11.2 39.27 - - None None None None N-1-12-III
- 0 27065300 40042714 0 8 0 0 0 SUZE
ZUBAIRIAH D213434 60 22270 DR ARU, SPPD 0138R0170418V003996
0002339117875 3;JKN DR RIZKI; 5.2.1.201804062320 4 170591
1#1#vvip#8#12977414#0.0#2018-05-04 14:50:37#0#19:01:01#19:01:01#00:00:00
1 5debac262e0b6dad60a175b3a540c98c 0 12346250 5635000 0
0 20212464 0 0 0 0 0 0 0 0 0
1849000
3201126 B 2 BS 1 16/04/2018 18/04/2018 16/04/2018 2937 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1880751 0 3 0 0 0 BAYI NY IRMAWATY
D396150 0 0 DR RIANITA SYAMSU, SPA 0138R0170418V006139
0002445929447 3;JKN DR RIZKI; 5.2.1.201804062320 4 172993
1#0##0#0#0.0#2018-05-11 08:38:42#0#00:00:00#00:00:00#00:00:00 1
13d54b2c56c67a9e86567281d3b6f0b1 0 0 433812 0 0 509299
0 0 0 0 937640 0 0 0 0 0
3201126 B 3 BS 1 15/04/2018 18/04/2018 05/02/1967 0 2
1 T09.3;M54.57;R33 - - - None None None None G-4-10-I
(RINGAN) 4236000 0 0 - 0 - 0 - 0 - 0
4236000 5500673 0 4 0 0 0 KUSMIATI D337579
51 18697 DR MAYSAMIRAWATI SPS 0138R0170418V004969 0000510702399
3;JKN DR RIZKI; 5.2.1.201804062320 4 171608 1#0##0#0#0.0#2018-
05-14 16:00:01#0#00:00:00#00:00:00#00:00:00 1
ea24f78b9bcc5e2b4bbdd8f82f86f200 0 0 623201 0 0
3439615 0 0 0 0 1437857 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 18/04/2018 02/07/1952 0 1
1 J18.0;A41.9 87.44 - - None None None None J-4-16-III None
6419700 0 0 - 0 - 0 - 0 - 0
6419700 1372781 0 2 0 0 0 AMAN D396246 65
24030 DR VINSENSIA NOVI KARTIKA 0138R0170418V005890 0001014308965
3;JKN DR RIZKI; 5.2.1.201804062320 4 173242 1#0##0#0#0.0#2018-
05-14 16:05:14#0#00:00:00#00:00:00#00:00:00 1
ccc68efbf5323b3625fa750b36e28d73 0 0 577773 0 0 416200
0 0 0 0 378808 0 0 0 0 0
3201126 B 2 BS 1 14/04/2018 18/04/2018 14/06/1974 0 1
1 B17.9;R10.3 - - - None None None None B-4-13-I None
0 0 - 0 - 0 - 0 - 0 5045200
6581310 0 5 0 0 0 DEDI SISKA D388377 43 16010
5.2.1.201804062320 4 171580 1#0##0#0#0.0#2018-05-15
16:21:31#0#00:00:00#00:00:00#12:00:00 1 8aa2d01e5729bdb8d6b240a07d1f9f22
0 0 507068 0 0 3092689 0 0 0 0
2981553 0 0 0 0 0
3201126 B 3 BS 1 16/04/2018 18/04/2018 29/03/2017 0 2
1 A49.9;B34.9;D64.9 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 2753900 0 0 - 0 - 0 - 0
- 0 2753900 2397831 0 3 0 0 0 SARAH AQEELA
WIRAWAN D362727 1 383 DR RIANITA SYAMSU, SPA 0138R0170418V010403
0002269674404 3;JKN DR RIZKI; 5.2.1.201804062320 4 181865
1#0##0#0#0.0#2018-05-19 10:58:25#1#00:00:00#00:00:00#00:00:00 1
aa4cb733985ce98266ceddcf092bb614 0 0 272160 0 0
1139024 0 0 0 0 785780 0 0 0 156867
44000
3201126 B 1 BS 1 09/04/2018 18/04/2018 10/02/1942 0 1
1 F03;I64;R63.0 - - - None None None None F-4-16-III
None None None None None None GANGGUAN OTAK ORGANIK LAIN-LAIN TERMASUK
KETERBELAKANGAN MENTAL (BERAT) 12279700 0 0 - 0 - 0
- 0 - 0 12279700 15551398 0 10 0 0 0
MUSIRWAN D395538 76 27817 DR. ARU ARIADNO, SPPD
0138R0170418V003015 0000039260373 3;JKN irene; 5.2.1.201804062320
4 169575 1#0##0#0#0.0#2018-08-11
13:39:25#0#22:12:52#22:12:52#00:00:00 3 d8360bca6d8dfc8cf8d0e619c92aeb0c
0 0 1105160 0 0 5339857 0 0 0 0
8348381 0 0 0 0 758000
3201126 B 2 BS 1 17/04/2018 18/04/2018 03/04/1947 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 10471126 0 2 0 0 0 YOYADJI PRIBADI
0138R0170418V005963 0001268820549 3;JKN DR RIZKI; 5.2.2.201806040537
4 172848 1#0##0#0#0.0#2018-08-20
12:16:12#0#00:00:00#00:00:00#00:00:00 2 0fc28c6779e0f36d6ae3d6526eed6890
0 4024100 2298005 0 0 3338994 0 0 0 0
741027 0 0 0 0 69000
3201126 B 3 BS 1 12/04/2018 18/04/2018 12/04/2018 3300 2
DENGAN PROSEDUR MAYOR (SEDANG) 14296600 0 0 - 0 - 0
- 0 - 0 14296600 29000684 0 7 1 6 100
BAYI NY DEBI ANGGRAENI D395800 0 0 DR AULIA TANGKARI, SPA
0138R0170418V004266 0002423591908 3;JKN DR RIZKI; 5.2.2.201806040537
4 171535 1#0##0#0#0.0#2018-08-23
08:45:23#0#16:11:22#16:11:22#00:00:00 2 61e049a0836d6cc502064f6edbb11a3b
0 0 1905554 0 0 10333130 0 0 0 0
7958000 0 0 0 0 8804000
3201126 B 3 BS 1 17/04/2018 18/04/2018 05/06/1968 0 1
4 I24.9;R57.0 99.60 - - None None None None I-4-20-III None
7040000 0 0 - 0 - 0 - 0 - 0
7040000 1689779 0 2 0 0 0 KAMAL FASYAH
D058686 49 18213 DR ERTY MASIHAT 0138R0170418V005944
0001637888657 3;JKN DR RIZKI; 5.2.2.201806040537 4 172837
1#0##0#0#0.0#2018-08-23 11:08:08#0#20:13:24#20:13:24#00:00:00 2
74b943a79ee35923b131ddb1a0fa33cb 0 0 195183 0 0
1095050 0 0 0 0 399546 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 18/04/2018 21/04/1978 0 1
1 T82.4;I12.0 39.53 - - None None None None I-1-20-II None
(SEDANG) 19193800 0 0 - 0 - 0 - 0 - 0
19193800 18402550 0 2 0 0 0 MUHAMAD SOLEH TN
0001455588617 3;JKN DR RIZKI; 5.2.2.201806040537 4 172627
1#0##0#0#0.0#2018-09-26 20:47:36#0#14:29:58#14:29:58#00:00:00 2
ef2552719cfd6f3e8f6246bf7e1c17e1 0 0 4035320 0 0
9959730 0 0 0 0 4338500 0 0 0 0 69000
3201126 B 2 BS 1 17/04/2018 18/04/2018 06/10/1967 0 1
1 T82.4;E11.2 39.42 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 10865986 0 2 0 0 0 DRS. HELMI PURWANA
0138R0170418V005728 0002142462868 3;JKN DR RIZKI; 5.2.2.201806040537
4 172539 1#0##0#0#0.0#2018-09-26
20:50:06#0#13:11:02#13:11:02#12:00:00 2 71a19ec11d5901229d2cd8313e2079e8
0 4439100 1781760 0 0 3809267 0 0 0 0
766859 0 0 0 0 69000
3201126 B 3 BS 1 17/04/2018 18/04/2018 03/03/2002 0 1
0 0 - 0 - 0 - 0 - 0 2841500
16 5889 DR NIA KURNIATI, SPA 0138R0170418V006176 0001620848485
3;JKN DR RIZKI; 5.2.2.201806040537 4 173092 1#0##0#0#0.0#2018-
10-01 09:32:35#0#11:54:57#11:54:57#12:00:00 2
a2b9a177909eeecbbce491d15ea537a6 0 0 358020 0 1216500
0 0 0 0 0 0 0 0 26000 0 0
3201126 B 1 BS 1 16/04/2018 19/04/2018 19/04/1994 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 18689492 0 4 0 0 0 ANGGI HENDRIYANI
d375288 23 8763 ENDANG TRI KURNIADEWI DR SPOG 0138R0170418V005680
0002305729743 3;JKN DR RIZKI; 5.2.1.201804062320 4 172465
1#1#vvip#4#11707992#0.0#2018-04-30 14:23:03#0#11:26:24#11:26:24#00:00:00
1 d5a2f5508bf7557070aeee9c1e1127e6 0 9464400 5138926 0
0 2588166 0 0 0 0 1301000 0 0 0 0
197000
3201126 B 1 BS 1 17/04/2018 19/04/2018 17/04/2018 2931 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040617 0 3 0 0 0 SRI JAHTU FATMASARI BY
NY D396238 0 0 DR RIANITA SYAMSU, SPA 0138R0170418V006298
0002450880685 3;JKN DR RIZKI; 5.2.1.201804062320 4 173239
1#0##0#0#0.0#2018-05-02 08:53:45#0#16:05:07#16:05:07#00:00:00 1
c1f85d4a64980deb3cfda0bc61796267 0 0 499620 0 0 88899
0 0 0 0 1452098 0 0 0 0 0
3201126 B 1 BS 1 11/04/2018 19/04/2018 16/12/1936 0 1
1 N18.5;M13.98;R63.0 89.52;87.44 - - None None None None
N-4-10-I None None None None None None TUMOR GINJAL & SALURAN URIN &
GAGAL GINJAL (RINGAN) 4639400 0 0 - 0 - 0 - 0
- 0 4639400 11204007 0 9 0 0 0 DJAMILUDDIN
NASUTION H, SH,MM D352241 81 29701 DR. ARU ARIADNO, SPPD
0138R0170418V003980 0000060786527 3;JKN DR RIZKI; 5.2.1.201804062320
4 170589 1#0##0#0#0.0#2018-05-02
09:01:09#0#17:49:31#17:49:31#00:00:00 1 afb7229f38d8f00ad0b14784c291566d
0 0 547342 0 0 3214193 0 0 0 0
7442472 0 0 0 0 0
3201126 B 1 BS 1 16/04/2018 19/04/2018 16/04/2018 3515 1
1 P59.9;P03.4 99.82 - - None None None None P-8-17-I None
(RINGAN) 5118000 0 0 - 0 - 0 - 0 - 0
5118000 4645994 0 4 0 0 0 ANGGI HENDRIYANI BY NY
0002450034257 3;JKN DR RIZKI; 5.2.1.201804062320 4 172220
1#0##0#0#0.0#2018-05-02 09:05:30#0#14:34:00#14:34:00#00:00:00 1
bcd54cf1c95964866ea21477a1a1306d 0 0 845085 0 0 330965
0 0 0 0 3129944 0 0 0 0 340000
3201126 B 2 BS 1 12/04/2018 19/04/2018 03/07/1950 0 2
12482300 0 0 - 0 - 0 - 0 - 0
12482300 10503365 0 8 1 3 0 SUJATMI NY D395883
67 24755 DR AZRI NURIZAL SPPD KKV 0138R0170418V004452
0000044086274 3;JKN DR RIZKI; 5.2.1.201804062320 4 171034
1#0##0#0#0.0#2018-05-02 11:23:22#0#22:03:15#22:03:15#00:00:00 1
aadfb77f47266bc0afd2e4a5da75d00f 0 0 989171 0 0
4162058 0 0 0 0 5352136 0 0 0 0 0
3201126 B 2 BS 1 12/04/2018 19/04/2018 09/11/2006 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 19757646 0 8 0 0 0 ZAHIRA KAYLA PUTRI
0001110460342 3;JKN DR RIZKI; 5.2.1.201804062320 4 171030
1#0##0#0#0.0#2018-05-02 11:24:13#0#19:34:58#19:34:58#00:00:00 1
a8b7b550c24f93aa4e29bd5633e11af7 0 7233800 2858300 0 0
7894546 0 0 0 0 1286000 0 0 0 0 485000
3201126 B 2 BS 1 16/04/2018 19/04/2018 12/12/2016 0 1
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 3886793 0 4 0 0 0 RAFARDAN MAULANA RIZIEQ
0002246581822 3;JKN DR RIZKI; 5.2.1.201804062320 4 172164
1#0##0#0#0.0#2018-05-02 11:35:14#0#14:04:13#14:04:13#00:00:00 1
64cf2ff15af1dd81b24deed126f70a51 0 0 339830 0 0
1246687 0 0 0 0 2300276 0 0 0 0 0
3201126 B 2 BS 1 17/04/2018 19/04/2018 24/06/1970 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 1964824 0 3 0 0 0 TROY WIBISANTO
0001802032604 3;JKN DR RIZKI; 5.2.1.201804062320 4 172846
1#0##0#0#0.0#2018-05-02 11:36:10#0#00:00:00#00:00:00#12:00:00 1
8435dd8f28bee9c7e46603e6bcc8363b 0 0 298025 0 0 502259
0 0 0 0 1164540 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 19/04/2018 16/11/1987 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10797431 0 4 0 0 0 UMI NURUL KOMARIAH
0138R0170418V005012 0002248678348 3;JKN DR RIZKI; 5.2.1.201804062320
4 171631 1#0##0#0#0.0#2018-05-02
11:46:19#0#02:50:58#02:50:58#00:00:00 1 b0ae91cc1733702b21c97c623c3a3ac0
0 5684900 2087593 0 0 1907564 0 0 0 0
792374 0 0 0 0 325000
3201126 B 2 BS 1 17/04/2018 19/04/2018 03/03/1991 0 2
(RINGAN) 5984100 0 0 - 0 - 0 - 0 - 0
5984100 10348599 0 3 0 0 0 BETARI ELIDA S.L
d3751111 27 9907 DR BAGUS T, SPOG 0138R0170418V005887
0002310072118 3;JKN DR RIZKI; 5.2.1.201804062320 4 172832
1#0##0#0#0.0#2018-05-02 11:51:22#0#00:00:00#00:00:00#00:00:00 2
b8c1e906738c3a5dffb64fec96a45569 0 5269900 2087594 0 0
2006094 0 0 0 0 788011 0 0 0 0 197000
3201126 B 2 BS 1 17/04/2018 19/04/2018 08/01/2014 0 1
0 - 0 2376200 2182700 0 3 0 0 0
MATHEOZ MORENZO NANARIAIN D323662 4 1560 DR OTTY MITHA S, SPA
0138R0170418V005956 0002135847971 3;JKN DR RIZKI; 5.2.1.201804062320
4 172843 1#0##0#0#0.0#2018-05-02
11:53:41#0#00:00:00#00:00:00#12:00:00 1 0169ebc5d757b2a941d785e3d696a10a
0 0 238535 0 0 467872 0 0 0 0
1476293 0 0 0 0 0
3201126 B 2 BS 1 17/04/2018 19/04/2018 09/11/1933 0 1
0 0 - 0 - 0 - 0 - 0 4290800
3594862 0 3 0 0 0 MANGASI SINAGA D396231 84
30840 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170418V005688 0000061023069
3;JKN DR RIZKI; 5.2.1.201804062320 4 175978 1#0##0#0#0.0#2018-
05-02 11:57:46#0#00:00:00#00:00:00#00:00:00 1
ed8801b13737a2b3a06225c7033c437a 0 0 439172 0 0
1379512 0 0 0 0 1776178 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 19/04/2018 28/08/1972 0 1
1 L02.4 86.22;83.21 - - None None None None L-4-12-I None
2103200 0 0 - 0 - 0 - 0 - 0
2103200 9274090 0 4 0 0 0 ADE IRAWAN TN
0001431192881 3;JKN DR RIZKI; 5.2.1.201804062320 4 172332
1#0##0#0#0.0#2018-05-02 11:58:33#0#19:02:33#19:02:33#00:00:00 1
77927dc9c63a7b37c3b3466176ad1878 0 5366100 606756 0 0
2569518 0 0 0 0 662716 0 0 0 0 69000
3201126 B 2 BS 1 14/04/2018 19/04/2018 14/04/1959 0 1
1 I63.9;G81.9;E78.5;J22 87.03;87.44;93.94 - - None None None
- 0 - 0 8291400 10377313 0 6 0 0 0
SENEN HERMANTO D396038 59 21550 DR MAYSAMIRAWATI SPS
0138R0170418V004952 0001958814145 3;JKN DR RIZKI; 5.2.1.201804062320
4 175968 1#0##0#0#0.0#2018-05-02
12:04:51#0#00:00:00#00:00:00#00:00:00 1 d8076f975eb87e2037a54bc7c9811895
0 0 965053 0 0 6182370 0 0 0 0
3229890 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 19/04/2018 29/10/1992 0 1
1 A41.9;T82.4;I12.0 38.95 - - None None None None N-1-12-III
- 0 19332400 22145141 0 3 0 0 0 REZA ANDENI
P D395244 25 9301 DR ARU, SPPD 0138R0170418V005474
0002444706112 3;JKN DR RIZKI; 5.2.1.201804062320 4 172337
1#0##0#0#0.0#2018-05-02 12:08:47#0#03:43:21#03:43:21#00:00:00 1
0128f3549565edc4d8d59730287b80d0 0 4128100 5659396 0 0
9856395 0 0 0 0 2432250 0 0 0 0 69000
3201126 B 3 BS 1 17/04/2018 19/04/2018 27/11/1982 0 1
0 0 - 0 - 0 - 0 - 0 8672000
11213139 0 3 0 0 0 ARTABAN MARADONGAN D395938
35 12925 DR RAY HENDRY, SPOT 0138R0170418V005948 0001263246208
3;JKN DR RIZKI; 5.2.1.201804062320 4 172838 1#0##0#0#0.0#2018-
05-02 12:17:28#0#20:27:37#20:27:37#00:00:00 1
0e54963e16e7505055cb87749ddd2dad 0 0 3678160 0 0
2622309 0 0 0 0 4767670 0 0 0 0 145000
3201126 B 3 BS 1 17/04/2018 19/04/2018 12/01/2001 0 1
2646600 0 0 - 0 - 0 - 0 - 0
2646600 2073428 0 3 0 0 0 M. REZA ALTARIKH
0001463815585 3;JKN DR RIZKI; 5.2.1.201804062320 4 172338
1#0##0#0#0.0#2018-05-02 12:22:06#0#00:00:00#00:00:00#00:00:00 1
412f2fa534f3257c2c6389f462dbab79 0 0 291194 0 0 831589
0 0 0 0 950645 0 0 0 0 0
3201126 B 3 BS 1 18/04/2018 19/04/2018 19/12/1949 0 1
1 J22;R07.4 - - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 2798500 0 0 - 0 - 0 - 0
- 0 2798500 1409547 0 2 0 0 0 BENNY HENDRA
WIJAYA D396360 68 24957 DR DICKY KARUNDENG 0138R0170418V006374
0001259077599 3;JKN DR RIZKI; 5.2.1.201804062320 4 173263
1#0##0#0#0.0#2018-05-08 15:13:08#0#20:52:33#20:52:33#00:00:00 1
816c00fd7da424d8a112cd0471588d5c 0 0 378234 0 0 650100
0 0 0 0 381213 0 0 0 0 0
3201126 B 3 BS 1 13/04/2018 19/04/2018 25/12/1975 0 2
1 I50.0;I82.8;J18.8;I49.8 89.52 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 11261915 0 7 0 0 0 NURHASANAH D381936
0000510466959 3;JKN DR RIZKI; 5.2.1.201804062320 4 171567
1#0##0#0#0.0#2018-05-08 15:27:29#0#00:00:00#00:00:00#12:00:00 1
3be375411bd3e994aed75d833884828f 0 0 2496650 0 0
4260504 0 0 0 0 4504761 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 19/04/2018 15/12/1956 0 1
1 I87.2;I73.9;I25.0;I08.9;I11.0;D29.1 88.48;00.41 - - None None
None None I-1-20-III None None None None None None PROSEDUR SISTIM
PEREDARAN DARAH LAIN-LAIN (BERAT) 20176600 0 0 - 0 - 0
- 0 - 0 20176600 50431225 0 3 0 0 0
HAMZAH SIMIN D378274 61 22403 DR AZRI NURIZAL SPPD KKV
0138R0170418V005513 0001772148969 3;JKN DR RIZKI; 5.2.1.201804062320
4 172341 1#0##0#0#0.0#2018-05-11
16:19:26#0#00:00:00#00:00:00#12:00:00 1 0dc2560f4661e7d5157624825a63c5d2
0 9217000 4035320 0 0 28228905 0 0 0 0
1381000 0 0 0 0 7569000
3201126 B 1 BS 1 18/04/2018 19/04/2018 29/11/1958 0 1
- 0 58821400 61042450 0 2 0 0 0 M.YAZIK
0001422847664 3;JKN DR RIZKI; 5.2.1.201804062320 4 172867
1#0##0#0#0.0#2018-05-14 14:15:23#0#08:25:54#08:25:54#12:00:00 1
81a4c1464ca9624a8e4647837e78dbd5 0 10062000 9619120 0 0
32516330 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 17/04/2018 19/04/2018 27/02/1960 0 1
None None None None None None PROSEDUR KANDUNG KEMIH DAN SALURAN URIN
BAWAH (RINGAN) 12159100 0 0 - 0 - 0 - 0 -
0 12159100 20513337 0 3 0 0 0 FIRDAUS PERMANA
0001728982664 3;JKN DR RIZKI; 5.2.1.201804062320 4 172371
1#0##0#0#0.0#2018-05-14 16:01:46#0#09:56:15#09:56:15#12:00:00 1
23cbb4265b697fa65ceb57d5fe25082a 0 9792600 3215072 0 0
2835665 0 0 0 0 4601000 0 0 0 0 69000
3201126 B 2 BS 1 18/04/2018 19/04/2018 10/11/1960 0 2
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 10087406 0 2 0 0 0 NANI MARDIYANTI
0138R0170418V006189 0001730363848 3;JKN DR RIZKI; 5.2.1.201804062320
4 173106 1#0##0#0#0.0#2018-05-15
16:06:40#0#12:38:14#12:38:14#12:00:00 1 d45190acd4bc50a3f6c22ffa3aff2fd8
0 4911100 2245005 0 0 2126377 0 0 0 0
735924 0 0 0 0 69000
3201126 B 2 BS 1 18/04/2018 19/04/2018 09/08/1962 0 1
1 I12.0;A16.0 39.27 - - None None None None N-1-12-II None
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0 10690500 7707846 0 2 0 0 0 SABENUH
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1#0##0#0#0.0#2018-05-15 18:10:09#0#15:29:10#15:29:10#00:00:00 1
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1187000 0 0 0 0 530252 0 0 0 0 0
3201126 B 3 BS 1 18/04/2018 19/04/2018 10/10/1953 0 2
1 I21.3;E87.1;E87.5;N18.5;E87.2;A41.9 90.59;89.52 - - None None
AKUT (BERAT) 10401900 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-05-31 10:19:07#0#16:15:20#16:15:20#00:00:00 1
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6020390 0 0 0 0 1061259 0 0 0 0 0
3201126 B 1 BS 1 17/04/2018 19/04/2018 02/01/1986 0 2
0 - 0 - 0 - 0 - 0 6981500 12859009
0 3 0 0 0 SRI JAHTU FATMASARI D396205 32 11793
DR ARJU A, SPOG 0138R0170418V005734 0001649272667 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 172552 1#0##0#0#0.0#2018-05-31
10:29:33#0#13:53:47#13:53:47#00:00:00 1 e2e16e48b3a815edca20c424501a688d
0 7098900 2426710 0 0 2184155 0 0 0 0
952244 0 0 0 0 197000
3201126 B 1 BS 1 17/04/2018 19/04/2018 30/11/1941 0 1
1 D64.9;E14.9 99.04 - - None None None None D-4-13-I None
- 0 4181800 4611014 0 3 0 0 0 SAADIAR
0000061000661 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172834
1#0##0#0#0.0#2018-05-31 11:04:51#0#18:26:30#18:26:30#00:00:00 1
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1856497 0 0 0 0 2325155 0 0 0 0 0
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(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
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0002222571341 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172866
1#0##0#0#0.0#2018-05-31 11:06:02#0#08:21:10#08:21:10#12:00:00 1
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38564255 0 0 0 0 1256000 0 0 0 0
7569000
3201126 B 2 BS 1 18/04/2018 19/04/2018 27/08/1945 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
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3;JKN irene; 5.2.2.201806040537 4 173195 1#0##0#0#0.0#2018-
06-05 12:14:05#0#15:26:51#15:26:51#00:00:00 1
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3278129 0 0 0 0 710511 0 0 0 0 0
3201126 B 3 BS 1 19/04/2018 19/04/2018 16/04/2018 990 1
1 P07.3;P07.0;P22.9 96.72;99.82 - - None None None None P-8-
02-I None None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-1
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1 L95.9;L03.9 - - - None None None None L-4-14-I None
(RINGAN) 4121600 0 0 - 0 - 0 - 0 - 0
4121600 16995242 0 13 0 0 0 EKO NURDYANTO
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1#0##0#0#0.0#2018-08-11 13:40:26#0#21:52:36#21:52:36#00:00:00 3
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5335960 0 0 0 0 11129338 0 0 0 0 0
3201126 B 2 BS 1 17/04/2018 19/04/2018 16/04/2018 2917 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1703773 0 3 0 0 0 UMI NURUL KOMARIAH BY NY
D396096 0 1 DR. TRI LESTARI 0138R0170418V005710
0002436610083 3;JKN DR RIZKI; 5.2.2.201806040537 4 172534
1#0##0#0#0.0#2018-08-20 12:14:16#0#12:03:28#12:03:28#00:00:00 2
530b07f4eae796cd81745de50d68b0cd 0 0 433812 0 0 88899
0 0 0 0 1181062 0 0 0 0 0
3201126 B 3 BS 1 16/04/2018 19/04/2018 01/02/1996 0 2
5062600 0 0 - 0 - 0 - 0 - 0
5062600 2622771 0 4 0 0 0 DWI FEBRIYANTI
0000512908896 3;JKN DR RIZKI; 5.2.2.201806040537 4 172331
1#0##0#0#0.0#2018-08-23 11:03:19#0#18:39:27#18:39:27#00:00:00 2
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3201126 B 3 BS 1 18/04/2018 20/04/2018 17/08/1967 0 2
1 N18.5;A49.9;R11 - - - None None None None N-4-10-I
GINJAL (RINGAN) 3313800 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-05-08 15:24:31#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 2200963 0 0 0 0 0
3201126 B 2 BS 1 19/04/2018 20/04/2018 20/04/1973 0 2
0 - 0 - 0 - 0 - 0 7842900 4357554
0 2 0 0 0 TETY POLMASARI D073586 44 16435
RACHMAWATI DR,SPB(K)ONK 0138R0170418V006771 0002315370126 3;JKN DR
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08:35:24#0#20:50:05#20:50:05#12:00:00 1 b8ca43cc2b1ef6ca81d846e1a1797562
0 802500 1568580 0 0 1675400 0 0 0 0
311074 0 0 0 0 0
3201126 B 2 BS 1 18/04/2018 20/04/2018 18/04/2018 3129 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2053821 0 3 0 0 0 BAYI NY TIRA DESHINTA
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1#0##0#0#0.0#2018-05-11 16:07:18#0#08:57:31#08:57:31#00:00:00 1
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3201126 B 1 BS 1 18/04/2018 20/04/2018 03/04/1978 0 2
1 I64;M75.0 87.03 - - None None None None G-4-15-I None
- 0 - 0 - 0 5734600 5990282 0 3 0
0 0 ROIDA EVA FLORA SIAGIAN D396298 40 14625 DR HARDI PRANATA
4 173259 1#0##0#0#0.0#2018-05-14
14:17:26#0#18:14:02#18:14:02#00:00:00 1 fe6eac19b61a5ada79b4e036ea5e9c82
0 0 754840 0 0 2474554 0 0 0 0
2760888 0 0 0 0 0
3201126 B 1 BS 1 19/04/2018 20/04/2018 01/11/1945 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 10168226 0 2 0 0 0 DR. SYAHRIR HUSIN LUBIS
0138R0170418V006586 0000045151029 3;JKN DR RIZKI; 5.2.1.201804062320
4 173492 1#0##0#0#0.0#2018-05-14
14:18:59#0#11:20:00#11:20:00#12:00:00 1 af1a47c41db1b67eef48588ba5abd354
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7159411 0 0 0 0 69000
3201126 B 1 BS 1 15/04/2018 20/04/2018 11/01/1965 0 2
1 I64;E11.9;E78.5 87.03 - - None None None None G-4-15-I
- 0 - 0 - 0 - 0 5734600 9603113 0
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DR MAYSAMIRAWATI SPS 0138R0170418V005006 0000042740796 3;JKN DR
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14:51:53#0#21:56:10#21:56:10#00:00:00 1 3b8f4da15b785b3e4f6299b7e67b735b
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5020741 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 20/04/2018 23/11/1997 0 1
1 L02.1;L04.0;R51 87.49;90.59 - - None None None None L-4-
12-I None None None None None None PERADANGAN KULIT/CELLULITIS (RINGAN)
1752700 0 0 - 0 - 0 - 0 - 0
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0000512633507 3;JKN DR RIZKI; 5.2.1.201804062320 4 172842
1#0##0#0#0.0#2018-05-15 16:52:25#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 1 BS 1 18/04/2018 20/04/2018 15/06/1949 0 1
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1#0##0#0#0.0#2018-05-15 18:18:13#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 1 BS 1 18/04/2018 20/04/2018 23/09/1957 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
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0001102669997 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172860
1#0##0#0#0.0#2018-05-15 18:20:52#0#08:04:43#08:04:43#00:00:00 1
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7569000
3201126 B 1 BS 1 16/04/2018 20/04/2018 27/09/1937 0 1
1 K41.9;I50.0 53.00 - - None None None None K-1-14-II None
None None None None None PROSEDUR HERNIA INGUINAL DAN FEMORAL (SEDANG)
9006100 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-05-15 18:22:44#0#19:58:22#19:58:22#00:00:00 1
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3201126 B 1 BS 1 19/04/2018 20/04/2018 23/08/1960 0 2
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0138R0170418V006591 0001727920225 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 173494 1#0##0#0#0.0#2018-05-15
18:28:14#0#11:20:39#11:20:39#00:00:00 1 75dd1c952f373f49af0dc2df1f123c78
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1763622 0 0 0 0 0
3201126 B 2 BS 1 17/04/2018 20/04/2018 07/05/1954 0 1
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None None None None None LEUKEMIA AKUT (SEDANG) 9223300 0 0
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0138R0170418V005722 0001278944526 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 172537 1#0##0#0#0.0#2018-05-15
19:11:49#0#00:00:00#00:00:00#12:00:00 1 7a830c541345fc3fd569edbc6140a79d
0 0 883097 0 0 3342100 0 0 0 0
2484984 0 0 0 0 0
3201126 B 2 BS 1 15/04/2018 20/04/2018 10/12/1951 0 2
1 S72.00;E87.1;I63.9 81.51 - - YY01 RR04 None None M-1-
04-III None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI
TUNGKAI BAWAH (BERAT) 21993000 0 0 HIP REPLACEMENT / KNEE REPLACEMENT
39340700 47435150 0 6 0 0 0 NURHAYATI ISHAQ
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1#0##0#0#0.0#2018-05-15 19:13:25#0#00:00:00#00:00:00#12:00:00 1
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19018060 0 0 0 0 8116500 0 0 0 0 138000
3201126 B 2 BS 1 16/04/2018 20/04/2018 17/02/1938 0 1
1 J18.0 90.59;87.49;89.52 - - None None None None J-4-16-I
(RINGAN) 4335900 0 0 - 0 - 0 - 0 - 0
4335900 4732653 0 5 0 0 0 ABDUL WAHAB D396155
80 29278 DR MOHAMAD NIZAM ERHAMZA SPP 0138R0170418V005457
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1#0##0#0#0.0#2018-05-15 19:18:53#0#19:38:16#19:38:16#00:00:00 1
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1428809 0 0 0 0 2860613 0 0 0 0 0
3201126 B 2 BS 1 18/04/2018 20/04/2018 24/09/2005 0 1
1 R50.9;R11 - - - None None None None A-4-12-I None
3167100 0 0 - 0 - 0 - 0 - 0
3167100 2913063 0 3 0 0 0 NINDY RASYA CAHYANI
0001200501775 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172852
1#0##0#0#0.0#2018-05-15 19:23:28#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1731574 0 0 0 0 0
3201126 B 2 BS 1 18/04/2018 20/04/2018 07/08/1981 0 2
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3 0 0 0 LIAWATI D208755 36 13403 DR ERDIYAN, SPOG
0138R0170418V006379 0001463521465 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 173265 1#0##0#0#0.0#2018-05-15
19:30:45#0#00:00:00#00:00:00#00:00:00 1 c26af6a550e19467b2786a6f200f0c89
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1178681 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 20/04/2018 03/09/2017 0 1
1 D56.1;J18.0 99.04;93.94 - - None None None None D-4-13-III
0 - 0 5407200 10712669 0 4 1 2 0 DARWIS
KHAIRY NASYWAN D396243 0 226 DR NOVIK BUDIWARDHANA, SPA
0138R0170418V005753 0002282410258 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 172542 1#0##0#0#0.0#2018-05-31
08:48:22#0#13:39:50#13:39:50#00:00:00 2 8b2a6411c11ca53d9dfde2ff83c261e7
0 0 321830 0 0 5844010 0 0 0 0
3320829 0 0 0 0 1226000
3201126 B 2 BS 1 18/04/2018 20/04/2018 07/09/1992 0 2
0 - 0 - 0 - 0 - 0 5984100 10490888
0 3 0 0 0 TRI LUSIANDA D262581 25 9354 DR
ERDIYAN, SPOG 0138r0170418v006371 0001639137216 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 173260 1#0##0#0#0.0#2018-05-31
10:27:42#0#20:04:35#20:04:35#00:00:00 1 9ec6f44ac2a10bdd648fe7e5931c48f4
0 5062400 2090753 0 0 2215415 0 0 0 0
797320 0 0 0 0 325000
3201126 B 2 BS 1 18/04/2018 20/04/2018 15/12/1988 0 2
0 - 0 - 0 - 0 - 0 2009900 5649048
0 3 0 0 0 TIRA DESHINTA D395772 29 10716 DR
ATJANG S, SPOG 0138R0170418V006151 0001438860238 3;JKN irene;
5.2.2.201806040537 4 173013 1#0##0#0#0.0#2018-08-11
13:42:48#0#10:25:57#10:25:57#00:00:00 2 971bcf3c682e9010790bfc565b89993a
0 0 454980 0 0 1441804 0 0 0 0
3496264 0 0 256000 0 0
3201126 B 2 BS 1 18/04/2018 20/04/2018 12/04/2018 3150 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 4091656 0 3 0 0 0 MUHAMMAD HIRO HADSA AL
BANTANI D396346 0 6 DR DYAH HARINI, SPA 0138R0170418V006355
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1#0##0#0#0.0#2018-08-11 13:43:22#0#18:02:59#18:02:59#00:00:00 2
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0 0 0 0 2031178 0 0 0 0 1452000
3201126 B 3 BS 1 19/04/2018 20/04/2018 31/12/1957 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7707945 0 2 0 0 0 NURUDIN LASMANA
0138R0170418V006571 0001278325067 3;JKN irene; 5.2.2.201806040537
4 173449 1#0##0#0#0.0#2018-08-11
13:47:59#0#10:46:07#10:46:07#00:00:00 2 80c7fdd3141b5dd50c6afcffb953fd08
0 3062500 921100 0 0 3095087 0 0 0 0
560258 0 0 0 0 69000
3201126 B 3 BS 1 19/04/2018 20/04/2018 15/01/1955 0 2
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0 0 - 0 - 0 - 0 - 0 2954900
5142892 0 2 0 0 0 KARTI d395511 63 23105 DR
ZULFAN, SPPD 0138R0170418V006751 0001312729514 3;JKN irene;
5.2.2.201806040537 4 173773 1#0##0#0#0.0#2018-08-11
13:48:51#0#18:12:50#18:12:50#00:00:00 2 df9a8f92582969f518806d91c7cbc38c
0 0 875082 0 0 978069 0 0 0 0
1540741 0 0 0 0 1749000
3201126 B 2 BS 1 17/04/2018 20/04/2018 06/04/2016 0 1
1 A09.9;R62.0;E43 - - - None None None None K-4-17-III
(BERAT) 3046500 0 0 - 0 - 0 - 0 - 0
3046500 2667055 0 4 0 0 0 RAFFA PUTRA ALFAEYZA
0002036460936 3;JKN DR RIZKI; 5.2.2.201806040537 4 172849
1#0##0#0#0.0#2018-08-21 09:45:06#0#00:00:00#00:00:00#00:00:00 2
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0 0 0 0 1715480 0 0 0 0 0
3201126 B 1 BS 1 17/04/2018 20/04/2018 23/08/1988 0 2
0 - 0 - 0 - 0 - 0 3035600 3650721
0 4 0 0 0 ARIK BINTARI D025603 29 10829 DR
AFRA FONDA SPOG 0138R0170418V006304 0002039872961 3;JKN DR RIZKI;
5.2.2.201806040537 4 173252 1#0##0#0#0.0#2018-08-21
11:34:53#0#16:22:24#16:22:24#00:00:00 2 86891934916c7314c03800c0c6301513
0 0 326204 0 0 698685 0 0 0 0
2625832 0 0 0 0 0
3201126 B 2 BS 1 16/04/2018 20/04/2018 02/05/1932 0 2
1 I50.0;I25.0;R63.0 89.52 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
13195672 0 5 1 2 0 NURANI YUSUF d025383 85
31395 DR PRIYO SUNARTO , SPJP 0138R0170418V005022 0000060836859 3;JKN
DR RIZKI; 5.2.2.201806040537 4 171632
1#1#kelas_1#5#715100#0.0#2018-08-23 11:24:48#0#00:00:00#00:00:00#12:00:00
3 10df57b7e297de6044ed6a863065f59a 0 0 741303 0 0
5388601 0 0 0 0 6477768 0 0 0 0 588000
3201126 B 2 BS 1 14/04/2018 20/04/2018 24/01/1983 0 2
1 E87.6;I11.9 - - - None None None None E-4-11-I None
3545800 0 0 - 0 - 0 - 0 - 0
3545800 8485020 0 7 0 0 0 LILIK KURNIA PUSPITA
C178580 35 12864 DR AZRI NURIZAL SPPD KKV 0138R0170418V004889
0001611520064 3;JKN DR RIZKI; 5.2.2.201806040537 4 171577
1#0##0#0#0.0#2018-09-26 20:52:29#0#00:00:00#00:00:00#00:00:00 2
ff86c90499f7ced73a07dec7f59db410 0 0 692576 0 0
3676349 0 0 0 0 4116095 0 0 0 0 0
3201126 B 1 BS 1 19/04/2018 20/04/2018 09/11/1959 0 2
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 10969614 0 2 0 0 0 RUSMIATI
0001212480202 3;JKN DR RIZKI; 5.2.2.201806040537 4 173608
1#0##0#0#0.0#2018-09-26 20:55:09#0#14:51:50#14:51:50#12:00:00 3
3338df333b11c8f7997f24cff7c9e226 0 5896000 1815214 0 0
2415762 0 0 0 0 773638 0 0 0 0 69000
3201126 B 1 BS 1 18/04/2018 20/04/2018 10/04/1959 0 2
1 K30;R63.0;N17.9;M54.57;M51.9;J18.0 90.59;89.52;87.44 - - None
None None None K-4-18-III None None None None None None GANGGUAN
SISTEM PENCERNAAN LAIN-LAIN (BERAT) 4118600 0 0 - 0 - 0
- 0 - 0 4118600 4485541 0 3 0 0 0
SURYAWATI D296383 59 21558 DR. ARU ARIADNO, SPPD
0138R0170418V006356 0000060722932 3;JKN DR RIZKI; 5.2.2.201806040537
4 173257 1#0##0#0#0.0#2018-09-26
20:58:38#0#18:02:16#18:02:16#00:00:00 2 d3c1f92728cb4e599fe7cada8dd56ab0
0 0 269459 0 0 1899135 0 0 0 0
2316947 0 0 0 0 0
3201126 B 1 BS 1 15/04/2018 20/04/2018 22/09/1954 0 1
4 E14.1;D64.9;N18.5;A41.9 99.04;38.95 - - None None None None
- 0 - 0 27065300 30953467 0 6 0 0 0
SUMI HARTANTO D268600 63 23216 DR. ARU ARIADNO, SPPD
0138R0170418V004972 0001298861177 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 171610 1#0##0#0#0.0#2018-10-10
18:12:01#0#08:52:25#08:52:25#00:00:00 1 6853d1953580e0825d7571cb6c1a9bd3
0 0 2040138 0 9384000 18150329 0 0 0 0
1200000 0 0 0 179000 0
3201126 B 3 BS 1 16/04/2018 21/04/2018 13/07/1950 0 1
1 I11.0;G93.4;A49.9 39.95;38.95;99.04 - - None None None None
- 0 - 0 19332400 21559859 0 6 1 3 0
IGNATIUS ANTONO ADJI d389824 67 24749 DR BETTY DWI L, SPPD
0138R0170418V005262 0001463354684 3;JKN DR RIZKI; 5.2.1.201804062320
4 172028 1#0##0#0#0.0#2018-05-08
15:11:17#0#11:37:22#11:37:22#12:00:00 1 86736cff05f71d50312d2161736baff0
0 4562500 7399312 0 0 5642547 0 0 0 0
3588500 0 0 0 0 367000
3201126 B 2 BS 1 19/04/2018 21/04/2018 05/11/1948 0 1
1 I64;I11.9;G81.9;E78.4;E79.0 87.03 - - None None None None
0 0 - 0 - 0 - 0 - 0 5866300
4084599 0 3 0 0 0 SARIMAN D396410 69 25367
DR NURUL KOMARI SPS 0138R0170418V006609 0002057663823 3;JKN DR
RIZKI; 5.2.1.201804062320 4 173602 1#0##0#0#0.0#2018-05-08
15:34:45#0#14:48:59#14:48:59#00:00:00 1 1e6f924495beb7abfcb31752de74e808
0 0 882140 0 0 1394242 0 0 0 0
1808217 0 0 0 0 0
3201126 B 2 BS 1 15/04/2018 21/04/2018 08/07/1975 0 2
1743400 0 0 - 0 - 0 - 0 - 0
1743400 7438656 0 7 0 0 0 YULI YANITA A137284
3;JKN DR RIZKI; 5.2.1.201804062320 4 171621 1#0##0#0#0.0#2018-
05-08 15:38:27#0#00:00:00#00:00:00#00:00:00 1
d47a59e3a77f08b67fb8e88fdbd2e20b 0 0 483200 0 0
3205315 0 0 0 0 3750141 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 21/04/2018 16/03/1975 0 1
1 I10;R07.4 88.55 - - None None None None I-1-15-I None
0 - 0 - 0 - 0 - 0 6357300 12077218
0 2 0 0 0 MANSUR SUPRIADI D125761 43 15741 DR
AGOES KOOSHARTORO SPPD-KKV 0138R0170418V006976 0001623404395 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 174031 1#0##0#0#0.0#2018-
05-12 09:56:17#0#00:00:00#00:00:00#00:00:00 1
7d24bd2156708848de0a685f971c0695 0 4777000 1271460 0 0
3143660 0 0 0 0 816098 0 0 0 0
2069000
3201126 B 1 BS 1 20/04/2018 21/04/2018 15/10/1982 0 1
0 - 0 - 0 - 0 - 0 3247500 6010460
0 2 0 0 0 JOVIALTA TARIGAN D364977 35 12971 DR.
5.2.1.201804062320 4 173970 1#0##0#0#0.0#2018-05-14
14:13:54#0#21:37:38#21:37:38#00:00:00 1 20d88fc71a92e3b1f007993f93273f72
0 0 1025300 0 0 857952 0 0 0 0
2378208 0 0 0 0 1749000
3201126 B 1 BS 1 20/04/2018 21/04/2018 18/07/1940 0 1
- 0 58821400 59809510 0 2 0 0 0 DR.H.ABDUL
HAKIM RAHMAN D187230 77 28400 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170418V006898 0000050854915 3;JKN DR RIZKI; 5.2.1.201804062320
4 174045 1#0##0#0#0.0#2018-05-14
14:26:13#0#00:00:00#00:00:00#00:00:00 1 4ef71b9b2fe6d2e4467c67f49f05101c
0 10080000 9619120 0 0 31265390 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 19/04/2018 21/04/2018 23/05/1981 0 1
1 K40.4;K55.0 53.00;54.74 - - None None None None K-1-40-III
(BERAT) 21013600 0 0 - 0 - 0 - 0 - 0
21013600 21553251 0 3 0 0 0 RENO HARTANTO
0001640955025 3;JKN DR RIZKI; 5.2.1.201804062320 4 173594
1#0##0#0#0.0#2018-05-14 14:37:02#0#14:45:43#14:45:43#00:00:00 1
d410a1691d91085002922128ac986828 0 6587000 9849080 0 0
3747171 0 0 0 0 1301000 0 0 0 0 69000
3201126 B 1 BS 1 18/04/2018 21/04/2018 30/04/1973 0 2
0 0 - 0 - 0 - 0 - 0 11569900
15268685 0 4 0 0 0 IDA ISWATI D395177 44 16424
DR BAGUS T, SPOG 0138R0170418V006380 0000040614377 3;JKN DR RIZKI;
5.2.1.201804062320 4 173266 1#0##0#0#0.0#2018-05-14
14:38:12#0#23:19:23#23:19:23#00:00:00 1 3d904df104340026827561c342ec8de6
0 7096000 4228164 0 0 2790635 0 0 0 0
1084886 0 0 0 0 69000
3201126 B 1 BS 1 20/04/2018 21/04/2018 26/08/1962 0 2
0 - 0 - 0 - 0 - 0 3247500 6754439
0 2 0 0 0 EFAWITA D353470 55 20326 DR ARU, SPPD
0138R0170418V007284 0001103784862 3;JKN DR RIZKI; 5.2.1.201804062320
4 173965 1#0##0#0#0.0#2018-05-14
14:39:16#0#19:11:44#19:11:44#00:00:00 1 fd72935b85db7ad55513bb52184c49cc
0 0 962300 0 0 1650760 0 0 0 0
2426879 0 0 0 0 1714500
3201126 B 1 BS 1 17/04/2018 21/04/2018 07/12/1955 0 1
12373100 0 0 - 0 - 0 - 0 - 0
12373100 24537921 0 5 0 0 0 BAMBANG JOKO SUSILO
0001339260107 3;JKN DR RIZKI; 5.2.1.201804062320 4 172340
1#0##0#0#0.0#2018-05-14 14:52:57#0#06:04:17#06:04:17#12:00:00 1
430252bc3f20a9efc51fba7ecec1c206 0 11174600 3464468 0 0
4710853 0 0 0 0 4821000 0 0 0 0 367000
3201126 B 3 BS 1 20/04/2018 21/04/2018 02/02/1961 0 1
1 T82.4;I12.0;E11.9 39.42 - - None None None None N-1-12-II
- 0 8908800 8960734 0 2 0 0 0 HERU WIBOWO
0138R0170418V007283 0001476550192 3;JKN DR RIZKI; 5.2.1.201804062320
4 173963 1#0##0#0#0.0#2018-05-14
15:07:01#0#00:00:00#00:00:00#00:00:00 1 37818f69b629dda71c400e149a87fc29
0 2976000 974100 0 0 3143168 0 0 0 0
1798466 0 0 0 0 69000
3201126 B 3 BS 1 21/04/2018 21/04/2018 16/03/1966 0 1
- 0 - 0 - 0 4096200 4754166 0 1 0
0 0 KUSNADI D396563 52 19029 DR RENDRA RAMADYA
0138R0170418V007327 0000511397785 3;JKN DR RIZKI; 5.2.1.201804062320
4 173977 1#0##0#0#0.0#2018-05-14
15:13:50#0#07:53:28#07:53:28#00:00:00 1 6702f567a8971c99f08d32b1d0fd0481
0 0 439974 0 0 3714172 0 0 0 0 600020
0 0 0 0 0
3201126 B 3 BS 1 21/04/2018 21/04/2018 17/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 4202600
2484743 0 1 0 0 0 SUWITO D351573 62 22771
DR RENDRA RAMADYA 0138r0170418v007342 0000037182363 3;JKN DR RIZKI;
5.2.1.201804062320 4 174068 1#0##0#0#0.0#2018-05-14
15:21:25#0#10:32:04#10:32:04#00:00:00 1 5a98540eaa84e04538ad8cba49fd9286
0 0 363870 0 0 1669320 0 0 0 0 451553
0 0 0 0 0
3201126 B 3 BS 1 20/04/2018 21/04/2018 24/04/1955 0 2
1 K30;N17.9;A49.9 - - - None None None None K-4-18-III
(BERAT) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 1477071 0 2 0 0 0 YUSNIATI D324605
62 23007 DR ADRIAN HANDARU 0138R0170418V007567 0001811349652 3;JKN
DR RIZKI; 5.2.1.201804062320 4 174430 1#0##0#0#0.0#2018-05-14
15:54:33#0#14:27:36#14:27:36#00:00:00 1 a513b7a0c73de32bb7af9c14b9f54015
0 0 298242 0 0 793198 0 0 0 0 385631
0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 21/04/2018 15/07/1954 0 1
1 T82.4;D47.3 39.42 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 15102646 0 2 0 0 0 MF. MULAWARMAN
0138R0170418V007246 0001745382565 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 173953 1#0##0#0#0.0#2018-05-15
08:58:58#0#17:35:52#17:35:52#00:00:00 1 c559056d4a8ef1c81366661e611a224d
0 5550500 1458408 0 0 6975714 0 0 0 0
1049024 0 0 0 0 69000
3201126 B 2 BS 1 18/04/2018 21/04/2018 18/04/2018 2393 1
(RINGAN) 6580300 0 0 - 0 - 0 - 0 - 0
6580300 1881302 0 4 0 0 0 BAYI NY TRI LUSIANDA
D396380 0 0 DR A.D. PASARIBU SP.A 0138R0170418V006746
0002451330922 3;JKN DR RIZKI; 5.2.1.201804062320 4 173772
1#0##0#0#0.0#2018-05-15 16:00:34#0#17:43:16#17:43:16#00:00:00 1
9c124a7d11108fead8a7ed8139a7d1df 0 0 631227 0 0 430899
0 0 0 0 819176 0 0 0 0 0
3201126 B 1 BS 1 19/04/2018 21/04/2018 08/04/1973 0 2
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 3686900 0 3 0 0 0 HESTRI PURWANDINI
0001326342093 3;JKN DR RIZKI; 5.2.1.201804062320 4 173775
1#0##0#0#0.0#2018-05-15 16:05:00#0#20:48:21#20:48:21#00:00:00 1
5437e0fc3771a49ecf5ed3a75fd33810 0 0 236051 0 0
1186150 0 0 0 0 2264699 0 0 0 0 0
3201126 B 3 BS 1 17/04/2018 21/04/2018 08/05/1957 0 1
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5195043 0 5 0 0 0 SUHARTO
D396200 60 22259 DR MAYSAMIRAWATI SPS 0138R0170418V005623
0001264272142 3;JKN irene; 5.2.1.201804062320 4 172366
1#0##0#0#0.0#2018-05-15 17:11:11#0#09:32:24#09:32:24#00:00:00 3
d5c2299d0106226c9c8d0cf671840609 0 0 743950 0 0
2770230 0 0 0 0 1680863 0 0 0 0 0
3201126 B 1 BS 1 16/04/2018 21/04/2018 29/08/2013 0 1
1 A41.9;A16.0 93.19;93.94 - - None None None None A-4-10-II
0 - 0 - 0 - 0 - 0 6062400 9112814
0 6 0 0 0 SULTAN KHOIRUL AZZAM PAKAYA D273556 4
1691 DR KRISTY, SPA 0138R0170418V005279 0001860055389 3;JKN irene;
5.2.1.201804062320 4 172111 19#0##0#0#0.0#2018-05-17
09:24:15#1#13:39:37#13:39:37#12:00:00 2 79901d3934abca9e06cdcc71e2997b8f
0 0 696600 0 0 0 0 0 0 0 4192335
0 0 0 4223879 0
3201126 B 2 BS 1 17/04/2018 21/04/2018 10/07/1988 0 2
0 0 - 0 - 0 - 0 - 0 5984100
26475382 0 5 0 0 0 PUJI SOLEKAH D392287 29
10873 DR ARIS WAHJU, SPOG 0138R0170418V005863 D392287 3;JKN irene;
5.2.1.201804062320 4 172840 34#1#vvip#5#20491282#0.0#2018-05-17
09:26:53#1#21:28:55#21:28:55#00:00:00 2 120583248ea8ba37bf4662164f031424
0 10884474 8775922 0 0 0 0 0 0 0 0
0 0 0 6814986 0
3201126 B 2 BS 1 18/04/2018 21/04/2018 20/10/2015 0 1
1 R63.8;R50.9 - - - None None None None E-4-10-I None
- 0 4203300 3372259 0 4 0 0 0 TITAN
0002326791442 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173330
1#0##0#0#0.0#2018-05-31 10:31:19#0#08:55:32#08:55:32#00:00:00 1
7fc22c7c04262b166cd4291c0d319489 0 0 338039 0 0 975105
0 0 0 0 2059115 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 21/04/2018 23/12/1998 0 1
0 - 0 - 0 - 0 - 0 3247500 5784367
0 2 0 0 0 FARHAN SAUMI ABDILLAH D395663 19 7058
DR. ARU ARIADNO, SPPD 0138R0170418V007276 0000041941269 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 173961 1#0##0#0#0.0#2018-
05-31 11:02:00#0#00:00:00#00:00:00#00:00:00 1
5fb93f4e7937eff5dc3b8d43802331bc 0 0 962300 0 0 744150
0 0 0 0 2363417 0 0 0 0 1714500
3201126 B 1 BS 1 16/04/2018 21/04/2018 09/11/1993 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 17462630 0 6 0 0 0 LIDIYA FINDA PERMATA
0001636613346 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172066
1#0##0#0#0.0#2018-05-31 11:16:30#0#12:59:13#12:59:13#00:00:00 2
68c133be306456b1412cf8743fe5bc84 0 9250200 3325850 0 0
3582810 0 0 0 0 1234770 0 0 0 0 69000
3201126 B 1 BS 1 20/04/2018 21/04/2018 25/04/1961 0 2
3247500 0 0 - 0 - 0 - 0 - 0
3247500 6077315 0 2 0 0 0 SULASTRI d307421
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173969
1#0##0#0#0.0#2018-06-05 10:44:38#0#21:12:17#21:12:17#00:00:00 2
8da47327105a8dc2c28ed84cf6c55746 0 0 962300 0 0 837934
0 0 0 0 2562581 0 0 0 0 1714500
3201126 B 1 BS 1 19/04/2018 21/04/2018 15/04/2018 3000 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3109612 0 3 0 0 0 M ARZAN FIRAZ
0002449789053 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 173780
1#0##0#0#0.0#2018-06-05 10:50:52#0#22:26:09#22:26:09#00:00:00 1
d4a697e46957eae6586dc5b267615a19 0 0 382013 0 0 160666
0 0 0 0 2226933 0 0 0 0 340000
3201126 B 1 BS 1 17/04/2018 21/04/2018 28/08/1958 0 2
1 E87.1;R10.4;I10;I69.4;N39.8 90.59;89.52 - - None None None
None E-4-11-I None None None None None None HIPOVOLEMIA & GANGGUAN
ELEKROLIT (RINGAN) 4136800 0 0 - 0 - 0 - 0
- 0 4136800 9698820 0 5 0 0 0 NY.KUSNANI
PUJOGIRI D258422 59 21782 DR BETTY DWI L, SPPD 0138R0170418V005949
0000036145001 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 172839
1#1#vvip#5#5562020#0.0#2018-06-05 10:55:04#0#20:53:01#20:53:01#12:00:00
1 1256c369702e5aaf9295783beafb69ab 0 0 704546 0 0
3233772 0 0 0 0 5760502 0 0 0 0 0
3201126 B 3 BS 1 19/04/2018 21/04/2018 26/09/1981 0 2
1 N85.0 - - - None None None None W-4-12-I None None
None None None None GANGGUAN MENSTRUASI & SISTEM REPRODUKSI WANITA LAIN-
LAIN (RINGAN) 2809400 0 0 - 0 - 0 - 0 -
0 2809400 2207244 0 3 0 0 0 RIZTY SEPTRIAN
0001167788362 3;JKN irene; 5.2.2.201806040537 4 173770
1#0##0#0#0.0#2018-08-11 13:48:28#0#17:31:21#17:31:21#00:00:00 2
b515dc3acb09df300adcdbda9f2a6712 0 0 554865 0 0 692980
0 0 0 0 959399 0 0 0 0 0
3201126 B 2 BS 1 20/04/2018 21/04/2018 01/01/1950 0 1
1 T82.4;I12.0;E14.9 38.95;99.21 - - None None None None N-1-
- 0 10690500 9615355 0 2 0 0 0 MISWAR
0138R0170418V007026 0001883606286 3;JKN DR RIZKI; 5.2.2.201806040537
4 173911 1#0##0#0#0.0#2018-08-23
11:00:40#0#15:55:39#15:55:39#12:00:00 3 62d86d2a3901510bea593708fa149134
0 6677900 1041720 0 0 1156193 0 0 0 0
705042 0 0 0 0 34500
3201126 B 3 BS 1 21/04/2018 21/04/2018 03/04/1951 0 2
1 I95.9;E87.6;I20.0 89.52 - - None None None None I-4-24-II
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 4051370 0 1 0 0 0 HARTINI NY D396561
67 24490 DR RENDRA RAMADYA 0138R0170418V007309 0000040939108 3;JKN
DR RIZKI; 5.2.2.201806040537 4 173976 1#0##0#0#0.0#2018-08-23
11:16:30#0#06:53:21#06:53:21#00:00:00 2 f4d36d9959765b10a4805e00d25699c1
0 0 811197 0 0 2686130 0 0 0 0 554043
0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 21/04/2018 04/06/1957 0 2
None K-4-12-I None None None None None None GANGGUAN ESOFAGUS
(RINGAN) 4136800 0 0 - 0 - 0 - 0 - 0
4136800 6742909 0 2 0 0 0 AISYAH D378911
3;JKN DR RIZKI; 5.2.2.201806040537 4 173967 1#0##0#0#0.0#2018-
09-04 16:29:22#0#20:23:59#20:23:59#00:00:00 3
6feb7df830e55d96b8f69528f567300d 0 0 1274304 0 0 816280
0 0 0 0 2951625 0 0 0 0 1700700
3201126 B 1 BS 1 18/04/2018 21/04/2018 18/12/1985 0 2
1 K80.1;K83.1 51.22 - - None None None None B-1-12-II None
None None None None None CHOLESISTEKTOMI TANPA LAPAROSKOPIK (SEDANG)
10960600 0 0 - 0 - 0 - 0 - 0
10960600 16126745 0 4 0 0 0 DIAH CHRISTININGRUM
0001338600115 3;JKN DR RIZKI; 5.2.2.201806040537 4 173007
1#0##0#0#0.0#2018-09-26 21:02:52#0#10:17:07#10:17:07#12:00:00 2
ddeb4731897ca72562123c010604c884 0 7850200 3178574 0 0
3684450 0 0 0 0 1196021 0 0 0 0 217500
3201126 B 1 BS 1 20/04/2018 21/04/2018 17/09/1972 0 1
None None None None KATETERISASI JANTUNG (RINGAN) 6357300 0 0
- 0 - 0 - 0 - 0 6357300 12407677 0
2 0 0 0 MOSHE BONNAVENA KADI D396158 45 16651 DR
RIZKI; 5.2.2.201806040537 4 173847 1#0##0#0#0.0#2018-09-26
21:04:58#0#15:21:10#15:21:10#00:00:00 2 4e104592fabc57a41f744fcf644b74a1
0 4795000 1271460 0 0 3378500 0 0 0 0
893717 0 0 0 0 2069000
3201126 B 1 BS 1 20/04/2018 21/04/2018 19/11/1954 0 2
0 - 0 - 0 - 0 - 0 17095200 12723969
0 2 0 0 0 MULYATINI ,NY D285233 63 23163 DR
RIZKI; 5.2.2.201806040537 4 173841 1#0##0#0#0.0#2018-09-28
10:35:57#0#15:20:03#15:20:03#12:00:00 2 773c3b7e2ae2c6401f1aff0b88434152
0 4795000 1775560 0 0 3176000 0 0 0 0
908409 0 0 0 0 2069000
3201126 B 2 BS 1 20/04/2018 21/04/2018 01/08/1958 0 1
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
0 5208600 8474379 0 2 0 0 0 SUNARDI
0138R0170418V007019 0001607940213 3;JKN DR RIZKI; 5.2.2.201806040537
4 174444 1#0##0#0#0.0#2018-09-28
10:50:31#0#15:22:24#15:22:24#12:00:00 2 bc3d0d22b6c714f55698003b83cd3b0e
0 4911100 1128530 0 0 1735350 0 0 0 0
630399 0 0 0 0 69000
3201126 B 1 BS 1 20/04/2018 21/04/2018 03/10/1944 0 2
1 I25.0;E13.9;I11.9 88.55 - - None None None None I-1-15-I
0 0 - 0 - 0 - 0 - 0 6357300
12420795 0 2 0 0 0 DRA. SYAULIAH D042150 73
3;JKN DR RIZKI; 5.2.2.201806040537 4 174601 1#0##0#0#0.0#2018-
09-28 13:58:34#0#00:00:00#00:00:00#00:00:00 2
8557cea707cfc4524bda3dd06148ca74 0 4795000 1271460 0 0
3396760 0 0 0 0 888575 0 0 0 0
2069000
3201126 B 1 BS 1 19/04/2018 21/04/2018 22/01/1960 0 2
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 12026769 0 3 0 0 0 MAHDALIANA MANIHURUK
0000038347132 3;JKN DR RIZKI; 5.2.2.201806040537 4 173267
1#0##0#0#0.0#2018-09-28 13:59:47#0#01:19:43#01:19:43#00:00:00 2
2308a8e7b852dc90b0a4ca5ea0101bf3 0 6587000 1935837 0 0
2572134 0 0 0 0 862798 0 0 0 0 69000
3201126 B 1 BS 1 20/04/2018 21/04/2018 19/02/1960 0 1
1 I25.0;I11.0;K30 88.55 - - None None None None I-1-15-III
0 0 - 0 - 0 - 0 - 0 17095200
12656399 0 2 0 0 0 MUSRAD HABIB D361455 58
3;JKN DR RIZKI; 5.2.2.201806040537 4 174050 1#0##0#0#0.0#2018-
10-01 15:29:02#0#00:00:00#00:00:00#00:00:00 2
467813784b0b79d48f08dda62ef92e83 0 4777000 1775560 0 0
3130850 0 0 0 0 903989 0 0 0 0
2069000
3201126 B 3 BS 1 20/04/2018 22/04/2018 20/04/2018 2494 2
(RINGAN) 5483600 0 0 - 0 - 0 - 0 - 0
5483600 1175527 0 3 0 0 0 NANI SUNARSIH BY NY
0002318662809 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173879
1#0##0#0#0.0#2018-05-14 08:38:19#0#15:33:21#15:33:21#00:00:00 1
5769294fabc328cfc312b065007c8e95 0 0 532524 0 0 126499
0 0 0 0 516504 0 0 0 0 0
3201126 B 3 BS 1 21/04/2018 22/04/2018 01/04/1963 0 2
1 E11.2;I10 39.42 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 12908420 0 2 0 0 0 MASAMAH
0000368760791 3;JKN DR RIZKI; 5.2.1.201804062320 4 174245
1#0##0#0#0.0#2018-05-14 15:09:03#0#18:09:06#18:09:06#12:00:00 1
768009188c594a30eb54f7af476a8c4e 0 3352300 5659396 0 0
2907248 0 0 0 0 920476 0 0 0 0 69000
3201126 B 3 BS 1 22/04/2018 22/04/2018 19/07/1965 0 1
- 0 - 0 - 0 - 0 4043000 2777573 0
1 0 0 0 UJANG TUTANG D396691 52 19270 DR ADRIAN
HANDARU 0138R0170418V007445 0001428907588 3;JKN DR RIZKI;
5.2.1.201804062320 4 174713 1#0##0#0#0.0#2018-05-14
15:52:11#0#00:00:00#00:00:00#00:00:00 1 ff2b3bbcf6b38be2006c2fb2000b8710
0 0 936171 0 0 1224692 0 0 0 0 488710
0 0 0 0 128000
3201126 B 1 BS 1 19/04/2018 22/04/2018 30/04/2014 0 2
0 0 - 0 - 0 - 0 - 0 3695000
3542921 0 4 0 0 0 KEIRA ANGGI NATHANIA PASARIBU
0001338242624 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173783
1#0##0#0#0.0#2018-05-15 07:53:46#0#23:38:48#23:38:48#00:00:00 1
20dcdb3ca7240906542b6d7a9d289bdc 0 0 231209 0 0 710932
0 0 0 0 2600780 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 22/04/2018 18/03/2017 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3859917 0 3 0 0 0 ALYA AMIRA PUTRI
0002233789176 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173786
1#0##0#0#0.0#2018-05-15 08:50:11#0#02:44:23#02:44:23#00:00:00 1
5ab78f2153ab57739bf20b525d1644b4 0 0 298025 0 0 940374
0 0 0 0 2621518 0 0 0 0 0
3201126 B 1 BS 1 21/04/2018 22/04/2018 25/11/1962 0 2
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 11897723 0 2 0 0 0 SRI IRIYANTI
d396564 55 20236 DR BETTY DWI L, SPPD 0138R0170418V007332
0001340225482 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173987
1#0##0#0#0.0#2018-05-15 08:55:16#0#08:23:54#08:23:54#00:00:00 1
dc317db9c5b401d066bdb11c3c980e65 0 6648200 1815243 0 0
2510924 0 0 0 0 854356 0 0 0 0 69000
3201126 B 2 BS 1 20/04/2018 22/04/2018 16/11/1983 0 1
1 N18.5;I50.0;D63.8 38.95;99.04;39.95 - - None None None None
- 0 - 0 10690500 18803989 0 3 0 0 0
AHMAD DZULFAHMI RIDHO D396477 34 12574 DR. ARU ARIADNO, SPPD
0138R0170418V006941 0001515749152 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 173959 1#0##0#0#0.0#2018-05-15
14:39:19#0#00:00:00#00:00:00#00:00:00 1 f147307a0540f04f9aa99447071a6c82
0 0 3153245 0 0 7189144 0 0 0 0
8392600 0 0 0 0 69000
3201126 B 2 BS 1 18/04/2018 22/04/2018 25/03/2018 0 1
1 P59.9;Q43.1 99.82 - - None None None None B-4-13-II None
None None None None None GANGGUAN HATI LAIN-LAIN (SEDANG) 5877400
0 0 - 0 - 0 - 0 - 0 5877400
8755988 0 5 0 0 0 MUHAMMAD SAHIL MUWAHHID D396329
0 24 DR AULIA TANGKARI, SPA 0138R0170418V006372 0002450581604
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173262
1#0##0#0#0.0#2018-05-15 14:41:10#0#20:20:31#20:20:31#00:00:00 1
261998a4344d1e6fc08e37a4a673a939 0 0 640740 0 0
2632926 0 0 0 0 3690322 0 0 0 0
1792000
3201126 B 2 BS 1 15/04/2018 22/04/2018 11/05/1932 0 2
1 I20.0;I11.0;E87.5;J18.9;I21.9 93.94 - - None None None None
DADA (BERAT) 8448000 0 0 - 0 - 0 - 0 -
0 8448000 15211797 0 8 0 0 0 DJAMILAH HJ NY
D396056 85 31385 DR BAMBANG DWIPUTRA SPJP 0138R0170418V004977
0000060809455 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 171613
1#0##0#0#0.0#2018-05-31 10:14:38#0#10:38:42#10:38:42#00:00:00 1
d31e7eab836e5751784f87e0429d9305 0 0 649840 0 0
5679293 0 0 0 0 6360664 0 0 0 0
2522000
3201126 B 1 BS 1 19/04/2018 22/04/2018 28/12/1956 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4832228 0 4 0 0 0 WIDODO SLAMET BASUKI
0000045095049 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173781
1#0##0#0#0.0#2018-05-31 10:21:39#0#22:56:48#22:56:48#00:00:00 1
9e157e3051ff8d4304504ef461f40f67 0 0 269459 0 0 996642
0 0 0 0 3566127 0 0 0 0 0
3201126 B 3 BS 1 19/04/2018 22/04/2018 03/09/1953 0 2
2944000 0 0 - 0 - 0 - 0 - 0
2944000 1839396 0 4 0 0 0 ILOH MARYAMAH
0001771603997 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173774
1#0##0#0#0.0#2018-05-31 10:24:04#0#19:24:54#19:24:54#00:00:00 1
d06c25167b9a0a892c45435fb8324973 0 0 317960 0 0 409602
0 0 0 0 1111834 0 0 0 0 0
3201126 B 1 BS 1 21/04/2018 22/04/2018 12/07/1983 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6721356 0 2 0 0 0 JULIVIANNI BR. PANGKAR
d396482 34 12702 DR FERRY SPOG 0138r0170418v007368
0001643677582 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174165
1#0##0#0#0.0#2018-05-31 10:26:09#0#12:45:47#12:45:47#00:00:00 1
9f5f333803442f0fd87ba73820161033 0 0 1247824 0 0
1416817 0 0 0 0 3911715 0 0 0 0 145000
3201126 B 2 BS 1 19/04/2018 22/04/2018 25/07/1985 0 2
1 A49.9;K59.0;K36 88.76 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 4489233 0 4 0 0 0 EKA YULIANTI
0001135492176 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173782
1#0##0#0#0.0#2018-05-31 10:55:34#0#23:24:28#23:24:28#00:00:00 1
0a4b16f5200d1a07c3f6ebf30535bd34 0 0 209906 0 0
1939639 0 0 0 0 2339688 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 22/04/2018 14/01/1990 0 1
5480800 0 0 - 0 - 0 - 0 - 0
5480800 3181470 0 3 0 0 0 HARIODO TRI REZKI
0001628171357 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173958
1#0##0#0#0.0#2018-05-31 11:01:06#0#18:24:20#18:24:20#00:00:00 1
c3048a5c2c33e7ce7e532adf52f08035 0 0 546272 0 0 403564
0 0 0 0 2231634 0 0 0 0 0
3201126 B 1 BS 1 19/04/2018 22/04/2018 15/07/1985 0 1
1 A01.0;A91;B17.8 90.59 - - None None None None A-4-14-III
LAIN-LAIN (BERAT) 4626600 0 0 - 0 - 0 - 0 -
0 4626600 5063963 0 4 0 0 0 FARHAN HARYANATA
0000148311819 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173771
1#0##0#0#0.0#2018-05-31 11:07:04#0#17:33:53#17:33:53#00:00:00 1
55ab04097088f9993cdcdecb2aa3b037 0 0 469394 0 0
1113282 0 0 0 0 3481287 0 0 0 0 0
3201126 B 2 BS 1 20/04/2018 22/04/2018 14/09/1981 0 1
1 R51;R50.9 90.59;87.49;89.52 - - None None None None G-4-
23-I None None None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN)
3180100 0 0 - 0 - 0 - 0 - 0
3180100 3754445 0 3 0 0 0 FATHUROZIQIN
0002432604475 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173906
1#0##0#0#0.0#2018-05-31 11:09:42#0#15:53:26#15:53:26#00:00:00 1
3944eef59850d5a3f21102c07a0673c8 0 0 338039 0 0
1629788 0 0 0 0 1786618 0 0 0 0 0
3201126 B 3 BS 1 19/04/2018 22/04/2018 12/04/1968 0 1
1 E10.1;N39.8;A01.0;I10;E87.6;E16.2 90.59;89.52 - - None None
- 0 - 0 - 0 6262900 7243858 0 4 1
0 1 BUDIMAN D393779 50 18269 DR BETTY DWI L, SPPD
0138R0170418V006385 0001014219191 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 173269 1#0##0#0#0.0#2018-06-05
10:49:40#0#00:00:00#00:00:00#12:00:00 1 654c0fe0b4e0d5bd053f326e4ca962b4
0 0 616661 0 0 3877300 0 0 0 0
2161897 0 0 0 0 588000
3201126 B 3 BS 1 20/04/2018 22/04/2018 10/10/1983 0 2
10326200 0 0 - 0 - 0 - 0 - 0
10326200 15075478 0 3 0 0 0 RAYNA ANGELA MAKARTI
0001735361842 3;JKN irene; 5.2.2.201806040537 4 174255
1#0##0#0#0.0#2018-08-11 13:47:38#0#00:00:00#00:00:00#00:00:00 2
8a1c058458d452cc40376d210d9b79f7 0 0 2621588 0 0
6716144 0 0 0 0 5592746 0 0 145000 0
0
3201126 B 3 BS 1 01/04/2018 22/04/2018 28/03/2018 1980 1
1 Q42.3;P36.9;P74.4;P61.0 54.11;46.11;96.72 - - None None None
- 0 - 0 - 0 40034400 86903009 0 22 1
6 100 BAYI NY DEWI KOMALA SARI D394770 0 4 DR CATUR
SUZANTARA 0138R01704180000458 0002438966193 3;JKN DR RIZKI;
5.2.2.201806040537 4 167027 1#0##0#0#0.0#2018-08-23
10:13:36#0#12:00:00#12:00:00#12:00:00 3 6f8f860bc34a9e6f785c67d4a4da9838
0 0 5603616 0 0 26231693 0 0 0 0
27562700 0 0 0 0 27505000
3201126 B 1 BS 1 21/04/2018 22/04/2018 22/06/1953 0 2
4 I21.2;E11.9;I25.0;I08.9 88.55;36.07 - - YY02 None None None
- 0 46734600 72193412 0 2 0 0 0 JUNIARTIE
HARTONO NY D396556 64 23679 DR EKA GINANJAR SPPD 0138R0170418V007305
0001460301726 3;JKN DR RIZKI; 5.2.2.201806040537 4 173974
1#0##0#0#0.0#2018-08-23 10:34:48#0#01:59:18#01:59:18#00:00:00 2
3b41f111bf8bc03c9d368a45a76cf7d4 0 10426000 3056220 0 0
49860192 0 0 0 0 1282000 0 0 0 0
7569000
3201126 B 1 BS 1 21/04/2018 22/04/2018 27/11/1979 0 1
- 0 12472300 10664571 0 2 0 0 0 DEDY
0000164837531 3;JKN DR RIZKI; 5.2.2.201806040537 4 174243
1#0##0#0#0.0#2018-08-23 10:39:32#0#16:25:03#16:25:03#12:00:00 3
edfa66a683e6e75d77f178424829d346 0 5730500 1398426 0 0
2747463 0 0 0 0 753682 0 0 0 0 34500
3201126 B 1 BS 1 20/04/2018 22/04/2018 21/03/1965 0 2
1 K51.9;E11.9;N39.9 45.23 - - None None None None K-4-13-I
0 - 0 - 0 5576700 8678500 0 3 0 0
0 CICIH WARDANINGSIH d395240 53 19388 DR BETTY DWI L, SPPD
0138R0170418V006820 0001303917748 3;JKN DR RIZKI; 5.2.2.201806040537
4 174017 1#0##0#0#0.0#2018-09-04
15:55:37#0#00:00:00#00:00:00#00:00:00 2 56a16a8de7d909993e1027cb63b63a03
0 0 1971616 0 0 1348632 0 0 0 0
3609252 0 0 0 0 1749000
3201126 B 2 BS 1 18/04/2018 22/04/2018 10/04/1969 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 14918601 0 5 0 0 0 ARI WATI D396370
3;JKN DR RIZKI; 5.2.2.201806040537 4 173264 1#0##0#0#0.0#2018-
09-28 10:43:34#0#21:44:50#21:44:50#00:00:00 2
282abedb25ef19aa71a09f5e09c944cd 0 5269100 4069918 0 0
4426600 0 0 0 0 1007983 0 0 0 0 145000
3201126 B 3 BS 1 22/04/2018 22/04/2018 20/02/1950 0 2
4 I63.9;A41.9;R57.0 87.03;99.60 - - None None None None G-4-
- 0 8672200 4756465 0 1 0 0 0 IYUS
RISNAWATI D394830 68 24898 DR RICO ADITYA 0138R0170418V007424
0000062888534 3;JKN DR RIZKI; 5.2.2.201806040537 4 174250
1#0##0#0#0.0#2018-09-28 11:06:00#0#02:16:02#02:16:02#12:00:00 2
90ddfcc54d225c33bcc56d36d3a4f3f0 0 0 780498 0 0
2769796 0 0 0 0 618171 0 0 0 0 588000
3201126 B 3 BS 1 20/04/2018 22/04/2018 22/08/1978 0 2
0 0 - 0 - 0 - 0 - 0 4986800
8458370 0 3 0 0 0 NANI SUNARSIH D396475 39
14486 DR FAHMIALDI, SPOG 0138R0170418V006986 0002318653978 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 173861 1#0##0#0#0.0#2018-
09-28 13:25:24#0#15:26:52#15:26:52#00:00:00 2
6d1b64614a50fd909bf307b0f3fdf075 0 3534500 1814644 0 0
2129875 0 0 0 0 654351 0 0 0 0 325000
3201126 B 3 BS 1 21/04/2018 22/04/2018 28/02/1955 0 1
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 6522799 0 2 0 0 0 K A R D I
0138R0170418V007356 0002273332577 3;JKN DR RIZKI; 5.2.2.201806040537
4 180189 1#0##0#0#0.0#2018-09-28
14:01:16#0#00:00:00#00:00:00#12:00:00 2 f7d831493247904f4873b0153cab011b
0 3062500 2138112 0 0 0 0 0 0 0 804962
0 0 0 90500 426725
3201126 B 3 BS 1 17/04/2018 23/04/2018 16/07/1977 0 2
1 D26.1;K66.0;N80.8;D63.0;A41.9 68.49;65.49;47.09;54.59 - - None
None None None K-1-11-III None None None None None None ADHESIOLISIS
PERITONEAL (BERAT) 19360200 0 0 - 0 - 0 - 0
- 0 19360200 26326669 0 7 0 0 0 NY AYANIH
D393885 40 14885 DR FERRI SABARUDDIN SPOG 84N5050000170418
3276065607770002 3;JKN DR RIZKI; 5.2.1.201804062320 4 174443
1#0##0#0#0.0#2018-05-04 15:11:50#0#15:14:50#15:14:50#00:00:00 1
c87974407bfd5cd377e9651d43858ca5 0 6851000 3721725 0
2634000 11808944 0 0 0 0 1311000 0 0 0
0 0
3201126 B 3 BS 1 21/04/2018 23/04/2018 26/11/2014 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 2563351 0 3 0 0 0 RAFANDRA ALKHALIFI AQLAN
KAMIL D396576 3 1242 DR KRISTON SILITONGA, SPA 0138R0170418V007357
0002043996827 3;JKN DR RIZKI; 5.2.1.201804062320 4 174082
1#0##0#0#0.0#2018-05-14 15:11:28#0#10:38:55#10:38:55#00:00:00 1
12495cd14a2d457b352bca27757fbb2b 0 0 378188 0 0 862467
0 0 0 0 982696 0 0 0 0 340000
3201126 B 3 BS 1 20/04/2018 23/04/2018 02/12/1973 0 2
0 0 - 0 - 0 - 0 - 0 6781600
3251672 0 4 0 0 0 SANIMAH D378889 44 16210
DR BETTY DWI L, SPPD 0138R0170418V007036 0000512943816 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 173840 1#0##0#0#0.0#2018-
05-14 15:15:35#0#15:19:57#15:19:57#12:00:00 1
d43eed7e605b0aab32d7969271b1fe3e 0 0 663344 0 0
1297602 0 0 0 0 1290726 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 23/04/2018 16/09/1961 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 7160951 0 4 0 0 0 NURAYA SITORUS
0001300218851 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173968
1#0##0#0#0.0#2018-05-14 15:17:03#0#21:08:13#21:08:13#00:00:00 1
65704f7067e44309e5011169775bbf4a 0 0 573641 0 0
2968837 0 0 0 0 3618473 0 0 0 0 0
3201126 B 3 BS 1 18/04/2018 23/04/2018 24/06/2013 0 1
0 0 - 0 - 0 - 0 - 0 2392700
5310282 0 6 0 0 0 AKHTAR FADHIL ZAKI D377828
4 1759 DR OTTY MITHA S, SPA 0138R0170418V005972 0001454077179
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 172851
1#0##0#0#0.0#2018-05-14 15:19:34#0#00:00:00#00:00:00#12:00:00 1
6930838e8c6fe15e7ab7a7ada59f5cad 0 0 207620 0 0
3151260 0 0 0 0 1951402 0 0 0 0 0
3201126 B 2 BS 1 21/04/2018 23/04/2018 05/02/1943 0 1
(RINGAN) 4203300 0 0 - 0 - 0 - 0 - 0
4203300 3398429 0 3 0 0 0 USUP D351940 75
TANTIYO S;16137 5.2.1.201804062320 4 174237 1#0##0#0#0.0#2018-
05-14 15:27:57#0#16:04:06#16:04:06#00:00:00 1
661decf14056450876a9bf7e3d5ff2e5 0 0 431297 0 0
1411305 0 0 0 0 1555827 0 0 0 0 0
3201126 B 1 BS 1 21/04/2018 23/04/2018 04/08/1954 0 2
5879800 0 0 - 0 - 0 - 0 - 0
5879800 4246199 0 3 0 0 0 HERMINA KASMIYATUN NY
0000041904347 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173975
1#0##0#0#0.0#2018-05-14 15:29:56#0#06:35:01#06:35:01#00:00:00 1
d0e8c553b498203d1db536d27e13aa98 0 0 338858 0 0
1260552 0 0 0 0 2646789 0 0 0 0 0
3201126 B 1 BS 1 22/04/2018 23/04/2018 10/08/1980 0 2
0 - 0 - 0 - 0 - 0 9150100 4959300
0 2 0 0 0 SONNYA MARIA TOKAN PHILIP D394213 37
13769 RACHMAWATI DR,SPB(K)ONK 0138R0170418V007470 0001646390305 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 174265 1#0##0#0#0.0#2018-
05-14 15:33:28#0#20:36:23#20:36:23#00:00:00 1
e807cb0682c5c9e4831473131e20c087 0 0 1307160 0 0
1739700 0 0 0 0 1912440 0 0 0 0 0
3201126 B 3 BS 1 21/04/2018 23/04/2018 14/04/1944 0 2
1 A01.0;K29.7;A41.9 - - - None None None None A-4-14-III
LAIN-LAIN (BERAT) 3304700 0 0 - 0 - 0 - 0 -
0 3304700 2614286 0 3 0 0 0 DEMI D396664
TANTIYO S;16137 5.2.1.201804062320 4 174246 1#0##0#0#0.0#2018-
05-14 15:44:37#0#19:57:39#19:57:39#00:00:00 1
4734cecb6b6bdec6296545b81f2d1113 0 0 350423 0 0
1364335 0 0 0 0 899528 0 0 0 0 0
3201126 B 2 BS 1 19/04/2018 23/04/2018 29/06/1987 0 2
1 A91;K30 - - - None None None None A-4-13-I None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 5604552 0 5 0 0 0 SYNDI D152162 30
11252 DR ARU, SPPD 0138R0170418V006694 0001866221695 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 173707 1#0##0#0#0.0#2018-
05-14 15:52:25#0#15:40:06#15:40:06#00:00:00 1
92d120d3691089cc61f6633f8ba6f4a6 0 0 278711 0 0
2408188 0 0 0 0 2917653 0 0 0 0 0
3201126 B 3 BS 1 20/04/2018 23/04/2018 05/06/1970 0 2
1 K74.6;E11.6;R77.0;R18 54.91 - - None None None None B-4-
13-II None None None None None None GANGGUAN HATI LAIN-LAIN (SEDANG)
4897800 0 0 - 0 - 0 - 0 - 0
4897800 3127805 0 4 0 0 0 MASKUNA D393070
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173851
1#0##0#0#0.0#2018-05-14 16:00:19#0#15:23:03#15:23:03#12:00:00 1
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1151380 0 0 0 0 1282623 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 23/04/2018 28/03/1977 0 1
1 R50.9;R06.0 - - - None None None None A-4-12-I None
3695000 0 0 - 0 - 0 - 0 - 0
3695000 5623177 0 4 0 0 0 TONI TUMPAL SAGALA TN
0001309255097 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173785
1#0##0#0#0.0#2018-05-14 16:02:44#0#02:12:05#02:12:05#00:00:00 1
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1788975 0 0 0 0 3517871 0 0 0 0 0
3201126 B 2 BS 1 21/04/2018 23/04/2018 16/05/1981 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10162069 0 3 0 0 0 RINA SILVIA D396622 36 13489
DR ARIS WAHJU, SPOG 0138R0170418V007392 0000059683893 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 174233 1#0##0#0#0.0#2018-
05-14 16:03:53#0#15:19:51#15:19:51#00:00:00 1
72e2401894ceba8ed7cea27beed086f9 0 5062400 2090753 0 0
1898108 0 0 0 0 785808 0 0 0 0 325000
3201126 B 2 BS 1 21/04/2018 23/04/2018 21/04/2018 2904 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1233723 0 3 0 0 0 BAYI NY RINA SILVIA
0002452197183 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174450
1#0##0#0#0.0#2018-05-15 10:45:37#0#15:48:36#15:48:36#00:00:00 1
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3201126 B 2 BS 1 22/04/2018 23/04/2018 29/01/1985 0 2
0 - 0 - 0 - 0 - 0 3545800 5382947
0 2 0 0 0 RIANTI D301153 33 12136 DR ZULFAN,
SPPD 0138R0170418V007454 0001327937398 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 174436 1#0##0#0#0.0#2018-05-15
14:34:59#0#14:57:34#14:57:34#00:00:00 1 8a81dff0858fc376013c0c28c55d14a1
0 0 827372 0 0 690420 0 0 0 0
2150655 0 0 0 0 1714500
3201126 B 2 BS 1 19/04/2018 23/04/2018 18/10/2015 0 1
1 B34.9;A09.9 - - - None None None None A-4-13-I None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4132783 0 5 0 0 0 IMANUEL AFFERA SETIAWAN
D313104 2 914 DR RASTRA, SPA 0138R0170418V006383
0001895457374 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173270
1#0##0#0#0.0#2018-05-15 14:54:41#0#00:00:00#00:00:00#12:00:00 1
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1032703 0 0 0 0 2821369 0 0 0 0 0
3201126 B 2 BS 1 22/04/2018 23/04/2018 29/01/1985 0 2
0 - 0 - 0 - 0 - 0 3545800 5382947
0 2 0 0 0 RIANTI D301153 33 12136 DR ZULFAN,
SPPD 0138R0170418V007464 0001327937398 3;JKN irene; 5.2.1.201804062320
4 174436 1#0##0#0#0.0#2018-05-16
18:27:05#0#14:57:34#14:57:34#00:00:00 2 ce438810dac0981a50e6fc0f4039d945
0 0 827372 0 0 690420 0 0 0 0
2150655 0 0 0 0 1714500
3201126 B 1 BS 1 22/04/2018 23/04/2018 19/09/1949 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 12206460 0 2 0 0 0 SUHAIRI D392588
0000039905943 3;JKN irene; 5.2.1.201804062320 4 174257
1#0##0#0#0.0#2018-05-17 09:47:40#0#00:00:00#00:00:00#12:00:00 2
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1673355 0 0 0 0 874553 0 0 0 0 197000
3201126 B 2 BS 1 19/04/2018 23/04/2018 15/11/1972 0 1
1 I63.9;N39.0;D45;I10;E13.9 87.03 - - None None None None
0 - 0 8291400 9562065 0 5 0 0 0
ROLANDO ATJE D059489 45 16591 DR. ARU ARIADNO, SPPD
0138R0170418V006607 0001388652873 3;JKN irene; 5.2.1.201804062320
4 173699 15#0##0#0#0.0#2018-05-17
09:50:41#1#15:36:35#15:36:35#00:00:00 2 93cc92583a77d7925e516e1db120858a
0 0 1049760 0 0 0 0 0 0 0 2112480
0 0 0 6399825 0
3201126 B 3 BS 1 21/04/2018 23/04/2018 04/01/2007 0 2
- 0 - 0 - 0 - 0 5838600 4334438 0
3 0 0 0 SALWA CINTA MADINA D378250 11 4125 DR
RASTRA, SPA 0138R0170418V007394 0001872023591 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 174236 1#0##0#0#0.0#2018-05-31
11:30:12#0#15:30:31#15:30:31#12:00:00 1 e83ea3dbbe9c22efc79b966c8af763c9
0 0 458183 0 0 2777694 0 0 0 0
1098561 0 0 0 0 0
3201126 B 2 BS 1 20/04/2018 23/04/2018 30/12/1955 0 2
1 I63.9;I11.0;J80;G31.9;A41.9 - - - None None None None
0 - 0 10406600 15872331 0 4 1 3 0 SARNI
0000061040204 3;JKN irene; 5.2.1.201804062320 4 173784
5#0##0#0#0.0#2018-06-05 12:41:12#0#00:26:47#00:26:47#00:00:00 2
6b849145816a46395e52b97a58e81d64 0 0 1001992 0 0
9032462 0 0 0 0 4015877 0 0 0 0
1822000
3201126 B 1 BS 1 19/04/2018 23/04/2018 16/03/1964 0 2
1 K30;R63.0;H81.3 90.59;89.52 - - None None None None K-4-
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 6676921 0 5 0 0 0 SRI HARYANTI
0001273811027 3;JKN irene; 5.2.2.201806040537 4 173571
1#0##0#0#0.0#2018-08-11 13:42:26#0#14:31:34#14:31:34#12:00:00 2
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1970255 0 0 0 0 4367808 0 0 0 0 0
3201126 B 1 BS 1 20/04/2018 23/04/2018 02/11/1955 0 1
1 I21.9;I47.1;J18.9;I11.0 88.55 - - None None None None I-1-
17095200 0 0 - 0 - 0 - 0 - 0
17095200 17880578 0 4 1 1 0 WAHIDI D396467
0000037304537 3;JKN DR RIZKI; 5.2.2.201806040537 4 173973
1#0##0#0#0.0#2018-08-21 10:02:16#0#00:07:38#00:07:38#00:00:00 2
2e334848a93b7e80634f1a7c4ca85db0 0 5811000 3472040 0 0
5282781 0 0 0 0 1245757 0 0 0 0
2069000
3201126 B 1 BS 1 22/04/2018 23/04/2018 25/12/1965 0 2
1 I63.9;I20.0;A41.9;E14.7;J80 96.71 - - None None None None
- 0 40790100 18310010 0 2 1 2 48 MAEMUNAH
0001434491504 3;JKN DR RIZKI; 5.2.1.201804062320 4 174252
1#0##0#0#0.0#2018-09-05 16:26:48#0#03:25:28#03:25:28#00:00:00 2
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8393050 0 0 0 0 3291851 0 0 0 0
2700000
3201126 B 2 BS 1 22/04/2018 23/04/2018 04/06/1959 0 2
- 0 - 0 - 0 - 0 3545800 6827263 0
2 0 0 0 NUR AINI D394324 58 21507 DR ZULFAN, SPPD
0138R0170418V007461 0001257722368 3;JKN DR RIZKI; 5.2.2.201806040537
4 174263 1#0##0#0#0.0#2018-09-05
18:24:45#0#17:48:09#17:48:09#12:00:00 3 fff57a48eabdaf2e124b485a5dac6ffe
0 0 1045824 0 0 1406796 0 0 0 0
2660143 0 0 0 0 1714500
3201126 B 1 BS 1 23/04/2018 24/04/2018 14/12/1955 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
0000060481574 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174470
1#0##0#0#0.0#2018-05-08 16:32:14#0#20:02:56#20:02:56#00:00:00 1
5a6337d8ac3c1e04bd72ecd9ba356ec6 0 0 520641 0 0
1961400 0 0 0 0 2740405 0 0 0 0 0
3201126 B 1 BS 1 22/04/2018 24/04/2018 30/05/1962 0 1
1 A09.9;E11.9;I25.0;Q21.0 89.52 - - None None None None K-4-
17-II None None None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 8950052 0 3 0 0 0 BUDI MANDALA
0001623402461 3;JKN DR RIZKI; 5.2.1.201804062320 4 174889
1#1#vip#3#2221425#75.0#2018-05-11 08:57:08#0#19:26:58#19:26:58#00:00:00
1 4730055d970256097f16c6a5d30f42a7 0 0 519499 0 0
3994036 0 0 0 0 4436517 0 0 0 0 0
3201126 B 3 BS 1 23/04/2018 24/04/2018 07/02/1981 0 2
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 5044952 0 2 0 0 0 DIANA BATARA MUNTI
0001193545089 3;JKN DR RIZKI; 5.2.1.201804062320 4 174477
1#0##0#0#0.0#2018-05-11 15:13:53#0#23:12:14#23:12:14#00:00:00 1
5f01eff003d8949c65555b24f6d75164 0 2207000 872168 0 0
1362740 0 0 0 0 406044 0 0 0 0 197000
3201126 B 3 BS 1 24/04/2018 24/04/2018 07/04/1956 0 2
1 I21.1;I64 - - - None None None None I-4-10-III None
0 - 0 - 0 - 0 - 0 10401900 1794492
0 1 0 0 0 LS HARISWATI D396830 62 22662 DR
5.2.1.201804062320 4 174673 1#0##0#0#0.0#2018-05-11
15:22:27#0#11:38:00#11:38:00#00:00:00 1 3d1c4194fc5859f03f300add081a80ae
0 0 936171 0 0 451924 0 0 0 0 406397
0 0 0 0 0
3201126 B 2 BS 1 22/04/2018 24/04/2018 10/02/1960 0 1
1 I64;N18.9 87.03;87.44 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 5866300 5366625 0
3 0 0 0 SUYONO D157890 58 21256 DR HARDI PRANATA
4 174249 1#0##0#0#0.0#2018-05-11
16:10:03#0#01:20:41#01:20:41#00:00:00 1 1e5001ee724e311cbc5c0a5fd6a36e1d
0 0 594422 0 0 2880115 0 1892088 0 0
0 0 0 0 0 0
3201126 B 2 BS 1 21/04/2018 24/04/2018 15/09/1978 0 1
1 G08;R51;G81.9 87.03 - - None None None None G-4-18-II
7105000 0 0 - 0 - 0 - 0 - 0
7105000 5131327 0 4 0 0 0 NAMAN TN D396591
39 14463 DR NURUL KOMARI SPS 0138R0170418V007396 0001770218616
3;JKN DR RIZKI; 5.2.1.201804062320 4 174235 1#0##0#0#0.0#2018-
05-11 16:16:24#0#15:29:05#15:29:05#00:00:00 1
0f13dc24a39ca6a80ca2403c7a46d840 0 0 438728 0 0
2310905 0 0 0 0 2381694 0 0 0 0 0
3201126 B 1 BS 1 23/04/2018 24/04/2018 13/03/2007 0 2
(RINGAN) 6041900 0 0 - 0 - 0 - 0 - 0
6041900 10146637 0 2 0 0 0 ANNABELLE KESYA FLORENCE
P D268669 11 4059 DR MOHAMMAD AULIA HERDIYANA,SPOT
0138R0170418V007534 0001965633412 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 174431 1#0##0#0#0.0#2018-05-12
09:59:49#0#14:41:38#14:41:38#00:00:00 1 53360438798244fc416c7fc59725dc84
0 0 1208368 0 0 1289870 0 0 0 0
7579399 0 0 0 0 69000
3201126 B 3 BS 1 23/04/2018 24/04/2018 20/03/1962 0 2
5013100 0 0 - 0 - 0 - 0 - 0
5013100 2858423 0 2 0 0 0 RUMSIYAH D373952
56 20488 DR ANGGA TOMALA PUTRA 0138R0170418V007763 0002250550192
3;JKN DR RIZKI; 5.2.1.201804062320 4 174467 1#0##0#0#0.0#2018-
05-14 15:15:00#0#17:18:16#17:18:16#12:00:00 1
ba21d635ee220b38724b56490bddb422 0 0 621855 0 0
1760568 0 0 0 0 476000 0 0 0 0 0
3201126 B 3 BS 1 23/04/2018 24/04/2018 01/04/1960 0 1
0 - 0 - 0 - 0 - 0 6341300 23056135
0 2 0 0 0 DAHLAN ISKANDAR D394167 58 21206 DR
5.2.1.201804062320 4 174445 1#0##0#0#0.0#2018-05-14
15:57:06#0#15:28:44#15:28:44#12:00:00 1 75cc14e915f0176d7b22dcae925bef04
0 7996000 2442160 0 0 3772975 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 21/04/2018 24/04/2018 02/04/1943 0 2
1 E10.2;A49.9 - - - None None None None N-4-16-I None
(RINGAN) 5174200 0 0 - 0 - 0 - 0 - 0
5174200 5735833 0 4 0 0 0 SANUDAH D263937
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174238
1#0##0#0#0.0#2018-05-15 09:07:34#0#16:06:03#16:06:03#12:00:00 1
80c9e940b06feb24ae36d92e7d47d3ca 0 0 494342 0 0
2061750 0 0 0 0 3179741 0 0 0 0 0
3201126 B 2 BS 1 22/04/2018 24/04/2018 26/07/1973 0 1
1 N18.5;J90 34.91 - - None None None None N-4-10-III None
(BERAT) 7293200 0 0 - 0 - 0 - 0 - 0
7293200 6076281 0 3 0 0 0 SUMARTANA D369438
0001101686411 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174262
1#0##0#0#0.0#2018-05-15 10:50:05#0#16:35:16#16:35:16#00:00:00 1
bd9af467add28bab4e18a8063e2d4712 0 0 1804174 0 0
2333593 0 0 0 0 1938514 0 0 0 0 0
3201126 B 2 BS 1 20/04/2018 24/04/2018 26/11/2016 0 2
1 A09.9;B37.8 - - - None None None None K-4-17-III None
(BERAT) 3046500 0 0 - 0 - 0 - 0 - 0
3046500 3166020 0 5 0 0 0 ACHIERA KIREINA JOY
PASARIBU D355944 1 510 DR OTTY MITHA S, SPA 0138R0170418V007291
0002197086074 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173966
1#0##0#0#0.0#2018-05-15 14:45:59#0#19:25:38#19:25:38#00:00:00 1
f36fb011aa68a8c261fdc9d2810de6a6 0 0 238535 0 0 711862
0 0 0 0 2045623 0 0 0 0 170000
3201126 B 2 BS 1 17/04/2018 24/04/2018 29/06/2017 0 2
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 6642194 0 8 0 0 0 AFIFAH FITRIANI AN
D396212 0 292 DR RASTRA, SPA 0138R0170418V005477
0002264013437 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 178775
1#0##0#0#0.0#2018-05-15 14:50:48#0#00:00:00#00:00:00#00:00:00 2
ee57e48b251ecd8aef464095a75eb524 0 0 339830 0 0
1801828 0 0 0 0 4500536 0 0 0 0 0
3201126 B 2 BS 1 23/04/2018 24/04/2018 01/08/1958 0 1
1 T82.4;I15.8;N18.5 39.42 - - None None None None N-1-12-I
- 0 5208600 8549180 0 2 0 0 0 SUNARDI
0138R0170418V007552 0001607940213 3;JKN irene; 5.2.1.201804062320
4 174888 1#0##0#0#0.0#2018-05-15
15:53:15#0#19:24:15#19:24:15#12:00:00 2 3b3a1f79bf01d085209147e0269a716a
0 4439100 1094720 0 0 2345568 0 0 0 0
635292 0 0 0 0 34500
3201126 B 3 BS 1 24/04/2018 24/04/2018 01/12/1936 0 1
1 I50.0;D61.9 99.04 - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 4973600 3414625
0 1 0 0 0 M. ISHAK D385408 81 29729 DR DICKI
PRATAMA 0138R0170418V007900 0000511744544 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 174480 1#0##0#0#0.0#2018-05-15
16:06:43#0#00:16:34#00:16:34#12:00:00 1 795e48f2161a827f10dd10e40a50efe1
0 0 268830 0 0 2069408 0 0 0 0 530387
0 0 0 0 546000
3201126 B 3 BS 1 24/04/2018 24/04/2018 01/06/1952 0 1
1 N18.5;I50.0 - - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 1893035 0 1 0 0 0 SATAR TN D350156
65 24068 DR DICKI PRATAMA 0138R0170418V008025 0000511411612 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 174536 1#0##0#0#0.0#2018-
05-15 16:31:20#0#09:27:48#09:27:48#00:00:00 1
7705ab6e77fb8c07ea9e0d9c7672ae58 0 0 298242 0 0 25700
0 0 0 0 1569093 0 0 0 0 0
3201126 B 3 BS 1 22/04/2018 24/04/2018 03/11/1978 0 2
0 - 0 - 0 - 0 - 0 1674900 6142150
0 3 0 0 0 DINI SUMARTINI D375104 39 14415 DR
NINING H, SPOG 0138R0170418V007426 0001769490461 3;JKN irene;
5.2.1.201804062320 4 174251 7#0##0#0#0.0#2018-05-17
10:07:05#1#03:05:05#03:05:05#00:00:00 2 641984c118739531c6f1fdcb0d55763e
0 1849005 1707092 0 0 1822630 0 0 0 0
164600 0 0 0 401823 197000
3201126 B 2 BS 1 23/04/2018 24/04/2018 01/08/1958 0 1
1 T82.4;I15.8;N18.5 39.42 - - None None None None N-1-12-I
- 0 5208600 8549180 0 2 0 0 0 SUNARDI
0138R0170418V007652 0001607940213 3;JKN DR RIZKI; 5.2.2.201806040537
4 174888 1#0##0#0#0.0#2018-08-21
10:33:26#0#19:24:15#19:24:15#12:00:00 3 349b6ac17bb1c94ff2cc8f850ac90bb7
0 4439100 1094720 0 0 2345568 0 0 0 0
635292 0 0 0 0 34500
3201126 B 3 BS 1 20/04/2018 24/04/2018 10/01/1971 0 2
4 C34.9;C78.2;A49.9 34.91 - - None None None None J-4-14-II
None None None None None None TUMOR PARU (SEDANG) 7406000 0
0 - 0 - 0 - 0 - 0 7406000 10030387
0 5 0 0 0 SRI RATNA SARI D000465 47 17267 DR
MOHAMAD NIZAM ERHAMZA SPP 0138R0170418V007247 0000511418968 3;JKN DR
RIZKI; 5.2.2.201806040537 4 173954 1#0##0#0#0.0#2018-08-23
09:01:23#0#17:37:50#17:37:50#12:00:00 2 1149d4080b19c3bbfc1a38330336304b
0 0 2470645 0 0 5562548 0 0 0 0
1997194 0 0 0 0 0
3201126 B 2 BS 1 21/04/2018 24/04/2018 13/12/2007 0 2
- 0 - 0 - 0 - 0 3187000 4552055 0
4 0 0 0 VANIA PUTRI AN D396621 10 3782 DR OTTY
MITHA S, SPA 0138R0170418V007408 0001527463631 3;JKN DR RIZKI;
5.2.2.201806040537 4 174244 1#0##0#0#0.0#2018-09-06
17:21:35#0#16:49:57#16:49:57#00:00:00 2 fbe6dc77c6f8da9ba38a2d656dbdd0dc
0 0 353851 0 0 2061906 0 0 0 0
2136298 0 0 0 0 0
3201126 B 3 BS 1 15/04/2018 24/04/2018 17/06/1959 0 2
1 I64;E11.1;I10;A41.9 87.03;90.59;89.52 - - None None None
DARAH OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (BERAT)
6899800 0 0 - 0 - 0 - 0 - 0
6899800 31982813 0 10 1 4 0 GOKHAN JUNITA SIREGAR
0000168463102 3;JKN DR RIZKI; 5.2.2.201806040537 4 171607
1#1#vvip#6#25083013#0.0#2018-09-28 10:32:27#0#00:00:00#00:00:00#12:00:00
3 29b229a592c666b63799370ee11505fe 0 0 1202004 0 0
14867309 0 0 0 0 12575500 0 0 0 0
3338000
3201126 B 1 BS 1 23/04/2018 24/04/2018 11/09/1955 0 2
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 54435570 0 2 0 0 0 INDESWARI
0001457476029 3;JKN DR RIZKI; 5.2.2.201806040537 4 174711
1#0##0#0#0.0#2018-09-28 11:14:21#0#00:00:00#00:00:00#12:00:00 2
60eaa678c75054c5ceb9de8cd64b1a23 0 10062000 7201760 0 0
28326810 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 22/04/2018 24/04/2018 28/11/1957 0 1
1 N18.5;E11.2;D63.8;J81 99.04;39.27 - - None None None None
- 0 - 0 27065300 16685105 0 3 0 0 0
SUJARWO D396385 60 22060 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V007437 0000038865508 3;JKN DR RIZKI; 5.2.2.201806040537
4 174256 1#0##0#0#0.0#2018-09-28
11:29:08#0#00:00:00#00:00:00#00:00:00 2 bc67ba677fa780909c142e4c03427417
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1167549 0 0 0 0 128000
3201126 B 3 BS 1 24/04/2018 24/04/2018 14/04/1950 0 1
1 I50.0;L95.9 89.52 - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 3575600 1677980
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SUNARTO , SPJP 0138R0170418V007903 0001338993461 3;JKN DR RIZKI;
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10:50:18#0#19:33:04#19:33:04#12:00:00 2 0224162bd80b3e27e91de1c93f5490d0
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1 I50.0;E14.1 89.52 - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 4973600 3070221
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PRABHA DUHITA 0138R0170418V008359 0000060846467 3;JKN DR RIZKI;
5.2.1.201804062320 4 174896 1#0##0#0#0.0#2018-05-11
09:49:02#0#23:12:00#23:12:00#00:00:00 1 3a337e041895b60dc804ebda7f0a5268
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3201126 B 3 BS 1 25/04/2018 25/04/2018 13/10/1986 0 1
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4132100 1908549 0 1 0 0 0 MOCH ROCHLY WAHYUDI TN
D343257 31 11517 DR NIKEN PRABHA DUHITA 0138R0170418V008372
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1#0##0#0#0.0#2018-05-11 09:51:32#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 24/04/2018 25/04/2018 14/08/1972 0 1
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DR ANGGA TOMALA PUTRA 0138R0170418V008354 0001379060649 3;JKN DR
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15:34:12#0#22:43:51#22:43:51#00:00:00 1 798f7cb179c1ef0f89a437c74c65a547
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3201126 B 3 BS 1 23/04/2018 25/04/2018 11/08/1961 0 1
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3201126 B 3 BS 1 22/04/2018 25/04/2018 01/02/1975 0 1
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1#0##0#0#0.0#2018-05-11 15:40:58#0#21:09:51#21:09:51#12:00:00 1
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3201126 B 1 BS 1 22/04/2018 25/04/2018 17/06/1957 0 2
1 L03.1;E11.5;A41.9 - - - None None None None L-4-12-III
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1#0##0#0#0.0#2018-05-11 15:47:06#0#20:24:19#20:24:19#00:00:00 1
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0001628805958 3;JKN DR RIZKI; 5.2.1.201804062320 4 174893
1#0##0#0#0.0#2018-05-11 15:48:37#0#20:36:25#20:36:25#00:00:00 1
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3201126 B 1 BS 1 23/04/2018 25/04/2018 01/05/1971 0 1
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11257400 15827947 0 3 0 0 0 BUYUNG SUTAN TN
0000203899871 3;JKN DR RIZKI; 5.2.1.201804062320 4 174929
1#0##0#0#0.0#2018-05-11 15:53:56#0#08:55:48#08:55:48#00:00:00 1
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3201126 B 2 BS 1 23/04/2018 25/04/2018 22/05/2011 0 1
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0001289434599 3;JKN DR RIZKI; 5.2.1.201804062320 4 174451
1#0##0#0#0.0#2018-05-11 16:06:27#0#15:48:48#15:48:48#00:00:00 2
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3201126 B 2 BS 1 22/04/2018 25/04/2018 23/03/1971 0 2
1 I63.8;G81.9;K29.7 87.03;87.44;93.19 - - None None None None
0 - 0 8291400 6389885 0 4 0 0 0 TETI
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0002282788078 3;JKN DR RIZKI; 5.2.1.201804062320 4 174260
1#0##0#0#0.0#2018-05-11 16:12:07#0#14:31:58#14:31:58#00:00:00 1
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3201126 B 3 BS 1 24/04/2018 25/04/2018 17/03/1961 0 2
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0138R0170418V008055 0001390997485 3;JKN DR RIZKI; 5.2.1.201804062320
4 174703 1#0##0#0#0.0#2018-05-11
16:21:36#0#12:03:53#12:03:53#00:00:00 1 54ac595d6c01047af3d76de7fc1863d9
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629503 0 0 0 0 69000
3201126 B 3 BS 1 25/04/2018 25/04/2018 10/02/1942 0 1
1 I64;E14.1;A49.9 87.03 - - None None None None G-4-15-III
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PUTRA 0138R0170418V008364 0000039260373 3;JKN DR RIZKI; 5.2.1.201804062320
4 174899 1#0##0#0#0.0#2018-05-11
16:24:36#0#00:06:21#00:06:21#00:00:00 1 382e3a86fb88f6f7c4349a5dbc30abe4
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3201126 B 2 BS 1 23/04/2018 25/04/2018 11/12/1939 0 2
3 I11.0;R57.9;E14.9 - - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4973600
4317904 0 3 0 0 0 HAJRAH D347707 78 28623
DR AZRI NURIZAL SPPD KKV 0138R0170418V007857 0000126813442 3;JKN
DR RIZKI; 5.2.1.201804062320 4 174472 1#0##0#0#0.0#2018-05-11
16:28:00#0#20:18:20#20:18:20#00:00:00 1 b12b354ee540dd9574024e02e2c25084
0 0 500624 0 0 1911300 0 0 0 0
1615980 0 0 0 0 290000
3201126 B 1 BS 1 23/04/2018 25/04/2018 12/12/2012 0 1
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2961900 3069222 0 3 0 0 0 DANISH FADIL MAKMUR
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1#0##0#0#0.0#2018-05-12 12:55:29#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 1 BS 1 24/04/2018 25/04/2018 16/09/2016 0 1
(RINGAN) 12096300 0 0 - 0 - 0 - 0 - 0
12096300 11727289 0 2 0 0 0 KUSAVERO GERRARD PUTRA
WARDHANA D391940 1 585 DR ASRI RAHMAWATI SPB 0138R0170418V007996
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1#0##0#0#0.0#2018-05-12 12:57:07#0#09:13:27#09:13:27#00:00:00 1
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1464156 0 0 0 0 843206 0 0 0 0 69000
3201126 B 2 BS 1 24/04/2018 25/04/2018 17/06/1957 0 2
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0001380709506 3;JKN DR RIZKI; 5.2.1.201804062320 4 174539
1#0##0#0#0.0#2018-05-14 16:25:57#0#09:39:42#09:39:42#00:00:00 1
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7569000
3201126 B 2 BS 1 23/04/2018 25/04/2018 07/09/1968 0 1
1 E10.8;I11.0;I84.2 90.59;89.52 - - None None None None E-4-
0 - 0 7515400 5322182 0 3 0 0 0 MUHSAN
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1#0##0#0#0.0#2018-05-15 10:53:15#0#14:49:18#14:49:18#00:00:00 1
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2753712 0 0 0 0 1889180 0 0 0 0 0
3201126 B 2 BS 1 24/04/2018 25/04/2018 31/12/1994 0 2
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0 2 0 0 0 DESY RATNASARI D340582 23 8515 DR
5.2.1.201804062320 4 174485 1#0##0#0#0.0#2018-05-15
10:56:54#0#02:42:12#02:42:12#00:00:00 1 60dd0ad619f676ff20b2c3ed92b5c01c
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3097308 0 0 0 0 335000
3201126 B 3 BS 1 11/04/2018 25/04/2018 12/12/2001 0 2
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3;JKN TANTIYO S;16137 5.2.1.201804062320 4 170595
1#0##0#0#0.0#2018-05-15 19:39:59#0#21:02:20#21:02:20#00:00:00 1
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3201126 B 3 BS 1 25/04/2018 25/04/2018 05/04/1998 0 2
1 S31.4 70.71 - - None None None None W-1-30-I None None
4665300 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-08-11 13:49:46#0#15:25:55#15:25:55#00:00:00 3
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3201126 B 2 BS 1 23/04/2018 25/04/2018 31/12/1957 0 1
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0 0 - 0 - 0 - 0 - 0 4973600
4650820 0 3 0 0 0 NURDIN D350309 60 22028
5.2.2.201806040537 4 174363 1#0##0#0#0.0#2018-08-21
10:27:05#0#13:38:05#13:38:05#00:00:00 4 8d2283f45eb01c47bfc163d54ae69a80
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1845259 0 0 0 0 0
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15158572 0 3 0 0 0 AGUS SAPTO USODO d305084 44
3;JKN DR RIZKI; 5.2.2.201806040537 4 174471 1#0##0#0#0.0#2018-
08-23 09:30:29#0#20:07:53#20:07:53#12:00:00 2
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3480350 0 0 0 0 1067682 0 0 0 0
2069000
3201126 B 3 BS 1 25/04/2018 25/04/2018 01/05/1954 0 2
1 I67.9;R40.1 - - - None None None None G-4-26-II None
(SEDANG) 4302200 0 0 - 0 - 0 - 0 - 0
4302200 3815822 0 1 0 0 0 MUINAH D347564
3;JKN DR RIZKI; 5.2.2.201806040537 4 174900 1#0##0#0#0.0#2018-
08-24 08:51:06#0#00:16:40#00:16:40#00:00:00 2
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2655334 0 0 0 0 538633 0 0 0 0 0
3201126 B 3 BS 1 24/04/2018 25/04/2018 01/04/1965 0 2
1 I12.0;T82.4;D63.8 39.42;99.04 - - None None None None N-1-
- 0 - 0 19332400 12617023 0 2 0 0 0
UMIATI D392934 53 19381 DR BETTY DWI L, SPPD
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4 174892 1#0##0#0#0.0#2018-09-26
19:49:32#0#20:11:47#20:11:47#12:00:00 2 7f1bd033aabca3a2d42a79c269963496
0 3062500 5659396 0 0 3023714 0 0 0 0
871413 0 0 0 0 0
3201126 B 1 BS 1 23/04/2018 25/04/2018 29/06/1963 0 1
(RINGAN) 15016100 0 0 PCI 10725800 - 0 - 0 -
0 25741900 61664945 0 3 0 0 0 MULYADI
0001271252665 3;JKN DR RIZKI; 5.2.2.201806040537 4 174469
1#0##0#0#0.0#2018-09-26 19:50:38#0#19:51:31#19:51:31#12:00:00 2
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31793325 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 24/04/2018 25/04/2018 01/07/1964 0 1
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(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
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1#0##0#0#0.0#2018-09-26 19:53:13#0#09:55:17#09:55:17#12:00:00 2
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39688550 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 24/04/2018 25/04/2018 12/12/1950 0 2
1 I64;G81.9 87.03 - - None None None None G-4-15-II None
- 0 - 0 - 0 4888600 2350421 0 2 0
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0138R0170418V008361 0001739793565 3;JKN DR RIZKI; 5.2.2.201806040537
4 175965 1#0##0#0#0.0#2018-09-28
13:44:21#0#00:00:00#00:00:00#00:00:00 2 c2dee1d3e08e9382bf9786072ac5e2bd
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3201126 B 3 BS 1 23/04/2018 25/04/2018 17/01/1951 0 2
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N-4-12-II None None None None None None INFEKSI GINJAL DAN SALURAN
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0001336662898 3;JKN DR RIZKI; 5.2.1.201804062320 4 174553
1#0##0#0#0.0#2018-09-28 13:51:05#0#09:59:35#09:59:35#12:00:00 2
ce309b7ce422cbe406071dd9e88d8275 0 0 527768 0 0
1298180 0 0 0 0 999866 0 0 0 0 0
3201126 B 2 BS 1 24/04/2018 25/04/2018 08/10/1964 0 2
- 0 10690500 18608179 0 2 0 0 0 LILIS S
0138R0170418V008076 0001463375147 3;JKN DR RIZKI; 5.2.2.201806040537
4 174641 1#0##0#0#0.0#2018-09-28
13:54:54#0#11:12:55#11:12:55#00:00:00 2 1f6c13330efa90cfb64d31571be34563
0 4439100 5567736 0 0 7290843 0 0 0 0
1276000 0 0 0 0 34500
3201126 B 1 BS 1 24/04/2018 26/04/2018 24/04/2018 3640 1
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1#0##0#0#0.0#2018-05-08 16:30:31#0#17:55:51#17:55:51#00:00:00 1
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3201126 B 3 BS 1 25/04/2018 26/04/2018 01/03/2018 0 1
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1#0##0#0#0.0#2018-05-11 09:09:08#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 26/04/2018 26/04/2018 20/01/1946 0 2
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0138R0170418V008832 0001014392261 3;JKN DR RIZKI; 5.2.1.201804062320
4 175684 1#0##0#0#0.0#2018-05-11
09:12:28#0#00:00:00#00:00:00#00:00:00 1 8cd6fb29fe19e7152bcda8fc9ddb8e2a
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3201126 B 1 BS 1 25/04/2018 26/04/2018 05/05/1953 0 1
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0138R0170418V008434 0000037949231 3;JKN DR RIZKI; 5.2.1.201804062320
4 174907 1#0##0#0#0.0#2018-05-11
11:29:49#0#07:45:50#07:45:50#00:00:00 1 e0e6d389d19dbfd523e1558b2f3abceb
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11306000 0 0 0 0 7069000
3201126 B 1 BS 1 25/04/2018 26/04/2018 25/08/2016 0 1
1 G40.9;G31.0 - - - None None None None G-4-22-II None
None None None None None SERANGAN KEJANG (SEDANG) 4750700 0
0 - 0 - 0 - 0 - 0 4750700 2903435
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DR OTTY MITHA S, SPA 0138R0170418V008526 0002077408214 3;JKN DR
RIZKI; 5.2.1.201804062320 4 174953 1#0##0#0#0.0#2018-05-11
13:45:59#0#09:53:23#09:53:23#00:00:00 1 b1292236be92dccdc52c432bcc028cd3
0 0 480563 0 0 456928 0 0 0 0
1795944 0 0 0 0 170000
3201126 B 1 BS 1 24/04/2018 26/04/2018 18/04/2018 3000 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3157127 0 3 1 3 0 LIFIA ZARALIYAN
0002451395709 3;JKN DR RIZKI; 5.2.1.201804062320 4 174887
1#0##0#0#0.0#2018-05-11 13:53:32#0#17:40:58#17:40:58#00:00:00 1
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3201126 B 2 BS 1 24/04/2018 26/04/2018 24/04/2018 3795 1
4386800 0 0 - 0 - 0 - 0 - 0
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0002453233263 3;JKN DR RIZKI; 5.2.1.201804062320 4 175127
1#0##0#0#0.0#2018-05-11 15:59:23#0#13:19:09#13:19:09#00:00:00 1
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2083299 0 0 0 0 921025 0 0 0 0 0
3201126 B 2 BS 1 24/04/2018 26/04/2018 21/05/1985 0 2
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0001635173897 3;JKN DR RIZKI; 5.2.1.201804062320 4 174636
1#0##0#0#0.0#2018-05-11 16:04:55#0#11:11:29#11:11:29#00:00:00 1
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2099280 0 0 0 0 804655 0 0 0 0 325000
3201126 B 3 BS 1 23/04/2018 26/04/2018 17/08/1953 0 1
1 A01.0;I10;I69.4;M54.59 87.49;90.59;89.52 - - None None None
None A-4-14-I None None None None None None PENYAKIT INFEKSI BAKTERI
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4 174479 1#0##0#0#0.0#2018-05-11
16:17:46#0#23:49:28#23:49:28#00:00:00 1 19f4e21359c6f7e3b1222664a5838dec
0 0 257183 0 0 1544723 0 0 0 0
1017443 0 0 0 0 0
3201126 B 3 BS 1 22/04/2018 26/04/2018 11/07/1955 0 1
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MAHSUN ALFAKIH D396686 62 22931 DR NURUL KOMARI SPS
0138R0170418V007447 0000508113617 3;JKN DR RIZKI; 5.2.1.201804062320
4 174259 1#0##0#0#0.0#2018-05-11
16:23:04#0#14:31:25#14:31:25#00:00:00 1 470e7d2856ec75c670a9dba32bbe4a68
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1771486 0 0 0 0 0
3201126 B 3 BS 1 25/04/2018 26/04/2018 07/03/1974 0 2
1 M54.57;E11.4 - - - None None None None M-4-17-II
(SEDANG) 5157800 0 0 - 0 - 0 - 0 - 0
5157800 2113756 0 2 0 0 0 NUNUNG D396970
3;JKN DR RIZKI; 5.2.1.201804062320 4 175401 1#0##0#0#0.0#2018-
05-11 16:25:53#0#20:46:57#20:46:57#00:00:00 1
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3201126 B 1 BS 1 23/04/2018 26/04/2018 26/05/1946 0 1
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(SEDANG) 10960600 0 0 - 0 - 0 - 0 - 0
10960600 18238059 0 4 0 0 0 TIMBUL NABABAN
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1#0##0#0#0.0#2018-05-12 09:45:10#0#15:02:18#15:02:18#12:00:00 1
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0 0 - 0 - 0 - 0 - 0 6981500
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11126 DR ERDIYAN, SPOG 0138R0170418V008355 0001657510244 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 174894 1#0##0#0#0.0#2018-
05-12 10:01:09#0#22:43:24#22:43:24#00:00:00 1
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3201126 B 1 BS 1 24/04/2018 26/04/2018 12/07/1987 0 2
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TANTIYO S;16137 5.2.1.201804062320 4 174898 1#0##0#0#0.0#2018-
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3201126 B 1 BS 1 23/04/2018 26/04/2018 15/11/1964 0 1
11257400 0 0 - 0 - 0 - 0 - 0
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3201126 B 1 BS 1 23/04/2018 26/04/2018 11/03/1965 0 1
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1#0##0#0#0.0#2018-05-12 10:44:16#0#21:13:36#21:13:36#12:00:00 1
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3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174473
1#0##0#0#0.0#2018-05-12 10:57:59#0#20:24:44#20:24:44#00:00:00 1
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3201126 B 1 BS 1 21/04/2018 26/04/2018 21/05/2002 0 1
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None None None None None TUMOR MUSKULOSKLETAL,JARINGAN KONEKTIF DAN
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5.2.1.201804062320 4 174247 1#1#vvip#6#17136262#0.0#2018-05-12
12:51:39#0#23:54:53#23:54:53#12:00:00 1 5fb7a55646215d7d76209243a5476f3e
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DR RIZKI; 5.2.1.201804062320 4 174906 1#0##0#0#0.0#2018-05-14
16:29:41#0#06:22:04#06:22:04#12:00:00 1 1f24d6fe15a3d8b46140dd58532f0d1a
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1#0##0#0#0.0#2018-05-14 16:30:58#0#08:52:08#08:52:08#00:00:00 1
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3201126 B 3 BS 1 26/04/2018 26/04/2018 07/07/1951 0 2
1 K65.0;S36.90;R57.1 99.04;88.01 - - None None None None
K-4-16-III None None None None None None INFEKSI-INFEKSI
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D394574 66 24400 DR WIDHI DEWANTA K AJI 0138R0170418V009192
0001256916047 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175836
1#0##0#0#0.0#2018-05-15 16:25:51#0#15:23:11#15:23:11#12:00:00 1
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3863247 0 0 0 0 612163 0 0 0 0 0
3201126 B 2 BS 1 24/04/2018 26/04/2018 16/04/2018 0 1
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RIANITA SYAMSU, SPA 0138R0170418V008096 0002445929447 3;JKN DR RIZKI;
5.2.1.201804062320 4 174677 1#0##0#0#0.0#2018-05-15
16:45:37#0#11:41:17#11:41:17#00:00:00 1 1c12dae90a251b6d1ff5723116ce03c8
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2372471 0 0 0 0 1792000
3201126 B 3 BS 1 24/04/2018 26/04/2018 17/03/1972 0 2
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- 0 6077700 12199954 0 3 0 0 0 ERLIYANI
0001264472122 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174490
1#0##0#0#0.0#2018-05-15 18:07:07#0#08:27:05#08:27:05#12:00:00 1
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5191320 0 0 0 0 3441878 0 0 0 0
1749000
3201126 B 2 BS 1 20/04/2018 26/04/2018 31/12/1959 0 2
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58 21295 DR PRIYO SUNARTO , SPJP 0138R0170418V007301 0000036905668
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173971
1#0##0#0#0.0#2018-05-15 18:57:32#0#21:48:41#21:48:41#00:00:00 1
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1#0##0#0#0.0#2018-05-15 19:41:41#0#16:20:38#16:20:38#12:00:00 1
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3201126 B 3 BS 1 25/04/2018 26/04/2018 03/10/1963 0 1
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D396917 54 19928 DR ARU, SPPD 0138R0170418V008806
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1#0##0#0#0.0#2018-06-05 12:13:20#0#21:20:55#21:20:55#00:00:00 1
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3201126 B 3 BS 1 22/04/2018 26/04/2018 02/11/1965 0 2
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INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 7260904 0 5 0 0 0 ATI SURYATI
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1#0##0#0#0.0#2018-08-21 10:21:02#0#21:51:50#21:51:50#00:00:00 2
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3201126 B 3 BS 1 25/04/2018 26/04/2018 14/09/1938 0 2
4 I50.0;I48;I95.9;I67.9 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
9633268 0 2 1 2 0 ASMI D396991 79 29078 DR
5.2.2.201806040537 4 175397 1#0##0#0#0.0#2018-08-23
09:12:26#0#19:57:28#19:57:28#00:00:00 2 131d9584a82f8a658f8a6cf2248b503b
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2275214 0 0 0 0 911000
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None None None None None None PROSEDUR SISTEM PERNAFASAN NON-KOMPLEKS
(SEDANG) 26415700 0 0 - 0 - 0 - 0 - 0
26415700 23315209 0 1 1 1 24 B SUTIANTO ARI WIDODO
0001133368244 3;JKN DR RIZKI; 5.2.2.201806040537 4 175419
1#0##0#0#0.0#2018-09-05 15:29:32#0#02:21:44#02:21:44#00:00:00 3
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12359049 0 0 0 0 2260000 0 0 0 0
1809000
3201126 B 3 BS 1 19/04/2018 26/04/2018 09/07/2007 0 1
7792500 0 0 - 0 - 0 - 0 - 0
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0001770807688 3;JKN DR RIZKI; 5.2.2.201806040537 4 173777
1#0##0#0#0.0#2018-09-10 10:03:21#0#21:21:06#21:21:06#00:00:00 2
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6384860 0 0 0 0 1176972 0 0 0 0 485000
3201126 B 3 BS 1 26/04/2018 26/04/2018 10/09/1980 0 1
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None None None None None SEPTIKEMIA (SEDANG) 4330300 0 0
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1 0 0 0 DICKY D397075 37 13742 DR AHMAD HIBBAN A WRIYA
0138R0170418V009239 0001282844417 3;JKN DR RIZKI; 5.2.2.201806040537
4 175943 1#0##0#0#0.0#2018-09-25
18:57:08#0#18:24:44#18:24:44#00:00:00 2 b29f5de4106d9d86563fead4b248e072
0 0 563661 0 0 500784 0 0 0 0 383741
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3201126 B 3 BS 1 26/04/2018 27/04/2018 17/09/1961 0 2
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0001228740412 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175951
1#0##0#0#0.0#2018-05-08 16:57:52#0#21:48:15#21:48:15#00:00:00 1
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2980177 0 0 0 0 570913 0 0 0 0 69000
3201126 B 2 BS 1 24/04/2018 27/04/2018 24/04/2018 3200 1
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DENGAN SINDROMA DISTRES PERNAFASAN (RINGAN) 5066300 0 0 - 0
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4 24 SYAHRIL PUTRA SEGARA d396895 0 0 DR AULIA TANGKARI,
4 176052 1#0##0#0#0.0#2018-05-11
08:47:06#0#10:06:14#10:06:14#00:00:00 1 1f14f5d7f18cf5f13e3900c8d54b1f83
0 0 508967 0 0 4344220 0 0 0 0
3588663 0 0 0 0 1825000
3201126 B 2 BS 1 25/04/2018 27/04/2018 25/04/2018 3560 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437343 0 3 0 0 0 RETNO TRI APRIANI
d396971 0 0 DR DYAH HARINI, SPA 0138R0170418V009467
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1#0##0#0#0.0#2018-05-11 08:58:39#0#00:00:00#00:00:00#00:00:00 1
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(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 1046236 0 1 0 0 0 RUSMINI d388763
DR RIZKI; 5.2.1.201804062320 4 176096 1#0##0#0#0.0#2018-05-11
10:23:49#0#10:37:51#10:37:51#12:00:00 1 260f3150572a27beb9140c1998668792
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0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 27/04/2018 12/01/1957 0 2
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- 0 6076700 11611622 0 2 0 0 0 ANAH
0138R0170418V009125 0001257026297 3;JKN DR RIZKI; 5.2.1.201804062320
4 175704 1#0##0#0#0.0#2018-05-11
11:23:20#0#13:34:49#13:34:49#00:00:00 1 4ac07b7169b74ede9fc8d6d93db848fe
0 6468200 2619183 0 0 1738600 0 0 0 0
785639 0 0 0 0 0
3201126 B 1 BS 1 25/04/2018 27/04/2018 10/11/1945 0 2
1 G45.9;I49.3;N02.9 87.03;89.52 - - None None None None G-4-
16-III None None None None None None ISKEMIK TRANSIENT (BERAT)
8938000 0 0 - 0 - 0 - 0 - 0
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1#1#vip#3#6703500#75.0#2018-05-11 11:26:32#0#11:21:31#11:21:31#00:00:00
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3475453 0 0 0 0 3112802 0 0 0 0 0
3201126 B 1 BS 1 24/04/2018 27/04/2018 02/05/1960 0 1
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1#0##0#0#0.0#2018-05-11 13:50:45#0#15:16:12#15:16:12#00:00:00 1
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1853422 0 0 0 0 3553078 0 0 0 0 0
3201126 B 1 BS 1 25/04/2018 27/04/2018 14/08/1954 0 1
1 J91;C78.0 34.91;87.44 - - None None None None J-4-20-II
None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (SEDANG)
9001900 0 0 - 0 - 0 - 0 - 0
9001900 6269058 0 3 0 0 0 ZAHIRMAN ARIFIN
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1#0##0#0#0.0#2018-05-11 14:02:22#0#12:54:20#12:54:20#12:00:00 1
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1336762 0 0 0 0 2779125 0 0 0 0 290000
3201126 B 1 BS 1 23/04/2018 27/04/2018 20/01/1979 0 1
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DR RIZKI; 5.2.1.201804062320 4 174476 1#0##0#0#0.0#2018-05-11
14:04:30#0#22:31:48#22:31:48#00:00:00 1 1042d4a3f9258cc7c8777d7757627db8
0 6177000 1828560 0 0 5635055 0 0 0 0
1180993 0 0 0 0 2069000
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(SEDANG) 6486300 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.1.201804062320 4 175298 1#0##0#0#0.0#2018-
05-14 16:18:29#0#15:44:28#15:44:28#00:00:00 1
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2532327 0 0 0 0 830517 0 0 0 0 197000
3201126 B 2 BS 1 25/04/2018 27/04/2018 12/07/1976 0 2
(RINGAN) 4203300 0 0 - 0 - 0 - 0 - 0
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D396982 41 15262 DR ARU, SPPD 0138R0170418V008801
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1#0##0#0#0.0#2018-05-14 16:21:06#0#20:43:40#20:43:40#00:00:00 1
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3201126 B 2 BS 1 25/04/2018 27/04/2018 16/02/1983 0 1
6586700 0 0 - 0 - 0 - 0 - 0
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D194324 35 12852 DR SURYA POHAN SPB 0138R0170418V008510
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1#0##0#0#0.0#2018-05-14 16:37:30#0#09:24:03#09:24:03#00:00:00 1
376d8bcd20d40a87c5493b81b62d5c36 0 5344100 1154272 0 0
2056215 0 0 0 0 684971 0 0 0 0 69000
3201126 B 2 BS 1 24/04/2018 27/04/2018 05/12/2013 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
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0001634547745 3;JKN DR RIZKI; 5.2.1.201804062320 4 174484
1#0##0#0#0.0#2018-05-14 16:41:20#0#01:52:28#01:52:28#00:00:00 1
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3201126 B 3 BS 1 25/04/2018 27/04/2018 01/07/1970 0 1
1 N18.5;I11.0 39.27;39.95 - - None None None None N-1-12-III
- 0 19332400 12058533 0 3 0 0 0 SUFIRMAN
0000512797623 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175406
1#0##0#0#0.0#2018-05-15 14:58:29#0#00:00:00#00:00:00#00:00:00 1
4be312946470a9ef08096427db8e5746 0 3149000 974100 0 0
5564807 0 0 0 0 2336126 0 0 0 0 34500
3201126 B 3 BS 1 26/04/2018 27/04/2018 31/12/1957 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7386617 0 2 0 0 0 NURUDIN LASMANA
0138R0170418V009088 0001278325067 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 175664 1#0##0#0#0.0#2018-05-15
15:01:59#0#11:50:23#11:50:23#00:00:00 2 85b59446d91c078b426e4d2b052f74e8
0 3438800 921100 0 0 2398480 0 0 0 0
559237 0 0 0 0 69000
3201126 B 2 BS 1 24/04/2018 27/04/2018 05/05/1958 0 1
1 N13.2 56.31;59.8;56.0 - - None None None None N-1-40-I
(RINGAN) 9649200 0 0 - 0 - 0 - 0 - 0
9649200 20701386 0 4 0 0 0 SONY MISENA D395624
59 21904 DR HERY TIERA, SPU 0138R0170418V008010 0000205811008
3;JKN DR RIZKI; 5.2.1.201804062320 4 174512 1#0##0#0#0.0#2018-
05-15 15:12:38#0#09:00:30#09:00:30#00:00:00 1
c972e69d19a97dc1dae7c6c5cd6e4e7d 0 7861500 5201776 0 0
2968110 0 0 0 0 4601000 0 0 0 0 69000
3201126 B 2 BS 1 25/04/2018 27/04/2018 02/09/2010 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3974639 0 3 0 0 0 PUTRA RAMADHAN
0001461196383 3;JKN DR RIZKI; 5.2.1.201804062320 4 175087
1#0##0#0#0.0#2018-05-15 15:13:49#0#11:31:44#11:31:44#12:00:00 1
456ab8e45ce93825064dc59f99bf1376 0 0 298025 0 0
1875591 0 0 0 0 1801023 0 0 0 0 0
3201126 B 3 BS 1 25/04/2018 27/04/2018 17/01/1969 0 1
- 0 - 0 19332400 18802470 0 3 0 0 0
SAUBIH d387689 49 17995 DR BETTY DWI L, SPPD
0138R0170418V008798 0001770795415 3;JKN DR RIZKI; 5.2.1.201804062320
4 175399 1#0##0#0#0.0#2018-05-15
15:16:32#0#20:23:31#20:23:31#12:00:00 1 3abf337795b9ce5497069369209f4a5e
0 5150800 7154706 0 0 5125964 0 0 0 0
1226000 0 0 0 0 145000
3201126 B 1 BS 1 23/04/2018 27/04/2018 31/12/2015 0 1
1 N39.0;A49.9;J02.9 - - - None None None None N-4-12-I
3349800 0 0 - 0 - 0 - 0 - 0
3349800 7537818 0 5 0 0 0 MUHAMMAD FADLI PRAYOGA
0001903343951 3;JKN DR RIZKI; 5.2.1.201804062320 4 176518
1#0##0#0#0.0#2018-05-15 15:57:44#0#00:00:00#00:00:00#00:00:00 1
3dd40822fb95c4142bd9f3e2f091085b 0 0 354482 0 0
2764708 0 0 0 0 4078628 0 0 0 0 340000
3201126 B 3 BS 1 27/04/2018 27/04/2018 24/12/1953 0 2
1 S09.9;A49.9;Z59.4 87.03 - - None None None None G-4-24-I
0 - 0 - 0 - 0 - 0 3043100 2046292
0 1 0 0 0 TIEN HARYATIN D397097 64 23500 DR
YOHANNES DWINANDA 0138R0170418V009275 0001306301837 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 175962 1#0##0#0#0.0#2018-05-15
18:34:16#0#01:56:44#01:56:44#00:00:00 1 dbd23875742bfd47a8832064b4564c1f
0 0 273879 0 0 249730 0 0 0 0 345883
0 0 0 1176800 0
3201126 B 3 BS 1 24/04/2018 27/04/2018 25/09/1965 0 2
1 I72.1;N18.5 39.52 - - None None None None I-1-20-I None
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
15363900 19143291 0 4 0 0 0 DJOHAR SETYOWATI
0138R0170418V010391 0002196417036 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 180321 1#0##0#0#0.0#2018-05-15
19:08:51#0#00:00:00#00:00:00#12:00:00 1 c8e8aabc232da661ccc94979c76f3df7
0 5219300 4961070 0 0 5950671 0 0 0 0
2432250 0 0 0 0 580000
3201126 B 1 BS 1 20/04/2018 27/04/2018 18/08/1961 0 2
1 E07.9;E87.6;E87.1 - - - None None None None E-4-13-II
(SEDANG) 7581900 0 0 - 0 - 0 - 0 - 0
7581900 12158838 0 8 0 0 0 MUJI RAHAYU D336527
56 20699 DR ARU, SPPD 0138R0170418V007260 0000198227024 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 173956 1#0##0#0#0.0#2018-
05-15 19:45:43#0#17:55:11#17:55:11#12:00:00 1
14b1b2098398731b68ff9957101da4a1 0 0 735370 0 0
4681530 0 0 0 0 6741938 0 0 0 0 0
3201126 B 3 BS 1 25/04/2018 27/04/2018 11/07/1977 0 2
- 0 8908800 10108292 0 3 0 0 0 YULI
RAHMAWATI D396919 40 14898 DR ARU, SPPD 0138R0170418V008797
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1#0##0#0#0.0#2018-05-17 10:35:37#0#20:06:22#20:06:22#00:00:00 2
868accb7c303eb1b45d5928c94670584 0 3615300 2636552 0 0
3050150 0 0 0 0 737290 0 0 0 0 69000
3201126 B 3 BS 1 23/04/2018 27/04/2018 10/11/1977 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 3429322 0 5 0 0 0 FITRIA TAMBUNAN
0001457444171 3;JKN irene; 5.2.2.201806040537 4 174428
1#0##0#0#0.0#2018-08-11 13:44:37#0#14:26:30#14:26:30#00:00:00 4
f4206cfdea35715cf5c97208be668296 0 0 261764 0 0
1602210 0 0 0 0 1565348 0 0 0 0 0
3201126 B 3 BS 1 24/04/2018 27/04/2018 13/08/1956 0 2
1 E14.5;I10 - - - None None None None I-4-15-I None
(RINGAN) 4482300 0 0 - 0 - 0 - 0 - 0
4482300 4194650 0 4 0 0 0 SULIANAH d396843
61 22534 DR ARU, SPPD 0138R0170418V008346 0000511040068 3;JKN
irene; 5.2.2.201806040537 4 174891 1#0##0#0#0.0#2018-08-11
13:45:01#0#19:37:50#19:37:50#12:00:00 2 90de919ad131ef4671490328f126d6c2
0 0 421243 0 0 2507491 0 0 0 0
1265916 0 0 0 0 0
3201126 B 3 BS 1 24/04/2018 27/04/2018 03/02/1930 0 1
3688800 0 0 - 0 - 0 - 0 - 0
3688800 5346521 0 4 0 0 0 BOY TANGKILISAN
0001311737545 3;JKN DR RIZKI; 5.2.2.201806040537 4 174487
1#0##0#0#0.0#2018-09-07 16:26:21#0#04:29:57#04:29:57#00:00:00 3
919793e74396e5ef66a1bc77ea45931a 0 0 773780 0 0
3126969 0 0 0 0 1445772 0 0 0 0 0
3201126 B 3 BS 1 16/04/2018 27/04/2018 10/12/1946 0 1
1 I64;E87.6;J22 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 24433393 0
12 0 0 0 MAHMUD D396088 71 26060 DR AL RASYID SPS
0138R0170418V005008 0000511453438 3;JKN DR RIZKI; 5.2.2.201806040537
4 171629 1#0##0#0#0.0#2018-09-07
16:28:21#0#00:22:47#00:22:47#00:00:00 2 95d9d2c1f0f5f0016bd136c4447b50b2
0 0 949974 0 0 11381419 0 0 0 0
8652000 0 0 0 0 3450000
3201126 B 3 BS 1 25/04/2018 27/04/2018 18/08/2015 0 1
1 J45.9;R56.0;J22 93.94 - - None None None None J-4-18-II
2969700 0 0 - 0 - 0 - 0 - 0
2969700 4847212 0 3 0 0 0 MUHAMMAD REZA HIDAYAT
0002284818254 3;JKN DR RIZKI; 5.2.2.201806040537 4 174904
1#0##0#0#0.0#2018-09-07 16:33:15#0#02:59:15#02:59:15#00:00:00 2
8cfcba0eb8bc9b77c84c46a633508452 0 0 253330 0 0
1814275 0 0 0 0 2311607 0 0 0 0 468000
3201126 B 3 BS 1 23/04/2018 27/04/2018 15/03/1943 0 1
4973600 0 0 - 0 - 0 - 0 - 0
4973600 11538887 0 5 0 0 0 RATOYO PRANOTO
0000512045493 3;JKN DR RIZKI; 5.2.2.201806040537 4 175963
1#0##0#0#0.0#2018-09-07 16:36:28#0#08:15:35#08:15:35#12:00:00 2
5eab717f90f6ed2e039d07fb1089656a 0 0 989171 0 0
3173336 0 0 0 0 4242380 0 0 0 0
3134000
3201126 B 1 BS 1 26/04/2018 27/04/2018 05/04/1953 0 2
0 0 - 0 - 0 - 0 - 0 3247500
5737574 0 2 0 0 0 WANTI D007884 / D347181 65 23762
5.2.2.201806040537 4 175959 1#0##0#0#0.0#2018-09-28
10:22:42#0#00:00:00#00:00:00#00:00:00 2 be84f8f201f39d2ca6244e4527cfcd5b
0 0 962300 0 0 973419 0 0 0 0
2052855 0 0 0 0 1749000
3201126 B 3 BS 1 19/04/2018 27/04/2018 27/04/2008 0 2
1 N89.8;N39.0 99.06 - - None None None None W-4-12-II None
LAIN-LAIN (SEDANG) 3857000 0 0 - 0 - 0 - 0
- 0 3857000 19288320 0 9 0 0 0 MARSA
0001739755923 3;JKN DR RIZKI; 5.2.2.201806040537 4 173778
1#0##0#0#0.0#2018-09-28 14:13:11#0#21:37:01#21:37:01#00:00:00 2
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15077610 0 0 0 0 3506500 0 0 0 0 0
3201126 B 3 BS 1 25/04/2018 28/04/2018 02/06/2001 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 10683931 0 4 0 0 0 MUHAMMAD ARMANAL HAKAM
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1#0##0#0#0.0#2018-05-08 15:27:59#0#02:28:31#02:28:31#00:00:00 1
b8495e6b84bac0d13c29a623f476f5a9 0 3784800 2288900 0 0
3756282 0 0 0 0 784949 0 0 0 0 69000
3201126 B 3 BS 1 27/04/2018 28/04/2018 21/06/2016 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6050631 0 2 0 0 0 KHIAR RAIHAN RAMADHAN
0002053937698 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175975
1#0##0#0#0.0#2018-05-08 16:29:08#0#09:13:11#09:13:11#00:00:00 1
f1b68f4d41ef1766a375211a0e7adabc 0 3444900 961912 0 0
1026983 0 0 0 0 471836 0 0 0 0 145000
3201126 B 3 BS 1 27/04/2018 28/04/2018 10/03/1961 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 6743151 0 2 0 0 0 SITI SURYANI
0138R0170418V009478 0001479071957 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176201 1#0##0#0#0.0#2018-05-08
16:48:37#0#11:50:58#11:50:58#12:00:00 1 7b587c2c4ed3927b268643c27135e80b
0 3438800 1128530 0 0 1609680 0 0 0 0
497141 0 0 0 0 69000
3201126 B 2 BS 1 25/04/2018 28/04/2018 12/03/1989 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10438939 0 4 0 0 0 ERNA KOMALASARI D376023 29
10636 DR NINING H, SPOG 0138R0170418V008802 0001257791725 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 175402 1#0##0#0#0.0#2018-
05-11 08:18:40#0#20:47:43#20:47:43#00:00:00 1
dcaefde2920cf31cee0fb4e4eba19a0d 0 5269900 2507481 0 0
1665637 0 0 0 0 798921 0 0 0 0 197000
3201126 B 2 BS 1 22/04/2018 28/04/2018 19/08/1944 0 1
1 M65.07;A48.0;E13.7;A41.9;D64.9 99.04;84.17 - - None None
None None M-1-02-III None None None None None None AMPUTASI (BERAT)
30848800 0 0 - 0 - 0 - 0 - 0
30848800 20376621 0 7 0 0 0 TADJERIH H.AHMAD
0001270688815 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174258
1#0##0#0#0.0#2018-05-11 08:25:18#0#11:15:13#11:15:13#12:00:00 1
49f5200869eb110c72da5a39efd05354 0 7364100 4080776 0 0
7492745 0 0 0 0 1301000 0 0 0 0 138000
3201126 B 2 BS 1 26/04/2018 28/04/2018 01/12/1922 0 2
1 I63.9;G43.9;E75.6 87.03 - - None None None None G-4-14-I
INFARK (RINGAN) 6015800 0 0 - 0 - 0 - 0 -
0 6015800 3926508 0 3 0 0 0 ISTIYAH
0000043352594 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175410
1#0##0#0#0.0#2018-05-11 08:34:59#0#00:00:00#00:00:00#00:00:00 1
8feebcfc49fcdac8254b1a9960cab105 0 0 339209 0 0
1789425 0 0 0 0 1797874 0 0 0 0 0
3201126 B 2 BS 1 26/04/2018 28/04/2018 24/09/2016 0 2
- 0 - 0 - 0 - 0 3187000 2312249 0
3 0 0 0 ALEXA ARSYILA AGUNG D397087 1 579 DR
5.2.1.201804062320 4 176516 1#0##0#0#0.0#2018-05-11
08:38:21#0#00:00:00#00:00:00#00:00:00 1 ccaa5aef1614e9105c7a632070b7ba2e
0 0 339830 0 0 280150 0 0 0 0
1692269 0 0 0 0 0
3201126 B 2 BS 1 26/04/2018 28/04/2018 04/03/1969 0 2
1 J18.0;A09.0;I10;E14.9;A41.9 87.44 - - None None None None
COUGH (BERAT) 7703700 0 0 - 0 - 0 - 0 -
0 7703700 2820338 0 3 0 0 0 ARDEWI
0001466274914 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175958
1#0##0#0#0.0#2018-05-11 08:43:08#0#22:47:55#22:47:55#12:00:00 1
638ab57730770f260112fd0bbca9dc5c 0 0 238535 0 0
1361295 0 0 0 0 1220508 0 0 0 0 0
3201126 B 3 BS 1 26/04/2018 28/04/2018 05/06/1960 0 2
- 0 8908800 9414943 0 3 0 0 0 IYOM
0138R0170418V009234 0000386115748 3;JKN DR RIZKI; 5.2.1.201804062320
4 175942 1#0##0#0#0.0#2018-05-11
08:43:14#0#17:34:00#17:34:00#00:00:00 1 d6ca037dfc312889fada12a14407d011
0 3525300 2138112 0 0 2990600 0 0 0 0
691931 0 0 0 0 69000
3201126 B 2 BS 1 22/04/2018 28/04/2018 27/07/1939 0 2
1 I63.9;L89.9;R47.0;J18.9 87.03;93.94 - - None None None None
0 - 0 10406600 15072201 0 7 1 3 0 MIMI
SURATMI D396672 78 28759 DR HARDI PRANATA SPS 0138R0170418V007432
0000060818578 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174254
1#0##0#0#0.0#2018-05-11 08:58:19#0#06:33:08#06:33:08#00:00:00 1
fc0db9a8ae11f410bd9cbfaa7e1b6183 0 0 799226 0 0
6230443 0 0 0 0 5478532 0 0 0 0
2564000
3201126 B 3 BS 1 28/04/2018 28/04/2018 09/05/2010 0 1
1 R90.0;G91.8;A49.9 - - - None None None None G-4-26-I
LAIN (RINGAN) 3587300 0 0 - 0 - 0 - 0 -
0 3587300 1029431 0 1 0 0 0 RIZKY ARYAJI
0001775693406 3;JKN DR RIZKI; 5.2.1.201804062320 4 176316
1#0##0#0#0.0#2018-05-11 09:03:32#0#00:00:00#04:00:00#12:00:00 1
cda4351bab1e8772ee6609de8ca2d909 0 0 411435 0 0 261650
0 0 0 0 356346 0 0 0 0 0
3201126 B 2 BS 1 27/04/2018 28/04/2018 23/06/1979 0 1
1 A41.9;K76.0;N39.0 99.21 - - None None None None A-4-10-II
0 - 0 - 0 - 0 - 0 5196400 2959550
0 2 0 0 0 CEPI SETIADI D397104 38 14188 DR.
5.2.1.201804062320 4 176236 1#0##0#0#0.0#2018-05-11
14:06:47#0#12:30:40#12:30:40#00:00:00 1 09edf106000e667ea38af29ab03a6d4d
0 0 781694 0 0 948241 0 0 0 0
1229615 0 0 0 0 0
3201126 B 2 BS 1 26/04/2018 28/04/2018 26/04/2018 2838 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437343 0 3 0 0 0 ERNA KOMALASARI BY NY
0002454136435 3;JKN DR RIZKI; 5.2.1.201804062320 4 176083
1#0##0#0#0.0#2018-05-11 14:07:35#0#10:28:50#10:28:50#00:00:00 1
9f92bbf49057d0313ce43107f4ba933e 0 0 433812 0 0 88899
0 0 0 0 914632 0 0 0 0 0
3201126 B 2 BS 1 25/04/2018 28/04/2018 08/01/2014 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3677822 0 4 0 0 0 MATHEOZ MORENZO
NANARIAIN D323662 4 1568 DR OTTY MITHA S, SPA 0138R0170418V008810
0002135847971 3;JKN DR RIZKI; 5.2.1.201804062320 4 175407
1#0##0#0#0.0#2018-05-11 14:26:09#0#22:24:38#22:24:38#12:00:00 1
e40c99659cf93c230ea3d3c2a95dc806 0 0 298025 0 0
1093192 0 0 0 0 2286605 0 0 0 0 0
3201126 B 1 BS 1 27/04/2018 28/04/2018 27/07/1963 0 1
- 0 12472300 18722957 0 2 0 0 0 NURJAMAN
0138R0170418V009650 0001662640255 3;JKN DR RIZKI; 5.2.1.201804062320
4 176299 1#0##0#0#0.0#2018-05-11
14:44:57#0#17:14:11#17:14:11#00:00:00 1 79707a13cf9c3f676477842ba083af28
0 5896000 6548672 0 0 4953285 0 0 0 0
1256000 0 0 0 0 69000
3201126 B 1 BS 1 27/04/2018 28/04/2018 04/11/1957 0 2
- 0 58821400 60772660 0 2 0 0 0 SRI REDJEKI
0000060740122 3;JKN DR RIZKI; 5.2.1.201804062320 4 176102
1#0##0#0#0.0#2018-05-11 14:47:34#0#00:00:00#00:00:00#00:00:00 1
70253f2a23232ba8214d6750b98dbb60 0 10062000 7201760 0 0
34653900 0 0 0 0 1286000 0 0 0 0
7569000
3201126 B 2 BS 1 27/04/2018 28/04/2018 26/02/2014 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4483864 0 2 0 0 0 DEVANDRA ARYANTO
0002065219942 3;JKN DR RIZKI; 5.2.1.201804062320 4 176039
1#0##0#0#0.0#2018-05-11 15:01:21#0#09:57:02#09:57:02#00:00:00 1
891000af368a67e783ed1fb5b8309b1f 0 2846000 493024 0 0
650503 0 0 0 0 349337 0 0 0 0 145000
3201126 B 3 BS 1 25/04/2018 28/04/2018 21/12/1947 0 1
1 J45.9;K76.0;D29.1 93.94 - - None None None None J-4-18-II
2969700 0 0 - 0 - 0 - 0 - 0
2969700 3105890 0 4 0 0 0 JENI D396929 70
25693 DR BETTY DWI L, SPPD 0138R0170418V008783 0001432866958 3;JKN
DR RIZKI; 5.2.1.201804062320 4 175395 1#0##0#0#0.0#2018-05-15
15:19:41#0#18:31:38#18:31:38#00:00:00 1 951a55581065eeff912c8486d2b01cca
0 0 320273 0 0 1590928 0 0 0 0
1194689 0 0 0 0 0
3201126 B 3 BS 1 25/04/2018 28/04/2018 22/11/1954 0 2
1 E16.2;E14.4 - - - None None None None E-4-10-I None
- 0 3502700 3423275 0 4 0 0 0 EPA WANI
0001739635637 3;JKN DR RIZKI; 5.2.1.201804062320 4 175293
1#0##0#0#0.0#2018-05-15 15:20:47#0#15:35:14#15:35:14#12:00:00 1
036b21e918c1c45bd377b46d57204b91 0 0 368243 0 0
1753079 0 0 0 0 1301953 0 0 0 0 0
3201126 B 3 BS 1 21/04/2018 28/04/2018 19/04/1941 0 2
1 I64;I48;E14.9 - - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 8031977 0
8 0 0 0 ACAH ASMAD D396596 77 28126 DR AL RASYID SPS
0138R0170418V007383 0002250895779 3;JKN DR RIZKI; 5.2.1.201804062320
4 174230 1#0##0#0#0.0#2018-05-15
15:22:56#0#14:15:13#14:15:13#00:00:00 1 7ae511c798cf1241f6839fe73feddd41
0 0 743950 0 0 4614571 0 0 0 0
2673456 0 0 0 0 0
3201126 B 3 BS 1 24/04/2018 28/04/2018 01/12/2006 0 1
0 - 0 - 0 - 0 3417600 2851063 0 5
0 0 0 M GUSTI SETIAWAN D369603 11 4162 DR RASTRA, SPA
0138R0170418V008182 0000511824611 3;JKN DR RIZKI; 5.2.1.201804062320
4 174723 1#0##0#0#0.0#2018-05-15
15:24:01#0#13:49:24#13:49:24#00:00:00 1 a218c1b9adfeaf319d4c629367b80b19
0 0 183752 0 0 1139793 0 0 0 0
1527518 0 0 0 0 0
3201126 B 3 BS 1 26/04/2018 28/04/2018 18/12/1942 0 2
1 J18.0;A41.9;R63.0;I69.4 87.44 - - None None None None J-4-
(BERAT) 6419700 0 0 - 0 - 0 - 0 - 0
6419700 3027365 0 3 0 0 0 NAMI NY D397064
75 27523 DR BETTY 0138R0170418V009264 0000510907803 3;JKN DR
RIZKI; 5.2.1.201804062320 4 175954 1#0##0#0#0.0#2018-05-15
15:26:38#0#22:10:34#22:10:34#00:00:00 2 ebba868ddca7be215458fe3c11c7e441
0 0 630773 0 0 1646540 0 0 0 0 750052
0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 28/04/2018 26/04/2018 3474 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3341165 0 3 0 0 0 BAYI NY DINA EKASARI
0002454215736 3;JKN DR RIZKI; 5.2.1.201804062320 4 176305
1#0##0#0#0.0#2018-05-15 15:27:53#0#18:45:21#18:45:21#00:00:00 1
55f4eea37deb6cfb51ab22f432a195c0 0 0 845085 0 0 88899
0 0 0 0 2407181 0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 28/04/2018 27/09/1988 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 21082347 0 3 0 0 0 DINA EKASARI NY
D239738 29 10803 DR KARTIKA MAYA, SPOG 0138R0170418V008828
0001892722511 3;JKN DR RIZKI; 5.2.1.201804062320 4 175417
1#1#vvip#3#14100847#0.0#2018-05-15 15:38:08#0#01:29:19#01:29:19#00:00:00
2 4cd2a1904d3535b44db6a741c49935b7 0 8289400 6813000 0
0 4471947 0 0 0 0 1311000 0 0 0 0
197000
3201126 B 1 BS 1 22/04/2018 28/04/2018 24/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 14562700
13952250 0 7 1 3 0 BARKAH MASYA JAYA D396706 41
3;JKN DR RIZKI; 5.2.1.201804062320 4 174268 1#0##0#0#0.0#2018-
05-15 15:39:23#0#23:52:01#23:52:01#00:00:00 1
5b1e78ab0c988b32779c121c37b3c8c2 0 0 1715543 0 0
3755943 0 0 0 0 5900764 0 0 0 0
2580000
3201126 B 1 BS 1 26/04/2018 28/04/2018 16/12/1936 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4514948 0 3 0 0 0 DJAMILUDDIN NASUTION H,
SH,MM D352241 81 29716 DR. ARU ARIADNO, SPPD 0138R0170418V009243
0000060786527 3;JKN DR RIZKI; 5.2.1.201804062320 4 175944
1#0##0#0#0.0#2018-05-15 15:40:22#0#19:37:30#19:37:30#00:00:00 1
08c735fb98a68304930e6080e6a5951f 0 0 520641 0 0
1675437 0 0 0 0 2318870 0 0 0 0 0
3201126 B 1 BS 1 25/04/2018 28/04/2018 10/08/1960 0 1
- 0 58821400 51888705 0 4 0 0 0 JUNAEDI
0000060513581 3;JKN DR RIZKI; 5.2.1.201804062320 4 175119
1#0##0#0#0.0#2018-05-15 15:42:54#0#11:51:26#11:51:26#00:00:00 1
cf75533212bca2435eb4ece37f05142b 0 10753000 9619120 0 0
22662585 0 0 0 0 1226000 0 0 0 0
7628000
3201126 B 1 BS 1 26/04/2018 28/04/2018 24/03/1939 0 2
1 I63.9;G81.9;G40.9 87.03;87.44 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 8210458 0 3 0 0 0 MARYANAH
0001438668257 3;JKN DR RIZKI; 5.2.1.201804062320 4 175414
1#0##0#0#0.0#2018-05-15 15:55:41#0#00:48:28#00:48:28#00:00:00 1
4586114b9aaa5d1098ceceec08ecd7b7 0 0 684656 0 0
4619669 0 0 0 0 2906133 0 0 0 0 0
3201126 B 1 BS 1 25/04/2018 28/04/2018 13/04/1949 0 1
(SEDANG) 8537100 0 0 - 0 - 0 - 0 - 0
8537100 11967046 0 4 1 2 0 HASYIM TN D396880
0000042830245 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 174901
1#0##0#0#0.0#2018-05-15 19:00:19#0#00:30:37#00:30:37#00:00:00 1
32208ed09190ff683717f01fdde85e3b 0 0 1258610 0 0
3629545 0 0 0 0 4855891 0 0 0 0
2223000
3201126 B 1 BS 1 25/04/2018 28/04/2018 21/12/1981 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 24507409 0 4 0 0 0 HASTIN PARASIH
D187984 36 13274 DR MUTIA P, SPOG 0138R0170418V008804
0001970896814 3;JKN irene; 5.2.2.201806040537 4 175403
1#1#vvip#4#17525909#0.0#2018-08-11 13:40:47#0#21:15:54#21:15:54#00:00:00
2 5ce2d3cb2e47f028061da92795fdcb20 0 8973200 8981000 0
0 5034209 0 0 0 0 1322000 0 0 0 197000
0
3201126 B 1 BS 1 27/04/2018 28/04/2018 03/12/1974 0 2
1 K29.8;K29.6;J45.9 44.43 - - None None None None K-4-11-I
3247500 0 0 - 0 - 0 - 0 - 0
3247500 6881748 0 2 0 0 0 SELO ENDARTI
D396432 43 15851 DR ARU, SPPD 0138R0170418V009500
0000059671629 3;JKN DR RIZKI; 5.2.2.201806040537 4 176301
1#0##0#0#0.0#2018-09-05 18:27:07#0#17:34:10#17:34:10#00:00:00 3
92c9cf87331d5f3d80e62822df326bf5 0 0 1345200 0 0 826840
0 0 0 0 2780708 0 0 0 0 1929000
3201126 B 2 BS 1 27/04/2018 28/04/2018 19/07/1965 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8613387 0 2 0 0 0 HJ. SRI AMALIAH
0138R0170418V009643 0001262119329 3;JKN DR RIZKI; 5.2.2.201806040537
4 176298 1#0##0#0#0.0#2018-09-06
12:00:20#0#16:43:59#16:43:59#12:00:00 2 60e7787ff686818aa80bc3f69f52c08d
0 4911100 1250064 0 0 1763730 0 0 0 0
619493 0 0 0 0 69000
3201126 B 3 BS 1 27/04/2018 28/04/2018 08/09/1975 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 10094048 0 2 0 0 0 AMIRRUDIN
0138R0170418V009543 0001266283269 3;JKN DR RIZKI; 5.2.2.201806040537
4 176244 1#0##0#0#0.0#2018-09-07
16:39:18#0#13:53:56#13:53:56#12:00:00 2 5c4acb15ebff2843bda3436b7a16479d
0 0 3687336 0 0 2568854 0 0 0 0
3768858 0 0 0 0 69000
3201126 B 3 BS 1 28/04/2018 28/04/2018 18/11/1964 0 1
1 E14.1;K92.0 - - - None None None None E-4-10-II None
- 0 4894400 1475464 0 1 0 0 0 TAUFIK
WAHYUDIN D368022 53 19519 DR RICO ADITYA 0138R0170418V009695
0001618277657 3;JKN DR RIZKI; 5.2.2.201806040537 4 176318
1#0##0#0#0.0#2018-09-10 09:49:18#0#00:00:00#00:00:00#00:00:00 2
6fab38060c6be97a7ffae0ec410ee947 0 0 627336 0 0 462602
0 0 0 0 385526 0 0 0 0 0
3201126 B 3 BS 1 27/04/2018 28/04/2018 08/12/1954 0 1
1 I64;J96.9;I11.0;I49.3;J44.9;A16.1 96.05;87.03 - - None None
6899800 0 0 - 0 - 0 - 0 - 0
6899800 10646181 0 2 0 0 0 SURYADI D397143
63 23151 DR DINI DANIATY 0138R0170418V009673 0002442606636 3;JKN
DR RIZKI; 5.2.2.201806040537 4 176308 1#0##0#0#0.0#2018-09-10
10:00:28#0#19:26:18#19:26:18#00:00:00 3 ff682643ee589eff399bcbf35bfe3252
0 0 780498 0 0 8880204 0 0 0 0 985479
0 0 0 0 0
3201126 B 3 BS 1 26/04/2018 28/04/2018 09/05/1942 0 1
- 0 45079800 70580923 0 3 0 0 0 TUKIYAR
PRANOTO SAPUTRO D301407 75 27746 DR AZRI NURIZAL SPPD KKV
0138R0170418V008838 0000060700803 3;JKN DR RIZKI; 5.2.2.201806040537
4 175420 1#0##0#0#0.0#2018-10-01
09:19:02#0#04:21:51#04:21:51#00:00:00 2 977103d7fc9620374622c68a8775f609
0 9401000 6923000 0 0 45458213 0 0 0 0
1229710 0 0 0 0 7569000
3201126 B 1 BS 1 27/04/2018 28/04/2018 17/02/1955 0 2
- 0 12472300 13582826 0 2 0 0 0 TRI RINI
SURYOKANTI d392677 63 23080 DR. ARU ARIADNO, SPPD 0138R0170418V009667
0000061047461 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 176307
1#0##0#0#0.0#2018-10-10 18:18:50#0#19:05:44#19:05:44#00:00:00 3
bf39c2ee8f7f6bb1315e7e02ef5437a0 0 0 2619183 0 0
4365304 0 0 0 0 6563839 0 0 0 0 34500
3201126 B 3 BS 1 24/04/2018 29/04/2018 05/11/2000 0 1
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 6945569 0 6 0 0 0 BAGUS D391833 17
TANTIYO S;16137 5.2.1.201804062320 4 174491 1#0##0#0#0.0#2018-
05-08 17:03:50#0#08:35:10#08:35:10#12:00:00 1
f1e119f05242df0a76bbe113e021f0d9 0 0 630386 0 0
4256800 0 0 0 0 2058383 0 0 0 0 0
3201126 B 1 BS 1 28/04/2018 29/04/2018 12/04/1996 0 1
1 I12.0;R04.0 - - - None None None None N-4-10-II None
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 2322428 0 2 0 0 0 GURUH ARISTANTYO PANDU
WIBOWO D381904 22 8051 DR ARU, SPPD 0138R0170418V009786
0001827910754 3;JKN DR RIZKI; 5.2.1.201804062320 4 176567
1#0##0#0#0.0#2018-05-11 10:52:38#0#16:43:12#16:43:12#12:00:00 1
f246b166a0faee898decbd30f035ddf7 0 0 573641 0 0 354352
0 0 0 0 1394435 0 0 0 0 0
3201126 B 1 BS 1 27/04/2018 29/04/2018 24/06/1945 0 1
- 0 12472300 15575689 0 3 0 0 0 HARTO
0000044218765 3;JKN DR RIZKI; 5.2.1.201804062320 4 176302
1#0##0#0#0.0#2018-05-11 14:28:15#0#17:47:39#17:47:39#00:00:00 1
5dda43daed72441be4e3150d18ee1e7b 0 0 3669967 0 0
4174752 0 0 0 0 7661970 0 0 0 0 69000
3201126 B 1 BS 1 24/04/2018 29/04/2018 04/11/1965 0 1
1 I64;I10;E11.9;G81.9;E78.5 90.59;89.52;87.03 - - None None
6844000 0 0 - 0 - 0 - 0 - 0
6844000 10335154 0 6 0 0 0 MT. BASARINO L TOBING
0001422594584 3;JKN DR RIZKI; 5.2.1.201804062320 4 174481
1#0##0#0#0.0#2018-05-11 14:36:17#0#00:25:46#00:25:46#00:00:00 1
04449a920f3bce1be4ead4d414336eef 0 0 1117063 0 0
3829959 0 0 0 0 5388132 0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 29/04/2018 11/06/1979 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 8360318 0 4 0 0 0 SUPRIADI TN
0000211433501 3;JKN DR RIZKI; 5.2.1.201804062320 4 175885
1#0##0#0#0.0#2018-05-11 14:40:04#0#15:58:38#15:58:38#00:00:00 1
acabc339ff0a74d139f5a3562b6794c9 0 0 626641 0 0
3225990 0 0 0 0 4507687 0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 29/04/2018 25/02/1980 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 26129840 0 4 0 0 0 VERA DWIWATI
D111522 38 13940 DR ARJU A, SPOG 0138R0170418V009250
0001807893033 3;JKN DR RIZKI; 5.2.1.201804062320 4 175945
1#1#vvip#4#19148340#0.0#2018-05-11 14:42:43#0#20:11:23#20:11:23#00:00:00
1 b9dcc9199a47edf1ac74b03170a59042 0 8973200 8981000 0
0 6677640 0 0 0 0 1301000 0 0 0 0
197000
3201126 B 2 BS 1 26/04/2018 29/04/2018 15/07/1968 0 2
1 K25.9;D64.9 45.16;99.04 - - None None None None K-4-11-II
3955700 0 0 - 0 - 0 - 0 - 0
3955700 9784406 0 4 0 0 0 UMMU HANNI D397065
49 18182 DR ARU, SPPD 0138R0170418V009266 0001316770749 3;JKN
DR RIZKI; 5.2.1.201804062320 4 175955 1#0##0#0#0.0#2018-05-11
14:52:43#0#00:00:00#00:00:00#00:00:00 1 f6ea3d6a3fd96b1a3ebb65b5cdf169ca
0 0 1213596 0 0 3808209 0 0 0 0
2833601 0 0 0 0 1929000
3201126 B 2 BS 1 27/04/2018 29/04/2018 05/06/1948 0 1
0 - 0 - 0 - 0 - 0 7609600 12113802
0 3 0 0 0 H.MAS'UD BIN ABAS D396397 69 25528 DR
RIZKI; 5.2.1.201804062320 4 176040 1#0##0#0#0.0#2018-05-11
14:55:18#0#09:57:20#09:57:20#00:00:00 1 fe869600129fc18fea9ed3a092145fa3
0 3970000 1521920 0 0 3659390 0 0 0 0
893492 0 0 0 0 2069000
3201126 B 2 BS 1 27/04/2018 29/04/2018 26/11/2002 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3087133 0 3 0 0 0 GADIS RAMIDHANTI
0001456655736 3;JKN DR RIZKI; 5.2.1.201804062320 4 176285
1#0##0#0#0.0#2018-05-11 14:56:43#0#16:18:04#16:18:04#12:00:00 1
5e77f88c877eaa5b76c2f0a709ffbd15 0 0 298025 0 0
1046146 0 0 0 0 1742962 0 0 0 0 0
3201126 B 2 BS 1 26/04/2018 29/04/2018 28/10/1957 0 2
1 I63.9;I10;E78.5;E79.0 89.52;87.44;87.03 - - None None None
None G-4-14-I None None None None None None KECEDERAAN PEMBULUH
DARAH OTAK DENGAN INFARK (RINGAN) 6015800 0 0 - 0 - 0
- 0 - 0 6015800 4554208 0 4 0 0 0
DJUBAEDAH D336164 60 22095 DR MAYSAM I., SPS 0138R0170418V009258
0001339589981 3;JKN DR RIZKI; 5.2.1.201804062320 4 175950
1#0##0#0#0.0#2018-05-11 14:59:54#0#21:08:58#21:08:58#00:00:00 1
01386c2fee0a679466d6b2d7640950ee 0 0 594422 0 0
1823347 0 0 0 0 2136439 0 0 0 0 0
3201126 B 2 BS 1 27/04/2018 29/04/2018 11/08/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2605395 0 3 0 0 0 BAYI NY RUT LEBERINA
0002263478747 3;JKN DR RIZKI; 5.2.1.201804062320 4 176261
1#0##0#0#0.0#2018-05-11 15:03:44#0#15:05:02#15:05:02#12:00:00 1
001cc6183f350e405e65823cf118dc3d 0 0 238535 0 0 485414
0 0 0 0 1711446 0 0 0 0 170000
3201126 B 2 BS 1 24/04/2018 29/04/2018 22/06/1938 0 2
1 I61.9;G81.9;I10 - - - None None None None G-4-13-II
(SEDANG) 6183900 0 0 - 0 - 0 - 0 - 0
6183900 7007637 0 6 0 0 0 OMI D319239 79
29161 DR MAYSAMIRAWATI SPS 0138R0170418V007906 0000045682931 3;JKN
DR RIZKI; 5.2.1.201804062320 4 174483 1#0##0#0#0.0#2018-05-11
15:07:51#0#01:35:05#01:35:05#00:00:00 1 d546d2afceea1329187192d576c868fc
0 0 425158 0 0 3068035 0 0 0 0
3514444 0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 29/04/2018 10/08/1986 0 2
0 0 - 0 - 0 - 0 - 0 6981500
20059333 0 4 0 0 0 JELITA ANGGRAINI d095940 31
11582 DR NINING H, SPOG 0138R0170418V008918 0001632075513 3;JKN DR
RIZKI; 5.2.1.201804062320 4 175422 1#1#vvip#4#13077833#0.0#2018-
05-15 16:44:02#0#07:45:21#07:45:21#00:00:00 1
e22fba742d1b94ed73369c1a933c61f9 0 9464400 6488000 0 0
2588933 0 0 0 0 1321000 0 0 0 0 197000
3201126 B 1 BS 1 26/04/2018 29/04/2018 10/01/1943 0 1
5164300 0 0 - 0 - 0 - 0 - 0
5164300 5725930 0 4 0 0 0 W TOGIM SAGALA
0001309254186 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175418
1#0##0#0#0.0#2018-05-15 19:03:46#0#01:54:32#01:54:32#00:00:00 1
b069e5149a4e40054665bcf8af1db971 0 0 517787 0 0
1683549 0 0 0 0 3524594 0 0 0 0 0
3201126 B 3 BS 1 28/04/2018 29/04/2018 01/09/1964 0 1
4 E87.2;A41.9;N18.5;R40.2 99.60 - - None None None None E-4-
(BERAT) 6293300 0 0 - 0 - 0 - 0 - 0
6293300 3567428 0 2 0 0 0 SYAMSUAR D397278
53 19597 DR AHMAD HIBBAN A WRIYA 0138R0170418V009805 0001856195774
3;JKN DR RIZKI; 5.2.1.201804062320 4 176574 1#0##0#0#0.0#2018-
05-24 15:06:24#0#00:00:00#00:00:00#00:00:00 1
18f539c028ce51b41f4292b258f8e765 0 0 566397 0 0
2478648 0 0 0 0 522383 0 0 0 0 0
3201126 B 2 BS 1 23/04/2018 29/04/2018 02/10/1945 0 2
4 I46.9;K56.7;K30 - - - None None None None I-4-14-II
None None None None None None CARDIAC ARREST, TIDAK DIKETAHUI (SEDANG)
4265200 0 0 - 0 - 0 - 0 - 0
4265200 10020348 0 7 0 0 0 DEWI SRI BRUNTAK
0000060576423 3;JKN DR RIZKI; 5.2.2.201806040537 4 174478
1#0##0#0#0.0#2018-09-07 16:45:03#0#23:26:51#23:26:51#00:00:00 2
531bfadb1591b86749abcae8fb5b328e 0 0 539531 0 0
4915280 0 0 0 0 3729537 0 0 0 0 836000
3201126 B 3 BS 1 24/04/2018 29/04/2018 12/10/2016 0 1
1 N47;G40.9 64.0 - - None None None None V-1-15-II None
None None None None None SIRKUMSISI DENGAN KONDISI TERTENTU (SEDANG)
1619200 0 0 - 0 - 0 - 0 - 0
1619200 6055686 0 6 0 0 0 KENZO ALFARIZIE
0002092515895 3;JKN DR RIZKI; 5.2.2.201806040537 4 176266
1#0##0#0#0.0#2018-09-07 16:55:03#0#15:37:01#15:37:01#12:00:00 2
87313c4bfc8054ec87ce75404a4d201c 0 0 652104 0 0
1741916 0 0 0 0 3516666 0 0 0 0 145000
3201126 B 1 BS 1 22/04/2018 29/04/2018 23/08/1951 0 1
1 G81.9;J22;R90.0 87.03 - - None None None None G-4-26-I
LAIN (RINGAN) 5022200 0 0 - 0 - 0 - 0 -
0 5022200 12930632 0 8 0 0 0 TAGOR HUTABARAT
0001383136839 3;JKN DR RIZKI; 5.2.2.201806040537 4 174261
1#0##0#0#0.0#2018-09-07 16:57:27#0#15:18:28#15:18:28#00:00:00 2
5f05fe6c0f16c5b2874fa9d2f8b9801b 0 0 504997 0 0
5305706 0 0 0 0 7119929 0 0 0 0 0
3201126 B 3 BS 1 28/04/2018 29/04/2018 15/02/1966 0 2
3 D17.5;E16.2;A41.9 - - - None None None None K-4-18-III
(BERAT) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 2418808 0 2 0 0 0 FANNY DE WILDE
0001339135244 3;JKN DR RIZKI; 5.2.2.201806040537 4 176571
1#0##0#0#0.0#2018-09-26 11:21:27#0#20:55:53#20:55:53#12:00:00 5
0ab4899600cc7e87967e96cacda4c1a0 0 0 714186 0 0
1257382 0 0 0 0 447240 0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 30/04/2018 10/01/1948 0 2
4 I44.0;G00.9;A41.9;N17.9;E87.2;R57.2 89.52;99.60 - - None None
None None I-4-19-III None None None None None None GANGGUAN KONDUKSI
& ARITMIA JANTUNG (BERAT) 7295800 0 0 - 0 - 0 -
0 - 0 7295800 5243022 0 2 0 0 0 ROSIDA
0001718765324 3;JKN DR RIZKI; 5.2.1.201804062320 4 176607
1#0##0#0#0.0#2018-05-11 09:06:43#0#23:22:00#23:22:00#00:00:00 1
e265d92b6bda756aede58bd4678dddb2 0 0 656622 0 0
3187399 0 0 0 0 650001 0 0 0 0 749000
3201126 B 3 BS 1 24/04/2018 30/04/2018 08/12/1945 0 1
1 I12.0;R18;T82.4 39.95;38.95;54.91 - - None None None None
- 0 - 0 19332400 28359399 0 7 1 3 0
AMIN SUWARDI d387627 72 26435 DR ARU, SPPD
0138R0170418V007939 0001455361727 3;JKN DR RIZKI; 5.2.1.201804062320
4 174488 1#0##0#0#0.0#2018-05-11
09:18:00#0#07:12:37#07:12:37#12:00:00 1 85798b4662c99cc9230b38387ff55473
0 0 6046044 0 0 11108855 0 0 0 0
9994000 0 0 0 0 1210500
3201126 B 3 BS 1 25/04/2018 30/04/2018 11/06/1958 0 2
0 - 0 - 0 - 0 - 0 4204300 4350392
0 6 0 0 0 UMROH NY D396993 59 21868 DR. ARU
5.2.1.201804062320 4 175409 1#0##0#0#0.0#2018-05-11
09:45:41#0#23:44:06#23:44:06#00:00:00 1 ce974cfa914d70a3d19214bcda71fa0f
0 0 431387 0 0 2293400 0 0 0 0
1625605 0 0 0 0 0
3201126 B 3 BS 1 27/04/2018 30/04/2018 21/10/1998 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1900085 0 4 0 0 0 SYIFA OKTAVIANI
0001740344905 3;JKN DR RIZKI; 5.2.1.201804062320 4 176313
1#0##0#0#0.0#2018-05-11 10:01:25#0#00:00:00#00:00:00#00:00:00 1
f8410626e6b0a52bf0e7c97bd60985e7 0 0 241100 0 0 719680
0 0 0 0 939305 0 0 0 0 0
3201126 B 3 BS 1 27/04/2018 30/04/2018 04/03/2017 0 1
0 - 0 2334400 2780696 0 4 0 0 0 JAZIMA
RASYA MUFLIH D397133 1 419 DR OTTY MITHA S, SPA
0138R0170418V009674 0002419035309 3;JKN DR RIZKI; 5.2.1.201804062320
4 176309 1#0##0#0#0.0#2018-05-11
10:21:40#0#20:25:07#20:25:07#00:00:00 2 258d87302e3a015ca17b894b653ea044
0 0 292031 0 0 1315250 0 0 0 0
1173415 0 0 0 0 0
3201126 B 1 BS 1 28/04/2018 30/04/2018 05/12/1989 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12729790 0 3 0 0 0 RAHMA MUTIA D330338
28 10371 DR MAMAN H, SPOG 0138R0170418V009737 0001664128517 3;JKN
DR RIZKI; 5.2.1.201804062320 4 176421 1#0##0#0#0.0#2018-05-11
11:06:42#0#10:51:37#10:51:37#00:00:00 1 e74748c0d3e0c8368fe2bd550984e281
0 7098900 2426710 0 0 2093390 0 0 0 0
913790 0 0 0 0 197000
3201126 B 1 BS 1 26/04/2018 30/04/2018 04/06/1957 0 2
1 I63.9;G81.9;E13.9;G40.9 87.03 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 9684264 0 5 0 0 0 YONG LIP NGO
0001448013802 3;JKN DR RIZKI; 5.2.1.201804062320 4 175439
1#0##0#0#0.0#2018-05-11 11:12:21#0#08:45:04#08:45:04#12:00:00 1
5e7331170629c49190b5f8cbe6b3dd5a 0 0 1117063 0 0
4002651 0 0 0 0 4564550 0 0 0 0 0
3201126 B 2 BS 1 29/04/2018 30/04/2018 04/04/1993 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 9014455 0 2 0 0 0 DWI AVIVIANI
0138R0170418V009812 0001901163069 3;JKN DR RIZKI; 5.2.1.201804062320
4 176577 1#0##0#0#0.0#2018-05-11
14:10:59#0#08:09:30#08:09:30#00:00:00 1 4d028bb6f4014095ff0ed6b02398a128
0 4911100 1510494 0 0 1858130 0 0 0 0
665731 0 0 0 0 69000
3201126 B 2 BS 1 25/04/2018 30/04/2018 06/02/1953 0 1
1 I20.0;I50.0;I25.0 - - - None None None None I-4-20-II
5824800 0 0 - 0 - 0 - 0 - 0
5824800 6732364 0 6 1 0 0 NAAN B.IMANG
0002298955241 3;JKN DR RIZKI; 5.2.1.201804062320 4 174905
1#0##0#0#0.0#2018-05-11 14:14:39#0#04:46:02#04:46:02#12:00:00 1
e3b1694c71eb1426db290fb9c2957db8 0 0 929132 0 0
1169797 0 0 0 0 3892435 0 0 0 0 741000
3201126 B 2 BS 1 27/04/2018 30/04/2018 12/01/1990 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 19416525 0 4 0 0 0 RIRIN BATAMMI
0001264332126 3;JKN DR RIZKI; 5.2.1.201804062320 4 176803
1#1#vvip#4#13432425#0.0#2018-05-11 14:17:23#0#12:25:04#12:25:04#00:00:00
2 e41b104ba81033aeab44b70271f415f5 0 8289400 6652400 0
0 3026725 0 0 0 0 1251000 0 0 0 0
197000
3201126 B 2 BS 1 24/04/2018 30/04/2018 03/10/1955 0 2
1 I21.2;I48;I50.0;E11.5;J18.8 - - - None None None None
12482300 0 0 - 0 - 0 - 0 - 0
12482300 20104273 0 7 1 4 0 SITI CHOTIMAH NY
0000060671799 3;JKN DR RIZKI; 5.2.1.201804062320 4 174486
1#1#vvip#7#7621973#0.0#2018-05-11 14:23:37#0#04:05:08#04:05:08#00:00:00
1 ad5df14507718b3459eae0f796556100 0 0 1997000 0 0
5676273 0 0 0 0 9528000 0 0 0 0
2903000
3201126 B 1 BS 1 19/04/2018 30/04/2018 05/05/1920 0 2
4 K74.6;B19.0;R18;R77.0;A41.9 - - - None None None None
(BERAT) 9446100 0 0 - 0 - 0 - 0 - 0
9446100 25880239 0 12 0 0 0 CHAIRUNNISA D322102
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 173268
1#0##0#0#0.0#2018-05-15 19:49:59#0#01:50:08#01:50:08#00:00:00 1
7cc5c1c4a2d716c00e86de6fb979d6b8 0 0 997610 0 0
12357129 0 0 0 0 10839500 0 0 0 0
1686000
3201126 B 3 BS 1 29/04/2018 30/04/2018 29/10/1964 0 2
0 - 0 - 0 - 0 - 0 4099300 5346315
0 2 0 0 0 PUJI LESTARI D396846 53 19540 DR
ZULFAN, SPPD 0138R0170418V009848 0001606581281 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176600 1#0##0#0#0.0#2018-05-24
10:37:06#0#20:19:01#20:19:01#00:00:00 1 5642a63ce8f084faae9b006ae084ca52
0 0 1263804 0 0 805752 0 0 0 0
1527759 0 0 0 0 1749000
3201126 B 3 BS 1 27/04/2018 30/04/2018 07/06/2017 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 7244810 0 4 0 0 0 HABIBIE KENTA RAMADHAN
0002253740512 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176315
1#0##0#0#0.0#2018-05-24 10:39:48#0#00:00:00#00:00:00#00:00:00 1
6ea0dfac6b9c22d2fe173ce45403baf0 0 3704400 1184912 0 0
1370538 0 0 0 0 499960 0 0 0 0 485000
3201126 B 1 BS 1 30/04/2018 30/04/2018 27/11/1961 0 1
1 E14.2;I25.0;T82.4 39.43 - - None None None None N-1-12-III
- 0 27065300 2000000 0 1 0 0 0 NUNU
HERIYANA TN D114692 56 20608 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V010143 0000060480268 3;JKN DR RIZKI; 5.2.1.201804062320
4 176802 1#0##0#0#0.0#2018-05-28
10:43:01#0#12:09:11#12:09:11#00:00:00 1 a3db5b640bbdd398a9325597bb4d3448
0 0 1999998 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 28/04/2018 30/04/2018 05/04/1953 0 2
1 I64;E11.1;I10 - - - None None None None G-4-15-III
- 0 - 0 - 0 - 0 9659700 13829647 0
3 1 3 0 RUSMIATI TRISNAWATI D397238 65 23764 DR.
ARU ARIADNO, SPPD 0138R0170418V009798 0000061070319 3;JKN ECHI;
5.2.1.201804062320 4 176570 1#0##0#0#0.0#2018-06-06
10:34:24#0#20:19:01#20:19:01#00:00:00 2 47e3a362596a472c38f71e6685c323d1
0 0 1267110 0 0 6659794 0 0 0 0
3169743 0 0 0 0 2733000
3201126 B 1 BS 1 29/04/2018 30/04/2018 03/03/1954 0 2
0 - 0 - 0 - 0 - 0 9150100 5429041
0 2 0 0 0 TJUTJU SUMARNI D359389 64 23433
RACHMAWATI DR,SPB(K)ONK 0138R0170418V009858 0000061157665 3;JKN ECHI;
5.2.1.201804062320 4 176604 1#0##0#0#0.0#2018-06-06
10:34:51#0#00:00:00#00:00:00#00:00:00 2 d3d4b03902e626e610a9fd62599af669
0 0 1830020 0 0 2001350 0 0 0 0
1597671 0 0 0 0 0
3201126 B 2 BS 1 29/04/2018 30/04/2018 26/07/1975 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8219726 0 2 0 0 0 ABDUL SYUKUR
0138R0170418V009822 0001634656307 3;JKN ECHI; 5.2.1.201804062320
4 176583 1#0##0#0#0.0#2018-06-06
10:35:19#0#11:42:05#11:42:05#00:00:00 2 d01afcd7ed92ca85ec1975bd4808451f
0 4911100 1041720 0 0 1634166 0 0 0 0
563740 0 0 0 0 69000
3201126 B 2 BS 1 29/04/2018 30/04/2018 16/11/1963 0 2
0 0 - 0 - 0 - 0 - 0 3545800
5798817 0 2 0 0 0 HASNA SAWARI d395760 54
19888 DR ZULFAN, SPPD 0138R0170418V010058 0001851887237 3;JKN ECHI;
5.2.1.201804062320 4 176647 1#0##0#0#0.0#2018-06-06
10:35:46#0#09:11:01#09:11:01#00:00:00 2 d464e6c45ee75822e9f893eab5c7d2c4
0 0 1045824 0 0 1083631 0 0 0 0
1920362 0 0 0 0 1749000
3201126 B 3 BS 1 14/04/2018 30/04/2018 14/07/2004 0 2
1 C49.9;A41.9;K36;E87.6 - - - None None None None M-4-
13-III None None None None None None TUMOR MUSKULOSKLETAL,JARINGAN
KONEKTIF DAN FRAKTUR PATOLOGIS (BERAT) 14385600 0 0 - 0 -
0 - 0 - 0 14385600 34082493 0 17 1 5
0 ATIKA LUTFI AURA D395966 13 5022 DR NOVIK BUDIWARDHANA, SPA
0138R0170418V004891 0001462540342 3;JKN ECHI; 5.2.1.201804062320
4 171579 1#0##0#0#0.0#2018-06-06
10:38:39#0#02:58:06#02:58:06#00:00:00 2 244c43c79a032a787a8c637fd1dcb4ba
0 0 2523560 0 0 16692933 0 0 0 0
10341000 0 0 0 0 4525000
3201126 B 3 BS 1 29/04/2018 30/04/2018 02/09/1961 0 2
1 N93.9;D64.9;C53.9 99.04;89.52 - - None None None None W-4-
0 - 0 3857000 4150630 0 2 0 0 0 NUNUK
SUMIYATINAH D397294 56 20693 DR ERDIYAN, SPOG 0138R0170418V010038
0002291076235 3;JKN ECHI; 5.2.1.201804062320 4 176667
1#0##0#0#0.0#2018-06-06 10:39:03#0#09:27:59#09:27:59#00:00:00 2
6b362090ae78cda2d0698df762791532 0 0 969533 0 0
2357560 0 0 0 0 823537 0 0 0 0 0
3201126 B 3 BS 1 27/04/2018 30/04/2018 15/04/2016 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 6146408 0 4 0 0 0 EL KIANO DAVIAN SUGIARTO
0002442760211 3;JKN irene; 5.2.1.201804062320 4 180921
1#0##0#0#0.0#2018-06-06 10:56:53#0#00:00:00#00:00:00#00:00:00 2
241aa300fbd6eeaf103ad674affd28bb 0 3704400 1016912 0 0
927995 0 0 0 0 428101 0 0 0 0 69000
3201126 B 2 BS 1 28/04/2018 30/04/2018 12/08/1989 0 2
None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG BELAKANG (RINGAN)
4425400 0 0 - 0 - 0 - 0 - 0
4425400 4193619 0 3 0 0 0 ROSIANA INDAH TARNIASARI
D164902 28 10486 DR. RAKHMAD HIDAYAT, SP.S (K) 0138R0170418V009752
0001626892198 3;JKN DR RIZKI; 5.2.2.201806040537 4 176493
1#0##0#0#0.0#2018-08-21 15:56:20#0#12:10:22#12:10:22#00:00:00 3
d577513167a9c3706dc51b13f1f19b59 0 1515000 703720 0 0
1674550 0 0 0 0 300349 0 0 0 0 0
3201126 B 3 BS 1 27/04/2018 30/04/2018 03/09/1945 0 2
1 I63.9;R09.8;E78.5;R40.2 89.52;87.44;87.03 - - None None None
- 0 - 0 6909500 11720554 0 4 1 2 0
MARYANI D397159 72 26534 DR MAYSAMIRAWATI SPS
0138R0170418V009679 0000512372439 3;JKN DR RIZKI; 5.2.2.201806040537
4 176312 1#0##0#0#0.0#2018-08-23
08:34:18#0#21:19:47#21:19:47#00:00:00 3 5ad9331a1eedd6bec675a0e8e84c7ea7
0 0 833498 0 0 7291291 0 0 0 0
2684765 0 0 0 0 911000
3201126 B 3 BS 1 28/04/2018 30/04/2018 03/03/1955 0 1
1 I64;E87.1 87.03;87.44 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 7161070 0
3 0 0 0 S HILAL HUTAHAEN D319043 63 23067 DR WIDHI
DEWANTA K AJI 0138R0170418V009780 0001740129366 3;JKN DR RIZKI;
5.2.2.201806040537 4 176565 1#0##0#0#0.0#2018-09-04
12:24:36#0#15:59:13#15:59:13#00:00:00 2 b50c8afe822911745cd0a06bcba2a9e0
0 0 621855 0 0 4894734 0 0 0 0 775481
0 0 0 0 869000
3201126 B 1 BS 1 27/04/2018 01/05/2018 12/11/1952 0 2
0 - 0 - 0 58821400 65774642 0 5 0 0
0 FARNI D397158 65 23907 DR AZRI NURIZAL SPPD KKV
0138R0170418V009662 0001808048136 3;JKN DR RIZKI; 5.2.1.201804062320
4 176304 1#0##0#0#0.0#2018-05-21
09:36:29#0#18:12:34#18:12:34#00:00:00 1 bcbaa8ac16f1acf9068c3fa3a4091710
0 11098500 9672120 0 0 36026022 0 0 0 0
1256000 0 0 0 0 7722000
3201126 B 3 BS 1 30/04/2018 01/05/2018 12/12/1945 0 2
1 N18.5;D63.8;H81.3 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2210882 0 2 0 0 0 GAWIEK SURASIAH
0001468930498 3;JKN DR RIZKI; 5.2.1.201804062320 4 177058
1#0##0#0#0.0#2018-05-21 09:39:18#0#19:43:56#19:43:56#12:00:00 1
9956e1d43c271d92cbcc5396b7b54679 0 0 371889 0 0
1142356 0 0 0 0 696637 0 0 0 0 0
3201126 B 2 BS 1 27/04/2018 01/05/2018 19/02/2018 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9377874 0 5 0 0 0 BAYI NY BUNGA WULANSARI
WIJAYA D395756 0 67 DR CATUR SUZANTARA 0138R0170418V009676
0002431445354 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176310
1#0##0#0#0.0#2018-05-23 08:20:41#0#21:10:59#21:10:59#00:00:00 2
ae29aff255275a725e07fbd7f6e59998 0 5533600 1844276 0 0
1195492 0 0 0 0 659506 0 0 0 0 145000
3201126 B 2 BS 1 26/04/2018 01/05/2018 08/09/2017 0 1
1 D47.3;J06.9;N47 - - - None None None None D-4-11-I
4851400 0 0 - 0 - 0 - 0 - 0
4851400 2437325 0 6 0 0 0 ALVIN PUTRA PRATAMA
0002284471978 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175947
1#0##0#0#0.0#2018-05-23 08:38:19#0#20:51:35#20:51:35#00:00:00 1
c5fcc28cdfe2c3c61ca89d5758cbf5f2 0 0 489626 0 0 412248
0 0 0 0 1195451 0 0 0 0 340000
3201126 B 2 BS 1 28/04/2018 01/05/2018 28/04/2018 2546 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2981567 0 4 0 0 0 RIRIN BATAMMI BY NY
D397232 0 0 DR RASTRA, SPA 0138R0170418V010259
0002454971624 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176922
1#0##0#0#0.0#2018-05-23 08:40:00#0#14:59:59#14:59:59#00:00:00 1
fda1c7434f0f7c47eb126853ce2cbb46 0 0 433812 0 0 164099
0 0 0 0 2383656 0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 01/05/2018 10/08/1993 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 7798357 0 3 0 0 0 MAYA SAFIRAH
D397292 24 9028 DR RAHMADSYAH SPOG 0138R0170418V009817
0001260318778 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176580
1#0##0#0#0.0#2018-05-24 10:43:59#0#09:45:00#09:45:00#00:00:00 1
99a625e1557cad42c8569718b10e2259 0 3534500 1751644 0 0
1779039 0 0 0 0 536174 0 0 0 0 197000
3201126 B 3 BS 1 29/04/2018 01/05/2018 04/02/1954 0 1
- 0 8908800 8976538 0 3 0 0 0 DOMINGGUS
GANGGAR D396921 64 23460 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170418V009825 0001744802965 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176584 1#0##0#0#0.0#2018-05-24
10:48:49#0#12:33:54#12:33:54#00:00:00 1 9acdeaebab906823fe816e636dab5c68
0 3062500 1870848 0 0 3360940 0 0 0 0
613250 0 0 0 0 69000
3201126 B 1 BS 1 29/04/2018 01/05/2018 17/05/2004 0 1
0 - 0 - 0 - 0 - 0 3116300 4958378
0 3 0 0 0 ABDUL FATTAH RIZIEQ D397322 13 5095
DR OTTY MITHA S, SPA 0138r0170418v009856 0000058881317 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 176603 1#0##0#0#0.0#2018-
05-24 10:54:39#0#21:32:25#21:32:25#00:00:00 1
99db978281b49b5e9b06c980009d6347 0 0 333467 0 0
2277031 0 0 0 0 2347880 0 0 0 0 0
3201126 B 2 BS 1 28/04/2018 01/05/2018 27/11/1993 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 11585162 0 4 0 0 0 NOVITA RANI KURNIASIH
0001455016342 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176566
1#0##0#0#0.0#2018-05-24 11:02:37#0#16:38:14#16:38:14#00:00:00 1
26446fe8af471fbba097458b4316cf75 0 5477400 2133753 0 0
2719745 0 0 0 0 860264 0 0 0 0 394000
3201126 B 3 BS 1 29/04/2018 01/05/2018 01/08/1963 0 2
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 4807402 0 3 0 0 0 MULYATI NY
D384081 54 19995 DR SRI KUNMARTINI, SPPD 0138R0170418V009816
0000512880366 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176579
1#0##0#0#0.0#2018-05-24 11:08:19#0#09:16:17#09:16:17#00:00:00 2
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2096760 0 0 0 0 2285753 0 0 0 0 0
3201126 B 1 BS 1 27/04/2018 01/05/2018 12/12/1944 0 2
1 I25.1;I11.0 36.07 - - YY02 None None None I-1-40-III None
None YY-02-III None None None PROSEDUR KARDIOVASKULAR PERKUTAN (BERAT)
48095600 0 0 PCI 10725800 - 0 - 0 - 0
58821400 55653618 0 5 0 0 0 TATTY ISMAIL,NY
0000060751405 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176222
1#0##0#0#0.0#2018-05-24 11:13:31#0#12:00:26#12:00:26#00:00:00 1
d8faf28c31015c3363ace9d6df86f1bf 0 10062000 9619120 0 0
27117498 0 0 0 0 1286000 0 0 0 0
7569000
3201126 B 2 BS 1 28/04/2018 01/05/2018 17/12/2015 0 2
1 D56.0;D55.0;T80.3 99.04 - - None None None None D-4-13-II
0 - 0 5073100 3210581 0 4 0 0 0 ADEEVA
0138R0170418V009776 0001898497269 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176564 1#0##0#0#0.0#2018-05-24
11:19:54#0#15:00:07#15:00:07#00:00:00 1 28f2c834b5e9b8bf8d1774944056c1c4
0 0 375596 0 0 1588947 0 0 0 0
1246038 0 0 0 0 0
3201126 B 1 BS 1 28/04/2018 01/05/2018 21/12/2007 0 1
- 0 5918600 5229150 0 4 0 0 0 IQBAL
0138R0170418V009753 0001335363658 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176498 1#0##0#0#0.0#2018-05-24
11:22:07#0#12:24:14#12:24:14#12:00:00 2 12f2aa4bb34bb3973c67621af0bc1e83
0 0 376362 0 0 2922694 0 0 0 0
1930094 0 0 0 0 0
3201126 B 3 BS 1 28/04/2018 01/05/2018 02/07/1960 0 1
- 0 8908800 8085718 0 4 0 0 0 SUTARNO
0002041709668 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176437
1#0##0#0#0.0#2018-05-24 11:43:53#0#11:01:50#11:01:50#00:00:00 1
c744a1f28bdd699e05768a3014abeab0 0 3080500 1941665 0 0
2463121 0 0 0 0 600432 0 0 0 0 0
3201126 B 1 BS 1 27/04/2018 01/05/2018 27/04/2018 3382 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3259347 0 5 0 0 0 VERA DWIWATI BY NY
D397117 0 0 KRISTYANINGESTI,DR.SPA 0138R0170418V009632
0002448380024 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176277
1#0##0#0#0.0#2018-05-24 11:51:04#0#16:04:03#16:04:03#00:00:00 1
178ebf04c3be277c44e062bac7c275fb 0 0 499620 0 0 88899
0 0 0 0 2670828 0 0 0 0 0
3201126 B 2 BS 1 28/04/2018 01/05/2018 10/08/2009 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 4790930 0 4 0 0 0 KRESNA DUTA ASMARA
0001623402887 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176424
1#0##0#0#0.0#2018-05-24 12:11:09#0#10:52:10#10:52:10#00:00:00 1
6970b11d842180ceb01980de8e8b0d89 0 0 443231 0 0
1988274 0 0 0 0 2359425 0 0 0 0 0
3201126 B 3 BS 1 01/05/2018 01/05/2018 27/11/2017 0 2
1 P29.3;Q25.0;Q31.5;A41.9 99.60 - - None None None None I-4-
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3201126 B 3 BS 1 30/04/2018 01/05/2018 12/06/1965 0 1
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1#0##0#0#0.0#2018-05-30 16:03:04#0#10:04:06#10:04:06#12:00:00 1
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3201126 B 2 BS 1 26/04/2018 01/05/2018 22/08/2017 0 1
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1#0##0#0#0.0#2018-06-12 15:33:01#0#09:35:57#09:35:57#12:00:00 1
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3201126 B 2 BS 1 29/04/2018 01/05/2018 08/10/1981 0 2
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DR ERDIYAN, SPOG 0138R0170418V009809 0001623403427 3;JKN DR RIZKI;
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08:45:55#0#00:00:00#00:00:00#00:00:00 2 f262b51405f61d27106ea52e5b587f55
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4 176800 1#0##0#0#0.0#2018-08-24
08:59:59#0#12:07:43#12:07:43#00:00:00 3 5f3e188bfdc33ef2c833a385b0756d31
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621712 0 0 0 0 69000
3201126 B 3 BS 1 25/04/2018 01/05/2018 30/12/1946 0 1
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09:12:11#0#14:27:33#14:27:33#00:00:00 2 047edf1ed411234be1efd6f1fcee278c
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3201126 B 2 BS 1 30/04/2018 02/05/2018 30/04/2018 3137 2
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1#0##0#0#0.0#2018-05-22 09:34:15#0#14:13:54#14:13:54#00:00:00 1
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3201126 B 2 BS 1 29/04/2018 02/05/2018 04/04/1993 0 2
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TANTIYO S;16137 5.2.1.201804062320 4 176608
1#1#vvip#4#13946554#0.0#2018-05-23 08:34:03#0#00:00:00#00:00:00#00:00:00
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394000
3201126 B 3 BS 1 02/05/2018 02/05/2018 24/05/1965 0 2
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13-III None None None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-
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1#0##0#0#0.0#2018-05-23 09:05:50#0#18:05:42#18:05:42#00:00:00 1
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13:10:09#0#18:38:51#18:38:51#00:00:00 1 c7d5365db5275ee6c6fb83d3d65df5e4
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14:27:08#0#15:11:15#15:11:15#00:00:00 1 afc43d4014b5332c612f4ff77fda3200
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3201126 B 2 BS 1 01/05/2018 02/05/2018 23/09/1992 0 2
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14:31:20#0#02:20:44#02:20:44#00:00:00 1 3775bfdda7099cb1d8158faec9dcb311
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1#0##0#0#0.0#2018-05-24 14:37:38#0#21:24:21#21:24:21#12:00:00 1
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14:47:32#0#17:04:47#17:04:47#00:00:00 1 14b5c6a328636b03e1a5bc6d1d653dce
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1#0##0#0#0.0#2018-05-24 14:49:58#0#15:45:04#15:45:04#12:00:00 1
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7569000
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4 176581 1#0##0#0#0.0#2018-05-24
15:01:09#0#10:25:47#10:25:47#12:00:00 1 147352142c1f5072de118186377ec8fa
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1#0##0#0#0.0#2018-05-24 15:23:26#0#21:05:03#21:05:03#00:00:00 1
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4 177061 1#0##0#0#0.0#2018-05-24
15:27:57#0#20:43:36#20:43:36#12:00:00 1 ea75e11300582307953a085b1f9914de
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1#0##0#0#0.0#2018-05-26 08:45:05#0#17:55:35#17:55:35#12:00:00 1
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13:33:26#0#17:02:57#17:02:57#00:00:00 1 fb9eb780cffd64f8d2eede6411be7fa5
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1#0##0#0#0.0#2018-08-24 09:26:28#0#14:29:12#14:29:12#00:00:00 2
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1#0##0#0#0.0#2018-08-24 09:54:55#0#11:31:47#11:31:47#00:00:00 2
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1180790 0 0 0 0 1240832 0 0 0 0 0
3201126 B 1 BS 1 01/05/2018 02/05/2018 26/06/1943 0 1
1 K51.8;I84.5 45.23;45.25 - - None None None None K-4-13-I
0 - 0 - 0 5576700 7746156 0 2 0 0
0 WACHDIJAT DINTAUKARDJA D128893 74 27338 DR ZULFAN, SPPD
0138R0170518V000046 0001299066423 3;JKN DR RIZKI; 5.2.2.201806040537
4 177069 1#0##0#0#0.0#2018-09-29
14:40:33#0#00:00:00#00:00:00#00:00:00 2 faa6fd8ccaa484b953967318b09b28f4
0 0 1926876 0 0 1233022 0 0 0 0
2837258 0 0 0 0 1749000
3201126 B 1 BS 1 29/04/2018 02/05/2018 07/11/1957 0 1
1 S42.70;E10.9;I10 79.31;99.17 - - None None None None M-1-
12140800 0 0 - 0 - 0 - 0 - 0
12140800 21335395 0 4 0 0 0 YOSMAR MUNIR
0000040543749 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 176595
1#0##0#0#0.0#2018-10-05 13:46:17#0#00:00:00#00:00:00#00:00:00 2
471140238c222b8110da8bfd239aaec2 0 0 7346708 0 0
4352087 0 0 0 0 9491600 0 0 0 0 145000
3201126 B 2 BS 1 26/04/2018 03/05/2018 17/08/1982 0 1
1 H46;H16.9 - - - None None None None H-4-11-I None
None None None None None GANGGUAN SARAF MATA (RINGAN) 3536300 0
0 - 0 - 0 - 0 - 0 3536300 19105461
0 8 0 0 0 RINA AGUSTINA d354107 35 13036 DR
ERRY, SPM 0138R0170418V009252 0001369093083 3;JKN DR RIZKI;
5.2.1.201804062320 4 181886 1#1#kelas_1#8#589400#0.0#2018-05-19
11:51:20#1#00:00:00#00:00:00#00:00:00 1 b43e5a22e3b0c8db3d4964e233272873
0 4535190 1493284 0 0 11850987 0 0 0 0
1226000 0 0 0 0 0
3201126 B 1 BS 1 01/05/2018 03/05/2018 05/08/1951 0 1
1 R63.0;F03 - - - None None None None E-4-10-I None
- 0 4903800 3452281 0 3 0 0 0 AGUS
TJIWARTO D397458 66 24376 DR. ARU ARIADNO, SPPD 0138R0170518V000115
0001479586454 3;JKN DR RIZKI; 5.2.1.201804062320 4 177630
1#0##0#0#0.0#2018-05-21 09:37:44#0#18:24:49#18:24:49#00:00:00 1
43503fd86f481476e1c3fa8adc5bbe0c 0 0 236051 0 0 621380
0 0 0 0 2594850 0 0 0 0 0
3201126 B 1 BS 1 03/05/2018 03/05/2018 08/12/1989 0 2
- 0 - 0 - 0 - 0 3035600 1818660 0
1 0 0 0 KEN ARUM EUREKA ROOS D370369 28 10373 DR
5.2.1.201804062320 4 177628 1#0##0#0#0.0#2018-05-22
15:29:46#0#17:52:47#17:52:47#00:00:00 1 a1cd6c627caa7298bbbf3769987e6ed6
0 0 576204 0 0 316478 0 0 0 0 925978
0 0 0 0 0
3201126 B 3 BS 1 03/05/2018 03/05/2018 31/12/1949 0 2
1 I63.9;I10;G81.9 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 2082856 0 1 0 0 0 NYAI D397597
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177236
1#0##0#0#0.0#2018-05-24 08:27:19#0#02:23:04#02:23:04#00:00:00 1
9c0fa21522b5fa9a51d03dacaa4e65ec 0 0 345475 0 0 560038
0 0 0 0 461343 0 0 0 0 716000
3201126 B 3 BS 1 30/04/2018 03/05/2018 01/03/1931 0 2
1 I63.9;I10;G81.9 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4773423 0 4 0 0 0 NEMU IDJO
0000511908265 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176612
1#0##0#0#0.0#2018-05-24 09:17:13#0#00:00:00#00:00:00#00:00:00 1
3f8156182d127fd0188f0b8c8cc53529 0 0 557179 0 0
2825964 0 0 0 0 1390280 0 0 0 0 0
3201126 B 1 BS 1 02/05/2018 03/05/2018 02/05/2018 3531 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1329518 0 2 0 0 0 RACHMA SYAFITRI BY NY
D397544 0 0 DR KHARINA CHATAR SPA 0138R0170518V000876
0002455727387 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177502
1#0##0#0#0.0#2018-05-24 09:28:29#0#11:26:27#11:26:27#00:00:00 1
c731cb13f8482be62012b3a5ac911d86 0 0 250041 0 0 88899
0 0 0 0 990578 0 0 0 0 0
3201126 B 1 BS 1 02/05/2018 03/05/2018 11/03/1994 0 2
0 0 - 0 - 0 - 0 - 0 2775400
5669411 0 2 0 0 0 RACHMA SYAFITRI D384825 24
TANTIYO S;16137 5.2.1.201804062320 4 177095 1#0##0#0#0.0#2018-
05-24 09:32:45#0#04:50:42#04:50:42#00:00:00 1
66a6fde8aa50e7a3b8a727a718962a21 0 0 521980 0 0
1135835 0 0 0 0 3883596 0 0 0 0 128000
3201126 B 2 BS 1 01/05/2018 03/05/2018 06/05/1989 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10332460 0 3 0 0 0 RIKA PRIHATIN D234937 28
TANTIYO S;16137 5.2.1.201804062320 4 177071 1#0##0#0#0.0#2018-
05-24 15:12:58#0#00:00:00#00:00:00#00:00:00 1
f45cef259cbccbb2c7b9b904598babd5 0 5269900 2090753 0 0
2003852 0 0 0 0 701955 0 0 0 0 266000
3201126 B 3 BS 1 28/04/2018 03/05/2018 28/06/1962 0 1
1 I63.9;E78.5;G81.9 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5421064 0 6 0 0 0 KARTO D397198
55 20393 DR MAYSAM I., SPS 0138R0170418V009744 0001610067791 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 176470 1#0##0#0#0.0#2018-
05-24 15:14:49#0#11:31:46#11:31:46#00:00:00 1
ac2c98a6431cb09bbf528a1bd2754502 0 0 743950 0 0
2718465 0 0 0 0 1958649 0 0 0 0 0
3201126 B 1 BS 1 26/04/2018 03/05/2018 18/10/1953 0 2
1 J18.9;J45.9;E87.6 93.94 - - None None None None J-4-16-II
(SEDANG) 7108500 0 0 - 0 - 0 - 0 - 0
7108500 14482811 0 8 0 0 0 RINTJE DAMERIA
0001257153311 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 175416
1#0##0#0#0.0#2018-05-26 10:15:37#0#01:19:55#01:19:55#00:00:00 1
6e25e0f570eec2b664dfb53a540aecb3 0 0 427175 0 0
6834162 0 0 0 0 7221474 0 0 0 0 0
3201126 B 1 BS 1 01/05/2018 03/05/2018 10/01/1959 0 2
0 - 0 11182000 17501431 0 3 0 0 0 RABIAH
WATI D206360 59 21661 DR RAY HENDRY, SPOT 0138R0170518V000126
0001468466706 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177085
1#0##0#0#0.0#2018-05-26 11:14:20#0#00:00:00#00:00:00#00:00:00 1
c07d61177486d6354cb0cc7856b66844 0 0 6117360 0 0
2500562 0 0 0 0 8745509 0 0 0 0 138000
3201126 B 1 BS 1 01/05/2018 03/05/2018 05/05/1953 0 1
1 I50.0;A41.9;I25.0;N18.1 - - - None None None None I-4-
6963100 0 0 - 0 - 0 - 0 - 0
6963100 4223213 0 3 0 0 0 SYAMSUDIN D370559
0000037949231 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177070
1#0##0#0#0.0#2018-05-26 13:36:10#0#00:00:00#00:00:00#00:00:00 1
fee162a0f3d90ac918dc3abe291d3099 0 0 679679 0 0 898249
0 0 0 0 2645285 0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 03/05/2018 18/05/1957 0 1
0 - 0 - 0 - 0 - 0 4144700 4057309
0 5 0 0 0 ABDUL KARIM D397299 60 22261 DR BAMBANG
DWIPUTRA SPJP 0138R0170418V009836 0002424447347 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176594 1#0##0#0#0.0#2018-05-30
12:38:51#0#17:28:36#17:28:36#00:00:00 1 29cf87435b208694b787c1e9c374a99d
0 0 479023 0 0 2058355 0 0 0 0
1519931 0 0 0 0 0
3201126 B 3 BS 1 30/04/2018 03/05/2018 02/02/2017 0 1
(SEDANG) 2753900 0 0 - 0 - 0 - 0 - 0
2753900 4045569 0 4 0 0 0 RONAL VAN BASTEN GULTOM
0002293567086 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176611
1#0##0#0#0.0#2018-05-30 15:50:21#0#00:00:00#00:00:00#00:00:00 1
14dbde421971a58374d2510172696fb4 0 0 292030 0 0
1900876 0 0 0 0 1342663 0 0 0 0 510000
3201126 B 3 BS 1 02/05/2018 03/05/2018 19/05/1956 0 2
1 J18.0;A41.9 - - - None None None None J-4-16-III None
6419700 0 0 - 0 - 0 - 0 - 0
6419700 2140800 0 2 0 0 0 R LUCY ROSMALIA DEWI
0001462507075 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177096
1#0##0#0#0.0#2018-05-30 15:58:10#0#05:41:47#05:41:47#00:00:00 1
9425896a801799ba1a766a8dec6c180d 0 0 630773 0 0 817975
0 0 0 0 692052 0 0 0 0 0
3201126 B 2 BS 1 01/05/2018 03/05/2018 18/09/2014 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2524894 0 3 0 0 0 ARSYL SAFIR SUYATNO
0001735257622 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177087
1#0##0#0#0.0#2018-05-30 15:59:20#0#20:15:49#20:15:49#00:00:00 1
2b5c25784fc28bf29faca7c4102dfd70 0 0 298025 0 0 728189
0 0 0 0 1498680 0 0 0 0 0
3201126 B 2 BS 1 02/05/2018 03/05/2018 11/12/1948 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4688424 0 2 0 0 0 IR PAUL RAUBUN,
M.S.E D361946 69 25344 SRI KUNMARTINI.DR,SPPD 0138R0170518V000510
0001222739706 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177214
1#0##0#0#0.0#2018-05-30 16:00:16#0#15:24:39#15:24:39#00:00:00 1
10aa7784cfa6a0c8be4ef16afcde808e 0 0 446265 0 0
1743190 0 0 0 0 2498969 0 0 0 0 0
3201126 B 3 BS 1 02/05/2018 03/05/2018 11/10/1953 0 1
- 0 8908800 9499522 0 2 0 0 0 H ISMET
RACHMANTO D373124 64 23579 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V000573 0001425176886 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 177224 1#0##0#0#0.0#2018-05-30
16:01:27#0#17:03:28#17:03:28#12:00:00 1 8890107f0ea8dfaa4785610b8bb81071
0 3438800 1870848 0 0 3473410 0 0 0 0
647464 0 0 0 0 69000
3201126 B 2 BS 1 29/04/2018 03/05/2018 22/04/1956 0 2
1 D64.9;J18.0;B34.9;K92.1 99.04 - - None None None None D-4-
- 0 - 0 6488600 9278518 0 5 0 0 0
WIJI PRIHATI d384810 62 22652 DR. ARU ARIADNO, SPPD
0138R0170418V009814 0000060981603 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 176578 1#0##0#0#0.0#2018-05-30
16:08:02#0#08:45:30#08:45:30#12:00:00 1 498250d658a2777fc7d4292ffeb5d4aa
0 0 601370 0 0 5501142 0 0 0 0
3176006 0 0 0 0 0
3201126 B 2 BS 1 01/05/2018 03/05/2018 01/05/2018 3312 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1844799 0 3 0 0 0 RIKA PRIHATIN BY NY
d397466 0 0 DR VERA MUNA MANOE, SPA 0138R0170518V000646
0002455216064 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177230
1#0##0#0#0.0#2018-05-30 16:11:11#0#20:47:29#20:47:29#00:00:00 1
331f3b301494c16cd2178c9328e19424 0 0 506812 0 0 396699
0 0 0 0 941288 0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 03/05/2018 05/05/1981 0 1
0 - 0 - 0 - 0 - 0 3575600 1900608
0 5 0 0 0 RACHMAT HIDAYAT d397307 36 13508 DR
S;16137 5.2.1.201804062320 4 176700 1#0##0#0#0.0#2018-05-30
16:12:55#0#09:53:44#09:53:44#00:00:00 1 563440fe041f2124e4ecdf99a3384759
0 0 374804 0 0 409965 0 0 0 0
1115839 0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 03/05/2018 01/12/1999 0 1
4 J18.0;A41.9;R57.2 87.44 - - None None None None J-4-16-III
6419700 0 0 - 0 - 0 - 0 - 0
6419700 16972152 0 5 1 3 0 QOMARIAH RAMDANIATI
D390764 18 6724 DR ARU, SPPD 0138R0170418V009833
0000511092562 3;JKN DR RIZKI; 5.2.1.201804062320 4 176590
1#0##0#0#0.0#2018-06-05 09:50:54#0#16:40:08#16:40:08#12:00:00 1
c957fa3ad731483d1a31c3389439e86a 0 0 509975 0 0
10052849 0 0 0 0 4281328 0 0 0 0
2128000
3201126 B 1 BS 1 02/05/2018 03/05/2018 06/11/1970 0 2
1 N18.5;T82.4;D63.8 39.42;99.04 - - None None None None N-1-
- 0 - 0 27065300 16904495 0 2 0 0 0
MAIMUNAH D392430 47 17344 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V000561 0000168357317 3;JKN DR RIZKI; 5.2.1.201804062320
4 177223 1#0##0#0#0.0#2018-08-24
10:06:13#0#16:53:17#16:53:17#12:00:00 2 4de9527bcc70226d902b14b7df8b6069
0 6468200 5683713 0 0 3245680 0 0 0 0
1181902 0 0 0 0 325000
3201126 B 1 BS 1 29/04/2018 03/05/2018 05/07/1957 0 2
1 I63.9;G81.9;J22 87.03;93.94 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 9268169 0 5 0 0 0 TITIN SOEDJARNA
0001264851999 3;JKN DR RIZKI; 5.2.2.201806040537 4 176598
1#0##0#0#0.0#2018-08-24 10:10:07#0#19:05:01#19:05:01#00:00:00 2
71fe9c2294edaf605986821582fd47fd 0 0 1267110 0 0
3809230 0 0 0 0 4191829 0 0 0 0 0
3201126 B 2 BS 1 02/05/2018 03/05/2018 12/03/1951 0 2
(SEDANG) 30864700 0 0 PCI 10725800 - 0 - 0 -
0 41590500 49195960 0 2 0 0 0 MUINAH
0000172689142 3;JKN DR RIZKI; 5.2.2.201806040537 4 177112
1#0##0#0#0.0#2018-08-24 10:14:08#0#08:45:42#08:45:42#12:00:00 2
da3434c5402ff1b16839eb76f5566145 0 9004000 6172940 0 0
24918020 0 0 0 0 1276000 0 0 0 0
7825000
3201126 B 2 BS 1 30/04/2018 03/05/2018 27/06/1976 0 2
1 I64;G81.9;E78.5 87.44;87.03 - - None None None None G-4-
- 0 - 0 - 0 - 0 5866300 5591505 0
4 0 0 0 DESI KURNIASIH D209045 41 15282 DR NURUL
KOMARI SPS 0138R0170418V010348 0001229141632 3;JKN DR RIZKI;
5.2.2.201806040537 4 177054 1#0##0#0#0.0#2018-08-24
10:30:00#0#17:18:10#17:18:10#12:00:00 2 f17b382efebac44459edefb7c0e87d56
0 0 799226 0 0 2380480 0 0 0 0
2411799 0 0 0 0 0
3201126 B 2 BS 1 01/05/2018 03/05/2018 19/07/2014 0 1
None None None None None None FRAKTUR/DISLOKASI SELAIN FEMUR DAN PELVIS
(RINGAN) 3536800 0 0 - 0 - 0 - 0 - 0
3536800 8028924 0 3 0 0 0 MUHAMMAD NUR RIZKY
RAMADHAN AN D397475 3 1382 DR RAY HENDRY, SPOT 0138R0170518V000132
0002431543555 3;JKN DR RIZKI; 5.2.2.201806040537 4 177088
1#0##0#0#0.0#2018-08-24 16:20:12#0#21:34:04#21:34:04#00:00:00 2
2814fd4841f6a123d889e3bd2f88fdd1 0 5275100 979940 0 0
1153627 0 0 0 0 551257 0 0 0 0 69000
3201126 B 3 BS 1 02/05/2018 03/05/2018 06/03/1947 0 2
- 0 45079800 54222750 0 2 0 0 0 JAENAH
0000511736624 3;JKN DR RIZKI; 5.2.2.201806040537 4 177097
1#0##0#0#0.0#2018-09-06 16:25:12#0#07:53:52#07:53:52#12:00:00 2
479b2e3e544051d992ee4efdb922a9fc 0 7996000 6870800 0 0
30510950 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 03/05/2018 03/05/2018 23/03/2003 0 1
2 S09.8;S06.41 - - - None None None None G-4-24-III
None None None None None None TRAUMA KEPALA (BERAT) 6333900 0
0 - 0 - 0 - 0 - 0 6333900 3242647
0 1 0 0 0 THEO RAPSANJANI AN D397601 15 5520
DR YOHANES DWINANDA R P 0138R0170518V000660 0001846117743 3;JKN DR
RIZKI; 5.2.2.201806040537 4 177237 1#0##0#0#0.0#2018-09-07
15:59:11#0#02:30:05#02:30:05#00:00:00 2 3e3e015075340006b91abd14e81ed4b0
0 0 273879 0 0 227277 1429900 0 0 0
425591 0 0 0 0 886000
3201126 B 3 BS 1 02/05/2018 03/05/2018 10/06/1956 0 1
1 S42.3;S09.9 - - - None None None None M-4-12-II None
(SEDANG) 4902300 0 0 - 0 - 0 - 0 - 0
4902300 2027443 0 2 0 0 0 JOHNY d397561 61
DR RIZKI; 5.2.2.201806040537 4 177228 1#0##0#0#0.0#2018-09-25
18:58:37#0#19:34:19#19:34:19#00:00:00 2 5f1039202c7e2214a1fd2e677185a09f
0 0 441207 0 0 430600 0 0 0 0 439636
0 0 0 0 716000
3201126 B 1 BS 1 02/05/2018 03/05/2018 05/03/1954 0 2
0 - 0 - 0 - 0 - 0 3247500 6714286
0 2 0 0 0 ENDANG SRI WARTIATI,S.PD D394459 64
23434 DR ARU, SPPD 0138R0170518V000248 0000042142713 3;JKN DR
RIZKI; 5.2.1.201804062320 4 177098 1#0##0#0#0.0#2018-09-28
09:37:48#0#08:10:42#08:10:42#12:00:00 2 3cedf09ec9090c6735f38cbb742e7d5e
0 0 1274304 0 0 771230 0 0 0 0
2739752 0 0 0 0 1929000
3201126 B 2 BS 1 26/04/2018 03/05/2018 12/04/1952 0 1
1 I21.9;J80;I12.0;D63.8;J81;J18.9 39.95;38.95;96.71 - - None
None None None J-1-20-III None None None None None None PROSEDUR
SISTEM PERNAFASAN NON-KOMPLEKS (BERAT) 34963000 0 0 - 0 -
0 - 0 - 0 34963000 47331013 0 8 1 2
24 LAMRI BIN UKON ATMADJA D329026 66 24120 DR BAMBANG DWIPUTRA SPJP
0138R0170418V008970 0000042985258 3;JKN DR RIZKI; 5.2.2.201806040537
4 175436 1#0##0#0#0.0#2018-10-02
10:59:54#0#08:40:47#08:40:47#00:00:00 2 7b7a8790795bcf2e868922d5bb7beb66
0 9580100 5302552 0 0 21947361 0 0 0 0
6216000 0 0 0 0 4285000
3201126 B 3 BS 1 02/05/2018 04/05/2018 17/08/1977 0 1
- 0 8908800 9970759 0 3 0 0 0 AGUS SALIM
0138R0170518V000581 0001428740133 3;JKN DR RIZKI; 5.2.1.201804062320
4 177629 1#0##0#0#0.0#2018-05-21
09:32:22#0#18:22:02#18:22:02#00:00:00 1 a6ce5bd95d6faf9dee8c7d8313bc096f
0 3611800 2583552 0 0 2948114 0 0 0 0
758293 0 0 0 0 69000
3201126 B 3 BS 1 04/05/2018 04/05/2018 06/06/1947 0 1
7040000 0 0 - 0 - 0 - 0 - 0
7040000 3160234 0 1 0 0 0 MOHAMMAD SUHADI
SUPRIYATNO D392782 70 25900 DR VINSENSIA NOVI KARTIKA
0138R0170518V001321 0002432175197 3;JKN DR RIZKI; 5.2.1.201804062320
4 177793 1#0##0#0#0.0#2018-05-22
08:43:32#0#10:58:57#10:58:57#12:00:00 1 97bb32f6894eaa169d0b09f7c3596d90
0 0 352341 0 0 2312149 0 0 0 0 495744
0 0 0 0 0
3201126 B 3 BS 1 03/05/2018 04/05/2018 10/09/1970 0 1
INTERNAL (RINGAN) 4315600 0 0 - 0 - 0 - 0 -
0 4315600 9835850 0 2 0 0 0 ALEX KASLAN
0001860112168 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177495
1#0##0#0#0.0#2018-05-22 14:41:29#0#11:19:06#11:19:06#12:00:00 1
6c2c8ac85941ba399ec7e6f5086c8018 0 0 1833368 0 0
1484015 0 0 0 0 6373467 0 0 0 0 145000
3201126 B 2 BS 1 02/05/2018 04/05/2018 02/11/2003 0 2
0 0 - 0 - 0 - 0 - 0 2871200
3233709 0 3 0 0 0 RIKA NOVITASARI AN D327079
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177092
1#0##0#0#0.0#2018-05-23 08:18:56#0#01:43:52#01:43:52#00:00:00 1
c5f400a065b86f22054fd256608d318e 0 0 311408 0 0
1169750 0 0 0 0 1752551 0 0 0 0 0
3201126 B 2 BS 1 02/05/2018 04/05/2018 05/04/1976 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2871486 0 3 0 0 0 PRIYONO TN D397497
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177093
1#0##0#0#0.0#2018-05-23 08:21:56#0#04:29:42#04:29:42#00:00:00 1
3a049ac6157f73876a042ceac0ff853c 0 0 354545 0 0 788087
0 0 0 0 1728854 0 0 0 0 0
3201126 B 1 BS 1 03/05/2018 04/05/2018 10/11/1976 0 1
0 - 0 - 0 - 0 - 0 3247500 6379511
0 2 0 0 0 IWAN SANTOSO d367315 41 15149 DR.
ARU ARIADNO, SPPD 0138R0170518V000934 0002095300282 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 177533 1#0##0#0#0.0#2018-05-23
08:24:25#0#13:36:05#13:36:05#00:00:00 1 a78977a7299f94c7babd826d89301909
0 0 1025300 0 0 837360 0 0 0 0
2767851 0 0 0 0 1749000
3201126 B 2 BS 1 30/04/2018 04/05/2018 07/02/1995 0 2
1 H81.1;N39.0 - - - None None None None U-4-11-II None
None None None None None DYSEQUILIBRIUM (SEDANG) 2648400 0 0
- 0 - 0 - 0 - 0 2648400 6553755 0
5 0 0 0 DEWI SUHARTINI D383651 23 8483 DR
MAYSAMIRAWATI SPS 0138R0170418V009869 0001876155761 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 176610 1#0##0#0#0.0#2018-05-23
08:28:28#0#01:45:29#01:45:29#12:00:00 1 9cf2e7fffdad81e2e817aa7e3a084147
0 0 317840 0 0 3256165 0 0 0 0
2979750 0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 04/05/2018 31/12/1956 0 1
1 A15.3;E14.8 - - - None None None None J-4-15-II None
5180900 0 0 - 0 - 0 - 0 - 0
5180900 10792611 0 6 1 0 0 MASRIH d397316
0001390518876 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176602
1#0##0#0#0.0#2018-05-23 08:32:08#0#20:47:27#20:47:27#00:00:00 1
a9d514f4dd60ae7d60d2b48c99ad5161 0 0 486650 0 0
5095402 0 0 0 0 5210559 0 0 0 0 0
3201126 B 3 BS 1 01/05/2018 04/05/2018 17/10/2005 0 2
1 M66.4;S81.9 86.22;83.72 - - None None None None M-1-50-I
5331600 0 0 - 0 - 0 - 0 - 0
5331600 7061545 0 4 0 0 0 TIARA AULIA ARDANNI
d397471 12 4579 DR ASRI RAHMAWATI SPB 0138R0170518V000121
0001211927422 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177081
1#0##0#0#0.0#2018-05-23 08:41:48#0#17:07:44#17:07:44#00:00:00 1
b46864df79cf8cd98591981fc555a2c1 0 3295800 1608848 0 0
1569927 0 0 0 0 517970 0 0 0 0 69000
3201126 B 3 BS 1 04/05/2018 04/05/2018 31/12/1954 0 2
1 J46;I25.0;J44.1 - - - None None None None J-4-18-II
2969700 0 0 - 0 - 0 - 0 - 0
2969700 1311839 0 1 0 0 0 KINI NY D397676
TANTIYO S;16137 5.2.1.201804062320 4 177650 1#0##0#0#0.0#2018-
05-24 08:28:54#0#05:09:12#05:09:12#00:00:00 2
cc506ef266385c2811f8c245492057d5 0 0 148485 0 0 645502
0 0 0 0 389852 0 0 0 0 128000
3201126 B 2 BS 1 01/05/2018 04/05/2018 07/07/1983 0 2
0 - 0 - 0 - 0 - 0 4290800 5629224
0 4 1 0 0 RINAH YULIANAH D397435 34 12717 DR
AZRI NURIZAL SPPD KKV 0138R0170518V000008 0001815864524 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 177067 1#0##0#0#0.0#2018-05-24
08:34:05#0#02:45:55#02:45:55#00:00:00 2 0012bd98c42953ad373c895671ddce76
0 0 439172 0 0 2365027 0 0 0 0
2825025 0 0 0 0 0
3201126 B 3 BS 1 30/04/2018 04/05/2018 18/04/1949 0 1
0 0 - 0 - 0 - 0 - 0 7219300
5101205 0 5 0 0 0 H.BUCHORI D385960 69 25214
TANTIYO S;16137 5.2.1.201804062320 4 176888 1#0##0#0#0.0#2018-
05-24 08:57:28#0#14:46:27#14:46:27#12:00:00 1
56e4a1b817144ca66b48f959fce52105 0 0 702737 0 0
1503744 0 0 0 0 2894724 0 0 0 0 0
3201126 B 2 BS 1 30/04/2018 04/05/2018 14/09/1983 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 21447782 0 5 0 0 0 ERNIYAWATI D141083
0001228692633 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177062
1#1#vvip#5#14961482#0.0#2018-05-24 09:00:28#0#23:09:45#23:09:45#00:00:00
1 aa138d945d9941f055f4c786e96d6883 0 10033900 6539722 0
0 3566260 0 0 0 0 1301000 0 0 0 0
6900
3201126 B 3 BS 1 01/05/2018 04/05/2018 01/06/1995 0 2
0 - 0 - 0 - 0 - 0 5331600 9229847
0 4 0 0 0 RITA ASTUTI D356265 22 8370 DR HENDRIEK
S, SPB 0138R0170518V000125 0001812882914 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 177084 1#0##0#0#0.0#2018-05-24
09:02:21#0#00:00:00#00:00:00#00:00:00 1 2f10fa2cf207e78c5a235f7434ae9ddc
0 3502000 1904880 0 0 2998145 0 0 0 0
679822 0 0 0 0 145000
3201126 B 2 BS 1 28/04/2018 04/05/2018 23/06/1971 0 2
1 D69.1;I70.2;E11.5 99.21 - - None None None None D-4-11-II
8717800 0 0 - 0 - 0 - 0 - 0
8717800 7842176 0 7 0 0 0 NURTAQDIRIA HAMZAH
0000136785025 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 176480
1#0##0#0#0.0#2018-05-24 09:03:58#0#11:46:50#11:46:50#00:00:00 1
05cb2635ba2e17ec82ffa7a8e0647781 0 0 837602 0 0
2930534 0 0 0 0 4074040 0 0 0 0 0
3201126 B 1 BS 1 03/05/2018 04/05/2018 14/06/1957 0 1
1 E13.2;I15.9 39.43 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 8691787 0 2 0 0 0 DANIEL NGADIMIN
0001261234462 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177581
1#0##0#0#0.0#2018-05-24 09:05:23#0#15:30:58#15:30:58#00:00:00 1
9e2038aa186d37129fab058d9e671e47 0 5896000 1215340 0 0
901325 0 0 0 0 644622 0 0 0 0 34500
3201126 B 1 BS 1 03/05/2018 04/05/2018 01/03/1999 0 1
(RINGAN) 6041900 0 0 - 0 - 0 - 0 - 0
6041900 14154091 0 2 0 0 0 FARHAN FADHILAH
d393600 19 7003 DR BENNY H T, SPOT 0138R0170518V000931
0002234532339 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177532
1#0##0#0#0.0#2018-05-24 09:07:07#0#13:32:38#13:32:38#12:00:00 1
86ab3e75e5a4f5609b9f274da7f9eda1 0 9763300 2379732 0 0
974590 0 0 0 0 1001969 0 0 0 0 34500
3201126 B 2 BS 1 01/05/2018 04/05/2018 01/05/2018 2820 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 4329455 0 4 0 0 0 BAYI NY ERNIYAWATI
0002455847627 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177668
1#0##0#0#0.0#2018-05-24 09:30:13#0#08:38:13#08:38:13#00:00:00 1
2b4856192a1d62689da33b4103f0de0b 0 0 802921 0 0 349699
0 0 0 0 3176835 0 0 0 0 0
3201126 B 2 BS 1 02/05/2018 04/05/2018 09/12/1980 0 1
0 - 0 - 0 - 0 7145100 9436590 0 3
0 0 0 DINO FERDIAN D397112 37 13658 DR E SURYA POHAN
DR SPB KBD 0138R0170518V000357 0002086761723 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 177154 1#0##0#0#0.0#2018-05-24
09:35:26#0#11:10:13#11:10:13#00:00:00 1 9d16bd4bcba229c4447a697091ac430e
0 4854100 2000628 0 0 1819515 0 0 0 0
693347 0 0 0 0 69000
3201126 B 2 BS 1 03/05/2018 04/05/2018 01/07/1991 0 2
1 O21.1;N39.0 - - - None None None None W-4-16-II None
0 - 0 - 0 - 0 - 0 3479400 2440006
0 2 0 0 0 SITI NUR ANGGRAINI NY D397599 26 9803
DR FAHMIALDI, SPOG 0138R0170518V000654 0001655339668 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 177235 1#0##0#0#0.0#2018-
05-24 09:37:39#0#00:55:16#00:55:16#00:00:00 1
49f764fd284778410ff779f56889b5e1 0 0 287171 0 0 939208
0 0 0 0 1213627 0 0 0 0 0
3201126 B 3 BS 1 02/05/2018 04/05/2018 01/12/1957 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 5248885 0 3 0 0 0 MURTOWO D389563
DR RIZKI; 5.2.1.201804062320 4 177164 1#0##0#0#0.0#2018-05-25
11:14:59#0#12:51:11#12:51:11#12:00:00 1 08a33da4635d1c9f746d31df6d74acf4
0 0 715760 0 0 878240 0 0 0 0
3654885 0 0 0 0 0
3201126 B 3 BS 1 03/05/2018 04/05/2018 12/12/1944 0 2
0 - 0 - 0 - 0 - 0 3575600 1579949
0 2 0 0 0 TATTY ISMAIL,NY D291451 73 26805 DR
IRVAN VERYADI 0138R0170518V001079 0000060751405 3;JKN DR RIZKI;
5.2.1.201804062320 4 177633 1#0##0#0#0.0#2018-05-28
08:12:26#0#19:08:53#19:08:53#00:00:00 1 0b724794d83c75391dab68e71b3b1518
0 0 522234 0 0 665354 0 0 0 0 392361
0 0 0 0 0
3201126 B 1 BS 1 03/05/2018 04/05/2018 03/09/2011 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 4704615 0 2 0 0 0 KENZIE AQEELA CHALIF
d397162 6 2434 DR ASRI DWI R, SPB 0138R0170518V001067
0001371227804 3;JKN DR RIZKI; 5.2.1.201804062320 4 177627
1#0##0#0#0.0#2018-05-28 08:18:24#0#17:34:29#17:34:29#00:00:00 1
33cf540f56d23aa260857c3f582dfa69 0 3052500 575204 0 0
548132 0 0 0 0 383779 0 0 0 0 145000
3201126 B 2 BS 1 02/05/2018 04/05/2018 24/04/2018 0 1
0 - 0 - 0 - 0 - 0 5045200 2890855
0 3 0 0 0 BAYI NY NUR YULIYANTI D397598 0 8
DR AULIA TANGKARI, SPA 0138R0170518V000653 0002429391789 3;JKN DR
RIZKI; 5.2.1.201804062320 4 177234 1#0##0#0#0.0#2018-05-28
09:29:39#0#23:43:18#23:43:18#00:00:00 1 2c958395e55f573665ef40a92b669a55
0 0 507068 0 0 160666 0 0 0 0
1569121 0 0 0 0 654000
3201126 B 2 BS 1 30/04/2018 04/05/2018 04/07/2016 0 2
1 J06.9;R56.0;J40 - - - None None None None U-4-13-II
- 0 - 0 2801300 5287695 0 5 0 0 0
AFIFAH SHAKILA C D397357 1 665 DR RIANITA SYAMSU, SPA
0138R0170418V010129 0002080216168 3;JKN irene; 5.2.1.201804062320
4 176797 1#1#kelas_1#5#466900#0.0#2018-05-28
14:25:03#1#11:59:34#11:59:34#00:00:00 5 029d63afa480f3e8245750537b53c254
0 0 696600 0 3001050 1218121 0 0 0 0
345924 0 0 0 26000 0
3201126 B 3 BS 1 03/05/2018 04/05/2018 10/05/1977 0 2
1 N18.5;D63.8;A49.9;E11.5 38.95;99.04 - - None None None None
- 0 - 0 8908800 14756582 0 2 0 0 0
HANIFAH D176994 40 14968 DR. ARU ARIADNO, SPPD
0138R0170518V001004 0001882521911 3;JKN DR RIZKI; 5.2.1.201804062320
4 177552 1#0##0#0#0.0#2018-05-30
15:16:04#0#15:08:22#15:08:22#12:00:00 1 7cbfe1e0ca0502cdf22174ffa12fffc4
0 3062500 5659396 0 0 3768052 0 0 0 0
2197634 0 0 0 0 69000
3201126 B 1 BS 1 30/04/2018 04/05/2018 10/03/1960 0 2
6795600 0 0 - 0 - 0 - 0 - 0
6795600 6061212 0 5 0 0 0 MARGARETHA SIWY
0001454106611 3;JKN DR RIZKI; 5.2.2.201806040537 4 180069
1#0##0#0#0.0#2018-06-05 15:22:40#0#00:00:00#00:00:00#00:00:00 2
f4b16d536fa310253bd2a9c04acf546e 0 0 582524 0 0
1932160 0 0 0 0 3546528 0 0 0 0 0
3201126 B 1 BS 1 03/05/2018 04/05/2018 12/12/1952 0 1
1 E10.2;T82.4;A49.9 99.21;99.17;38.95 - - None None None None
- 0 - 0 27065300 15524611 0 2 0 0 0
FRANS MARTINUS SAMUEL D111772 65 23883 DR. ARU ARIADNO, SPPD
0138R0170518V001080 0001318423162 3;JKN DR RIZKI; 5.2.1.201804062320
4 177634 1#0##0#0#0.0#2018-08-24
10:38:28#0#19:12:32#19:12:32#00:00:00 3 c57fe9d40bc9743319b2b6d080ca89a0
0 5550500 5953235 0 0 2767262 0 0 0 0
1219114 0 0 0 0 34500
3201126 B 1 BS 1 03/05/2018 04/05/2018 05/03/1963 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 9341967 0 2 0 0 0 YASIR D387102 55
20148 DR DEDY PRATAMA SPBV 0138R0170518V001017 0000040677963 3;JKN
DR RIZKI; 5.2.2.201806040537 4 177588 1#0##0#0#0.0#2018-08-24
10:40:30#0#15:33:54#15:33:54#12:00:00 2 056b3570fe39c99107cea23bd3b8911d
0 0 2494460 0 0 264350 0 0 0 0
6583157 0 0 0 0 0
3201126 B 2 BS 1 23/04/2018 04/05/2018 21/03/1956 0 1
1 I20.0;I50.0;N20.0;N18.9 90.59;89.52;88.76;88.01;93.94 - - None
None None None I-4-20-II None None None None None None ANGINA
PEKTORIS DAN NYERI DADA (SEDANG) 5824800 0 0 - 0 - 0
- 0 - 0 5824800 25494141 0 12 1 2 0
SUKIRNO D396717 62 22678 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170418V007640 0001148400213 3;JKN DR RIZKI; 5.2.2.201806040537
4 174648 1#0##0#0#0.0#2018-08-24
10:52:13#0#11:16:04#11:16:04#00:00:00 2 af5ca35908d4578c5e49b92acd216d7a
0 0 635480 0 0 13084661 0 0 0 0
8390000 0 0 0 0 3384000
3201126 B 3 BS 1 03/05/2018 04/05/2018 17/01/1969 0 1
1 N18.5;T82.4 39.42 - - None None None None N-1-12-III None
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 11868988 0 2 0 0 0 SAUBIH
0138R0170518V001088 0001770795415 3;JKN DR RIZKI; 5.2.1.201804062320
4 177638 1#0##0#0#0.0#2018-08-24
11:10:15#0#20:30:39#20:30:39#12:00:00 2 331a01bda1e938561f91fa17578fdcd9
0 2976000 921100 0 0 7084912 0 0 0 0
852476 0 0 0 0 34500
3201126 B 3 BS 1 04/05/2018 04/05/2018 25/12/1976 0 1
1 G03.9;R51 87.03 - - None None None None G-4-19-I None
- 0 - 0 3695600 3129500 0 1 0 0 0
IRWANTO D397675 41 15105 DR DICKI PRATAMA 0138R0170518V001103
0001302447585 3;JKN DR RIZKI; 5.2.2.201806040537 4 177648
1#0##0#0#0.0#2018-10-01 11:06:29#0#00:00:00#00:00:00#00:00:00 3
e5dcf34ca2473d61e52e75cbbc5fd0ab 0 0 451179 0 0
2184587 0 0 0 0 493734 0 0 0 0 0
3201126 B 1 BS 1 29/04/2018 05/05/2018 31/12/1946 0 2
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 28256811 0 7 0 0 0 NURYATI D397291
3;JKN DR RIZKI; 5.2.1.201804062320 4 178143
1#1#vvip#7#21981511#0.0#2018-05-21 09:30:16#0#19:42:19#19:42:19#00:00:00
2 e6acb233b1bbb717cf94026e9dd56a94 0 13741400 6231470 0
0 6938941 0 0 0 0 1276000 0 0 0 0
69000
3201126 B 3 BS 1 04/05/2018 05/05/2018 03/05/1968 0 1
- 0 8908800 10082226 0 2 0 0 0 EKO SUBANDI
0002287444465 3;JKN DR RIZKI; 5.2.1.201804062320 4 177839
1#0##0#0#0.0#2018-05-21 09:41:52#0#11:46:13#11:46:13#00:00:00 1
d211e74908e429bc29ef1b5c8cd1c57c 0 3062500 2636552 0 0
3598589 0 0 0 0 715585 0 0 0 0 69000
3201126 B 1 BS 1 04/05/2018 05/05/2018 19/06/1953 0 1
1 I12.0;D29.1 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 11914011 0 2 0 0 0 YONO SUYONO
0000061175733 3;JKN DR RIZKI; 5.2.1.201804062320 4 177828
1#0##0#0#0.0#2018-05-21 09:47:39#0#11:34:14#11:34:14#00:00:00 1
d7c626541c2e2ae7bd8e375f7ff64037 0 5896000 1754476 0 0
3359114 0 0 0 0 835421 0 0 0 0 69000
3201126 B 3 BS 1 04/05/2018 05/05/2018 01/04/1965 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8644671 0 2 0 0 0 UMIATI
0138R0170518V001504 0000511828751 3;JKN DR RIZKI; 5.2.1.201804062320
4 177994 1#0##0#0#0.0#2018-05-21
15:49:00#0#15:42:38#15:42:38#12:00:00 1 3d5a2fad16b0d0f3f2abc9d64bb14fc5
0 3611800 1870848 0 0 2471484 0 0 0 0
621539 0 0 0 0 69000
3201126 B 1 BS 1 04/05/2018 05/05/2018 27/02/1975 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 5821682 0 2 0 0 0 LELY UMARAH D102483
DR RIZKI; 5.2.1.201804062320 4 178034 1#0##0#0#0.0#2018-05-22
08:52:03#0#00:00:00#00:00:00#00:00:00 1 b1bc7d6a48095c0015741fc9702df351
0 0 1194824 0 0 833500 0 0 0 0
3724358 0 0 0 0 69000
3201126 B 1 BS 1 04/05/2018 05/05/2018 17/02/1955 0 2
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 11045733 0 2 0 0 0 TRI RINI SURYOKANTI
0000061047461 3;JKN DR RIZKI; 5.2.1.201804062320 4 178037
1#0##0#0#0.0#2018-05-22 10:03:35#0#00:00:00#00:00:00#00:00:00 2
7a0ff42eb8b4f411897d1e7788bd42e1 0 5550500 1815243 0 0
2812372 0 0 0 0 798618 0 0 0 0 69000
3201126 B 1 BS 1 02/05/2018 05/05/2018 03/03/1971 0 2
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4823489 0 4 0 0 0 DARWATI,S.IP
D355271 47 17227 DR ARU, SPPD 0138R0170518V000651
0002195803596 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177233
1#0##0#0#0.0#2018-05-22 14:58:05#0#22:42:01#22:42:01#00:00:00 1
87de6071355523860c9e188c92513021 0 0 269459 0 0
1433975 0 0 0 0 3120055 0 0 0 0 0
3201126 B 3 BS 1 30/04/2018 05/05/2018 02/02/1951 0 2
1 A16.0;E11.9;I10;A41.9 93.94 - - None None None None J-4-
(BERAT) 6970400 0 0 - 0 - 0 - 0 - 0
6970400 8235809 0 6 0 0 0 JASMI D397410 67
TANTIYO S;16137 5.2.1.201804062320 4 177056 1#0##0#0#0.0#2018-
05-22 15:27:57#0#18:44:22#18:44:22#00:00:00 1
9ce7618b3c2a00019aaa3536cf9cfec6 0 0 542440 0 0
2304578 0 0 0 0 5388791 0 0 0 0 0
3201126 B 2 BS 1 01/05/2018 05/05/2018 06/02/2018 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 7520849 0 5 0 0 0 GRACELYN ALINKA
PRIOSIRLY D397451 0 84 DR OTTY MITHA S, SPA 0138R0170518V000088
0002427334457 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177073
1#0##0#0#0.0#2018-05-22 15:31:30#0#00:00:00#00:00:00#00:00:00 1
868f594e5071fdec84e89fbd92f3e009 0 0 443231 0 0
3524600 0 0 0 0 3043018 0 0 0 0 510000
3201126 B 2 BS 1 25/04/2018 05/05/2018 02/03/2016 0 1
- 0 - 0 - 0 - 0 3187000 11674892 0
11 1 2 0 AL FATIH ALIEF SYAHENDRA D396977 2 784
DR RASTRA, SPA 0138R0170418V008791 0002213559764 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 175396 1#0##0#0#0.0#2018-05-22
15:34:19#0#18:56:14#18:56:14#00:00:00 1 b6695600c61e8daa9a5fcecfdd46ae74
0 0 392830 0 0 1804784 0 0 0 0
7195278 0 0 0 0 2282000
3201126 B 2 BS 1 04/05/2018 05/05/2018 11/07/1975 0 2
1 N85.1;D64.9;I10 69.09;99.04 - - None None None None W-1-
SERVIK (SEDANG) 3046400 0 0 - 0 - 0 - 0 -
0 3046400 6077661 0 2 0 0 0 YULIA RACHMAH
D388426 42 15638 DR MAMAN H, SPOG 0138R0170518V001616
0002326482876 3;JKN DR RIZKI; 5.2.1.201804062320 4 178038
1#0##0#0#0.0#2018-05-22 15:52:35#0#00:00:00#00:00:00#12:00:00 1
d50594198fbe5ce3d1531c3cf679e75f 0 0 1251992 0 0
1599065 0 0 0 0 3029604 0 0 0 0 197000
3201126 B 2 BS 1 04/05/2018 05/05/2018 17/08/1971 0 2
- 0 10690500 12559594 0 2 0 0 0 MURNITI
0138R0170518V001597 0002328341027 3;JKN DR RIZKI; 5.2.1.201804062320
4 178025 1#0##0#0#0.0#2018-05-22
15:54:02#0#18:11:26#18:11:26#12:00:00 1 42fcc91aa4dcfbec8f63a5530e4643d3
0 4703600 4836825 0 0 2072513 0 0 0 0
877656 0 0 0 0 69000
3201126 B 3 BS 1 04/05/2018 05/05/2018 25/09/1965 0 2
- 0 - 0 8908800 13111328 0 2 0 0 0
DJOHAR SETYOWATI D380179 52 19214 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V001599 0002196417036 3;JKN DR RIZKI; 5.2.1.201804062320
4 178026 1#0##0#0#0.0#2018-05-22
15:57:11#0#18:22:58#18:22:58#12:00:00 1 b3b5e5e420ace8cca09a0b80bff2a1c1
0 2976000 2138112 0 0 7014466 0 0 0 0
913750 0 0 0 0 69000
3201126 B 2 BS 1 03/05/2018 05/05/2018 09/01/1940 0 2
1 K80.8;J90 - - - None None None None B-4-14-III None
None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (BERAT)
7875800 0 0 - 0 - 0 - 0 - 0
7875800 4699100 0 3 0 0 0 WAHYURI.S D397648
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177637
1#0##0#0#0.0#2018-05-22 16:15:54#0#19:36:38#19:36:38#00:00:00 1
9c24ff7d750911a57244fa38adc1d377 0 0 761822 0 0
2088860 0 0 0 0 1848418 0 0 0 0 0
3201126 B 1 BS 1 03/05/2018 05/05/2018 07/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 11569900
14687465 0 3 0 0 0 RAULI JULIANTY,NY D067120 63
23372 DR FERRI SABARUDDIN SPOG 0138R0170518V000832 0000060820637
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177371
1#0##0#0#0.0#2018-05-22 16:28:03#0#10:15:43#10:15:43#12:00:00 1
c684476f147c04c02f0869ed7441060b 0 7096000 3990420 0 0
2485183 0 0 0 0 1046862 0 0 0 0 69000
3201126 B 1 BS 1 03/05/2018 05/05/2018 10/01/1957 0 2
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 5088323 0 3 0 0 0 JOJOR ADE LINCE.S
D140821 61 22393 DR ARU, SPPD 0138R0170518V000963
0001263245218 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177534
1#0##0#0#0.0#2018-05-22 16:29:44#0#14:09:23#14:09:23#00:00:00 1
2aa040ab2b2fd4755a51e9d3862dbbe2 0 0 425312 0 0
1961130 0 0 0 0 2701881 0 0 0 0 0
3201126 B 1 BS 1 01/05/2018 05/05/2018 01/06/1946 0 2
1 C49.4;D63.0 54.3;99.04 - - None None None None K-1-40-II
(SEDANG) 12400100 0 0 - 0 - 0 - 0 - 0
12400100 20329253 0 5 0 0 0 SUTIKEM D397437
71 26267 DR HENDRIEK S, SPB 0138R0170518V000004 0001905811637
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 178129
1#0##0#0#0.0#2018-05-22 16:40:24#0#15:05:27#15:05:27#00:00:00 1
dc18c5836964e166f6be708a7c83bb24 0 7969000 2569518 0 0
8369735 0 0 0 0 1276000 0 0 0 0 145000
3201126 B 3 BS 1 03/05/2018 05/05/2018 23/11/1997 0 1
0 - 0 - 0 - 0 - 0 5331600 8181394
0 3 0 0 0 HARDI GUNAWAN D390570 20 7466 DR
HENDRIEK S, SPB 0138R0170518V000664 0000512633507 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 177239 1#0##0#0#0.0#2018-05-22
16:43:29#0#05:55:09#05:55:09#12:00:00 2 50eb6487f4d4fd3446a33d7be51b7c59
0 3235500 1492848 0 0 2696815 0 0 0 0
611231 0 0 0 0 145000
3201126 B 1 BS 1 03/05/2018 05/05/2018 10/12/1976 0 2
(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 3610673 0 3 0 0 0 SITI KHODIJAH
B084772 41 15119 DR SOEGIONO, SPPD 0138R0170518V001094
0001724971105 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 177642
1#0##0#0#0.0#2018-05-24 08:37:53#0#21:43:53#21:43:53#00:00:00 2
9f69c19451ad2d3b0157278a7dffa8b9 0 0 399995 0 0 931935
0 0 0 0 2278743 0 0 0 0 0
3201126 B 1 BS 1 04/05/2018 05/05/2018 06/09/2012 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2670111 0 2 0 0 0 ACHMAD NIZAM YUSUF
D397680 5 2066 DR RASTRA, SPA 0138R0170518V001108
0002339129856 3;JKN DR RIZKI; 5.2.1.201804062320 4 177647
1#0##0#0#0.0#2018-05-25 10:50:19#0#00:00:00#00:00:00#00:00:00 1
6b3e253fcf0a62f7b4d10b595fbac688 0 0 338858 0 0 568573
0 0 0 0 1762680 0 0 0 0 0
3201126 B 1 BS 1 30/04/2018 05/05/2018 15/08/1952 0 2
1 E14.7;A49.9;G72.9 86.04 - - None None None None E-4-10-I
0 - 0 4903800 17095393 0 6 0 0 0 SUYATI
SRI SUNDARI D375438 65 23999 DR HENDRIEK S, SPB 0138R0170418V010296
0000044003608 3;JKN DR RIZKI; 5.2.1.201804062320 4 176961
1#0##0#0#0.0#2018-06-05 09:01:13#0#15:40:47#15:40:47#12:00:00 1
23dcdd2d34070a21132f37c3288177d7 0 8660000 2381766 0 0
4790237 0 0 0 0 1194390 0 0 0 0 69000
3201126 B 2 BS 1 29/04/2018 05/05/2018 29/04/2018 1986 2
1 P07.3;P23.9;P03.4;P59.9;P22.9 99.83 - - None None None None
P-8-12-III None None None None None None NEONATAL, BBL 1500 - 1999 GR
TANPA PROSEDUR MAYOR (BERAT) 18678700 0 0 - 0 - 0 -
0 - 0 18678700 21246004 0 7 0 0 0 NOVITA
RANI KURNIASIH BY NY D397290 0 0 DR AULIA TANGKARI, SPA
0138R0170418V010125 0002454788935 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 178965 1#0##0#0#0.0#2018-06-22
08:54:54#0#00:00:00#00:00:00#00:00:00 1 84d2c3dcdfb9c0b2d9fcfcfa70ddefe3
0 0 1097630 0 0 7180374 0 0 0 0
6732000 0 0 1226000 5010000 0
3201126 B 2 BS 1 04/05/2018 05/05/2018 14/04/1953 0 2
1 N18.5;D63.8;T82.4 99.04;38.95 - - None None None None N-1-
- 0 - 0 23198900 12739157 0 2 0 0 0
SITI KOMARIYAH D392764 65 23761 SRI KUNMARTINI.DR,SPPD
0138R0170518V001110 0000060656646 3;JKN DR RIZKI; 5.2.1.201804062320
4 177649 1#0##0#0#0.0#2018-08-24
11:16:41#0#00:00:00#00:00:00#12:00:00 2 87bfd03996d33d543b5f3835b15d8c50
0 4619100 3153245 0 0 4022909 0 0 0 0
909403 0 0 0 0 34500
3201126 B 3 BS 1 03/05/2018 05/05/2018 06/03/1947 0 2
0 - 0 - 0 - 0 - 0 3575600 1689701
0 3 0 0 0 JAENAH D389810 71 25991 DR AZRI
NURIZAL SPPD KKV 0138R0170518V001092 0000511736624 3;JKN DR RIZKI;
5.2.2.201806040537 4 177641 1#0##0#0#0.0#2018-09-06
16:22:54#0#21:00:32#21:00:32#12:00:00 2 d869a65599f950eb322e07002558909e
0 0 317771 0 0 709389 0 0 0 0 662541
0 0 0 0 0
3201126 B 3 BS 1 29/04/2018 05/05/2018 29/04/2018 2990 2
1 P25.1;P03.4 34.91;96.72 - - None None None None P-8-07-I
- 0 - 0 5099100 25327753 0 7 0 0 0
BAYI NY MAYA SAFIRAH D397306 0 0 DR AULIA TANGKARI, SPA
0138R0170418V010096 0002434233126 3;JKN DR RIZKI; 5.2.2.201806040537
4 176743 1#0##0#0#0.0#2018-09-26
18:04:20#0#00:00:00#00:00:00#00:00:00 3 e385144084bc6a6b18a2150115efa8e0
0 0 1833364 0 0 8081889 0 0 0 0
7854500 0 0 0 0 7558000
3201126 B 3 BS 1 29/04/2018 05/05/2018 19/03/2018 0 1
None None None None None VENTILASI MEKANIKAL LONG TERM TANPA TRAKEOSTOMI
(RINGAN) 28848300 0 0 - 0 - 0 - 0 - 0
28848300 27031283 0 7 1 2 99 ABISATYA D397303
3;JKN DR RIZKI; 5.2.2.201806040537 4 176582 1#0##0#0#0.0#2018-
09-26 18:18:18#0#11:34:28#11:34:28#00:00:00 2
ee9b8b5f895a3bc7f342b1c2a3bdaa09 0 0 6686160 0 0
3803623 0 0 0 0 7336500 0 0 0 0
9205000
3201126 B 2 BS 1 03/05/2018 05/05/2018 17/08/1981 0 2
(RINGAN) 4203300 0 0 - 0 - 0 - 0 - 0
4203300 2617118 0 3 0 0 0 ALIYAH ULPAH NY
D397658 36 13408 DR ARU, SPPD 0138R0170518V001099
0002096925952 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 178139
1#0##0#0#0.0#2018-09-28 13:42:51#0#16:45:39#16:45:39#00:00:00 2
6054500db2f88756bb4bc4d2c4cc82a6 0 0 431297 0 0 473608
0 0 0 0 1712213 0 0 0 0 0
3201126 B 3 BS 1 04/05/2018 06/05/2018 03/02/1930 0 1
1 I11.0;I48;J44.1 89.52;87.44 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
6166731 0 3 0 0 0 BOY TANGKILISAN D311760 88
3;JKN DR RIZKI; 5.2.1.201804062320 4 177646 1#0##0#0#0.0#2018-
05-21 15:50:51#0#03:37:28#03:37:28#00:00:00 1
403dabb258316fe7f7de55687a6df609 0 0 373023 0 0
2737777 0 0 0 0 2144931 0 0 0 0 911000
3201126 B 2 BS 1 05/05/2018 06/05/2018 08/03/1986 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 9404033 0 2 0 0 0 AHMAD HUSNI D397776
3;JKN DR RIZKI; 5.2.1.201804062320 4 178117 1#0##0#0#0.0#2018-
05-21 16:08:37#0#12:37:33#12:37:33#00:00:00 1
d8b8b8de26384561bb6c0406cab158f3 0 4439100 1563494 0 0
2661222 0 0 0 0 671217 0 0 0 0 69000
3201126 B 1 BS 1 04/05/2018 06/05/2018 20/08/1962 0 2
- 0 58821400 59112790 0 3 0 0 0 DINI ARIYATI
0001633397297 3;JKN DR RIZKI; 5.2.1.201804062320 4 178130
1#0##0#0#0.0#2018-05-22 10:13:18#0#15:12:46#15:12:46#00:00:00 1
c334b3ff379726a9a2c2c75daf361ddf 0 10753000 9619120 0 0
29895670 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 04/05/2018 06/05/2018 05/02/1969 0 1
- 0 12472300 19273750 0 3 0 0 0 M YUNUS
0001457654657 3;JKN DR RIZKI; 5.2.1.201804062320 4 177882
1#0##0#0#0.0#2018-05-22 14:56:15#0#13:44:58#13:44:58#00:00:00 2
b388755ccdcb94cbb739e00f86c8e434 0 0 2494460 0 0
7396040 0 0 0 0 9314250 0 0 0 0 69000
3201126 B 3 BS 1 04/05/2018 06/05/2018 24/05/1981 0 1
1 F41.9;R13 - - - None None None None F-4-15-II None
None None None None None FOBIA, ANXIETAS DAN NEUROSIS LAIN-LAIN (SEDANG)
4151900 0 0 - 0 - 0 - 0 - 0
4151900 1949735 0 3 0 0 0 DENI KUSNANDAR
0001903162667 3;JKN DR RIZKI; 5.2.1.201804062320 4 178021
1#0##0#0#0.0#2018-05-22 14:58:33#0#17:01:36#17:01:36#00:00:00 1
143de28f5aa19c8b76659c14ffdac3c1 0 0 183752 0 0 909930
0 0 0 0 856053 0 0 0 0 0
3201126 B 2 BS 1 02/05/2018 06/05/2018 24/09/1969 0 1
INFARK (RINGAN) 6015800 0 0 - 0 - 0 - 0 -
0 6015800 5823225 0 5 0 0 0 IWAN SETIAWAN
0002445604266 3;JKN DR RIZKI; 5.2.1.201804062320 4 177091
1#0##0#0#0.0#2018-05-22 14:59:56#0#01:07:36#01:07:36#00:00:00 1
595cf1c1e43ce72999b9fe20d0a8d646 0 0 882140 0 0
2009126 0 0 0 0 2931959 0 0 0 0 0
3201126 B 1 BS 1 04/05/2018 06/05/2018 14/02/1990 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 13046616 0 3 0 0 0 LAELATUSSAADAH
d344622 28 10306 DR ERDIYAN, SPOG 0138R0170518V001208
0001721594621 3;JKN DR RIZKI; 5.2.1.201804062320 4 177652
1#0##0#0#0.0#2018-05-22 15:04:55#0#07:53:52#07:53:52#00:00:00 1
c693a2d0899bf58e3176f629301c27b0 0 7098900 2497209 0 0
2273990 0 0 0 0 979517 0 0 0 0 197000
3201126 B 1 BS 1 04/05/2018 06/05/2018 10/11/1980 0 2
O-6-13-II None None None None None None PERSALINAN VAGINAL (SEDANG)
2775400 0 0 - 0 - 0 - 0 - 0
2775400 9130790 0 3 0 0 0 SRINOVIATI D097950
37 13689 DR. SITI AZIZAH SPOG 0138R0170518V001100 0000152079254
3;JKN DR RIZKI; 5.2.1.201804062320 4 177645 1#0##0#0#0.0#2018-
05-22 15:10:58#0#00:00:00#00:00:00#00:00:00 1
f795d8741ab7959de4b72b842e301906 0 0 608080 0 0
3519669 0 0 0 0 4875041 0 0 0 0 128000
3201126 B 1 BS 1 04/05/2018 06/05/2018 07/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 17095200
16408915 0 3 0 0 0 HILDA ELLY D309277 60 22032
DR RIZKI; 5.2.1.201804062320 4 177677 1#0##0#0#0.0#2018-05-22
15:20:44#0#08:59:22#08:59:22#00:00:00 1 86b865bfb9bc42169c21677d9bbcf5d3
0 5468000 3419040 0 0 4303395 0 0 0 0
1149480 0 0 0 0 2069000
3201126 B 2 BS 1 30/04/2018 06/05/2018 24/09/1983 0 1
None None None None None PROSEDUR HERNIA INGUINAL DAN FEMORAL (SEDANG)
7719500 0 0 - 0 - 0 - 0 - 0
7719500 15672416 0 7 0 0 0 NASIR D351543 34
12637 DR HENDRIEK S, SPB 0138R0170418V010388 0001959070972 3;JKN
DR RIZKI; 5.2.1.201804062320 4 178125 1#0##0#0#0.0#2018-05-22
15:24:30#0#14:54:25#14:54:25#12:00:00 1 315114ec2e364bb0b93b8ebd27c48b4b
0 0 3241580 0 0 4419438 0 0 0 0
7942398 0 0 0 0 69000
3201126 B 2 BS 1 01/05/2018 06/05/2018 02/05/1950 0 1
1 E11.6;I79.2 86.22;86.63 - - None None None None L-1-30-I
None None None None None None PEMINDAHAN KULIT TANPA LUKA BAKAR
(RINGAN) 10660100 0 0 - 0 - 0 - 0 - 0
10660100 11207038 0 6 0 0 0 SUDARNO D393327
3;JKN DR RIZKI; 5.2.1.201804062320 4 177075 1#0##0#0#0.0#2018-
05-22 16:14:14#0#00:00:00#00:00:00#12:00:00 1
7b00e5424eaa1c3444f2a01b4daee86c 0 6571100 2048900 0 0
1708867 0 0 0 0 809171 0 0 0 0 69000
3201126 B 3 BS 1 04/05/2018 06/05/2018 10/02/1986 0 1
1 S68.0;S62.51 79.34;82.53;79.64 - - None None None None
M-1-80-I None None None None None None PROSEDUR ANGGOTA TUBUH ATAS
(RINGAN) 8672000 0 0 - 0 - 0 - 0 - 0
8672000 13781197 0 3 0 0 0 ELAN SUKARLAN
0138R0170518V001412 0000511014644 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 177883 1#0##0#0#0.0#2018-05-24
08:52:36#0#13:58:36#13:58:36#00:00:00 2 534890e2652e547cecdd18378b8f6ffb
0 5827000 5115570 0 0 1614384 0 0 0 0
1079243 0 0 0 0 145000
3201126 B 3 BS 1 04/05/2018 06/05/2018 10/06/1969 0 1
- 0 45079800 58790680 0 3 0 0 0 SAEPUDIN
TAURAN d368875 48 17860 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170518V001178 0000512426204 3;JKN DR RIZKI; 5.2.1.201804062320
4 177651 1#0##0#0#0.0#2018-05-25
10:22:53#0#07:24:23#07:24:23#00:00:00 1 c27607c6e7f96991e84c299fd97034f2
0 8169000 6870800 0 0 34905880 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 3 BS 1 06/05/2018 06/05/2018 15/03/2010 0 1
1 S06.40;S42.00;A41.9 87.03;87.44 - - None None None None
6333900 0 0 - 0 - 0 - 0 - 0
6333900 1637293 0 1 0 0 0 ARFA PRATAMA ARYANSYAH
0001770808656 3;JKN DR RIZKI; 5.2.1.201804062320 4 178161
1#0##0#0#0.0#2018-05-25 10:35:09#0#04:25:31#04:25:31#00:00:00 1
9f51f23f595072c3aa94b8032ebcfec7 0 0 338005 0 0 903175
0 0 0 0 396113 0 0 0 0 0
3201126 B 3 BS 1 04/05/2018 06/05/2018 05/11/2000 0 1
- 0 - 0 - 0 - 0 3874400 7463887 0
3 0 0 0 BAGUS D391833 17 6389 DR OTTY MITHA S, SPA
0138R0170518V001531 0002096527746 3;JKN DR RIZKI; 5.2.1.201804062320
4 178014 1#0##0#0#0.0#2018-05-25
10:49:06#0#16:17:14#16:17:14#12:00:00 1 e093fe13019bbde15182dc63a7fb4096
0 3531400 1603528 0 0 1669667 0 0 0 0
514292 0 0 0 0 145000
3201126 B 3 BS 1 06/05/2018 06/05/2018 28/05/1942 0 1
1 I63.9;I11.9 87.03;89.52 - - None None None None G-4-14-I
INFARK (RINGAN) 5013100 0 0 - 0 - 0 - 0 -
0 5013100 5823509 0 1 0 0 0 R.SOEWARSO
0002064371376 3;JKN DR RIZKI; 5.2.1.201804062320 4 178159
1#0##0#0#0.0#2018-05-28 08:10:16#0#00:00:00#00:00:00#12:00:00 1
d8707987d523fd4d54fcee9705ac0a42 0 0 780498 0 0
3462034 0 0 0 0 669977 0 0 0 0 911000
3201126 B 1 BS 1 05/05/2018 06/05/2018 26/03/1948 0 2
1 I12.0;E11.7;I25.0;B16.9 39.42 - - None None None None N-1-
- 0 12472300 9523652 0 2 0 0 0 SURARTINI
SURYOSURARSO D395350 70 25607 DEDY PRATAMA,SPBV 0138R0170518V001711
0001718879657 3;JKN DR RIZKI; 5.2.1.201804062320 4 178136
1#1#vvip#2#0#0.0#2018-05-28 08:23:43#0#15:51:49#15:51:49#00:00:00 1
1016645f2dfb7a4515616cd78e30cc5b 0 3376000 3500000 0 0
1899609 0 0 0 0 679043 0 0 0 0 69000
3201126 B 3 BS 1 05/05/2018 06/05/2018 29/01/1949 0 2
1 I61.9;R90.0 87.03 - - None None None None G-4-13-I None
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 1872712 0 2 0 0 0 SRI KUSDIAH D343534
69 25298 DR RICO ADITYA 0138R0170518V001740 0000038615815 3;JKN
DR RIZKI; 5.2.1.201804062320 4 178151 1#0##0#0#0.0#2018-05-28
09:40:25#0#00:00:00#00:00:00#00:00:00 1 52bf7a1142136f0cf4d6c384f52e792c
0 0 265968 0 0 1195230 0 0 0 0 411514
0 0 0 0 0
3201126 B 3 BS 1 06/05/2018 06/05/2018 22/09/1972 0 2
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 13762267 0 1 0 0 0 MURDIAWATI NY
0138R0170518V001765 0001212051014 3;JKN DR RIZKI; 5.2.1.201804062320
4 178164 1#0##0#0#0.0#2018-05-30
15:10:00#0#09:09:53#09:09:53#00:00:00 1 341f340a60724068494365d28cb952c3
0 0 2138112 0 0 7550820 0 0 0 0
4038835 0 0 0 0 34500
3201126 B 1 BS 1 26/04/2018 06/05/2018 10/05/1962 0 1
1 G93.5;R90.0;A41.9;R57.1 87.03;87.44;93.94;93.19 - - None None
None None G-4-21-III None None None None None None KOMA & STUPOR NON
TRAUMA (BERAT) 7728700 0 0 - 0 - 0 - 0 -
0 7728700 25587251 0 11 1 3 0 DEDY MAIZAL
0000043446014 3;JKN DR RIZKI; 5.2.1.201804062320 4 175952
1#0##0#0#0.0#2018-06-05 08:50:19#0#00:00:00#00:00:00#00:00:00 2
e6dd8586c89820d63f29df968847224e 0 0 623553 0 0
11808698 0 0 0 0 9477000 0 0 0 0
3678000
3201126 B 1 BS 1 04/05/2018 06/05/2018 27/04/2018 0 2
0 - 0 - 0 - 0 - 0 5886000 3702767
0 3 0 0 0 VERA DWIWATI BY NY D397117 0 7
KRISTYANINGESTI,DR.SPA 0138R0170518V001375 0002448380024 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 177874 1#0##0#0#0.0#2018-
06-12 16:09:02#0#13:24:49#13:24:49#00:00:00 1
ba9308766df2c4abea3eaf4ba147f7a4 0 0 529740 0 0 363790
0 0 0 0 2299237 0 0 0 510000 0
3201126 B 1 BS 1 05/05/2018 07/05/2018 21/02/1959 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 6318906 0 3 0 0 0 ROSIYATI D384812
3;JKN DR RIZKI; 5.2.1.201804062320 4 178149 1#0##0#0#0.0#2018-
05-21 09:53:51#0#21:50:29#21:50:29#12:00:00 1
3d1e4a59bef4dfe8b3618428f2f020b1 0 0 573641 0 0
2152129 0 0 0 0 3593136 0 0 0 0 0
3201126 B 1 BS 1 05/05/2018 07/05/2018 05/05/2018 2815 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2899185 0 3 0 0 0 BAYI NY TRI SULISTIANING
ASTUTI D397820 0 0 DR AWIDIYA, SPA 0138R0170518V002053
0002456528297 3;JKN DR RIZKI; 5.2.1.201804062320 4 178502
1#0##0#0#0.0#2018-05-21 15:38:18#0#00:00:00#00:00:00#00:00:00 1
9339d626ee95bcae0061eec768d856f1 0 0 499620 0 0 88899
0 0 0 0 2310666 0 0 0 0 0
3201126 B 1 BS 1 06/05/2018 07/05/2018 01/02/1987 0 2
None None None None ABORTUS (RINGAN) 1741300 0 0 - 0
- 0 - 0 - 0 1741300 3031430 0 2 0
0 0 WIDIYANA D397883 31 11417 DR ATJANG S, SPOG
0138R0170518V001787 0001312828176 3;JKN DR RIZKI; 5.2.1.201804062320
4 178395 1#0##0#0#0.0#2018-05-21
15:41:22#0#10:53:46#10:53:46#00:00:00 1 12882a9a762e14d71c70ed802338d212
0 0 576204 0 0 650908 0 0 0 0
1804318 0 0 0 0 0
3201126 B 2 BS 1 02/05/2018 07/05/2018 21/01/1997 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 7001562 0 6 0 0 0 REYNALD MARTIANO SOEDIRA
D032285 21 7771 DR ARU, SPPD 0138R0170518V000353
0001285383532 3;JKN DR RIZKI; 5.2.1.201804062320 4 177153
1#0##0#0#0.0#2018-05-21 15:52:41#0#10:55:10#10:55:10#00:00:00 1
bd5a6b30fb9f13fc18192e6d929aab11 0 0 443231 0 0
3044285 0 0 0 0 3514046 0 0 0 0 0
3201126 B 1 BS 1 29/04/2018 07/05/2018 15/06/1969 0 1
1 B17.9;R18;J45.9 87.44 - - None None None None B-4-13-II
None None None None None None GANGGUAN HATI LAIN-LAIN (SEDANG)
6857000 0 0 - 0 - 0 - 0 - 0
6857000 13891337 0 9 0 0 0 PARUDI D397320
48 17850 DR ARU, SPPD 0138R0170418V009859 0000042712356 3;JKN
DR RIZKI; 5.2.1.201804062320 4 176605 1#0##0#0#0.0#2018-05-21
15:55:50#0#00:00:00#00:00:00#00:00:00 1 a8f979d6d5e34f41bff7c3123c9a81e9
0 0 670130 0 0 5298928 0 0 0 0
7922279 0 0 0 0 0
3201126 B 1 BS 1 04/05/2018 07/05/2018 01/06/1955 0 2
1 K92.0;K92.1;D64.9 99.04 - - None None None None K-4-18-II
(SEDANG) 3432200 0 0 - 0 - 0 - 0 - 0
3432200 8436437 0 4 0 0 0 SARINEM D340445
62 22983 DR ARU, SPPD 0138R0170518V001604 0001258010627 3;JKN
DR RIZKI; 5.2.1.201804062320 4 178135 1#0##0#0#0.0#2018-05-21
15:59:10#0#15:51:07#15:51:07#00:00:00 1 69b707768add651ea2946b6849a91ff5
0 0 429362 0 0 4650659 0 0 0 0
3356416 0 0 0 0 0
3201126 B 3 BS 1 03/05/2018 07/05/2018 07/11/2015 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2364308 0 5 0 0 0 MUHAMMAD FAUZAN ALVIANTO
D362550 2 908 DR RASTRA, SPA 0138R0170518V000897
0001722989507 3;JKN DR RIZKI; 5.2.1.201804062320 4 177529
1#0##0#0#0.0#2018-05-21 16:10:07#0#12:33:03#12:33:03#00:00:00 1
bfe681d4a7a00927bbdd7a5b527fd801 0 0 207620 0 0 661014
0 0 0 0 1495674 0 0 0 0 0
3201126 B 3 BS 1 05/05/2018 07/05/2018 07/05/2006 0 2
None None None None None PROSEDUR KAKI (RINGAN) 8740200 0 0
- 0 - 0 - 0 - 0 8740200 11312767 0
3 0 0 0 NADIA PUTRI MELATI D135745 11 4381 DR
BENNY H TUMBELAKA 0138R0170518V001717 0002436994293 3;JKN DR RIZKI;
5.2.1.201804062320 4 178140 1#0##0#0#0.0#2018-05-21
16:25:23#0#17:14:05#17:14:05#00:00:00 1 d214afacb644a26e2231f363165ecc30
0 0 4550060 0 0 1948519 0 0 0 0
4669188 0 0 0 0 145000
3201126 B 3 BS 1 05/05/2018 07/05/2018 14/08/1954 0 1
1 N18.5;D63.8;K92.1;E79.0 99.04;90.59;89.52 - - None None None
0 - 0 4132100 3155895 0 3 0 0 0
SOBANDI d284634 63 23275 SRI KUNMARTINI.DR,SPPD
0138R0170518V001713 0001406328006 3;JKN DR RIZKI; 5.2.1.201804062320
4 178138 1#0##0#0#0.0#2018-05-22
08:46:33#0#16:02:36#16:02:36#12:00:00 1 82064c2e3781af5285a487dc43adaa4a
0 0 466210 0 0 1668225 0 0 0 0
1021460 0 0 0 0 0
3201126 B 3 BS 1 05/05/2018 07/05/2018 05/12/1996 0 2
0 - 0 - 0 - 0 - 0 6781600 2109625
0 3 0 0 0 HARTI LIA DESTRINA d190306 21 7821
DR BETTY DWI L, SPPD 0138R0170518V001741 0001789414233 3;JKN DR
RIZKI; 5.2.1.201804062320 4 178152 1#0##0#0#0.0#2018-05-22
10:06:12#0#00:00:00#00:00:00#00:00:00 1 e13676c1e476df5149c9dd760cc53572
0 0 663344 0 0 579768 0 0 0 0 866513
0 0 0 0 0
3201126 B 2 BS 1 06/05/2018 07/05/2018 26/07/1975 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 10520090 0 2 0 0 0 ABDUL SYUKUR
0138R0170518V001769 0001634656307 3;JKN DR RIZKI; 5.2.1.201804062320
4 178166 1#0##0#0#0.0#2018-05-22
10:33:36#0#10:31:46#10:31:46#00:00:00 1 f1faf096890be5abc1582567624291ad
0 0 2565720 0 0 2682040 0 0 0 0
5203330 0 0 0 0 69000
3201126 B 2 BS 1 04/05/2018 07/05/2018 22/09/1957 0 2
0 - 0 - 0 - 0 - 0 4290800 3888917
0 4 0 0 0 DEWI SETIANINGSIH D382383 60 22139 DR
CELLY ANANTARIA. SPJP 0138R0170518V001315 0000043200459 3;JKN DR RIZKI;
5.2.1.201804062320 4 178128 1#0##0#0#0.0#2018-05-22
13:18:19#0#15:02:40#15:02:40#12:00:00 1 cb895f0f82dda1f73bd7c9ac141abec4
0 0 439172 0 0 1149330 0 0 0 0
2300415 0 0 0 0 0
3201126 B 2 BS 1 04/05/2018 07/05/2018 08/06/1991 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10828865 0 4 0 0 0 ROSITA RIANTYH BASYA
0001717111563 3;JKN DR RIZKI; 5.2.1.201804062320 4 178027
1#0##0#0#0.0#2018-05-22 13:21:39#0#18:48:20#18:48:20#00:00:00 2
514db96b99cd979e323603259f463bda 0 5477400 2090753 0 0
2111282 0 0 0 0 824430 0 0 0 0 325000
3201126 B 3 BS 1 03/05/2018 07/05/2018 15/09/1965 0 2
1 J18.0;E87.7;E14.9;N39.0 87.44 - - None None None None J-4-
(SEDANG) 5077500 0 0 - 0 - 0 - 0 - 0
5077500 3617969 0 5 0 0 0 WARSIAH D397623
3;JKN DR RIZKI; 5.2.1.201804062320 4 177536 1#0##0#0#0.0#2018-
05-22 13:25:07#0#14:38:37#14:38:37#00:00:00 1
034d4cecf3a3b3eab6c2968f6141cf78 0 0 632429 0 0
1407850 0 0 0 0 1577690 0 0 0 0 0
3201126 B 2 BS 1 07/05/2018 07/05/2018 05/05/1977 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 4872300 0 1 0 0 0 TRI ENDAH PUSPITA SARI
D349162 41 14977 DR. SITI AZIZAH SPOG 0138R0170518V001817
0002229778416 3;JKN DR RIZKI; 5.2.1.201804062320 4 178199
1#0##0#0#0.0#2018-05-22 13:27:27#0#03:14:17#03:14:17#00:00:00 1
4211da9b485415d6813e73a4d52f19ce 0 0 888996 0 0
1032555 0 0 0 0 2805749 0 0 0 0 145000
3201126 B 3 BS 1 04/05/2018 07/05/2018 31/12/1937 0 1
1 I13.2 88.76;90.59;89.52 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 3575600
3678011 0 4 0 0 0 M YUNUS YAHYA d397071 80
RIZKI; 5.2.1.201804062320 4 177924 1#0##0#0#0.0#2018-05-22
13:30:44#0#14:37:00#14:37:00#00:00:00 1 e0e59ca94955447694defd9886caf70f
0 0 599993 0 0 1759400 0 0 0 0
1318618 0 0 0 0 0
3201126 B 3 BS 1 03/05/2018 07/05/2018 26/11/2000 0 2
1 K71.5;A18.2;R63.0 87.44 - - None None None None B-4-13-II
4897800 0 0 - 0 - 0 - 0 - 0
4897800 4648423 0 5 0 0 0 MELINDA RAHMAWATI
D397672 17 6367 DR ARU, SPPD 0138R0170518V001096
0000511299911 3;JKN DR RIZKI; 5.2.1.201804062320 4 177643
1#0##0#0#0.0#2018-05-22 13:36:25#0#00:00:00#00:00:00#00:00:00 1
46e487f37a9f975bd6a7f9830e354753 0 0 431387 0 0
2658434 0 0 0 0 1558602 0 0 0 0 0
3201126 B 2 BS 1 28/04/2018 07/05/2018 25/11/1965 0 1
1 D68.9;E11.9;I11.9 88.74 - - None None None None D-4-11-I
4851400 0 0 - 0 - 0 - 0 - 0
4851400 9879537 0 10 0 0 0 MUSTARI D384697
0002257349275 3;JKN DR RIZKI; 5.2.1.201804062320 4 176569
1#0##0#0#0.0#2018-05-22 13:40:22#0#19:04:48#19:04:48#12:00:00 2
3932356ae7da6f6950b45e1b8902bdb3 0 0 897800 0 0
3131412 0 0 0 0 5722325 0 0 0 0 128000
3201126 B 3 BS 1 03/05/2018 07/05/2018 11/09/1969 0 2
1 I50.0;I48;E05.0;J18.8 87.44 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 4026914 0 5 0 0 0 SANIYAH NY D397579
0002089849105 3;JKN DR RIZKI; 5.2.1.201804062320 4 177238
1#0##0#0#0.0#2018-05-22 13:51:28#0#04:09:12#04:09:12#00:00:00 1
80af4f4681a877379c591916202e7870 0 0 777923 0 0
1516548 0 0 0 0 1604443 0 0 0 0 128000
3201126 B 1 BS 1 03/05/2018 07/05/2018 23/07/1947 0 2
1 E11.6;E16.2;M81.8 87.44 - - None None None None E-4-10-I
0 - 0 4903800 6449214 0 5 0 0 0
RAHAYU,NY. d234786 70 25852 DR. ARU ARIADNO, SPPD
0138R0170518V001050 0000061034477 3;JKN DR RIZKI; 5.2.1.201804062320
4 177625 1#0##0#0#0.0#2018-05-22
13:55:40#0#17:18:37#17:18:37#00:00:00 1 6dbcf75d243696048cc321a3e935d25b
0 0 616661 0 0 1825142 0 0 0 0
4007411 0 0 0 0 0
3201126 B 2 BS 1 05/05/2018 07/05/2018 13/12/2007 0 2
- 0 - 0 - 0 - 0 3187000 3524631 0
3 0 0 0 VANIA PUTRI AN D396621 10 3796 DR OTTY
5.2.1.201804062320 4 178150 1#0##0#0#0.0#2018-05-22
14:30:38#0#21:51:38#21:51:38#00:00:00 1 10cae29823d6867d103c6224e2b9aa8f
0 0 339830 0 0 1413218 0 0 0 0
1771583 0 0 0 0 0
3201126 B 1 BS 1 04/05/2018 07/05/2018 23/09/2017 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4633019 0 4 0 0 0 AZAM NAZRIL ZLATAN
PRATAMA D397644 0 223 DR OTTY MITHA S, SPA 0138R0170518V001572
0002281694905 3;JKN DR RIZKI; 5.2.1.201804062320 4 178022
1#0##0#0#0.0#2018-05-22 14:35:46#0#17:38:26#17:38:26#00:00:00 1
68ab9c7bd8773b6ad8ca712cae4e23fa 0 0 269459 0 0 740465
0 0 0 0 3453095 0 0 0 0 170000
3201126 B 1 BS 1 04/05/2018 07/05/2018 17/12/2017 0 1
1 A37.0;J18.0 93.94;87.44 - - None None None None J-4-16-III
8987600 0 0 - 0 - 0 - 0 - 0
8987600 6101147 0 4 0 0 0 MUHAMMAD NAZRAN ALDHANNY
0002320991234 3;JKN DR RIZKI; 5.2.1.201804062320 4 177872
1#0##0#0#0.0#2018-05-22 14:43:07#0#12:52:30#12:52:30#00:00:00 1
8d4bf2001318f7ee048e691fefdc3450 0 0 508265 0 0
1951742 0 0 0 0 3641140 0 0 0 0 0
3201126 B 1 BS 1 05/05/2018 07/05/2018 12/12/1948 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3805071 0 3 0 0 0 METANFANUAN DOLFINA
0000060923428 3;JKN ECHI; 5.2.1.201804062320 4 178127
1#0##0#0#0.0#2018-05-23 11:30:20#0#14:56:42#14:56:42#00:00:00 1
16dee84895dfa75e787a824a9a1e9cb4 0 0 269459 0 0 917682
0 0 0 0 2617930 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 07/05/2018 23/08/1975 0 1
4 I50.0;R57.0;E87.7;J91;R18;R77.0 99.60 - - None None None
(BERAT) 4973600 0 0 - 0 - 0 - 0 - 0
4973600 12679108 0 1 0 0 0 AL IHWAN D391267
3;JKN DR RIZKI; 5.2.1.201804062320 4 178196 1#0##0#0#0.0#2018-
05-25 10:44:14#0#01:48:36#01:48:36#12:00:00 1
be40422671b0b0d4fb8a113d66c4e865 0 0 447624 0 0
11113010 0 0 0 0 1118474 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 07/05/2018 15/09/1948 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 852985 0 1 0 0 0 SYARIF HIDAYAT
0001442626648 3;JKN DR RIZKI; 5.2.1.201804062320 4 178926
1#0##0#0#0.0#2018-05-25 10:48:10#0#00:00:00#00:00:00#00:00:00 1
8892440c05cef98db66c6297cc0dc6ac 0 0 210130 0 0 298052
0 0 0 0 344803 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 07/05/2018 10/11/1946 0 2
4 I46.9;I64 99.60 - - None None None None I-4-14-III None
None None None None None CARDIAC ARREST, TIDAK DIKETAHUI (BERAT)
6043900 0 0 - 0 - 0 - 0 - 0
6043900 2623954 0 1 0 0 0 ETY MASNUN NY
0001339857055 3;JKN DR RIZKI; 5.2.1.201804062320 4 178650
1#0##0#0#0.0#2018-05-25 11:09:23#0#15:51:28#15:51:28#00:00:00 1
fae5a6aa3041123912b8ccb8dcfa9322 0 0 302195 0 0
1861098 0 0 0 0 460661 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 07/05/2018 27/11/1961 0 1
1 N18.5;E87.7 89.52 - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 942207 0 1 0 0 0 NUNU HERIYANA TN
0000060480268 3;JKN DR RIZKI; 5.2.1.201804062320 4 178200
1#0##0#0#0.0#2018-05-28 09:44:51#0#04:13:34#04:13:34#00:00:00 1
a1f3e53e7c0fc5f67746180cb573c484 0 0 298242 0 0 147325
0 0 0 0 368640 0 0 0 0 128000
3201126 B 3 BS 1 07/05/2018 07/05/2018 18/03/1965 0 2
- 0 45079800 49179275 0 1 0 0 0 SUDARTI
0001740574179 3;JKN DR RIZKI; 5.2.1.201804062320 4 178335
1#0##0#0#0.0#2018-05-30 15:12:10#0#00:00:00#00:00:00#12:00:00 1
62f7effda94df46ec83ffec2373b8d9c 0 7996000 6870800 0 0
25467475 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 07/05/2018 07/05/2018 14/05/1970 0 2
1 Z51.1;D05.9 99.25 - - None None None None C-4-13-I None
- 0 - 0 - 0 - 0 2216400 6190423 0
5.2.1.201804062320 4 178491 1#0##0#0#0.0#2018-06-05
09:14:55#0#00:00:00#00:00:00#12:00:00 1 e1970d2a3f199e4b8d7f689fcae2e143
0 0 715980 0 0 4780462 0 0 0 0 693981
0 0 0 0 0
3201126 B 1 BS 1 02/05/2018 07/05/2018 12/06/1947 0 1
1 A49.9;E14.9;F09 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0 - 0
- 0 3855500 10951506 0 6 0 0 0 HARUN
NUROCHADI D397277 70 25892 DR. ARU ARIADNO, SPPD 0138R0170518V000644
0000060799059 3;JKN DR RIZKI; 5.2.2.201806040537 4 177229
1#0##0#0#0.0#2018-06-05 10:16:55#0#20:17:19#20:17:19#00:00:00 1
22463eca98d76af17bd388a9e3254e60 0 0 806742 0 0
5061810 0 0 0 0 5082954 0 0 0 0 0
3201126 B 3 BS 1 02/05/2018 07/05/2018 17/08/1953 0 1
1 J18.0;A01.0;I69.4;I10;N20.0 87.44;87.03 - - None None None
None J-4-16-III None None None None None None SIMPLE PNEUMONIA &
- 0 6419700 6682915 0 6 0 0 0 MAMAN RAHMAN
0000512020056 3;JKN DR RIZKI; 5.2.1.201804062320 4 177168
1#0##0#0#0.0#2018-08-24 11:25:07#0#13:52:21#13:52:21#00:00:00 2
4592cf687af3552ad3f285589245f946 0 0 694970 0 0
3946745 0 0 0 0 2041200 0 0 0 0 0
3201126 B 3 BS 1 03/05/2018 07/05/2018 23/02/2009 0 2
1 Q42.3;K60.3 46.10 - - None None None None K-1-20-I None
None None None None None PROSEDUR INTESTINAL KOMPLEKS (RINGAN)
12174500 0 0 - 0 - 0 - 0 - 0
12174500 14417663 0 5 0 0 0 ALUNG CAHYA UTAMI
0001739999452 3;JKN DR RIZKI; 5.2.2.201806040537 4 177294
1#0##0#0#0.0#2018-08-24 14:19:36#0#09:21:45#09:21:45#00:00:00 2
ea38cbad1b7079da9161a44c9d9d7e9c 0 3963900 4119840 0 0
4979711 0 0 0 0 1064212 0 0 0 0 290000
3201126 B 1 BS 1 07/05/2018 07/05/2018 31/10/1977 0 2
1 Z51.1;D05.9 99.25 - - None None None None C-4-13-I None
- 0 - 0 - 0 - 0 3103000 3647978 0
1 0 0 0 INDAH SUSHANTY D381833 40 14798 RACHMAWATI
5.2.2.201806040537 4 178486 1#0##0#0#0.0#2018-08-24
16:14:31#0#00:00:00#00:00:00#12:00:00 2 f5260a0592eb3723b201a2157c8314cb
0 0 1002360 0 0 1599965 0 0 0 0
1045653 0 0 0 0 0
3201126 B 2 BS 1 04/05/2018 07/05/2018 04/05/2018 868 2
02-II None None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-1
- 0 - 0 116896900 37621414 0 4 0 0 0
VIVI NOVIANTI BY NY D397608 0 0 DR KHARINA CHATAR SPA
0138R0170518V001481 0002456037472 3;JKN DR RIZKI; 5.2.2.201806040537
4 178023 1#0##0#0#0.0#2018-09-25
19:06:10#0#17:40:56#17:40:56#00:00:00 2 cd7c4025c10cb5dd5280dedd6fde0fa8
0 0 13169678 0 0 12127736 0 0 0 0
5362000 0 0 0 0 6962000
3201126 B 3 BS 1 02/05/2018 07/05/2018 05/04/1979 0 2
3914900 0 0 - 0 - 0 - 0 - 0
3914900 4814626 0 6 0 0 0 AFRIANTI NURKOMARIA
0001740633456 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 177231
1#0##0#0#0.0#2018-09-28 13:39:37#0#20:51:20#20:51:20#00:00:00 2
eadbd9c403430b84ddb245500c190505 0 0 709621 0 0
2185979 0 0 0 0 1919026 0 0 0 0 0
3201126 B 1 BS 1 05/05/2018 07/05/2018 01/09/1982 0 2
6981500 0 0 - 0 - 0 - 0 - 0
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1#1#vvip#3#15071715#0.0#2018-10-01 09:12:01#0#08:18:12#08:18:12#00:00:00
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197000
3201126 B 3 BS 1 07/05/2018 07/05/2018 06/02/1984 0 1
3914900 0 0 - 0 - 0 - 0 - 0
3914900 1045631 0 1 0 0 0 SYAHRIMAR ISMAIL
D331498 34 12509 DR NIKEN PRABHA 0138R0170518V002040
0001645826679 3;JKN DR RIZKI; 5.2.1.201804062320 4 178371
1#0##0#0#0.0#2018-10-01 09:24:10#0#10:43:25#10:43:25#12:00:00 2
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3201126 B 1 BS 1 06/05/2018 08/05/2018 19/06/1953 0 1
1 I63.9;G81.9;N18.5;I10 87.03;89.52 - - None None None None
0 - 0 9673300 4762851 0 3 0 0 0 YONO
SUYONO D397689 64 23697 DR NURUL KOMARI SPS 0138R0170518V001798
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1#0##0#0#0.0#2018-05-21 14:24:42#0#20:00:34#20:00:34#00:00:00 1
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1310700 0 0 0 0 2335088 0 0 0 0 0
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1 S06.9;H81.3 87.03;87.44 - - None None None None G-4-24-I
0 - 0 - 0 - 0 - 0 4260400 4450051
0 3 0 0 0 SADIAH YULIANTI D397827 47 17450 DR
NURUL KOMARI SPS 0138R0170518V001749 0002197685024 3;JKN DR RIZKI;
5.2.1.201804062320 4 178157 1#0##0#0#0.0#2018-05-21
15:33:18#0#00:00:00#00:00:00#00:00:00 1 d2ae25400de3b781af6325bcddae2f56
0 0 436436 0 0 1353490 0 0 0 0
2660125 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 08/05/2018 08/05/1966 0 2
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0001794459881 3;JKN DR RIZKI; 5.2.1.201804062320 4 178687
1#0##0#0#0.0#2018-05-21 15:44:24#0#17:51:15#17:51:15#00:00:00 1
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2006035 0 0 0 0 534154 0 0 0 0 69000
3201126 B 1 BS 1 06/05/2018 08/05/2018 27/07/1952 0 2
1 A09.9;E14.9;I50.0 - - - None None None None K-4-17-II
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 5523490 0 3 0 0 0 NY TUTI SUWARSIH S S
0001273539532 3;JKN DR RIZKI; 5.2.1.201804062320 4 178162
1#0##0#0#0.0#2018-05-21 16:11:58#0#00:00:00#00:00:00#00:00:00 1
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2298798 0 0 0 0 2730350 0 0 0 0 0
3201126 B 3 BS 1 06/05/2018 08/05/2018 12/04/1972 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 8333663 0 3 0 0 0 RIDHA LUCIA D397875
3;JKN DR RIZKI; 5.2.1.201804062320 4 178174 1#0##0#0#0.0#2018-
05-21 16:24:17#0#15:50:01#15:50:01#00:00:00 1
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2719925 0 0 0 0 4232993 0 0 0 0 69000
3201126 B 2 BS 1 06/05/2018 08/05/2018 05/07/1960 0 2
- 0 3584400 5184278 0 3 0 0 0 SURYANIH
D397847 57 21124 DR ARU, SPPD 0138R0170518V001753
0001266397323 3;JKN DR RIZKI; 5.2.1.201804062320 4 178225
1#0##0#0#0.0#2018-05-21 16:27:45#0#00:00:00#00:00:00#00:00:00 1
6eb0cae0416484032e8fac9349980aff 0 0 375596 0 0
2928524 0 0 0 0 1880158 0 0 0 0 0
3201126 B 2 BS 1 05/05/2018 08/05/2018 20/11/1986 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 13147749 0 4 0 0 0 DESI MANDASARI
0001292612321 3;JKN DR RIZKI; 5.2.1.201804062320 4 178144
1#0##0#0#0.0#2018-05-21 16:33:41#0#19:47:09#19:47:09#00:00:00 1
78aef1fb09306a45474f06736ab2e0ab 0 6339900 3377003 0 0
2262713 0 0 0 0 971133 0 0 0 0 197000
3201126 B 2 BS 1 06/05/2018 08/05/2018 19/01/2018 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 5515359 0 3 0 0 0 KEINARRA SCHAACI
0002317627618 3;JKN DR RIZKI; 5.2.1.201804062320 4 178170
1#1#vvip#3#3453859#0.0#2018-05-21 16:36:20#0#14:50:27#14:50:27#00:00:00
1 8fa769d34c536cdd3aae048074546b51 0 0 452861 0 0
844680 0 0 0 0 4217818 0 0 0 0 0
3201126 B 2 BS 1 05/05/2018 08/05/2018 08/09/1965 0 2
1 I50.0;J22 - - - None None None None I-4-12-I None
0 - 0 - 0 - 0 - 0 4290800 3939752
0 4 0 0 0 SIWUH D397781 52 19232 DR AGOES
5.2.1.201804062320 4 178119 1#0##0#0#0.0#2018-05-22
08:24:12#0#13:33:15#13:33:15#00:00:00 1 2d076d825ebf3a7b35f839e007535c15
0 0 500624 0 0 1135387 0 0 0 0
2303741 0 0 0 0 0
3201126 B 1 BS 1 06/05/2018 08/05/2018 22/05/1973 0 2
- 0 - 0 27065300 18946207 0 3 0 0 0
SUMAWATI D380937 44 16420 DR BETTY DWI L, SPPD
0138R0170518V001780 0001652014642 3;JKN DR RIZKI; 5.2.1.201804062320
4 178172 1#0##0#0#0.0#2018-05-22
08:25:37#0#14:50:47#14:50:47#00:00:00 1 2ee935a434443a47a6900011c674e15c
0 7159200 7901937 0 0 2540070 0 0 0 0
1276000 0 0 0 0 69000
3201126 B 2 BS 1 07/05/2018 08/05/2018 01/12/1991 0 2
0 - 0 - 0 - 0 - 0 3479400 3397754
0 2 0 0 0 RYANI PUSPA DEWI D361233 26 9654 ENDANG
TRI KURNIADEWI DR SPOG 0138R0170518V002081 0001228560423 3;JKN DR RIZKI;
5.2.1.201804062320 4 178501 1#0##0#0#0.0#2018-05-22
10:11:18#0#12:11:10#12:11:10#00:00:00 1 9b5987e21ddff2d3287252ce44391622
0 0 287171 0 0 1706300 0 0 0 0
1276283 0 0 0 0 128000
3201126 B 3 BS 1 05/05/2018 08/05/2018 17/03/2010 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 3906010 0 4 0 0 0 ALFATHIRA
KRISYANTO D392584 8 2971 DR VERA MUNA MANOE, SPA 0138R0170518V001689
0001265724505 3;JKN DR RIZKI; 5.2.1.201804062320 4 178118
1#0##0#0#0.0#2018-05-22 10:15:36#0#13:13:42#13:13:42#12:00:00 1
29e9cde9d33a17f1fcba49d95bc76418 0 0 268830 0 0
2829647 0 0 0 0 807533 0 0 0 0 0
3201126 B 2 BS 1 07/05/2018 08/05/2018 06/06/1990 0 2
0 - 0 - 0 - 0 - 0 3545800 5594016
0 2 0 0 0 HENI NOVIAH D397524 27 10197 DR ZULFAN,
4 178700 1#0##0#0#0.0#2018-05-22
10:16:58#0#00:00:00#00:00:00#00:00:00 1 2bf84d789d4775366fe759f6181c3edd
0 0 1045824 0 0 842228 0 0 0 0
1956964 0 0 0 0 1749000
3201126 B 1 BS 1 07/05/2018 08/05/2018 02/12/1974 0 2
1 I25.0;I11.0;E14.9;N18.5 88.55 - - None None None None I-1-
17095200 0 0 - 0 - 0 - 0 - 0
17095200 14889191 0 2 0 0 0 DEWI SUGIARTI
0000043603031 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 178211
1#0##0#0#0.0#2018-05-22 14:27:21#0#00:00:00#00:00:00#12:00:00 1
6d444af143900caa200a0c460c77300a 0 4777000 3419040 0 0
3574092 0 0 0 0 1050059 0 0 0 0
2069000
3201126 B 3 BS 1 07/05/2018 08/05/2018 21/06/1955 0 1
- 0 8908800 9306954 0 2 0 0 0 YANTO
0138R0170518V002369 0002099388082 3;JKN DR RIZKI; 5.2.1.201804062320
4 178689 1#0##0#0#0.0#2018-05-24
16:00:51#0#18:58:16#18:58:16#00:00:00 1 f73dede117084c7bd2bbbed6e65432c4
0 3352300 1870848 0 0 3329940 0 0 0 0
684866 0 0 0 0 69000
3201126 B 1 BS 1 07/05/2018 08/05/2018 06/04/1977 0 2
0 - 0 - 0 - 0 - 0 3247500 6461212
0 2 0 0 0 SETYOWATI D107684 41 15006 DR. ARU
5.2.1.201804062320 4 178692 1#0##0#0#0.0#2018-05-25
08:52:08#0#19:31:41#19:31:41#12:00:00 1 9139899540750367e23324d68bc36acb
0 0 1211304 0 0 1093212 0 0 0 0
2407696 0 0 0 0 1749000
3201126 B 2 BS 1 07/05/2018 08/05/2018 10/06/1961 0 2
1 I12.0;I72.1;E86;A16.1 39.52 - - None None None None I-1-
(SEDANG) 23032500 0 0 - 0 - 0 - 0 - 0
23032500 11621803 0 2 0 0 0 SRI RAHAYU D366199
0001722154689 3;JKN DR RIZKI; 5.2.1.201804062320 4 178541
1#0##0#0#0.0#2018-05-25 09:14:21#0#00:00:00#00:00:00#00:00:00 1
21c3005d3de4932c86bcdb5a2b18a56c 0 4911100 3871708 0 0
1933690 0 0 0 0 836305 0 0 0 0 69000
3201126 B 1 BS 1 06/05/2018 08/05/2018 21/11/2016 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3696490 0 3 0 0 0 NYIAYU KARINA NOUREEN
D352237 1 531 DR AWIDIYA, SPA 0138R0170518V001794
0002232215493 3;JKN DR RIZKI; 5.2.1.201804062320 4 178180
1#0##0#0#0.0#2018-05-25 09:26:13#0#19:22:58#19:22:58#00:00:00 1
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0 0 0 0 2610826 0 0 0 0 0
3201126 B 2 BS 1 07/05/2018 08/05/2018 02/02/1963 0 2
1 T82.4;I12.0;D63.8 99.21;39.42;99.04 - - None None None None
- 0 - 0 10690500 16533916 0 2 0 0 0
PURBONINGSIH D395835 55 20183 DR. ARU ARIADNO, SPPD
0138R0170518V001814 0001294463902 3;JKN DR RIZKI; 5.2.1.201804062320
4 178198 1#0##0#0#0.0#2018-05-25
10:04:23#0#02:55:15#02:55:15#00:00:00 1 803b9dbe4988a73afe1e04d4ab275690
0 0 2404910 0 0 8463248 0 0 0 0
5596758 0 0 0 0 69000
3201126 B 1 BS 1 01/05/2018 08/05/2018 21/11/1961 0 1
1 I63.9;L89.1;N39.0;G81.9;I10 87.03;87.44 - - None None None
- 0 - 0 9673300 17986140 0 8 0 0 0
ALLER SILALAHI D397473 56 20615 DR NURUL KOMARI SPS
0138R0170518V000134 0000040955319 3;JKN DR RIZKI; 5.2.1.201804062320
4 177090 1#0##0#0#0.0#2018-05-25
10:56:30#0#22:02:18#22:02:18#00:00:00 1 178565871c33dfd21014a11144d11876
0 0 882140 0 0 7296337 0 0 0 0
6945663 0 0 0 0 2862000
3201126 B 2 BS 1 07/05/2018 08/05/2018 29/04/2018 0 1
0 - 0 - 0 - 0 - 0 5045200 3396109
0 2 0 0 0 SAIDAH BY NY D397287 0 8 DR
RASTRA, SPA 0138R0170518V002279 0002454790555 3;JKN DR RIZKI;
5.2.1.201804062320 4 178685 1#0##0#0#0.0#2018-05-25
11:10:50#0#16:46:47#16:46:47#00:00:00 1 ed1eed01324b5e72b8cdaa0d26d2a1bc
0 0 454068 0 0 201866 0 0 0 0
1602175 0 0 0 0 1138000
3201126 B 2 BS 1 05/05/2018 08/05/2018 05/05/2018 3341 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1437343 0 4 0 0 0 MEHRUNISA HARSYAHIRA
d397846 0 0 DR NOVIK BUDIWARDHANA, SPA 0138R0170518V002060
0002456518138 3;JKN DR RIZKI; 5.2.1.201804062320 4 178437
1#0##0#0#0.0#2018-05-25 11:12:59#0#00:00:00#00:00:00#00:00:00 1
21021429065ff981040ffcf928bfc59e 0 0 433812 0 0 88899
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3201126 B 1 BS 1 05/05/2018 08/05/2018 17/12/1947 0 1
6795600 0 0 - 0 - 0 - 0 - 0
6795600 5522959 0 4 0 0 0 S.SOEKARNO.IM.K
0001282893726 3;JKN DR RIZKI; 5.2.1.201804062320 4 178145
1#0##0#0#0.0#2018-05-25 13:49:47#0#19:50:09#19:50:09#12:00:00 1
2140f0fa4c848e0d58c2afd13868382e 0 0 743310 0 0
1613834 0 0 0 0 3165815 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 08/05/2018 07/12/1962 0 1
1 I13.1;M54.56;D63.8 99.04;39.95 - - None None None None
- 0 4132100 3544486 0 2 0 0 0 KASONO TN
0002223029204 3;JKN DR RIZKI; 5.2.1.201804062320 4 178691
1#0##0#0#0.0#2018-06-05 09:12:14#0#19:06:10#19:06:10#00:00:00 2
83aa7205e7f09a656146a989a0170175 0 0 371889 0 0
1318965 0 0 0 0 1853632 0 0 0 0 0
3201126 B 3 BS 1 28/04/2018 08/05/2018 24/04/1954 0 1
1 I50.0;I21.2;E11.2;J18.8 87.44 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 25118611 0 11 1 7 0 MUHAMMAD NADJIB NASUTION
0001772159207 3;JKN DR RIZKI; 5.2.1.201804062320 4 176317
1#0##0#0#0.0#2018-06-05 09:21:40#0#00:00:00#00:00:00#00:00:00 1
ba04768d0c40a3eb437ac9c6f5322239 0 0 1093190 0 0
11561921 0 0 0 0 8095500 0 0 0 0
4368000
3201126 B 1 BS 1 02/05/2018 08/05/2018 17/03/1971 0 2
1 I64;J18.9;G81.9 87.44;87.03 - - None None None None G-4-
- 0 - 0 - 0 - 0 9659700 19733241 0
7 0 0 0 PURI NARINDRA NY D397494 47 17213 DR
MAYSAMIRAWATI SPS 0138R0170518V000149 0001808095094 3;JKN DR RIZKI;
5.2.2.201806040537 4 177094 1#0##0#0#0.0#2018-08-24
14:25:08#0#04:43:35#04:43:35#00:00:00 2 ce8df867a418f9ff679568369f2106ff
0 0 1267110 0 0 9889131 0 0 0 0
7061000 0 0 0 0 1516000
3201126 B 3 BS 1 07/05/2018 08/05/2018 21/05/1994 0 1
1 N18.5;D63.8;T82.4;A49.9 39.42;99.04 - - None None None None
- 0 - 0 19332400 11048508 0 2 0 0 0
ISMAIL D395805 23 8752 SRI KUNMARTINI.DR,SPPD
0138R0170518V002399 0001233775078 3;JKN DR RIZKI; 5.2.1.201804062320
4 183661 1#0##0#0#0.0#2018-08-24
14:45:18#0#00:00:00#00:00:00#00:00:00 3 7bb3d9fce849753b1b2b7ad704a0f5d7
0 0 5904214 0 0 1421494 0 0 0 0
3688300 0 0 0 0 34500
3201126 B 3 BS 1 30/04/2018 08/05/2018 16/03/2018 0 2
JANTUNG (BERAT) 8387700 0 0 - 0 - 0 - 0 -
0 8387700 26721185 0 9 1 6 0 AHZA RUMAISA
0002448994634 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 177063
1#0##0#0#0.0#2018-09-28 13:33:30#0#00:06:37#00:06:37#00:00:00 2
9fffa32299d93b69cf82e5a14b43b414 0 0 1327547 0 0
11697638 0 0 0 0 7956000 0 0 0 0
5740000
3201126 B 1 BS 1 06/05/2018 08/05/2018 02/12/1938 0 2
1 C20;I10 45.23 - - None None None None K-4-10-I None
None None None None None TUMOR PENCERNAAN (RINGAN) 6881700 0
0 - 0 - 0 - 0 - 0 6881700 7720024
0 3 0 0 0 TIURLAN SIAGIAN,NY D346828 79 29010
RIZKI; 5.2.2.201806040537 4 178175 1#0##0#0#0.0#2018-09-29
14:37:05#0#16:57:29#16:57:29#12:00:00 2 b561a88371ee251aef2dd79bed5af2cf
0 0 1979876 0 0 2124600 0 0 0 0
3546548 0 0 0 0 69000
3201126 B 3 BS 1 08/05/2018 09/05/2018 31/12/2000 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1024549 0 2 0 0 0 AN SALMA HAYET
0001406330199 3;JKN DR RIZKI; 5.2.1.201804062320 4 179016
1#0##0#0#0.0#2018-05-21 14:34:14#0#20:44:21#20:44:21#00:00:00 1
1b4de5a94d9a18612b77853dab7233ea 0 0 207620 0 0 284402
0 0 0 0 532527 0 0 0 0 0
3201126 B 3 BS 1 09/05/2018 09/05/2018 30/12/2017 0 2
2 A41.9;A09.9 96.05 - - None None None None A-4-10-I None
- 0 - 0 - 0 - 0 2534700 4630991 0
1 0 0 0 BAYI NY IFAH ZULAIFAH D388628 0 130 DR
YOHANES DWINANDA R P 0138R0170518V003945 0002420311656 3;JKN DR RIZKI;
5.2.1.201804062320 4 179713 1#0##0#0#0.0#2018-05-21
15:25:13#0#00:00:00#00:00:00#12:00:00 1 63f9658ee151b4d7ad9c1106ecc0a268
0 0 392430 0 0 3646599 0 0 0 0 591962
0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 09/05/2018 07/05/2018 3512 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040617 0 3 0 0 0 BAYI NY. SUBEKTI
SULISTYAWATI D397937 0 0 DR OTTY MITHA S, SPA
0138R0170518V002967 0002440330053 3;JKN DR RIZKI; 5.2.1.201804062320
4 179031 1#0##0#0#0.0#2018-05-22
10:59:35#0#00:00:00#00:00:00#00:00:00 1 ae4a50cfe5da9b30d6d99c6429e6aa34
0 0 499620 0 0 88899 0 0 0 0 1452098
0 0 0 0 0
3201126 B 2 BS 1 03/05/2018 09/05/2018 01/01/1938 0 1
1 C20;I63.9;D63.0;E87.8 99.04;90.59;89.52 - - None None None
None K-4-10-III None None None None None None TUMOR PENCERNAAN (BERAT)
13320000 0 0 - 0 - 0 - 0 - 0
13320000 14041191 0 7 0 0 0 DJADENAK KULON DAMANIK
0000060711513 3;JKN DR RIZKI; 5.2.1.201804062320 4 177640
1#0##0#0#0.0#2018-05-24 15:41:34#0#20:58:17#20:58:17#00:00:00 1
9bdb90169b88d1476623d0a9e469c0d8 0 0 1385000 0 0
7879108 0 0 0 0 4777083 0 0 0 0 0
3201126 B 2 BS 1 05/05/2018 09/05/2018 10/11/1953 0 2
1 M51.9;M21.3 - - - None None None None M-4-17-II None
(SEDANG) 6189400 0 0 - 0 - 0 - 0 - 0
6189400 4606141 0 5 0 0 0 TURIAH D397828
3;JKN DR RIZKI; 5.2.1.201804062320 4 178142 1#0##0#0#0.0#2018-
05-24 15:43:03#0#18:43:08#18:43:08#00:00:00 1
06233d3ff618086b80f3561913957118 0 0 671940 0 0
1586865 0 0 0 0 2347336 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 09/05/2018 11/03/1952 0 2
1 I10;E14.9 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 2669400 4321961 0
3 0 0 0 SUKARTIYEM D333262 66 24163 DR SOEGIONO, SPPD
0138R0170518V002374 0000061047022 3;JKN DR RIZKI; 5.2.1.201804062320
4 178690 1#0##0#0#0.0#2018-05-24
15:44:11#0#19:02:51#19:02:51#00:00:00 1 d4acea40e46b1ff953f60d9ff5e28bcf
0 0 494342 0 0 1521374 0 0 0 0
2306245 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 09/05/2018 10/12/1970 0 2
- 0 8908800 9791359 0 3 0 0 0 H E N A H
0001718194768 3;JKN DR RIZKI; 5.2.1.201804062320 4 178503
1#0##0#0#0.0#2018-05-24 15:54:13#0#00:00:00#00:00:00#00:00:00 1
cd048f40afecbca91173ce5007aaa732 0 3611800 2012936 0 0
3431067 0 0 0 0 666556 0 0 0 0 69000
3201126 B 2 BS 1 06/05/2018 09/05/2018 21/09/1952 0 1
1 E14.7 88.76;90.59;89.52;99.17;99.21 - - None None None None
E-4-10-I None None None None None None PENYAKIT KENCING MANIS &
GANGGUAN NUTRISI/ METABOLIK (RINGAN) 4203300 0 0 - 0 -
0 - 0 - 0 4203300 6457286 0 4 0 0
0 FA SUTARMAN D341353 65 23968 DR. ARU ARIADNO, SPPD
0138R0170518V001759 0000041517955 3;JKN DR RIZKI; 5.2.1.201804062320
4 178160 1#0##0#0#0.0#2018-05-25
08:25:54#0#04:17:24#04:17:24#12:00:00 1 19dcd243e66a55ec5412be596d1f707f
0 0 834794 0 0 2649053 0 0 0 0
2973439 0 0 0 0 0
3201126 B 1 BS 1 08/05/2018 09/05/2018 14/05/1958 0 1
1 I25.1;I08.9;I11.0;E11.5 88.55;36.07 - - None None None None
I-1-40-III None None None None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (BERAT) 48095600 0 0 - 0 - 0 - 0 -
0 48095600 59356549 0 2 0 0 0 WAHYUDI
0001432296538 3;JKN DR RIZKI; 5.2.1.201804062320 4 178888
1#0##0#0#0.0#2018-05-25 08:33:09#0#12:08:09#12:08:09#00:00:00 1
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30777429 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 05/05/2018 09/05/2018 05/10/1959 0 1
1 I64;E78.5 87.03 - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 5460868 0 5 0
0 0 DJAENAL ABIDIN d397844 58 21397 DR HARDI PRANATA SPS
0138R0170518V001745 0002375257904 3;JKN DR RIZKI; 5.2.1.201804062320
4 178154 1#0##0#0#0.0#2018-05-25
08:34:58#0#00:00:00#00:00:00#00:00:00 2 a5a9a6bd5530b1de06be774148d7c2bc
0 0 727855 0 0 3121260 0 0 0 0
1611753 0 0 0 0 0
3201126 B 2 BS 1 08/05/2018 09/05/2018 11/08/1973 0 1
0 - 0 - 0 - 0 - 0 2783600 5870084
0 2 0 0 0 AGUS PONIMAN D397557 44 16341 DR.
5.2.1.201804062320 4 178710 1#0##0#0#0.0#2018-05-25
09:17:48#0#07:27:36#07:27:36#00:00:00 1 30562d757aa5a82ef75c551997e43676
0 0 895408 0 0 1093152 0 0 0 0
2132524 0 0 0 0 1749000
3201126 B 3 BS 1 04/05/2018 09/05/2018 15/07/2012 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 3412114 0 6 0 0 0 AZKA ATTARAMADHAN
D397701 5 2119 DR RASTRA, SPA 0138R0170518V001470
0001282738555 3;JKN DR RIZKI; 5.2.1.201804062320 4 177958
1#0##0#0#0.0#2018-05-25 09:18:26#0#15:05:03#15:05:03#00:00:00 1
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1327709 0 0 0 0 1827222 0 0 0 0 0
3201126 B 3 BS 1 08/05/2018 09/05/2018 01/07/1970 0 1
12210800 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-05-25 09:53:26#0#07:52:11#07:52:11#00:00:00 1
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4461025 0 0 0 0 882553 0 0 0 0
2069000
3201126 B 2 BS 1 06/05/2018 09/05/2018 01/03/1968 0 1
1 I63.9;E14.9;G81.9;I10 87.03 - - None None None None G-4-
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-05-25 10:08:02#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 1 BS 1 07/05/2018 09/05/2018 18/05/1966 0 1
1 E14.2;D63.8;J20.9;I11.9 99.04;39.27 - - None None None None
- 0 - 0 12472300 13701702 0 3 0 0 0
SULISTYARTO WIDAGDO H097931 51 18982 SRI KUNMARTINI.DR,SPPD
0138R0170518V002397 0001642474719 3;JKN DR RIZKI; 5.2.1.201804062320
4 178701 1#0##0#0#0.0#2018-05-25
10:13:16#0#23:16:05#23:16:05#00:00:00 1 47b12abe2eae0fd1840cd34c824fb251
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972373 0 0 0 0 69000
3201126 B 2 BS 1 07/05/2018 09/05/2018 08/03/1995 0 2
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0 3 0 0 0 FITRIA SURYANINGRUM D333900 23 8461
DR ARIS WAHJU, SPOG 0138R0170518V002181 0001106798264 3;JKN DR
RIZKI; 5.2.1.201804062320 4 178570 1#0##0#0#0.0#2018-05-25
10:19:51#0#14:38:14#14:38:14#00:00:00 1 03a16d26334d311e6ac9ef54865aefbe
0 0 287171 0 0 949965 0 0 0 0
1754730 0 0 0 0 0
3201126 B 2 BS 1 08/05/2018 09/05/2018 08/05/1953 0 1
1 I12.0;K30 39.27 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
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0138R0170518V002601 0001148964118 3;JKN DR RIZKI; 5.2.1.201804062320
4 178827 1#0##0#0#0.0#2018-05-25
10:21:13#0#10:12:03#10:12:03#00:00:00 1 8fa76da22dfc4ec6c02a3f7d4dd5645a
0 4911100 1250064 0 0 2890170 0 0 0 0
719743 0 0 0 0 69000
3201126 B 2 BS 1 07/05/2018 09/05/2018 09/02/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2494772 0 3 0 0 0 MOCHAMAD ALIFIANDRA
AZZAHIR D377226 2 818 DR RASTRA, SPA 0138R0170518V001812
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1#0##0#0#0.0#2018-05-25 10:26:57#0#02:09:30#02:09:30#12:00:00 1
248bc7abe0312fdf748724b2c4858e29 0 0 238535 0 0 382028
0 0 0 0 1704209 0 0 0 0 170000
3201126 B 1 BS 1 06/05/2018 09/05/2018 24/03/1946 0 1
5164300 0 0 - 0 - 0 - 0 - 0
5164300 5706688 0 4 0 0 0 DODDY SUMANTRI
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1#0##0#0#0.0#2018-05-25 10:31:05#0#15:36:13#15:36:13#00:00:00 1
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1675088 0 0 0 0 3523335 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 09/05/2018 29/12/1993 0 2
0 0 - 0 - 0 - 0 - 0 8264200
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DR ARIS WAHJU, SPOG 0138R0170518V002392 0001070882493 3;JKN DR
RIZKI; 5.2.1.201804062320 4 178699 1#0##0#0#0.0#2018-05-25
10:39:31#0#21:48:34#21:48:34#00:00:00 1 05abfbe33756e2a0a5b443e62b3f20c0
0 3528500 2312825 0 0 2353850 0 0 0 0
707962 0 0 0 0 69000
3201126 B 1 BS 1 06/05/2018 09/05/2018 08/11/1991 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 19011804 0 4 0 0 0 CITRA PARAMITHA
D295874 26 9676 DR AFRA FONDA SPOG 0138R0170518V001800
0001306290385 3;JKN DR RIZKI; 5.2.1.201804062320 4 178186
1#1#vvip#4#12030304#0.0#2018-05-25 10:41:38#0#21:23:35#21:23:35#00:00:00
1 a6bee630b31b2a8fd76ca4f05b8108ed 0 8876900 6498000 0
0 2138904 0 0 0 0 1301000 0 0 0 0
197000
3201126 B 1 BS 1 06/05/2018 09/05/2018 10/02/1981 0 2
0 0 - 0 - 0 - 0 - 0 6981500
13928950 0 4 0 0 0 SUBEKTI SULISTYAWATI NY D208364
37 13599 DR NELWATI, SPOG 0138R0170518V001799 0001463279951 3;JKN
DR RIZKI; 5.2.1.201804062320 4 179068 1#0##0#0#0.0#2018-05-25
10:47:16#0#09:09:35#09:09:35#00:00:00 1 6eee74579839f8aae65bc83682315703
0 7444400 2862415 0 0 2402895 0 0 0 0
1022240 0 0 0 0 197000
3201126 B 3 BS 1 06/05/2018 09/05/2018 07/10/2017 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2126507 0 4 0 0 0 SHIREN NAJMA ALMIRA
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1#0##0#0#0.0#2018-05-25 10:51:10#0#10:03:13#10:03:13#00:00:00 1
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0 0 0 0 1217117 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 09/05/2018 10/07/1951 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 16150655 0 3 0 0 0 SUGIARTI D303896
3;JKN DR RIZKI; 5.2.1.201804062320 4 178552 1#0##0#0#0.0#2018-
05-25 10:58:32#0#14:24:55#14:24:55#00:00:00 2
2ff564aee414cdf3ac3078531b158ce9 0 0 4649424 0 0
2749046 0 0 0 0 8607185 0 0 0 0 145000
3201126 B 2 BS 1 08/05/2018 09/05/2018 12/07/1972 0 2
- 0 4203300 2104343 0 2 0 0 0 YULIA ULFAH
0001423421199 3;JKN DR RIZKI; 5.2.1.201804062320 4 178704
1#0##0#0#0.0#2018-05-25 11:00:45#0#01:31:27#01:31:27#00:00:00 1
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0 0 0 0 1173667 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 09/05/2018 07/05/2018 3211 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1926555 0 3 0 0 0 CITRA PARAMITHA BY NY
0002457010798 3;JKN DR RIZKI; 5.2.1.201804062320 4 179005
1#0##0#0#0.0#2018-05-25 11:04:21#0#16:32:56#16:32:56#00:00:00 1
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3201126 B 2 BS 1 05/05/2018 09/05/2018 23/02/1984 0 2
0 - 0 - 0 - 0 - 0 3479400 6869473
0 5 0 0 0 FAUZA D375639 34 12490 DR ERDIYAN, SPOG
0138R0170518V001626 0001632008193 3;JKN DR RIZKI; 5.2.1.201804062320
4 178040 1#0##0#0#0.0#2018-05-25
11:19:53#0#00:00:00#00:00:00#00:00:00 1 adbab3c16c855846d95863bb4bc61e36
0 0 669146 0 0 3029922 0 0 0 0
3000405 0 0 0 0 170000
3201126 B 1 BS 1 08/05/2018 09/05/2018 10/10/1964 0 2
(RINGAN) 4126300 0 0 - 0 - 0 - 0 - 0
4126300 9811062 0 2 0 0 0 MOI NAIBAHO NY
0000040057569 3;JKN DR RIZKI; 5.2.1.201804062320 4 178705
1#0##0#0#0.0#2018-05-25 13:43:44#0#01:43:47#01:43:47#00:00:00 1
5c8bda1aae0e46b19d9e5ff8a95827fe 0 0 1261364 0 0
1679253 0 0 0 0 6725445 0 0 0 0 145000
3201126 B 1 BS 1 08/05/2018 09/05/2018 21/08/1972 0 2
1 K21.0;K31.7;K29.8 45.16;45.42 - - None None None None K-4-
0 0 - 0 - 0 - 0 - 0 5739000
6493415 0 2 0 0 0 EKO AGUSNEHING PURWANINGSIH
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1#0##0#0#0.0#2018-05-30 15:31:04#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 07/05/2018 09/05/2018 15/11/1945 0 2
1 E14.2;T82.4;J18.0 38.95 - - None None None None N-1-12-III
- 0 23198900 15629348 0 3 0 0 0 GERTRUDE
ROOSILAWATI D397940 72 26471 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V002339 0000059085472 3;JKN DR RIZKI; 5.2.1.201804062320
4 178688 1#0##0#0#0.0#2018-06-05
08:55:40#0#18:20:28#18:20:28#00:00:00 1 0bacfd673fdc6cc808e62815ca4a3206
0 5118600 2245005 0 0 7148262 0 0 0 0
1048481 0 0 0 0 69000
3201126 B 3 BS 1 05/05/2018 09/05/2018 10/12/1981 0 2
1 C50.9;D63.0;J91;M54.55;M84.40 99.04;34.91 - - None None None
None L-4-11-III None None None None None None TUMOR PAYUDARA (BERAT)
11526100 0 0 - 0 - 0 - 0 - 0
11526100 6992685 0 5 0 0 0 SRI PURWANTI
0001962912317 3;JKN DR RIZKI; 5.2.2.201806040537 4 178141
1#0##0#0#0.0#2018-08-24 11:24:29#0#17:22:58#17:22:58#00:00:00 3
380b23039883de7df8d1d456429f5f7c 0 0 2090349 0 0
3190371 0 0 0 0 1711965 0 0 0 0 0
3201126 B 3 BS 1 09/05/2018 09/05/2018 01/08/1948 0 2
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- 0 - 0 - 0 - 0 3043100 2265323 0
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TOMALA PUTRA 0138R0170518V003216 0000061031013 3;JKN DR RIZKI;
5.2.2.201806040537 4 179177 1#0##0#0#0.0#2018-08-24
15:15:57#0#13:08:12#13:08:12#00:00:00 2 1cdda72693dc1b3986749dbf66be8300
0 0 273879 0 0 1554245 0 0 0 0 437199
0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 09/05/2018 17/05/1958 0 2
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0001447717882 3;JKN DR RIZKI; 5.2.1.201804062320 4 179025
1#0##0#0#0.0#2018-09-05 15:01:08#0#00:19:17#00:19:17#12:00:00 2
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3201126 B 3 BS 1 08/05/2018 09/05/2018 24/04/1962 0 1
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SUHADI D382531 56 20468 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V002679 0001278846731 3;JKN DR RIZKI; 5.2.2.201806040537
4 178890 1#0##0#0#0.0#2018-09-06
16:35:43#0#13:09:50#13:09:50#12:00:00 2 ace81c354208c3efa686fcc83cd651bb
0 3062500 1870848 0 0 3954900 0 0 0 0
708327 0 0 0 0 69000
3201126 B 2 BS 1 08/05/2018 09/05/2018 12/07/1972 0 2
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0001423421199 3;JKN DR RIZKI; 5.2.2.201806040537 4 228584
1#0##0#0#0.0#2018-09-29 15:29:17#0#00:00:00#00:00:00#00:00:00 2
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0 0 0 2104343 0 0 0 0 0
3201126 B 2 BS 1 30/04/2018 09/05/2018 12/07/1971 0 1
1 I61.9;I10;G81.9;K92.0 87.03;93.19 - - None None None None
0 - 0 6183900 24765230 0 10 1 5 0
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0138R0170418V009877 0000038197449 3;JKN DR RIZKI; 5.2.2.201806040537
4 176614 1#0##0#0#0.0#2018-10-01
09:04:54#0#00:00:00#00:00:00#00:00:00 2 8b149ac49826744c8eb664fde40b0e4b
0 0 786430 0 0 13114800 0 0 0 0
7228000 0 0 0 0 3636000
3201126 B 3 BS 1 09/05/2018 10/05/2018 07/05/1954 0 2
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2646600 0 0 - 0 - 0 - 0 - 0
2646600 999626 0 2 0 0 0 RAULI JULIANTY,NY
D067120 64 23378 DR ANGGA TOMALA PUTRA 0138R0170518V003342
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1#0##0#0#0.0#2018-05-21 15:21:02#0#21:14:05#21:14:05#12:00:00 1
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0 0 0 0 354396 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 10/05/2018 29/10/1972 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2208592 0 1 0 0 0 ENNA DWIANA SARI
NY D315730 45 16629 DR AHMAD HIBBAN A WRIYA 0138R0170518V003391
0001642462222 3;JKN DR RIZKI; 5.2.1.201804062320 4 179210
1#0##0#0#0.0#2018-05-21 15:22:40#0#00:00:00#00:00:00#00:00:00 1
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1568500 0 0 0 0 433487 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 10/05/2018 01/02/1965 0 1
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 3345755 0 1 0 0 0 SATYA WALUYO
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1#0##0#0#0.0#2018-05-22 11:11:22#0#04:17:26#04:17:26#00:00:00 1
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2610054 0 0 0 0 507881 0 0 0 0 0
3201126 B 1 BS 1 06/05/2018 10/05/2018 20/11/1958 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-05-24 15:56:46#0#12:58:57#12:58:57#00:00:00 1
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2060981 0 0 0 0 4421862 0 0 0 0 0
3201126 B 1 BS 1 06/05/2018 10/05/2018 06/12/1950 0 2
5058500 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-05-24 15:59:41#0#00:57:20#00:57:20#00:00:00 1
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DR RIZKI; 5.2.1.201804062320 4 178178 1#0##0#0#0.0#2018-05-24
16:03:16#0#17:40:38#17:40:38#00:00:00 1 2db7e437509596f964d768f89ddaf653
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706723 0 0 0 0 69000
3201126 B 1 BS 1 05/05/2018 10/05/2018 05/03/1973 0 2
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- 0 - 0 - 0 - 0 5734600 8121658 0
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4 178137 1#0##0#0#0.0#2018-05-25
08:36:34#0#15:58:23#15:58:23#00:00:00 1 f3b932d34c55ba0cc5c97c4c8765934b
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5243323 0 0 0 0 0
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(SEDANG) 7214600 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.1.201804062320 4 178039 1#0##0#0#0.0#2018-
05-25 08:44:42#0#00:00:00#00:00:00#00:00:00 1
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5746466 0 0 0 0 5495711 0 0 0 0 0
3201126 B 1 BS 1 08/05/2018 10/05/2018 28/01/1957 0 1
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6411793 0 3 0 0 0 SAMSON SURIYATNE ATTAP d396959
3;JKN DR RIZKI; 5.2.1.201804062320 4 178769 1#0##0#0#0.0#2018-
05-25 08:50:56#0#08:59:43#08:59:43#00:00:00 1
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3201126 B 1 BS 1 07/05/2018 10/05/2018 07/05/2018 3431 2
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0002457470327 3;JKN DR RIZKI; 5.2.1.201804062320 4 179176
1#0##0#0#0.0#2018-05-25 09:15:50#0#12:48:54#12:48:54#00:00:00 1
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3201126 B 3 BS 1 07/05/2018 10/05/2018 15/10/2014 0 2
0 - 0 - 0 - 0 - 0 2225900 3384818
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5.2.1.201804062320 4 178694 1#0##0#0#0.0#2018-05-25
09:20:46#0#20:48:52#20:48:52#00:00:00 1 d58fe6873db2a23e92b639461c28f1ef
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3201126 B 2 BS 1 07/05/2018 10/05/2018 07/08/1940 0 1
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1#0##0#0#0.0#2018-05-25 09:22:31#0#19:52:01#19:52:01#00:00:00 1
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2722533 0 0 0 0 721078 0 0 0 0 138000
3201126 B 2 BS 1 05/05/2018 10/05/2018 25/07/2012 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3040051 0 6 0 0 0 NAZWA SISILIA
0001321479821 3;JKN DR RIZKI; 5.2.1.201804062320 4 178146
1#0##0#0#0.0#2018-05-25 09:23:31#0#20:00:13#20:00:13#00:00:00 1
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3201126 B 2 BS 1 06/05/2018 10/05/2018 27/12/2013 0 2
0 0 - 0 - 0 - 0 - 0 2871200
4839004 0 5 0 0 0 SYALIA ANANDA JAYA PUTRI
0001650041875 3;JKN DR RIZKI; 5.2.1.201804062320 4 178156
1#0##0#0#0.0#2018-05-25 09:25:12#0#00:00:00#00:00:00#00:00:00 1
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1660026 0 0 0 0 2867570 0 0 0 0 0
3201126 B 1 BS 1 06/05/2018 10/05/2018 06/11/1982 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 26986117 0 5 0 0 0 NOVA ANGELINA NY
0002456032847 3;JKN DR RIZKI; 5.2.1.201804062320 4 179009
1#1#vvip#5#20004617#0.0#2018-05-25 09:49:13#0#17:41:20#17:41:20#00:00:00
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197000
3201126 B 2 BS 1 08/05/2018 10/05/2018 08/05/2018 3171 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1464200 0 3 0 0 0 BY NY NI WAYAN AYU
PERMATA SARI D398012 0 0 DR SUPROHAITA SPA(K)
0138R0170518V002851 0002457042052 3;JKN DR RIZKI; 5.2.1.201804062320
4 179008 1#0##0#0#0.0#2018-05-25
09:50:27#0#17:10:32#17:10:32#00:00:00 1 d98387681f503e862e5a1a4caeb7e85e
0 0 433812 0 0 181599 0 0 0 0 848789
0 0 0 0 0
3201126 B 2 BS 1 07/05/2018 10/05/2018 28/09/1989 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10965384 0 4 0 0 0 NI WAYAN AYU PERMATA
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0001275166675 3;JKN DR RIZKI; 5.2.1.201804062320 4 178697
1#0##0#0#0.0#2018-05-25 09:51:50#0#21:37:43#21:37:43#00:00:00 1
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2216641 0 0 0 0 828362 0 0 0 0 197000
3201126 B 1 BS 1 07/05/2018 10/05/2018 15/06/1954 0 2
9855000 0 0 - 0 - 0 - 0 - 0
9855000 15528124 0 4 0 0 0 ROSTINI D395468
63 23337 DR E SURYA POHAN DR SPB KBD 0138R0170518V002034
0000060980951 3;JKN DR RIZKI; 5.2.1.201804062320 4 178358
1#0##0#0#0.0#2018-05-25 09:56:20#0#00:00:00#00:00:00#00:00:00 1
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3566165 0 0 0 0 8985059 0 0 0 0 217500
3201126 B 2 BS 1 09/05/2018 10/05/2018 05/05/1979 0 1
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0002437157665 3;JKN DR RIZKI; 5.2.1.201804062320 4 179256
1#0##0#0#0.0#2018-05-25 15:27:31#0#08:43:36#08:43:36#00:00:00 1
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4189700 0 0 0 0 6534797 0 69000 0 0 0
3201126 B 1 BS 1 08/05/2018 10/05/2018 23/11/1952 0 2
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 5417416 0 3 0 0 0 SRI WAHYUNI D287335
3;JKN DR RIZKI; 5.2.1.201804062320 4 179013 1#0##0#0#0.0#2018-
05-25 16:02:31#0#18:52:49#18:52:49#12:00:00 1
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2980664 0 0 0 0 1942410 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 10/05/2018 12/06/1951 0 1
1 D29.1;R33;I11.9 60.29 - - None None None None V-1-14-I
(RINGAN) 8837900 0 0 - 0 - 0 - 0 - 0
8837900 16171576 0 4 0 0 0 M. ALI ROSID
0002078703156 3;JKN DR RIZKI; 5.2.1.201804062320 4 178202
1#0##0#0#0.0#2018-05-25 16:04:13#0#06:23:22#06:23:22#12:00:00 1
7839f554633a741a407072678905cf12 0 3784800 2474612 0 0
4866210 0 0 0 0 4678954 0 0 0 0 367000
3201126 B 2 BS 1 07/05/2018 10/05/2018 30/04/2018 0 2
0 - 0 - 0 - 0 - 0 5045200 4000980
0 4 0 0 0 SELLY NURLIYANI BY NY D397364 0 7
DR VERA MUNA MANOE, SPA 0138R0170518V002390 0002454933982 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 178696 1#0##0#0#0.0#2018-
06-22 08:28:17#0#20:58:42#20:58:42#00:00:00 1
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0 0 0 0 1737500 0 0 0 1308000 0
3201126 B 2 BS 1 30/04/2018 10/05/2018 17/07/1947 0 2
4 I21.4;I50.0;E14.9;I46.9 - - - None None None None I-4-
12482300 0 0 - 0 - 0 - 0 - 0
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0000060757569 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 176644
1#0##0#0#0.0#2018-06-22 08:58:52#0#09:05:22#09:05:22#00:00:00 1
8a7540e588574f10e72ce54aa556d74e 0 0 832679 0 0
7994000 0 0 0 0 1226000 0 0 4956000
11009819 0
3201126 B 1 BS 1 06/05/2018 10/05/2018 15/01/1957 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 15347230 0 5 0 0 0 AHMAD GHALIB TN
D397892 61 22391 E. SURYA POHAN 0138R0170518V001804
0000114761878 3;JKN DR RIZKI; 5.2.2.201806040537 4 178192
1#0##0#0#0.0#2018-08-24 15:17:51#0#22:13:33#22:13:33#00:00:00 2
2ddb7f8d52907fb7eff971f5925be01b 0 8195700 2344505 0 0
3633001 0 0 0 0 1105024 0 0 0 0 69000
3201126 B 3 BS 1 09/05/2018 10/05/2018 15/08/1948 0 1
1 I64;I11.9 87.03 - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 3234811 0 2 0
0 0 TARKI ISMAIL TN D398091 69 25469 DR ANGGA TOMALA PUTRA
0138R0170518V003319 0001434173264 3;JKN DR RIZKI; 5.2.2.201806040537
4 179183 1#0##0#0#0.0#2018-08-24
15:36:22#0#18:42:04#18:42:04#00:00:00 2 cfdbaa180077be4a89e22851bab98750
0 0 445475 0 0 2288713 0 0 0 0 500623
0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 10/05/2018 06/10/1978 0 2
4 A16.1;J91;A41.9 99.60 - - None None None None J-4-15-III
None None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (BERAT)
6970400 0 0 - 0 - 0 - 0 - 0
6970400 4895461 0 1 0 0 0 CLAUDIA CARDINA
D385081 39 14461 DR TANTIYO SETIYOWATI 0138R0170518V003365
0002277937686 3;JKN DR RIZKI; 5.2.2.201806040537 4 179203
1#0##0#0#0.0#2018-09-06 16:37:18#0#06:04:51#06:04:51#12:00:00 2
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2353810 0 0 0 0 609264 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 10/05/2018 13/03/1974 0 2
LAIN-LAIN (SEDANG) 5399900 0 0 - 0 - 0 - 0
- 0 5399900 5041398 0 2 0 0 0 DAMAYANTI
d054567 44 16128 DR FERRY SPOG 0138R0170518V003133
0001457187208 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 179133
1#0##0#0#0.0#2018-09-28 13:37:17#0#10:05:17#10:05:17#00:00:00 1
099bcbca337c7058c4e05014f86fc98c 0 0 788991 0 0
2334596 0 0 0 0 1562000 0 0 0 355811
0
3201126 B 2 BS 1 09/05/2018 11/05/2018 06/12/1960 0 1
(SEDANG) 30864700 0 0 PCI 10725800 - 0 - 0 -
0 41590500 58394765 0 3 0 0 0 MULYADI
0001469185986 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179173
1#0##0#0#0.0#2018-05-21 15:23:10#0#12:28:15#12:28:15#00:00:00 1
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33975825 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 2 BS 1 08/05/2018 11/05/2018 11/06/2012 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2800353 0 4 0 0 0 AN BINTANG ALICIA ARTHA
BAKARA D398074 5 2157 DR RASTRA, SPA 0138R0170518V002950
0001272583642 3;JKN DR RIZKI; 5.2.1.201804062320 4 179017
1#0##0#0#0.0#2018-05-22 10:30:13#0#21:29:14#21:29:14#00:00:00 1
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0 0 0 0 1724201 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 11/05/2018 28/04/1950 0 1
1 I10;R63.0;E79.0;M81.89 87.44 - - None None None None I-4-
0 - 0 - 0 - 0 - 0 2669400 4814646
0 3 0 0 0 PETRUS SUGARJITO D371995 68 24848 DR
ARU, SPPD 0138R0170518V002966 0000061106275 3;JKN DR RIZKI;
5.2.1.201804062320 4 179029 1#0##0#0#0.0#2018-05-22
10:32:17#0#01:10:25#01:10:25#12:00:00 2 4146f1c0aa1b2d7380329556ac0832dd
0 0 494342 0 0 1636327 0 0 0 0
2683977 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 11/05/2018 17/01/1947 0 1
1 N21.0;D29.1;I13.9 57.19 - - None None None None N-1-30-I
None None None None None None PROSEDUR KANDUNG KEMIH DAN SALURAN URIN
BAWAH (RINGAN) 12159100 0 0 - 0 - 0 - 0 -
0 12159100 16613625 0 5 0 0 0 SLAMET TARSA
0000060873671 3;JKN DR RIZKI; 5.2.1.201804062320 4 178203
1#0##0#0#0.0#2018-05-22 10:38:32#0#00:00:00#00:00:00#00:00:00 1
b27df6125772d1a78df6f0915ea0eb48 0 8541200 3404548 0 0
3273004 0 0 0 0 1187873 0 0 0 0 207000
3201126 B 1 BS 1 09/05/2018 11/05/2018 04/06/1985 0 2
(RINGAN) 6041900 0 0 - 0 - 0 - 0 - 0
6041900 14194082 0 3 0 0 0 GALIH FOURINASARI
0001307691639 3;JKN DR RIZKI; 5.2.1.201804062320 4 179187
1#0##0#0#0.0#2018-05-22 10:39:23#0#00:00:00#00:00:00#12:00:00 1
2bf93dc8b0b9ddb0f61d7496d4ed2bbd 0 10108800 2316732 0 0
694965 0 0 0 0 1004585 0 0 0 0 69000
3201126 B 1 BS 1 08/05/2018 11/05/2018 12/08/1964 0 2
1 K21.9;J40 87.44 - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 4136800 4098862
0 4 0 0 0 FIVI RIYANTI D051917 53 19627 DR
BETTY DWI L, SPPD 0138R0170518V002935 0001370360193 3;JKN DR RIZKI;
5.2.1.201804062320 4 179014 1#0##0#0#0.0#2018-05-22
10:40:31#0#18:56:11#18:56:11#00:00:00 1 02a5a284acdaecb816d96cf793e8c535
0 0 425312 0 0 1036400 0 0 0 0
2637150 0 0 0 0 0
3201126 B 2 BS 1 10/05/2018 11/05/2018 28/08/1945 0 2
1 I11.0;I48;E87.6 89.52 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4973600
2227980 0 2 0 0 0 DJOHARIJAH D291312 72 26553
DR RIZKI; 5.2.1.201804062320 4 179217 1#0##0#0#0.0#2018-05-22
10:41:42#0#15:29:42#15:29:42#00:00:00 1 488b372f13fd180a60880cf50f5dd5db
0 0 713024 0 0 333200 0 0 0 0
1181756 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 11/05/2018 01/02/2011 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4710735 0 5 0 0 0 ATHAYA RAYKA AL-FATH
D397990 7 2652 DR RASTRA, SPA 0138R0170518V002401
0001821594374 3;JKN DR RIZKI; 5.2.1.201804062320 4 178702
1#0##0#0#0.0#2018-05-22 10:43:45#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 3458179 0 0 0 0 0
3201126 B 2 BS 1 09/05/2018 11/05/2018 07/07/1970 0 1
1 E87.6;I10 - - - None None None None E-4-11-I None
3545800 0 0 - 0 - 0 - 0 - 0
3545800 3297819 0 3 0 0 0 KEMAS ZAINAL ARIFIN
AZHARY D297305 47 17473 DR SOEGIONO, SPPD 0138R0170518V003646
0001272485733 3;JKN DR RIZKI; 5.2.1.201804062320 4 179454
1#0##0#0#0.0#2018-05-22 10:52:27#0#12:30:22#12:30:22#00:00:00 1
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1180952 0 0 0 0 1744745 0 0 0 0 0
3201126 B 1 BS 1 06/05/2018 11/05/2018 14/09/1936 0 1
1 F03;R63.0 - - - None None None None F-4-16-I None
None None None None None GANGGUAN OTAK ORGANIK LAIN-LAIN TERMASUK
KETERBELAKANGAN MENTAL (RINGAN) 7912400 0 0 - 0 - 0
- 0 - 0 7912400 7759300 0 6 0 0 0
MUDJIONO D061958 81 29819 DR ARU, SPPD 0138R0170518V001790
0000061027457 3;JKN DR RIZKI; 5.2.1.201804062320 4 178179
1#0##0#0#0.0#2018-05-22 10:55:36#0#18:09:27#18:09:27#00:00:00 1
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1992340 0 0 0 0 5219618 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 11/05/2018 17/08/1938 0 1
4 N18.5;I50.0 99.60 - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3708225 0 2 0 0 0 M BAKRI D398184
3;JKN DR RIZKI; 5.2.1.201804062320 4 179273 1#0##0#0#0.0#2018-
05-22 11:44:28#0#00:00:00#00:00:00#00:00:00 1
3bb85e2f678ac51637bde38f84868418 0 0 303885 0 0
2872746 0 0 0 0 531594 0 0 0 0 0
3201126 B 2 BS 1 09/05/2018 11/05/2018 19/02/1993 0 1
0 - 0 - 0 - 0 - 0 10488200 15541283
0 3 0 0 0 ARIE SETIAWAN D398135 25 9210 DR
BENNY H TUMBELAKA 0138R0170518V003350 0001634526088 3;JKN DR RIZKI;
5.2.1.201804062320 4 179192 1#0##0#0#0.0#2018-05-22
11:47:31#0#23:08:57#23:08:57#00:00:00 2 f6b6175d3cc82d18a64d8d210a5e0569
0 0 4894792 0 0 1927272 0 0 0 0
8650219 0 0 0 0 69000
3201126 B 2 BS 1 08/05/2018 11/05/2018 29/12/1947 0 2
1 K74.6;R18;K92.0;R57.9 87.44;89.52 - - None None None None
B-4-13-II None None None None None None GANGGUAN HATI LAIN-LAIN
(SEDANG) 5877400 0 0 - 0 - 0 - 0 - 0
5877400 4309201 0 4 0 0 0 SAADAH d384129
DR RIZKI; 5.2.1.201804062320 4 178771 1#0##0#0#0.0#2018-05-22
11:49:38#0#09:02:33#09:02:33#12:00:00 1 7e74db4b953d9fd063939b7e2830fc84
0 0 581966 0 0 1399325 0 0 0 0
2327910 0 0 0 0 0
3201126 B 2 BS 1 09/05/2018 11/05/2018 26/07/1973 0 1
1 J90;N18.9 34.91 - - None None None None J-4-20-II None
7715900 0 0 - 0 - 0 - 0 - 0
7715900 3238840 0 3 0 0 0 SUMARTANA D369438
0001101686411 3;JKN DR RIZKI; 5.2.1.201804062320 4 179184
1#0##0#0#0.0#2018-05-22 11:51:36#0#19:17:14#19:17:14#00:00:00 1
87510e4d9c0ef9e7c9510d47675668f6 0 0 774674 0 0 918779
0 0 0 0 1545387 0 0 0 0 0
3201126 B 3 BS 1 05/05/2018 11/05/2018 23/04/1959 0 1
(RINGAN) 3687800 0 0 - 0 - 0 - 0 - 0
3687800 3607761 0 7 0 0 0 M YUNASRIL D393467
3;JKN DR RIZKI; 5.2.1.201804062320 4 178147 1#0##0#0#0.0#2018-
05-22 12:25:06#0#00:00:00#00:00:00#12:00:00 1
c0a079bb9375f37341d42517323ae1a1 0 0 437902 0 0
1329837 0 0 0 0 1840022 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 11/05/2018 12/08/1955 0 1
- 0 58821400 74332997 0 3 0 0 0 IR. H.
ACHRAR KARIM d390212 62 22916 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170518V003162 0001637055696 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 179172 1#0##0#0#0.0#2018-05-24
08:42:58#0#12:25:20#12:25:20#12:00:00 2 88c3010909a195bc6537cf5e2450ba3f
0 10753000 9619120 0 0 45115877 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 3 BS 1 10/05/2018 11/05/2018 25/08/1951 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 691573 0 2 0 0 0 POERWANTO D207639
DR RIZKI; 5.2.1.201804062320 4 179347 1#0##0#0#0.0#2018-05-30
15:33:19#0#10:21:55#10:21:55#00:00:00 1 c70e1ea0399ecdd16f037c7077af7945
0 0 210130 0 0 19200 0 0 0 0 334243
0 0 0 0 128000
3201126 B 2 BS 1 10/05/2018 11/05/2018 27/10/1989 0 2
0 - 0 - 0 - 0 - 0 2009900 4385320
0 2 0 0 0 PURWASIH IRANI D398158 28 10422 DR
5.2.1.201804062320 4 179201 1#0##0#0#0.0#2018-06-02
11:05:42#0#05:03:57#05:03:57#00:00:00 1 0fc7bd97525c7d45a5c6c1a9aa2ae084
0 0 454980 0 0 521450 0 0 0 0
3408890 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 11/05/2018 17/03/1942 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 39063450 0 3 0 0 0 KANDARI
0000060801658 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 186454
1#0##0#0#0.0#2018-06-05 09:52:09#0#00:00:00#00:00:00#12:00:00 1
e0a5149cd17d3afd9e8eff529c89c362 0 10935000 3419040 0 0
15123410 0 0 0 0 1276000 0 0 0 0
8310000
3201126 B 3 BS 1 02/05/2018 11/05/2018 12/07/1971 0 2
1 I50.0;R57.0;E14.6 87.44 - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 4973600
22149094 0 10 0 0 0 DONNA DIANA TETTY SARI D352829
3;JKN DR RIZKI; 5.2.1.201804062320 4 177232 1#0##0#0#0.0#2018-
06-05 10:46:01#0#21:07:43#21:07:43#00:00:00 1
056d4c6c294b2eb7c8d5e693e8424c88 0 0 785582 0 0
11301512 0 0 0 0 6051000 0 0 0 0
4011000
3201126 B 1 BS 1 11/05/2018 11/05/2018 14/02/1951 0 2
4 I21.3;R57.0;E87.2;E14.1 99.60 - - None None None None I-4-
14562700 0 0 - 0 - 0 - 0 - 0
14562700 5070177 0 1 0 0 0 SULIMAH D398209
0000060724822 3;JKN ECHI; 5.2.2.201806040537 4 179453
1#0##0#0#0.0#2018-06-05 17:05:14#0#12:27:05#12:27:05#00:00:00 2
5587446faf22e69599ebf6fac2880099 0 0 520095 0 0
3416388 0 0 0 0 638694 0 0 0 0 495000
3201126 B 1 BS 1 09/05/2018 11/05/2018 20/06/1941 0 1
- 0 58821400 75311775 0 3 0 0 0 MOHAMAD ZEN
KARIM D339667 76 28082 DR AZRI NURIZAL SPPD KKV 0138R0170518V003077
0000060825418 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 179046
1#0##0#0#0.0#2018-06-06 08:33:19#0#08:30:59#08:30:59#00:00:00 2
909ba48dbc96c25f208a69e7425eb612 0 10753000 7201760 0 0
48512015 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 08/05/2018 11/05/2018 11/12/1983 0 2
0 0 - 0 - 0 - 0 - 0 6981500
26837670 0 4 0 0 0 SITI JIRONAH D152654 34
12567 DR NELWATI, SPOG 0138R0170518V002955 0001370582807 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 179021
1#1#vvip#4#19856170#0.0#2018-06-12 15:35:56#0#22:57:30#22:57:30#00:00:00
1 c93e9bddee06789785e49f1b8217332b 0 9270600 10466800 0
0 5652270 0 0 0 0 1200000 0 0 0 248000
0
3201126 B 2 BS 1 09/05/2018 11/05/2018 02/06/1952 0 1
- 0 51950600 71975720 0 3 0 0 0 T. FIRDAUS
HUSEIN D375845 65 24082 DR AZRI NURIZAL SPPD KKV
0138R0170518V002972 0001257761068 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 179034 1#0##0#0#0.0#2018-06-12
15:38:19#0#00:00:00#00:00:00#12:00:00 1 1dac0203fb84e36fbbfd9bafb74df2b3
0 9401000 8244960 0 0 0 0 0 0 0
1276000 0 0 45484760 7569000 0
3201126 B 1 BS 1 09/05/2018 11/05/2018 09/05/2018 2900 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2676617 0 3 0 0 0 BY NY SITI JIRONAH
D398088 0 0 DR SUPROHAITA SPA(K) 0138R0170518V003800
0002457928192 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 179579
1#0##0#0#0.0#2018-06-12 15:42:02#0#15:37:00#15:37:00#00:00:00 1
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0 0 0 0 2315398 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 11/05/2018 16/05/1959 0 1
4 I61.9;I11.0;I48;G81.9 99.04;96.71 - - None None None None
- 0 29135800 33571652 0 5 1 0 48 R BASUKI
0001211417875 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 178684
1#0##0#0#0.0#2018-06-12 16:00:40#0#16:31:20#16:31:20#00:00:00 1
31f84fdee2af80ec668aaa68ef8c29ac 0 0 1957330 0 3990500
21436822 0 0 0 0 1226000 0 0 0 4961000
0
3201126 B 3 BS 1 08/05/2018 11/05/2018 18/08/1964 0 1
1 G45.9;R40.0 87.03;87.44 - - None None None None G-4-16-II
None None None None None None ISKEMIK TRANSIENT (SEDANG) 4483100
0 0 - 0 - 0 - 0 - 0 4483100
3225662 0 4 0 0 0 AGUS SUBIYANTO D331306 53
19621 DR ADITIA NATA KUSUMA 0138R0170518V002617 0001968633538 3;JKN
DR RIZKI; 5.2.2.201806040537 4 178848 1#0##0#0#0.0#2018-08-24
14:27:04#0#10:47:37#10:47:37#00:00:00 2 c4f254bbba707d4223ce0a69e969be7f
0 0 303903 0 0 1510734 0 0 0 0 500025
0 0 0 0 911000
3201126 B 2 BS 1 09/05/2018 11/05/2018 12/04/1973 0 2
1 E14.2;T82.4;D63.8;I10 99.04;38.95 - - None None None None
- 0 - 0 23198900 12651169 0 3 0 0 0
IHAT SOLIHAT D398139 45 16463 DR BETTY DWI L, SPPD
0138R0170518V003352 0001170428073 3;JKN DR RIZKI; 5.2.2.201806040537
4 179194 1#0##0#0#0.0#2018-09-06
17:50:41#0#23:45:39#23:45:39#00:00:00 2 d3a5216334669576c6f089bd645baaa4
0 4457100 2404910 0 0 3694762 0 0 0 0
2059897 0 0 0 0 34500
3201126 B 3 BS 1 09/05/2018 11/05/2018 03/07/1955 0 1
- 0 - 0 19332400 9255695 0 3 0 0 0
SANWANIH D398117 62 22956 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V003334 0001210525896 3;JKN DR RIZKI; 5.2.1.201804062320
4 179185 1#0##0#0#0.0#2018-09-06
17:51:49#0#00:00:00#00:00:00#00:00:00 2 cbe0a816f3e03b978d60639650a0854f
0 3149000 2012936 0 0 3377746 0 0 0 0
681513 0 0 0 0 34500
3201126 B 3 BS 1 11/05/2018 11/05/2018 17/12/1939 0 1
7040000 0 0 - 0 - 0 - 0 - 0
7040000 2076952 0 1 0 0 0 AMIRUDDIN D309480
3;JKN DR RIZKI; 5.2.1.201804062320 4 179225 1#0##0#0#0.0#2018-
09-26 12:18:23#0#07:18:55#07:18:55#00:00:00 2
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1131982 0 0 0 0 424875 0 0 0 0 0
3201126 B 2 BS 1 10/05/2018 11/05/2018 01/03/1962 0 2
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SUMARSIH D396937 56 20524 DR ZULFAN, SPPD 0138R0170518V003405
0001388085693 3;JKN DR RIZKI; 5.2.1.201804062320 4 179212
1#0##0#0#0.0#2018-09-28 10:02:34#0#00:00:00#00:00:00#00:00:00 2
427e87972d24afb4db8be94e514883ee 0 0 1391400 0 0
1006915 0 0 0 0 2214707 0 0 0 0
1749000
3201126 B 1 BS 1 08/05/2018 11/05/2018 24/02/1963 0 1
1 S42.20;S43.0;E11.9;I10 79.31 - - None None None None M-1-
12140800 0 0 - 0 - 0 - 0 - 0
12140800 17497249 0 4 0 0 0 ENDANG INSANI MUCHTAR
0001717780162 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 179023
1#0##0#0#0.0#2018-09-28 14:13:03#0#00:00:00#00:00:00#00:00:00 2
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3201126 B 3 BS 1 08/05/2018 11/05/2018 03/01/2015 0 1
1 K40.9;K36 53.00;54.19 - - None None None None K-1-40-I
(RINGAN) 7792500 0 0 - 0 - 0 - 0 - 0
7792500 10259705 0 4 0 0 0 ADVIDAN FELIX YEHEZKIEL
NABABAN d398032 3 1221 DR HENDRIEK S, SPB 0138R0170518V002713
0002440632071 3;JKN DR RIZKI; 5.2.2.201806040537 4 178899
1#0##0#0#0.0#2018-09-29 12:15:59#0#00:00:00#00:00:00#00:00:00 2
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3713009 0 0 0 0 4531996 0 0 0 0 315000
3201126 B 1 BS 1 08/05/2018 12/05/2018 22/12/1949 0 2
1 I64;G20;E11.9 87.03;87.44 - - None None None None G-4-
- 0 - 0 - 0 - 0 6844000 11846723 0
5 0 0 0 NURWILIS D397980 68 24974 DR MAYSAM I., SPS
0138R0170518V002403 0000039783284 3;JKN DR RIZKI; 5.2.1.201804062320
4 178703 1#1#vvip#5#5002723#0.0#2018-05-22
10:26:31#0#00:00:00#00:00:00#00:00:00 2 50574d9ec54135ef0bd4805d1d96b152
0 0 1130931 0 0 3539773 0 0 0 0
7176019 0 0 0 0 0
3201126 B 1 BS 1 08/05/2018 12/05/2018 07/05/1987 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 26521126 0 5 0 0 0 ADE ALFISAH D192887
DR RIZKI; 5.2.1.201804062320 4 179018 1#0##0#0#0.0#2018-05-22
11:03:54#0#22:10:16#22:10:16#00:00:00 1 59abb3257554f932b376cecd19e88be7
0 10268200 9283000 0 0 5718926 0 0 0 0
1251000 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 12/05/2018 01/06/1993 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8169651 0 3 0 0 0 FATMA JUNITA
0001766849793 3;JKN DR RIZKI; 5.2.1.201804062320 4 179195
1#0##0#0#0.0#2018-05-22 11:09:18#0#00:00:00#00:00:00#00:00:00 1
27c0175ac34761de3abbecc61783fd96 0 3534500 1761644 0 0
2041044 0 0 0 0 635463 0 0 0 0 197000
3201126 B 3 BS 1 08/05/2018 12/05/2018 24/06/2016 0 1
1 J06.9;R63.8 - - - None None None None U-4-13-I None
0 - 0 1980100 1993837 0 5 0 0 0 SADAM
BASIL RAMADHAN D337127 1 683 DR RASTRA, SPA 0138R0170518V002957
0002053054113 3;JKN DR RIZKI; 5.2.1.201804062320 4 179022
1#0##0#0#0.0#2018-05-22 11:15:11#0#23:31:39#23:31:39#00:00:00 1
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3201126 B 2 BS 1 09/05/2018 12/05/2018 30/10/2016 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3923058 0 4 0 0 0 NAUFAL AL FAKHRI SAPUTRA
D348931 1 556 DR RASTRA, SPA 0138R0170518V003119
0002197449066 3;JKN DR RIZKI; 5.2.1.201804062320 4 179094
1#0##0#0#0.0#2018-05-22 11:16:18#0#09:46:11#09:46:11#00:00:00 1
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0 0 0 0 3498649 0 0 0 0 0
3201126 B 3 BS 1 11/05/2018 12/05/2018 12/06/1981 0 2
1 N93.9;M32.9 99.04 - - None None None None W-4-12-I None
LAIN-LAIN (RINGAN) 2809400 0 0 - 0 - 0 - 0
- 0 2809400 2745855 0 2 0 0 0 YULYANTI
d397878 36 13482 DR RAHMADSYAH SPOG 0138R0170518V003622
0001337936038 3;JKN DR RIZKI; 5.2.1.201804062320 4 179418
1#0##0#0#0.0#2018-05-22 11:17:56#0#11:31:20#11:31:20#00:00:00 1
bb4a4a812f8162cee38640d338ceed93 0 0 305846 0 0
1562374 0 0 0 0 749635 0 0 0 0 128000
3201126 B 2 BS 1 10/05/2018 12/05/2018 26/08/1964 0 1
1 I20.0;B17.9 89.52 - - None None None None I-4-20-I None
5043100 0 0 - 0 - 0 - 0 - 0
5043100 3528909 0 3 0 0 0 TUGIMAN D398152
0001634292112 3;JKN DR RIZKI; 5.2.1.201804062320 4 179204
1#0##0#0#0.0#2018-05-22 11:19:37#0#06:37:42#06:37:42#00:00:00 1
0f02e5fbd196ad4f30cf32e40915c1d1 0 0 305155 0 0
1451891 0 0 0 0 1771863 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 12/05/2018 13/12/1959 0 2
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 13540784 0 6 0 0 0 MARIA V DYAH
SOENARYO D301040 58 21330 DR MAYSAM I., SPS 0138R0170518V001903
0001794562659 3;JKN DR RIZKI; 5.2.1.201804062320 4 178208
1#0##0#0#0.0#2018-05-22 11:22:30#0#07:53:24#07:53:24#00:00:00 1
01af2b0636f54db3d51286a8022b3e86 0 0 923596 0 0
7019342 0 0 0 0 5597846 0 0 0 0 0
3201126 B 3 BS 1 06/05/2018 12/05/2018 11/07/1966 0 1
1 A16.1;E11.1 87.44 - - None None None None J-4-15-III None
None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (BERAT)
6970400 0 0 - 0 - 0 - 0 - 0
6970400 15164196 0 7 1 3 0 VICKY MALAIHOLLO, S.SOS
0000163802103 3;JKN DR RIZKI; 5.2.1.201804062320 4 178183
1#0##0#0#0.0#2018-05-22 11:35:21#0#00:00:00#00:00:00#00:00:00 1
bb87e607ca8fb60fab922d79b3126b74 0 0 680336 0 0
6528810 0 0 0 0 6473050 0 0 0 0
1482000
3201126 B 2 BS 1 11/05/2018 12/05/2018 03/01/1975 0 2
(SEDANG) 5162700 0 0 - 0 - 0 - 0 - 0
5162700 2266700 0 2 0 0 0 LINA INDRIAWATI NASUTION
0001644305005 3;JKN DR RIZKI; 5.2.1.201804062320 4 179222
1#0##0#0#0.0#2018-05-22 11:38:23#0#02:08:56#02:08:56#00:00:00 1
8d5755317d1a6e14492de5c21e444b90 0 0 417689 0 0 664722
0 0 0 0 1184289 0 0 0 0 0
3201126 B 2 BS 1 10/05/2018 12/05/2018 24/02/1940 0 1
- 0 - 0 23198900 8365325 0 3 0 0 0
SULOMO D398160 78 28565 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V003413 0000060678202 3;JKN DR RIZKI; 5.2.1.201804062320
4 179214 1#0##0#0#0.0#2018-05-22
12:40:09#0#00:00:00#00:00:00#00:00:00 2 a94b127bbfc872696d4192d537a3b612
0 4854100 2191100 0 0 677861 0 0 0 0
573264 0 0 0 0 69000
3201126 B 1 BS 1 09/05/2018 12/05/2018 30/05/1962 0 1
1 S42.00;J22;I10 79.20;99.21 - - None None None None M-1-
0 - 0 11182000 27628748 0 4 0 0 0 RONALD
SIBAGARIANG D398131 55 20433 DR BENNY H TUMBELAKA 0138R0170518V003346
0000041147379 3;JKN DR RIZKI; 5.2.1.201804062320 4 179189
1#0##0#0#0.0#2018-05-22 12:47:25#0#22:36:56#22:36:56#00:00:00 1
71f90a1f5f2a841f52e545c23ad91241 0 10799800 10102208 0 0
5356740 0 0 0 0 1301000 0 0 0 0 69000
3201126 B 2 BS 1 11/05/2018 12/05/2018 23/03/1955 0 2
1 I13.1;E14.9;E87.7;D63.8 99.04 - - None None None None N-4-
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4516128 0 2 0 0 0 ASTUTI
0001843511747 3;JKN DR RIZKI; 5.2.1.201804062320 4 179455
1#0##0#0#0.0#2018-05-22 12:51:24#0#12:38:05#12:38:05#00:00:00 1
219146667529bd4b9e31e0f275ebf68b 0 0 499265 0 0
1529165 0 0 0 0 2487698 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 12/05/2018 08/04/1964 0 1
- 0 8908800 9885091 0 3 0 0 0 HARUMAN
WITARSA TN D398166 54 19755 SRI KUNMARTINI.DR,SPPD 0138R0170518V003396
0001454701735 3;JKN DR RIZKI; 5.2.1.201804062320 4 179211
1#0##0#0#0.0#2018-05-22 12:52:48#0#12:15:55#12:15:55#00:00:00 1
ad3ba8835a0cd52796995000e161e206 0 3881800 1834760 0 0
3396843 0 0 0 0 702688 0 0 0 0 69000
3201126 B 1 BS 1 10/05/2018 12/05/2018 12/12/1944 0 2
0 - 0 - 0 - 0 - 0 5005900 3330676
0 3 0 0 0 TATTY ISMAIL,NY D291451 73 26812 DR
RIZKI; 5.2.1.201804062320 4 179216 1#0##0#0#0.0#2018-05-22
12:54:28#0#15:17:26#15:17:26#00:00:00 1 269b9b8a7fdcb7ec28e7b36f6e972405
0 0 503531 0 0 585750 0 0 0 0
2241395 0 0 0 0 0
3201126 B 2 BS 1 09/05/2018 12/05/2018 06/08/2015 0 2
- 0 - 0 - 0 - 0 3187000 3362093 0
4 0 0 0 KEISHA ALIFA ZAHRA D307652 2 1007 DR
HUDA, SPA 0138R0170518V003337 0002052348794 3;JKN DR RIZKI;
5.2.1.201804062320 4 179186 1#0##0#0#0.0#2018-05-25
15:33:26#0#20:09:37#20:09:37#12:00:00 1 651566f8bcb3a007ca718fda8aea8ba8
0 0 339830 0 0 963813 0 0 0 0
2058450 0 0 0 0 0
3201126 B 3 BS 1 12/05/2018 12/05/2018 13/10/2012 0 1
4 J18.0;E87.5;E87.2;E16.2;A41.9;R57.9 99.60 - - None None None
- 0 6419700 4811658 0 1 0 0 0 MUHAMMAD
DAFFA AL BANJARI D389299 5 2037 DR DINI DANIATY 0138R0170518V004258
0001733944678 3;JKN DR RIZKI; 5.2.1.201804062320 4 179910
1#0##0#0#0.0#2018-05-30 15:37:41#0#10:02:56#10:02:56#12:00:00 1
719e0035d0bdffea156fce729d62aefa 0 0 421485 0 0
3198392 0 0 0 0 603781 0 0 0 0 588000
3201126 B 3 BS 1 12/05/2018 12/05/2018 14/11/1998 0 1
- 0 - 0 - 0 - 0 2655900 2031135 0
1 0 0 0 RIZQO SATRIA PUTRA D396271 19 7119 DR
5.2.1.201804062320 4 179734 1#0##0#0#0.0#2018-05-30
15:53:37#0#12:22:53#12:22:53#00:00:00 1 9cc215a3a8f19fd1d54c1b6f1a7523db
0 0 132795 0 0 1476462 0 0 0 0 421878
0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 12/05/2018 06/06/2016 0 2
1718000 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-05-31 14:32:26#0#00:00:00#00:00:00#12:00:00 1
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0 0 0 0 964612 0 0 0 0 340000
3201126 B 1 BS 1 09/05/2018 12/05/2018 09/05/2018 2273 2
(RINGAN) 7677000 0 0 - 0 - 0 - 0 - 0
7677000 5201901 0 4 0 0 0 NURAINI INSANI PUTRI BY
NY D398148 0 0 DR GUNAWAN S, SPA 0138R0170518V003663
0002457811225 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179458
1#0##0#0#0.0#2018-05-31 17:29:30#0#12:46:24#12:46:24#00:00:00 1
f1f5c379a4d8b812136ca04d9ed390d0 0 0 690930 0 0 782660
0 0 0 0 3470311 0 0 0 0 258000
3201126 B 2 BS 1 11/05/2018 12/05/2018 12/05/1959 0 2
1 N18.5;R57.1;K92.1;D64.9 99.04 - - None None None None N-4-
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 3309713 0 2 0 0 0 KUSMIATI LESTARI
0001289034044 3;JKN DR RIZKI; 5.2.1.201804062320 4 179459
1#0##0#0#0.0#2018-06-02 10:37:21#0#13:23:26#13:23:26#12:00:00 1
61df9ffefde3a15b071ea86fa8c09f6b 0 0 709388 0 0
1347802 0 0 0 0 1252523 0 0 0 0 0
3201126 B 2 BS 1 11/05/2018 12/05/2018 29/12/2017 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4454027 0 2 0 0 0 KLAY MATTHIAS RENEMINO
D397560 0 133 DR CATUR S, SPB 0138R0170518V003889
0002324936924 3;JKN DR RIZKI; 5.2.1.201804062320 4 179653
1#0##0#0#0.0#2018-06-02 10:47:16#0#22:14:18#22:14:18#00:00:00 1
b0448b82051ba631b7e2bb9cb8bc1639 0 2638500 493024 0 0
901118 0 0 0 0 352385 0 0 0 0 69000
3201126 B 1 BS 1 09/05/2018 12/05/2018 27/11/1990 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 13937248 0 4 0 0 0 NURAINI INSANI PUTRI
0001307373287 3;JKN DR RIZKI; 5.2.1.201804062320 4 179027
1#0##0#0#0.0#2018-06-02 13:00:46#0#01:05:02#01:05:02#00:00:00 1
aa4728e8b5ae26fc0cf2d9cf8da82683 0 7789900 2446895 0 0
2609670 0 0 0 0 962783 0 0 0 0 128000
3201126 B 1 BS 1 11/05/2018 12/05/2018 22/08/1951 0 1
1 N18.5;D63.8;K30 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 4712484 0 2 0 0 0 NOLDI BOLANG
0001723204596 3;JKN DR RIZKI; 5.2.1.201804062320 4 179626
1#0##0#0#0.0#2018-06-02 13:18:45#0#16:24:01#16:24:01#00:00:00 1
97f5eb6dafb7bfb8281d7d2815fba8c1 0 0 520641 0 0
1139300 0 0 0 0 3052543 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 12/05/2018 04/05/1990 0 1
1 K30;K37 - - - None None None None K-4-18-I None
2033900 0 0 - 0 - 0 - 0 - 0
2033900 5109037 0 4 0 0 0 MIRZA ZULMI D398098
28 10232 DR HENDRIEK SP B 0138R0170518V003221 0001099535545 3;JKN
DR RIZKI; 5.2.1.201804062320 4 179179 1#0##0#0#0.0#2018-06-02
13:20:12#0#13:13:12#13:13:12#00:00:00 1 e16a1346f23513be17369cdd23bff2ca
0 0 236051 0 0 1388750 0 0 0 0
3484236 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 12/05/2018 13/10/1963 0 2
1 I72.1;A49.9;N18.5 39.52;99.21 - - None None None None I-1-
20-I None None None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
15363900 14218891 0 3 0 0 0 SITI CHASIDAH
0138R0170518V003422 0000511209819 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 179218 1#0##0#0#0.0#2018-06-06
08:36:36#0#15:52:09#15:52:09#00:00:00 1 4d2a1e5fbc55d36c0bdf468f1615b1b0
0 3235500 4599142 0 0 5330910 0 0 0 0
1053339 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 12/05/2018 09/05/2018 3241 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3772934 0 4 0 0 0 MIKAYLA SYAFA HABIBAH
0002457580847 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 179208
1#1#vvip#4#0#0.0#2018-06-12 15:25:52#0#00:00:00#00:00:00#00:00:00 1
a2c78945c1cb4b3eabb493ffc212b251 0 0 204720 0 0 88899
0 0 0 0 3152000 0 0 0 327315 0
3201126 B 3 BS 1 11/05/2018 12/05/2018 16/08/1973 0 1
1 N18.5;D63.8;G72.9;I11.9 38.95;99.04 - - None None None None
- 0 - 0 8908800 11199825 0 2 0 0 0
MAMAN D395594 44 16339 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V003636 0001771853758 3;JKN DR RIZKI; 5.2.2.201806040537
4 179449 1#0##0#0#0.0#2018-09-06
17:53:58#0#12:07:07#12:07:07#00:00:00 3 88552e8229f1c80b9eca3544924c2aaf
0 3062500 3866480 0 0 3393146 0 0 0 0
808699 0 0 0 0 69000
3201126 B 1 BS 1 11/05/2018 12/05/2018 24/05/1957 0 2
0 - 0 - 0 - 0 - 0 17095200 13223167
0 2 0 0 0 SITI MULAT,NY D267004 60 22267 DR
RIZKI; 5.2.2.201806040537 4 179252 1#0##0#0#0.0#2018-09-06
17:56:42#0#08:42:37#08:42:37#00:00:00 2 e9c142419f0cd7202b4c5d2d004c246a
0 4777000 1775560 0 0 3651540 0 0 0 0
891067 0 0 0 0 2128000
3201126 B 2 BS 1 07/05/2018 12/05/2018 08/12/2017 0 1
1 L02.8;A49.9;D64.9 99.04;86.22 - - None None None None L-4-
12-II None None None None None None PERADANGAN KULIT/CELLULITIS (SEDANG)
2781800 0 0 - 0 - 0 - 0 - 0
2781800 15326438 0 6 0 0 0 UBAIQI D397569
3;JKN DR RIZKI; 5.2.2.201806040537 4 178201 1#0##0#0#0.0#2018-
09-06 18:04:29#0#04:45:52#04:45:52#00:00:00 2
6ed7a1d97c1afec51e3b4fdbf02ae362 0 6057500 2530356 0 0
5194918 0 0 0 0 1058664 0 0 0 0 485000
3201126 B 3 BS 1 11/05/2018 12/05/2018 05/02/1959 0 2
1 I25.1;I05.9;E11.9;I10 88.55;36.07 - - YY02 None None None
- 0 21451600 59033780 0 2 0 0 0 YANIH
0000512078387 3;JKN DR RIZKI; 5.2.2.201806040537 4 179648
1#0##0#0#0.0#2018-09-06 18:09:57#0#20:27:58#20:27:58#00:00:00 2
5ef3f5fe1a7478555821c47bf4c61139 0 7909500 6870800 0 0
35497480 0 0 0 0 1256000 0 0 0 0
7500000
3201126 B 3 BS 1 12/05/2018 12/05/2018 31/12/1969 0 2
3587300 0 0 - 0 - 0 - 0 - 0
3587300 2339252 0 1 0 0 0 SARWITRI D342461
48 17664 DR AHMAD HIBBAN A WRIYA 0138R0170518V003901 0001169727884
3;JKN DR RIZKI; 5.2.2.201806040537 4 179662 1#0##0#0#0.0#2018-
09-06 19:36:47#0#01:48:28#01:48:28#00:00:00 2
ca68a8db78b8fe4db99fdfa29f37cc7a 0 0 215240 0 0
1681977 0 0 0 0 442035 0 0 0 0 0
3201126 B 1 BS 1 07/05/2018 12/05/2018 06/09/2007 0 1
10909500 0 0 - 0 - 0 - 0 - 0
10909500 16511073 0 6 0 0 0 AHMAD IBRAHIM
0001309148561 3;JKN DR RIZKI; 5.2.2.201806040537 4 178618
1#0##0#0#0.0#2018-09-12 10:36:09#0#15:22:47#15:22:47#00:00:00 2
def07a2e886ed5380e7c6106a23b7617 0 9232200 1680260 0 0
4297449 0 0 0 0 1156164 0 0 0 0 145000
3201126 B 2 BS 1 11/05/2018 13/05/2018 08/09/2017 0 1
(SEDANG) 7719500 0 0 - 0 - 0 - 0 - 0
7719500 9756450 0 3 0 0 0 M SYAMIL HUDA AN
D395713 0 245 DR CATUR S, SPB 0138R0170518V003521
0002309851877 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179228
1#0##0#0#0.0#2018-05-21 15:17:09#0#08:02:23#08:02:23#00:00:00 1
37c35f1034877c92b8b7a1032e53d5aa 0 5366300 1501276 0 0
2044602 0 0 0 0 699272 0 0 0 0 145000
3201126 B 2 BS 1 11/05/2018 13/05/2018 15/06/2016 0 2
6586700 0 0 - 0 - 0 - 0 - 0
6586700 8527572 0 3 0 0 0 AQILA THALITA RAMADHANI
AN D397548 1 695 DR CATUR SUZANTARA 0138R0170518V003874
0002065965928 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179646
1#0##0#0#0.0#2018-05-21 15:21:02#0#19:41:16#19:41:16#00:00:00 1
8486848a76a0ddda8ad66f5433486e5d 0 5348300 1154272 0 0
1246121 0 0 0 0 633879 0 0 0 0 145000
3201126 B 1 BS 1 12/05/2018 13/05/2018 01/08/1953 0 2
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 8798264 0 2 0 0 0 AUGUSTIEN A.
SUNDALANGI D319145 64 23660 DEDY PRATAMA,SPBV 0138R0170518V003907
0001472918488 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179665
1#0##0#0#0.0#2018-05-21 15:29:50#0#06:31:13#06:31:13#00:00:00 1
4ebce0865c86005d5cfe5edcd5df34dc 0 0 1276107 0 0 925570
0 0 0 0 6527587 0 0 0 0 69000
3201126 B 2 BS 1 11/05/2018 13/05/2018 30/11/1972 0 2
1 K74.6;I98.3;D62 99.04;42.33 - - None None None None B-4-
5877400 0 0 - 0 - 0 - 0 - 0
5877400 15206942 0 3 0 0 0 SITI SUWARSIH
D050729 45 16598 DR ARU, SPPD 0138R0170518V003432
0002308555361 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179221
1#0##0#0#0.0#2018-05-21 15:42:23#0#00:55:26#00:55:26#00:00:00 1
1b42b7c31d376f5a2a07218e51c15997 0 0 4289755 0 0
6009840 0 0 0 0 3158347 0 0 0 0
1749000
3201126 B 2 BS 1 09/05/2018 13/05/2018 18/08/1945 0 1
1 E13.1;I50.0 - - - None None None None E-4-10-II None
- 0 5873300 6480354 0 5 0 0 0 S MIHARDJA
0000060968935 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179181
1#0##0#0#0.0#2018-05-21 15:51:36#0#16:53:50#16:53:50#12:00:00 1
5eca42f915072356bc9542001748fb96 0 0 500624 0 0
3004782 0 0 0 0 2974948 0 0 0 0 0
3201126 B 2 BS 1 09/05/2018 13/05/2018 01/12/1942 0 1
1 J18.0;E87.6 - - - None None None None J-4-16-II None
6093000 0 0 - 0 - 0 - 0 - 0
6093000 5871466 0 5 0 0 0 KARNA D349321 75
TANTIYO S;16137 5.2.1.201804062320 4 179191 1#0##0#0#0.0#2018-
05-21 16:00:19#0#22:38:02#22:38:02#00:00:00 1
ebdb09eb0c6ed52c29784eeab406cd97 0 0 443231 0 0
2700620 0 0 0 0 2727615 0 0 0 0 0
3201126 B 2 BS 1 11/05/2018 13/05/2018 16/11/1983 0 1
- 0 10690500 11843220 0 3 0 0 0 AHMAD
DZULFAHMI RIDHO D396477 34 12595 DR DEDY PRATAMA SPBV
0138R0170518V003808 0001515749152 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 179588 1#0##0#0#0.0#2018-05-21
16:02:50#0#15:49:37#15:49:37#00:00:00 1 6111da4d05d5ec3251f5f2999f0d58de
0 0 2138100 0 0 3449230 0 0 0 0
6186890 0 0 0 0 69000
3201126 B 1 BS 1 10/05/2018 13/05/2018 10/10/1948 0 2
1 J18.0;E14.1 - - - None None None None J-4-16-III None
8987600 0 0 - 0 - 0 - 0 - 0
8987600 5546768 0 4 0 0 0 TATI SUHARTI NY
0001313725443 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179213
1#0##0#0#0.0#2018-05-21 16:20:14#0#13:27:01#13:27:01#00:00:00 1
2d658309a892885c02f52ba52aaf3160 0 0 508265 0 0
1525630 0 0 0 0 3512873 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 13/05/2018 03/10/1946 0 2
1 I61.6;I10;G81.9;A41.9 - - - None None None None G-4-
13-III None None None None None None PERDARAHAN INTRA KRANIAL BUKAN
TRAUMATIK (BERAT) 6111900 0 0 - 0 - 0 - 0 -
0 6111900 21402951 0 7 0 0 0 SITI ROHIMAH NY
0001316718641 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 178683
1#1#vvip#7#15291051#0.0#2018-05-22 10:03:12#0#16:26:27#16:26:27#00:00:00
1 d21593aa2601726ccc29fb0807467552 0 0 908502 0 0
9833449 0 0 0 0 10151000 0 0 0 0 510000
3201126 B 1 BS 1 12/05/2018 13/05/2018 07/07/1953 0 2
- 0 12472300 10722579 0 2 0 0 0 ROFIAH,NY
0138R0170518V003956 0000060770553 3;JKN DR RIZKI; 5.2.1.201804062320
4 179719 1#0##0#0#0.0#2018-05-22
10:29:16#0#11:18:05#11:18:05#12:00:00 1 2d5e0896f710160b0ce298bb4bd174bf
0 0 552680 0 0 2837222 0 0 0 0
7263677 0 0 0 0 69000
3201126 B 3 BS 1 13/05/2018 13/05/2018 28/12/1952 0 1
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 2205342 0 1 0 0 0 AMAT d398445 65
23877 DR IRVAN VERYADI 0138R0170518V004062 0001740078303 3;JKN DR
RIZKI; 5.2.1.201804062320 4 180194 1#0##0#0#0.0#2018-05-30
15:58:03#0#00:00:00#00:00:00#00:00:00 1 202c134c9e76311e2948c382cf5f269a
0 0 215110 0 0 1556957 0 0 0 0 433275
0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 13/05/2018 14/11/1974 0 2
0 0 - 0 - 0 - 0 - 0 11569900
16513407 0 5 0 0 0 ELFINUR ZETHA RAHMAN D121118
0001462949008 3;JKN DR RIZKI; 5.2.1.201804062320 4 179143
1#0##0#0#0.0#2018-05-30 16:03:19#0#10:11:24#10:11:24#00:00:00 1
72967c68f2a27b1e3b73d83c1cd4a947 0 8478000 4280863 0 0
2494228 0 0 0 0 1191316 0 0 0 0 69000
3201126 B 3 BS 1 11/05/2018 13/05/2018 26/11/1997 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8793913 0 3 0 0 0 HOTIJAH TUSSOLEHA
0001466134402 3;JKN DR RIZKI; 5.2.1.201804062320 4 179606
1#0##0#0#0.0#2018-05-31 14:53:19#0#16:02:59#16:02:59#00:00:00 1
7b554bda02fbccb8b919bc6d31b27184 0 3534500 1751644 0 0
2563466 0 0 0 0 678303 0 0 0 0 266000
3201126 B 2 BS 1 10/05/2018 13/05/2018 24/09/1998 0 2
(BERAT) 3965700 0 0 - 0 - 0 - 0 - 0
3965700 3679237 0 4 0 0 0 DHEA LIAWANTI NN
0001888479415 3;JKN DR RIZKI; 5.2.1.201804062320 4 179206
1#0##0#0#0.0#2018-06-02 10:38:49#0#08:34:06#08:34:06#00:00:00 2
77806efe79fb688e489e217f84104fa2 0 0 298025 0 0
1094514 0 0 0 0 2286698 0 0 0 0 0
3201126 B 3 BS 1 13/05/2018 13/05/2018 06/06/1958 0 1
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 8254162 0 1 0 0 0 USMAN BIN SALIM
D398417 59 21891 DR RENDRA RAMADYA 0138R0170518V004025
0002068724619 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180702
1#0##0#0#0.0#2018-06-05 10:06:52#0#00:00:00#00:00:00#00:00:00 1
136eacedaf556d2c2a7143e13ebf5410 0 0 177310 0 0
6190860 0 0 0 0 846992 0 0 0 0
1039000
3201126 B 3 BS 1 12/05/2018 13/05/2018 21/04/1978 0 1
- 0 - 0 19332400 10164805 0 2 0 0 0
MUHAMAD SOLEH TN D332648 40 14631 DR DEDY PRATAMA SPBV
0138R0170518V003922 0001455588617 3;JKN DR RIZKI; 5.2.2.201806040537
4 179666 1#0##0#0#0.0#2018-09-06
18:14:12#0#07:34:32#07:34:32#00:00:00 2 ab6c869e593c7ad69b28583dbc96a323
0 3456800 4253128 0 0 1664890 0 0 0 0
720987 0 0 0 0 69000
3201126 B 1 BS 1 08/05/2018 13/05/2018 01/01/1991 0 2
1 O98.5;A91 - - - None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 3035600 6615760
0 6 0 0 0 PRIMA VINANDA MOERA D373247 27 9989
RIZKI; 5.2.2.201806040537 4 179174 1#0##0#0#0.0#2018-09-06
18:15:48#0#12:32:25#12:32:25#00:00:00 2 90c5fe279546a0367667432762f693b9
0 0 494331 0 0 1757622 0 0 0 0
4363807 0 0 0 0 0
3201126 B 1 BS 1 12/05/2018 13/05/2018 03/09/1945 0 1
1 I50.0;K21.0;R00.1 89.52 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 5802600
2857141 0 2 0 0 0 DALIMUN SANTONO, SPD D296788
72 26549 DR EKA GINANJAR SPPD 0138R0170518V003935 0000061004924
3;JKN DR RIZKI; 5.2.2.201806040537 4 179671 1#0##0#0#0.0#2018-
09-06 18:17:30#0#09:05:30#09:05:30#00:00:00 2
90993494c9337a4a1995c72c8f4be4a0 0 0 503531 0 0 560694
0 0 0 0 1792916 0 0 0 0 0
3201126 B 2 BS 1 09/04/2018 13/05/2018 21/08/2007 0 2
1 F81.9;J18.9;A19.9;J99.8;E41 96.72 - - None None None None
0 - 0 79597900 93120662 0 35 0 0 0 ARISKA
0001298456583 3;JKN DR RIZKI; 5.2.2.201806040537 4 169574
1#0##0#0#0.0#2018-09-26 17:57:43#0#21:09:14#21:09:14#00:00:00 3
288b0bc1bea1bf94006baf1f58a28dfd 0 0 4248560 0 0
46164602 0 0 0 0 27101500 0 0 0 0
15606000
3201126 B 2 BS 1 09/05/2018 13/05/2018 03/03/1976 0 2
1 I10;R19.0 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 2288000 5917186 0
5 0 0 0 HERTA HUTABARAT D398083 42 15407 DR ARU, SPPD
0138R0170518V002969 0001456129337 3;JKN DR RIZKI; 5.2.2.201806040537
4 179033 1#0##0#0#0.0#2018-09-29
12:05:18#0#00:00:00#00:00:00#00:00:00 2 7c7762c703e65d162671874cb33b1a52
0 0 767860 0 0 2211220 0 0 0 0
2938106 0 0 0 0 0
3201126 B 2 BS 1 07/05/2018 14/05/2018 01/12/1948 0 2
1 I50.0;I25.0;J18.0 - - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 5968400
7418448 0 8 0 0 0 MARYATI D397899 69 25359
DR SUPONO SPJP 0138R0170518V002041 0001718176228 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 178373 1#0##0#0#0.0#2018-05-21
15:19:46#0#00:00:00#00:00:00#00:00:00 1 0580fe73431ed786601c3b3b5446e97f
0 0 649839 0 0 2217290 0 0 0 0
4551319 0 0 0 0 0
3201126 B 3 BS 1 07/05/2018 14/05/2018 01/04/1981 0 2
0 - 0 - 0 - 0 5954200 11712890 0 8
0 0 0 HERWINA D397890 37 13550 DR HENDRIEK S, SPB
0138R0170518V001808 0000513152886 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 178194 1#0##0#0#0.0#2018-05-21
15:25:49#0#01:16:46#01:16:46#00:00:00 1 0e1990004229fce7d1c6d07987f653a3
0 4836800 1967718 0 0 3189107 0 0 0 0
842265 0 0 0 0 877000
3201126 B 1 BS 1 09/05/2018 14/05/2018 16/07/1942 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 17285454 0 6 0 0 0 LEO RONDONUWU
0001794059346 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179178
1#0##0#0#0.0#2018-05-22 08:33:58#0#13:10:47#13:10:47#00:00:00 1
aa8a58a3e91e0259afba7050840eb89f 0 9232200 2850095 0 0
3927335 0 0 0 0 1206824 0 0 0 0 69000
3201126 B 2 BS 1 10/05/2018 14/05/2018 06/06/1936 0 2
1 S72.00;R63.0;I10 - - - None None None None M-4-10-I
None None None None None None FRAKTUR FEMUR (RINGAN) 3555800 0
0 - 0 - 0 - 0 - 0 3555800 4849234
0 5 0 0 0 SABRUK, NY D398178 81 29923 DR. ARU
ARIADNO, SPPD 0138R0170518V003427 0000060721705 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 179219 1#0##0#0#0.0#2018-05-22
09:13:15#0#00:00:00#00:00:00#00:00:00 1 da709d67de7b61c9f654651e983d953f
0 0 426022 0 0 1554972 0 0 0 0
2868240 0 0 0 0 0
3201126 B 3 BS 1 11/05/2018 14/05/2018 04/07/1954 0 1
1 D64.9;N17.9;M10.96;E87.1 99.04 - - None None None None
D-4-13-III None None None None None None GANGGUAN SEL DARAH MERAH
0 - 0 - 0 5407200 4881611 0 4 0 0
0 HELDEM PASYA D359604 63 23322 DR. ARU ARIADNO, SPPD
0138R0170518V003867 0001276821865 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 179645 1#0##0#0#0.0#2018-05-22
09:32:05#0#18:11:26#18:11:26#00:00:00 1 adc9f4202b27ddf612b08b3e4c38375d
0 0 539648 0 0 3031105 0 0 0 0
1310858 0 0 0 0 0
3201126 B 3 BS 1 12/05/2018 14/05/2018 20/03/1991 0 2
None None None None None GANGGUAN POSTPARTUM (SEDANG) 2802100 0
0 - 0 - 0 - 0 - 0 2802100 3388055
0 3 0 0 0 ENI RIANTI D398413 27 9915 DR MAMAN H,
5.2.1.201804062320 4 179979 1#0##0#0#0.0#2018-05-22
09:49:52#0#10:45:53#10:45:53#00:00:00 1 b63cb31ad6af3a6dbd0356b50248cc55
0 0 486660 0 0 1933247 0 0 0 0 968148
0 0 0 0 0
3201126 B 1 BS 1 11/05/2018 14/05/2018 05/12/1970 0 1
0 0 - 0 - 0 - 0 - 0 14562700
6632855 0 4 0 0 0 SUTAN AFERUS BD D274470 47
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179223
1#0##0#0#0.0#2018-05-22 10:12:47#0#03:26:08#03:26:08#12:00:00 1
ede5b1c32f40685c3acf15e00b0144ae 0 0 1363643 0 0
1685287 0 0 0 0 3583925 0 0 0 0 0
3201126 B 3 BS 1 12/05/2018 14/05/2018 05/03/1960 0 2
1 D64.9;A49.9;N17.9 99.04 - - None None None None D-4-13-III
0 - 0 5407200 3893817 0 3 0 0 0 SAFIAH
0001458793225 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179767
1#0##0#0#0.0#2018-05-22 10:16:50#0#00:00:00#00:00:00#00:00:00 1
e36425f1ef67ca189e960e23dfa5b87c 0 0 300851 0 0
2523230 0 0 0 0 1069736 0 0 0 0 0
3201126 B 1 BS 1 12/05/2018 14/05/2018 01/06/1976 0 1
0 - 0 11182000 21995402 0 3 0 0 0 ADI
SUPRIYATNA d398386 41 15320 DR BENNY H TUMBELAKA 0138R0170518V004010
0001638938428 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179772
1#0##0#0#0.0#2018-05-22 12:49:45#0#20:41:40#20:41:40#00:00:00 1
685535797af2852933e04b4fd66e2f8f 0 0 7621960 0 0
2843642 0 0 0 0 11384800 0 0 0 0 145000
3201126 B 1 BS 1 13/05/2018 14/05/2018 28/04/1952 0 1
1 K21.9;E87.6;I25.0;I10 - - - None None None None K-4-
0 0 - 0 - 0 - 0 - 0 5739000
3287835 0 2 0 0 0 ESFI SIDAURUK D398431 66
24121 DR SRI KUNMARTINI, SPPD 0138R0170518V004041 0001833764185 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 179991 1#0##0#0#0.0#2018-
05-22 13:34:36#0#10:53:50#10:53:50#00:00:00 1
9eccb8f3f50fb3a5bcb388da8c3f6bf2 0 0 425312 0 0
1059431 0 0 0 0 1803092 0 0 0 0 0
3201126 B 3 BS 1 12/05/2018 14/05/2018 23/07/2010 0 2
1 B34.9;A09.9;J02.9 - - - None None None None A-4-13-I
(RINGAN) 2090000 0 0 - 0 - 0 - 0 - 0
2090000 1848101 0 3 0 0 0 REVIANA KEYRANISA
PRASETYO D398409 7 2850 DR RASTRA, SPA 0138R0170518V004014
0002195989762 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179775
1#0##0#0#0.0#2018-05-22 13:38:58#0#00:00:00#00:00:00#00:00:00 1
e1c95b79f1b9677b6d90dc1739f5f7ca 0 0 241100 0 0 757597
0 0 0 0 849404 0 0 0 0 0
3201126 B 2 BS 1 10/05/2018 14/05/2018 24/04/1987 0 1
- 0 - 0 - 0 - 0 4649300 11890858 0
5 0 0 0 ADHITYA SAPUTRA D174038 31 11339 YASMIN
SURYANDARI BACHTIAR. DR. SPB 0138R0170518V003386 0002075888845 3;JKN DR
RIZKI; 5.2.1.201804062320 4 179207 1#0##0#0#0.0#2018-05-25
15:19:07#0#00:00:00#00:00:00#00:00:00 1 2eae2c527bc0ade7236c26fecd83b994
0 5684100 1407804 0 0 3775047 0 0 0 0
878907 0 0 0 0 145000
3201126 B 2 BS 1 11/05/2018 14/05/2018 26/05/2017 0 1
0 - 0 2376200 7848777 0 4 0 0 0
ARSENIO SAKHA WAHYUDI D367329 0 350 DR OTTY MITHA S, SPA
0138R0170518V003876 0002253818057 3;JKN DR RIZKI; 5.2.1.201804062320
4 179647 1#1#vip#4#2475150#75.0#2018-05-25
15:26:26#0#20:07:18#20:07:18#12:00:00 1 115b5c4693ed2d01742856aa1d307ff0
0 0 620741 0 0 2176065 0 0 0 0
5051971 0 0 0 0 0
3201126 B 3 BS 1 13/05/2018 14/05/2018 27/01/1976 0 1
0 - 0 - 0 - 0 - 0 2954900 5513521
0 2 0 0 0 SELESTINUS D397932 42 15447 DR ZULFAN,
4 179800 1#0##0#0#0.0#2018-05-25
16:08:28#0#08:43:39#08:43:39#00:00:00 1 f34366df32c5bfe3d51c7650ae6233fb
0 0 890372 0 0 1105451 0 0 0 0
1768698 0 0 0 0 1749000
3201126 B 1 BS 1 13/05/2018 14/05/2018 06/02/1943 0 1
1 N18.5;J18.0;J91;D63.8;E14.9 39.27;87.44 - - None None None
0 - 0 - 0 27065300 15873406 0 2 0 0
0 BAMBANG IRAWAN D387962 75 27490 SRI KUNMARTINI.DR,SPPD
0138R0170518V004037 0000060852699 3;JKN DR RIZKI; 5.2.1.201804062320
4 179876 1#0##0#0#0.0#2018-05-30
16:05:53#0#09:36:07#09:36:07#12:00:00 2 e8eb81d33c552e149184487a87b21ac3
0 6648200 5466060 0 0 2575699 0 0 0 0
1114447 0 0 0 0 69000
3201126 B 2 BS 1 12/05/2018 14/05/2018 30/09/2015 0 1
None None None None PENYAKIT KULIT MAYOR (RINGAN) 2114800 0 0
- 0 - 0 - 0 - 0 2114800 3770762 0
3 0 0 0 HAIKAL FAJRI D377163 2 955 DR OTTY
5.2.1.201804062320 4 179766 1#0##0#0#0.0#2018-05-31
14:24:06#0#00:00:00#00:00:00#12:00:00 1 b56bd74c28b4e879dfebd99072194c4e
0 0 243332 0 0 842745 0 0 0 0
2684685 0 0 0 0 0
3201126 B 3 BS 1 13/05/2018 14/05/2018 17/09/1961 0 2
1 E11.2;D63.8;I10;I25.0 39.27;99.04 - - None None None None
- 0 - 0 8908800 7838163 0 2 0 0 0
DJUHROTUN D397013 56 20692 SRI KUNMARTINI.DR,SPPD
0138R0170518V004034 0001228740412 3;JKN DR RIZKI; 5.2.1.201804062320
4 179924 1#0##0#0#0.0#2018-05-31
14:29:33#0#10:18:11#10:18:11#00:00:00 1 831ba87107dee9001a6655aeaf47967c
0 3438800 921100 0 0 2820486 0 0 0 0
588777 0 0 0 0 69000
3201126 B 1 BS 1 13/05/2018 14/05/2018 01/07/1950 0 1
- 0 12472300 17345221 0 2 0 0 0 ENDANG
KOSWARA D385091 67 24788 SRI KUNMARTINI.DR,SPPD 0138R0170518V004055
0001274248304 3;JKN DR RIZKI; 5.2.1.201804062320 4 179824
1#0##0#0#0.0#2018-05-31 14:41:47#0#08:59:47#08:59:47#12:00:00 1
1eeb9e92dd21b039e57b933a7bd023ec 0 0 2547460 0 0
7787527 0 0 0 0 6941234 0 0 0 0 69000
3201126 B 1 BS 1 12/05/2018 14/05/2018 19/09/1958 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2897762 0 3 0 0 0 TATYANI LEWA
0002043202599 3;JKN DR RIZKI; 5.2.1.201804062320 4 180041
1#0##0#0#0.0#2018-06-02 13:21:18#0#00:00:00#00:00:00#00:00:00 1
67bee47a378a44521a7f02027d3babd4 0 0 269459 0 0 850730
0 0 0 0 1777573 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 14/05/2018 12/07/1977 0 1
0 - 0 - 0 - 0 - 0 7219300 1940032
0 1 0 0 0 YULAN MIRZA D398490 40 14916 DR DINI
DANIATY 0138R0170518V004497 0001647430198 3;JKN DR RIZKI;
5.2.1.201804062320 4 180280 1#0##0#0#0.0#2018-06-05
08:25:25#0#16:18:45#16:18:45#00:00:00 1 1e916677ea6d71ec2fbcbc1ab9d7f504
0 0 360965 0 0 1017149 0 0 0 0 433918
0 0 0 0 128000
3201126 B 2 BS 1 08/05/2018 14/05/2018 13/03/1950 0 2
1 I21.3;R57.0;G03.9;I13.0;B19.0;A15.3 96.04;96.71 - - None None
- 0 - 0 34963000 51945860 0 7 1 7 0
HJ. R. NIK GARMINI D302206 68 24893 DR ARU, SPPD
0138R0170518V002942 0001861205567 3;JKN irene; 5.2.2.201806040537
4 179015 1#0##0#0#0.0#2018-08-13
09:49:48#0#19:52:43#19:52:43#12:00:00 2 84a6b5891eac81f889b563ebb7751d94
0 9576000 6725604 0 0 26927256 0 0 0 0
0 0 0 0 0 8717000
3201126 B 1 BS 1 10/05/2018 14/05/2018 13/03/1952 0 1
1 I64;G81.9 - - - None None None None G-4-15-II None
- 0 - 0 - 0 6844000 7863754 0 5 0
0 0 BAMBANG SUDIARTO D327885 66 24164 DR HARDI PRANATA SPS
0138R0170518V003358 0000061002628 3;JKN DR RIZKI; 5.2.2.201806040537
4 179197 1#0##0#0#0.0#2018-09-06
18:22:29#0#00:00:00#00:00:00#00:00:00 2 c0a1e7eb15df59e5c33d5205291e1e9d
0 0 1468963 0 0 1949340 0 0 0 0
4445451 0 0 0 0 0
3201126 B 3 BS 1 11/05/2018 14/05/2018 11/12/1975 0 2
1 K92.1;A01.0;I10 - - - None None None None K-4-18-III
(BERAT) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 2085358 0 4 0 0 0 ROSALINA D352059
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 179657
1#0##0#0#0.0#2018-09-28 14:21:48#0#23:45:14#23:45:14#00:00:00 2
95a04204eb7605c37e4d83cc43449880 0 0 257183 0 0 876750
0 0 0 0 951425 0 0 0 0 0
3201126 B 3 BS 1 11/05/2018 14/05/2018 15/06/1953 0 1
1 N40;N35.9;D62;J18.0 60.29;58.6;99.04;99.21 - - None None
None None V-1-14-III None None None None None None PENGANGKATAN
PROSTAT MELALUI URETRA (BERAT) 16034600 0 0 - 0 - 0
- 0 - 0 16034600 19108258 0 4 0 0 0
MUHARI D397726 64 23706 MOHAMMAD JOHAN 0138R0170518V003501
0001380938591 3;JKN DR RIZKI; 5.2.1.201804062320 4 179226
1#0##0#0#0.0#2018-09-29 14:19:39#0#07:43:26#07:43:26#00:00:00 2
d02c75c5264240700964021e00b970ff 0 6092300 2474612 0 0
5138346 0 0 0 0 4746000 0 0 0 0 657000
3201126 B 1 BS 1 13/05/2018 14/05/2018 01/07/1950 0 1
- 0 12472300 17345221 0 2 0 0 0 ENDANG
KOSWARA D385091 67 24788 SRI KUNMARTINI.DR,SPPD 0138R0170518V010779
0001274248304 3;JKN DR RIZKI; 5.2.2.201806040537 4 228673
1#0##0#0#0.0#2018-10-01 09:28:27#0#00:00:00#00:00:00#12:00:00 1
f34be48250c96d1df6718c0266238619 0 0 2547460 0 5730500
7787527 0 0 0 0 1134734 0 0 69000 76000 0
3201126 B 1 BS 1 13/05/2018 15/05/2018 25/06/1983 0 2
1 N18.5;A09.9 39.95 - - None None None None N-4-10-I None
(RINGAN) 4639400 0 0 - 0 - 0 - 0 - 0
4639400 7880144 0 3 0 0 0 ERNI PUJI ASTUTI, SH
0001096805406 3;JKN DR RIZKI; 5.2.1.201804062320 4 179833
1#0##0#0#0.0#2018-05-30 15:21:25#0#09:03:35#09:03:35#12:00:00 1
b3e43b73419910f7da07580747f9364f 0 0 783705 0 0
2151166 0 0 0 0 4945273 0 0 0 0 0
3201126 B 3 BS 1 11/05/2018 15/05/2018 28/12/1956 0 2
1 I20.0;I11.9;K30 89.52 - - None None None None I-4-20-I
4202600 0 0 - 0 - 0 - 0 - 0
4202600 4353280 0 5 0 0 0 DJASRIL SYARIF
0001740153071 3;JKN DR RIZKI; 5.2.1.201804062320 4 179651
1#0##0#0#0.0#2018-05-30 15:26:57#0#21:02:56#21:02:56#12:00:00 1
5dc682cbdc956e485063e0caf0db204e 0 0 489860 0 0
2324126 0 0 0 0 1539294 0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 15/05/2018 05/08/1986 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 4955701 0 2 0 0 0 VIVI NURAVIANI
0001657553962 3;JKN DR RIZKI; 5.2.1.201804062320 4 180068
1#0##0#0#0.0#2018-05-30 15:32:15#0#12:02:04#12:02:04#00:00:00 1
6d507ba482e0cc718710b29ead0bca55 0 2864000 878996 0 0
743500 0 0 0 0 400205 0 0 0 0 69000
3201126 B 2 BS 1 11/05/2018 15/05/2018 15/09/1996 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4861541 0 5 0 0 0 AFIFAH AZHAR
0001256689721 3;JKN DR RIZKI; 5.2.1.201804062320 4 179654
1#0##0#0#0.0#2018-05-30 16:07:54#0#23:29:46#23:29:46#12:00:00 1
8a1ba45a4a26ed21707348ede47d5b23 0 0 278711 0 0
1751285 0 0 0 0 2661545 0 0 0 0 170000
3201126 B 3 BS 1 12/05/2018 15/05/2018 02/02/1972 0 1
0 - 0 - 0 - 0 - 0 3575600 3233236
0 4 0 0 0 KASUM BIN WARID D398340 46 16901 DR
BAMBANG DWIPUTRA SPJP 0138R0170518V003972 0000511457027 3;JKN DR RIZKI;
5.2.1.201804062320 4 179736 1#0##0#0#0.0#2018-05-30
16:09:59#0#12:55:18#12:55:18#00:00:00 1 b3d5c83d06ca9daceba7ab3d1c884c24
0 0 374804 0 0 1568912 0 0 0 0
1289520 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 15/05/2018 07/12/1962 0 1
4 N18.5;I47.2;R57.0 99.60 - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 2011693 0 2 0 0 0 KASONO TN
0002223029204 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180304
1#0##0#0#0.0#2018-05-30 16:44:50#0#20:28:20#20:28:20#00:00:00 1
6198b3506a5670c875f59d72ba652c63 0 0 303885 0 0
1287202 0 0 0 0 420606 0 0 0 0 0
3201126 B 3 BS 1 15/05/2018 15/05/2018 08/10/1976 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3302935 0 1 0 0 0 MUKLIM TN D349314
0001380849941 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180715
1#0##0#0#0.0#2018-05-30 16:45:49#0#15:07:03#15:07:03#00:00:00 1
ad9181791d858d05449d1733c6656c5d 0 0 206605 0 0
1435000 0 0 0 0 1661330 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 15/05/2018 30/12/1938 0 1
- 0 8908800 13914267 0 2 0 0 0 ADANG
0001740443117 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180141
1#0##0#0#0.0#2018-05-30 16:48:11#0#14:41:00#14:41:00#12:00:00 1
db009c5f79df7e5baa64ca9a1dc34561 0 0 1906030 0 0
7924958 0 0 0 0 4048779 0 0 0 0 34500
3201126 B 3 BS 1 14/05/2018 15/05/2018 22/11/1975 0 1
- 0 8908800 10593172 0 2 0 0 0 ALI NURDIN
0138R0170518V004610 0000367599306 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 180298 1#0##0#0#0.0#2018-05-30
16:52:57#0#18:13:10#18:13:10#00:00:00 1 59fc3a00cada2eb27da165c1dadbb901
0 0 2138112 0 0 4639049 0 0 0 0
3781511 0 0 0 0 34500
3201126 B 3 BS 1 15/05/2018 15/05/2018 24/05/1965 0 2
4 E87.2;A41.9;D64.9;N18.9;I21.2 99.60 - - None None None None
ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 - 0 -
0 6293300 4407952 0 1 0 0 0 NING ANDRIYANI
0001089754659 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180804
1#0##0#0#0.0#2018-05-30 17:19:12#0#16:41:21#16:41:21#12:00:00 1
86d5ade1cb2156bd5b910e391c7232f0 0 0 314665 0 0
3515916 0 0 0 0 577371 0 0 0 0 0
3201126 B 1 BS 1 12/05/2018 15/05/2018 28/07/1957 0 1
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 79900183 0 4 0 0 0 PUTU YULI HARSOYO
0001870574005 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179776
1#0##0#0#0.0#2018-05-31 12:50:24#0#21:52:47#21:52:47#00:00:00 1
1d3db5b18144c813c22bbc21cb2ea8ff 0 11098500 7254760 0 0
52676923 0 0 0 0 1301000 0 0 0 0
7569000
3201126 B 3 BS 1 13/05/2018 15/05/2018 31/05/1985 0 2
- 0 - 0 - 0 - 0 2168300 1806164 0
3 0 0 0 ZAITUNI D398457 32 12035 DR ERDIYAN, SPOG
0138R0170518V004074 0000763776652 3;JKN DR RIZKI; 5.2.1.201804062320
4 180002 1#0##0#0#0.0#2018-05-31
14:22:31#0#00:00:00#00:00:00#00:00:00 1 31081040e07d9d27d920550b866c090c
0 0 248147 0 0 693357 0 0 0 0 864660
0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 15/05/2018 15/03/1983 0 1
1 N39.0;R31 - - - None None None None N-4-12-I None
2871200 0 0 - 0 - 0 - 0 - 0
2871200 2689583 0 2 0 0 0 ARIFIANTO FAJAR FAHMI
RATMOKO D398448 35 12844 YASMIN SURYANDARI BACHTIAR. DR. SPB
0138R0170518V004320 0001730019396 3;JKN DR RIZKI; 5.2.1.201804062320
4 180052 1#0##0#0#0.0#2018-05-31
14:43:16#0#11:41:02#11:41:02#00:00:00 1 b018b6fc4abb0b793a70e5d7edb93466
0 0 475099 0 0 1002530 0 0 0 0
1211954 0 0 0 0 0
3201126 B 1 BS 1 09/05/2018 15/05/2018 17/06/1959 0 2
- 0 - 0 - 0 - 0 6844000 10811355 0
7 0 0 0 GOKHAN JUNITA SIREGAR D204917 58 21511 DR.
5.2.1.201804062320 4 179064 1#0##0#0#0.0#2018-05-31
14:45:00#0#09:03:58#09:03:58#12:00:00 1 3935cc621bbddcfe740db32eb92380f7
0 0 1020330 0 0 2791740 0 0 0 0
6999285 0 0 0 0 0
3201126 B 3 BS 1 12/05/2018 15/05/2018 19/08/1964 0 1
0 - 0 - 0 - 0 - 0 3575600 1951085
0 4 0 0 0 HARTOYO D360544 53 19624 DR AGOES
5.2.1.201804062320 4 179658 1#0##0#0#0.0#2018-05-31
14:46:55#0#01:33:35#01:33:35#00:00:00 1 ac0b6c78c808d36aa5cf003790c58443
0 0 374804 0 0 370640 0 0 0 0
1205641 0 0 0 0 0
3201126 B 2 BS 1 11/05/2018 15/05/2018 25/05/1958 0 1
4335900 0 0 - 0 - 0 - 0 - 0
4335900 5349527 0 5 0 0 0 BENY LIE D020344
3;JKN DR RIZKI; 5.2.1.201804062320 4 179655 1#0##0#0#0.0#2018-
05-31 14:49:14#0#23:31:08#23:31:08#00:00:00 1
7e3efb6f075fd22c4805cec505038949 0 0 443231 0 0
2212827 0 0 0 0 2693469 0 0 0 0 0
3201126 B 2 BS 1 13/05/2018 15/05/2018 11/05/1991 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 10797199 0 3 0 0 0 ELSA MELYAWATI SAFITRI
0001652984065 3;JKN DR RIZKI; 5.2.1.201804062320 4 179884
1#0##0#0#0.0#2018-05-31 14:50:47#0#09:41:51#09:41:51#00:00:00 1
57b29795bb77784cba6d9a31fc4a15fe 0 5251900 2107753 0 0
2423187 0 0 0 0 817359 0 0 0 0 197000
3201126 B 3 BS 1 12/05/2018 15/05/2018 01/08/1999 0 1
JANTUNG (BERAT) 8387700 0 0 - 0 - 0 - 0 -
0 8387700 3610431 0 4 0 0 0 ARDHYANSYAH
0001014245447 3;JKN DR RIZKI; 5.2.1.201804062320 4 179706
1#0##0#0#0.0#2018-05-31 14:55:33#0#10:27:36#10:27:36#00:00:00 1
188f5b8eb9a45a6b7681fc4fe7479028 0 0 807893 0 0
1751342 0 0 0 0 1051196 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 15/05/2018 31/12/1968 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 46586600 0 2 0 0 0 TOTONG SUPRIATNA
0000510580697 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179875
1#0##0#0#0.0#2018-05-31 16:22:19#0#09:33:25#09:33:25#12:00:00 1
2e644bf54e9e6940529f1fc6d58c165d 0 7996000 2442160 0 0
27303440 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 12/05/2018 15/05/2018 15/08/2016 0 1
- 0 - 0 - 0 - 0 3718200 5218389 0
4 0 0 0 SALMAN AHSANUL FIRDAUS D394277 1 635 DR
5.2.1.201804062320 4 179663 1#0##0#0#0.0#2018-06-02
12:55:38#0#04:03:42#04:03:42#12:00:00 1 c06fe96f8439e42691eff7c6ae1e429f
0 0 387638 0 0 1186361 0 0 0 0
3491390 0 0 0 0 153000
3201126 B 3 BS 1 14/05/2018 15/05/2018 05/03/2018 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1556205 0 2 0 0 0 ZEIN KHALIFATUL AZMI
0002458381206 3;JKN DR RIZKI; 5.2.1.201804062320 4 180293
1#0##0#0#0.0#2018-06-05 08:10:29#0#16:36:35#16:36:35#00:00:00 1
6c8960345b29df47602888692d2ff5da 0 0 207620 0 0 611277
0 0 0 0 567308 0 0 0 0 170000
3201126 B 3 BS 1 13/05/2018 15/05/2018 18/08/1962 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2099545 0 3 0 0 0 ROYANAH D398443
55 20357 YASMIN SURYANDARI BACHTIAR. DR. SPB 0138R0170518V004056
0001739596252 3;JKN DR RIZKI; 5.2.1.201804062320 4 179839
1#0##0#0#0.0#2018-06-05 08:13:18#0#00:00:00#00:00:00#00:00:00 1
d9cd5bd554b45bd61bf04339e1a412ca 0 0 183752 0 0
1049940 0 0 0 0 865853 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 15/05/2018 12/09/1954 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8944811 0 2 0 0 0 SURATI
0138R0170518V004645 0002258651439 3;JKN DR RIZKI; 5.2.1.201804062320
4 180307 1#0##0#0#0.0#2018-06-05
08:17:25#0#21:39:02#21:39:02#12:00:00 1 d4db84ae69d72053d132b4c292b610fa
0 3532300 1834760 0 0 2847576 0 0 0 0
661175 0 0 0 0 69000
3201126 B 3 BS 1 15/05/2018 15/05/2018 20/04/1952 0 1
4 I44.2;N18.5;R57.0;I46.9;R40.2 99.60 - - None None None None
I-4-19-III None None None None None None GANGGUAN KONDUKSI & ARITMIA
JANTUNG (BERAT) 7295800 0 0 - 0 - 0 - 0 -
0 7295800 3060726 0 1 0 0 0 SARIP D398593
DR RIZKI; 5.2.1.201804062320 4 180601 1#0##0#0#0.0#2018-06-05
08:29:16#0#11:30:56#11:30:56#00:00:00 1 5ad0290d97cfc20453630468372d9551
0 0 364790 0 0 2206702 0 0 0 0 489234
0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 15/05/2018 01/09/1953 0 1
- 0 45079800 55826360 0 2 0 0 0 YADI SALEH
0000512763952 3;JKN DR RIZKI; 5.2.1.201804062320 4 179874
1#0##0#0#0.0#2018-06-05 08:38:48#0#09:31:42#09:31:42#12:00:00 1
0d43f3cd1989c3bc327b898a80f8cf07 0 8502000 6870800 0 0
31608560 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 10/05/2018 15/05/2018 03/03/1966 0 1
0 0 - 0 - 0 - 0 - 0 10401900
19225118 0 6 1 2 0 A LALAN PRADESA TN D398177
52 19061 DR BAMBANG DWIPUTRA SPJP 0138R0170518V003412
0002137119759 3;JKN DR RIZKI; 5.2.1.201804062320 4 179215
1#0##0#0#0.0#2018-06-05 09:27:52#0#14:00:10#14:00:10#00:00:00 2
2532362acf6e528204fca1c3840a3410 0 0 2346624 0 0
7242994 0 0 0 0 7565500 0 0 0 0
2070000
3201126 B 3 BS 1 14/05/2018 15/05/2018 13/10/1963 0 2
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 9848652 0 2 0 0 0 SITI CHASIDAH
0138R0170518V004405 0000511209819 3;JKN ECHI; 5.2.1.201804062320
4 180088 1#0##0#0#0.0#2018-06-06
07:50:30#0#13:45:28#13:45:28#00:00:00 3 3f7912785c53fdad200db5e416870ebb
0 0 1906030 0 0 4125318 0 0 0 0
3782804 0 0 0 0 34500
3201126 B 2 BS 1 12/05/2018 15/05/2018 09/07/1955 0 2
4 I63.9;I49.3;E78.5;I10;G81.9 96.05;96.71;93.94;87.44;87.03 - -
None None None None J-1-20-III None None None None None None
PROSEDUR SISTEM PERNAFASAN NON-KOMPLEKS (BERAT) 34963000 0 0 -
0 - 0 - 0 - 0 34963000 35535765 0 4
1 3 48 YULIANA d398305 62 22953 DR. ARU ARIADNO, SPPD
0138R0170518V003959 0001259745489 3;JKN irene; 5.2.2.201806040537
4 179731 1#0##0#0#0.0#2018-08-13
09:41:25#0#11:46:34#11:46:34#00:00:00 2 e3225f7433017dab57d4f0967a84bfb2
0 0 7846471 0 0 19781294 0 0 0 0
4368000 0 0 0 0 3540000
3201126 B 3 BS 1 12/05/2018 15/05/2018 10/01/2018 0 1
1 S06.5;G93.6 87.03;87.44 - - None None None None G-4-24-II
None None None None None None TRAUMA KEPALA (SEDANG) 3802000 0
0 - 0 - 0 - 0 - 0 3802000 4181674
0 4 0 0 0 M FIQRI AL ABBAS D398240 0 122 DR
MAYSAM I., SPS 0138R0170518V003958 0002328510069 3;JKN irene;
5.2.2.201806040537 4 179727 1#0##0#0#0.0#2018-08-13
10:16:23#0#11:37:54#11:37:54#00:00:00 2 3a75af28271347d5168a96990d15d6a6
0 0 432879 0 0 2057228 0 0 0 0
1351567 0 0 0 0 340000
3201126 B 1 BS 1 14/05/2018 15/05/2018 11/06/1979 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5790726 0 2 0 0 0 SUPRIADI TN D346421
3;JKN DR RIZKI; 5.2.2.201806040537 4 180071 1#0##0#0#0.0#2018-
09-06 18:24:17#0#12:15:21#12:15:21#00:00:00 2
9d8de2a3bc7bfdec14047127be6d83fb 0 0 573641 0 0
2094002 0 0 0 0 3123082 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 15/05/2018 21/06/1955 0 1
1 I13.1;E87.7;D63.8;I25.0 99.04;90.59;38.95 - - None None None
0 - 0 - 0 8908800 8992858 0 2 0 0
0 YANTO D371143 62 22973 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V004476 0002099388082 3;JKN DR RIZKI; 5.2.2.201806040537
4 180173 1#0##0#0#0.0#2018-09-06
18:25:42#0#15:07:46#15:07:46#00:00:00 2 613305ef5a1f83338cf9ddbf65ab8939
0 3242500 1834760 0 0 3182280 0 0 0 0
664318 0 0 0 0 69000
3201126 B 1 BS 1 11/05/2018 15/05/2018 10/10/1953 0 2
1 J45.9;J22 93.94;87.44 - - None None None None J-4-18-I
3116300 0 0 - 0 - 0 - 0 - 0
3116300 6859749 0 5 0 0 0 EUIS NANI NURJANI
0001267825792 3;JKN DR RIZKI; 5.2.2.201806040537 4 179649
1#0##0#0#0.0#2018-09-06 18:29:50#0#20:40:24#20:40:24#00:00:00 3
676716c6f8865cf9058b21cbc093e3e2 0 0 508265 0 0
2317215 0 0 0 0 4034269 0 0 0 0 0
3201126 B 3 BS 1 10/05/2018 15/05/2018 15/02/1970 0 1
4973600 0 0 - 0 - 0 - 0 - 0
4973600 7794590 0 6 0 0 0 MULYADI D398154
48 17616 DR AGOES KOOSHARTORO SPPD 0138R0170518V003381
0002448769746 3;JKN DR RIZKI; 5.2.2.201806040537 4 179205
1#0##0#0#0.0#2018-09-29 15:19:30#0#00:00:00#00:00:00#00:00:00 2
fd29be2f462ecb45acd27f8900a6d285 0 0 785582 0 0
2757082 0 0 0 0 3655926 0 0 0 0 596000
3201126 B 1 BS 1 15/05/2018 16/05/2018 18/07/1954 0 2
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 10637098 0 2 0 0 0 PARIJAH D398584
3;JKN DR RIZKI; 5.2.1.201804062320 4 180808 1#0##0#0#0.0#2018-
05-28 10:38:24#0#17:41:05#17:41:05#00:00:00 1
276131a4f62d36073784afa27152ff90 0 0 1511408 0 0
2162105 0 0 0 0 6894585 0 0 0 0 69000
3201126 B 1 BS 1 15/05/2018 16/05/2018 27/11/1961 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3760077 0 2 0 0 0 NUNU HERIYANA TN
0000060480268 3;JKN DR RIZKI; 5.2.1.201804062320 4 180557
1#0##0#0#0.0#2018-05-28 10:48:02#0#10:55:32#10:55:32#00:00:00 2
a0dfbb193adaf5c97bc61dd194be90b2 0 0 573641 0 0 196200
0 0 0 0 2990236 0 0 0 0 0
3201126 B 3 BS 1 15/05/2018 16/05/2018 11/01/1974 0 1
- 0 - 0 8908800 11325253 0 2 0 0 0
JAMALUDIN D398607 44 16195 DR. ARU ARIADNO, SPPD
0138R0170518V005080 0001295605877 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 180790 1#0##0#0#0.0#2018-05-30
16:43:15#0#16:21:34#16:21:34#00:00:00 1 d16901869f8216f89ec2d045d1a6ad4a
0 0 2191112 0 0 5240237 0 0 0 0
3859404 0 0 0 0 34500
3201126 B 3 BS 1 15/05/2018 16/05/2018 22/08/1967 0 2
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 8273350 0 2 0 0 0 IMAH D398631
50 18529 DR ARU, SPPD 0138R0170518V005143 0000510954309 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 180815 1#0##0#0#0.0#2018-
05-30 16:53:46#0#22:30:09#22:30:09#00:00:00 1
ea427017b4f4e11d9ffb7ba05e976a0a 0 0 2191112 0 0
2474491 0 0 0 0 3573247 0 0 0 0 34500
3201126 B 2 BS 1 14/05/2018 16/05/2018 26/11/1975 0 2
0 0 - 0 - 0 - 0 - 0 5984100
28890157 0 3 0 0 0 LINDAWATI PURBA A174579 42
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180306
1#1#vvip#3#22906057#0.0#2018-05-31 12:05:38#0#21:24:04#21:24:04#00:00:00
1 331913d81da7feadb946b91d004e2e92 0 11169600 12085637 0
0 4126920 0 0 0 0 1311000 0 0 0 0
197000
3201126 B 1 BS 1 15/05/2018 16/05/2018 05/07/1955 0 1
1 I25.0;I11.0;I48 88.55;36.07 - - YY02 None None None I-1-
- 0 58821400 74278685 0 2 0 0 0 MUKHTADIN
0000061088578 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180324
1#0##0#0#0.0#2018-05-31 12:47:07#0#00:00:00#00:00:00#00:00:00 1
4263f7042715a66a7a50e4f054146cdd 0 10062000 9619120 0 0
45821565 0 0 0 0 1276000 0 0 0 0
7500000
3201126 B 3 BS 1 12/05/2018 16/05/2018 01/01/1953 0 2
1 I63.9;J18.0;K92.1;D64.9;N18.2 99.04 - - None None None None
0 - 0 8672200 6444116 0 5 0 0 0 SITI
SYAMSIAH BR TOBING D398364 65 23872 DR MAYSAM I., SPS
0138R0170518V004009 0001461366224 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 179773 1#0##0#0#0.0#2018-05-31
16:40:22#0#20:48:31#20:48:31#00:00:00 1 0ca671524193b82b581f0e67de06d65f
0 0 378188 0 0 4389850 0 0 0 0
1676078 0 0 0 0 0
3201126 B 2 BS 1 11/05/2018 16/05/2018 04/06/1968 0 2
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 5973065 0 6 0 0 0 LENNI ROSSELANI BR
0001191493427 3;JKN DR RIZKI; 5.2.1.201804062320 4 179650
1#0##0#0#0.0#2018-06-02 10:34:15#0#20:51:23#20:51:23#00:00:00 1
03b159e41e3f1f2fc3b27cb18f6eb082 0 0 504286 0 0
2229518 0 0 0 0 3239261 0 0 0 0 0
3201126 B 2 BS 1 12/05/2018 16/05/2018 09/09/1969 0 2
1 K80.8;K30 - - - None None None None B-4-14-I None
5039800 0 0 - 0 - 0 - 0 - 0
5039800 6117692 0 5 0 0 0 SITI AMINAH D398383
48 17777 DR ARU, SPPD 0138R0170518V004006 0001307456471 3;JKN
DR RIZKI; 5.2.1.201804062320 4 179769 1#0##0#0#0.0#2018-06-02
10:35:21#0#19:24:33#19:24:33#00:00:00 1 b6d97f6af643a6bbd9aa9fa67be0941d
0 0 559582 0 0 2814387 0 0 0 0
2743723 0 0 0 0 0
3201126 B 2 BS 1 15/05/2018 16/05/2018 07/02/1971 0 1
- 0 - 0 10690500 15789436 0 2 0 0 0
JOKO MURYANTO d390929 47 17264 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V004910 0001268747559 3;JKN DR RIZKI; 5.2.1.201804062320
4 180616 1#0##0#0#0.0#2018-06-02
10:41:41#0#12:19:40#12:19:40#12:00:00 1 0375afabd779c8c945ac2931cfc97160
0 0 2191100 0 0 8015782 0 0 0 0
5548054 0 0 0 0 34500
3201126 B 2 BS 1 13/05/2018 16/05/2018 15/05/1945 0 2
1 N13.6;R11;N18.2;A41.9 - - - None None None None N-4-
12-III None None None None None None INFEKSI GINJAL DAN SALURAN URIN
(BERAT) 6075100 0 0 - 0 - 0 - 0 - 0
6075100 4937750 0 4 0 0 0 ROHANI D398437
3;JKN DR RIZKI; 5.2.1.201804062320 4 179994 1#0##0#0#0.0#2018-
06-02 10:46:24#0#00:00:00#00:00:00#00:00:00 2
a533ebd58c5063bb610eadd400218d92 0 0 834450 0 0
1734270 0 0 0 0 2369030 0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 16/05/2018 11/03/2018 0 1
- 0 - 0 - 0 - 0 3187000 3084444 0
3 0 0 0 BAYI NY ANGGIA DEWI PRATIWI d398520 0 64
RIZKI; 5.2.1.201804062320 4 180299 1#0##0#0#0.0#2018-06-02
10:48:27#0#19:15:48#19:15:48#00:00:00 1 d16431fb71f591671dbf37e7937f142d
0 0 339830 0 0 1209328 0 0 0 0
1535286 0 0 0 0 0
3201126 B 2 BS 1 11/05/2018 16/05/2018 21/07/1983 0 2
0 - 0 - 0 - 0 - 0 2671100 6213846
0 6 0 0 0 SISKA SULISTIAWATI D398283 34 12713
DR MOHAMAD NIZAM ERHAMZA SPP 0138R0170518V003893 0001259742126 3;JKN
DR RIZKI; 5.2.1.201804062320 4 179664 1#0##0#0#0.0#2018-06-02
10:55:31#0#04:59:34#04:59:34#00:00:00 1 a11d9ea1025ddafb696e1146ada5f076
0 0 471399 0 0 2784934 0 0 0 0
2957513 0 0 0 0 0
3201126 B 2 BS 1 09/05/2018 16/05/2018 08/06/1992 0 2
1 K73.9;D27;D64.9;R63.0;E88.0 88.76;99.04 - - None None None
None B-4-13-II None None None None None None GANGGUAN HATI LAIN-LAIN
(SEDANG) 5877400 0 0 - 0 - 0 - 0 - 0
5877400 10331848 0 8 0 0 0 LIDIA FITRI D253085
DR RIZKI; 5.2.1.201804062320 4 179180 1#0##0#0#0.0#2018-06-02
11:03:50#0#16:14:38#16:14:38#12:00:00 1 d13acf60ae41beaf40e77565e2f39d77
0 0 634968 0 0 4954965 0 0 0 0
4741915 0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 16/05/2018 13/03/2017 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3821342 0 3 0 0 0 ALIKA RAFANIA PUTRI
D369321 1 427 DR RASTRA, SPA 0138R0170518V004250
0002273754791 3;JKN DR RIZKI; 5.2.1.201804062320 4 179913
1#0##0#0#0.0#2018-06-02 11:07:02#0#10:09:21#10:09:21#00:00:00 2
c9af990a7a4eec40d409986d27de4191 0 0 278711 0 0 854637
0 0 0 0 2687994 0 0 0 0 0
3201126 B 1 BS 1 13/05/2018 16/05/2018 15/07/1945 0 2
1 J20.9;E87.6;A09.9 - - - None None None None J-4-21-II
0 - 0 6311700 5336177 0 4 0 0 0
ELISABETH DIRK D277292 72 26600 DR BETTY DWI L, SPPD
0138R0170518V004047 0001720649722 3;JKN DR RIZKI; 5.2.1.201804062320
4 179852 1#0##0#0#0.0#2018-06-02
12:39:39#0#09:15:00#09:15:00#00:00:00 1 f737ddd5a303ed7335af8887cb2cbea7
0 0 621053 0 0 1216028 0 0 0 0
3499096 0 0 0 0 0
3201126 B 1 BS 1 14/05/2018 16/05/2018 10/05/1973 0 1
1 D21.0;E14.9;E87.6;I10 83.39 - - None None None None M-1-
50-II None None None None None None PROSEDUR JARINGAN LUNAK (SEDANG)
12386700 0 0 - 0 - 0 - 0 - 0
12386700 13720742 0 3 0 0 0 WEMPI KOSIM d395183
3;JKN DR RIZKI; 5.2.1.201804062320 4 180303 1#0##0#0#0.0#2018-
06-02 12:42:00#0#20:16:01#20:16:01#00:00:00 1
8807a1b544a88d4e300dfdb37ff16a23 0 6241500 3521276 0 0
2915347 0 0 0 0 973619 0 0 0 0 69000
3201126 B 1 BS 1 14/05/2018 16/05/2018 14/05/2018 2669 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3035054 0 3 0 0 0 BAYI NY RIZNAHAYATI ARZA
d398479 0 0 DR SONNY KUSUMA YULIARSO, SPA 0138R0170518V005010
0002458845898 3;JKN DR RIZKI; 5.2.1.201804062320 4 180722
1#1#vvip#3#0#0.0#2018-06-02 13:10:37#0#15:10:10#15:10:10#00:00:00 2
b05dd3d9c3b8f708d294532c709d694e 0 0 310000 0 0 88899
0 0 0 0 2636155 0 0 0 0 0
3201126 B 1 BS 1 15/05/2018 16/05/2018 09/05/1948 0 2
1 M66.44;M62.44 97.89;86.84 - - None None None None L-1-
40-I None None None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH
KULIT DAN PAYUDARA (RINGAN) 6969900 0 0 - 0 - 0 -
0 - 0 6969900 11133834 0 2 0 0 0
NURHASANAH D394299 70 25573 DR MARQUEE KENNY TUMBELAKA SPOT
0138R0170518V004993 0000060837186 3;JKN DR RIZKI; 5.2.1.201804062320
4 180651 1#0##0#0#0.0#2018-06-02
13:12:16#0#14:20:56#14:20:56#12:00:00 1 4dc572e4f891437cc82015d900d97853
0 0 2514572 0 0 912280 0 0 0 0
7637982 0 0 0 0 69000
3201126 B 1 BS 1 14/05/2018 16/05/2018 28/12/1947 0 1
1 J44.9;I50.0;N17.9;D29.1 87.44 - - None None None None J-4-
17-III None None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS
(BERAT) 8115800 0 0 - 0 - 0 - 0 - 0
8115800 8166588 0 3 0 0 0 OPARIS SIAHAAN,SH
D324861 70 25705 DR ARU, SPPD 0138R0170518V004085
0000038235868 3;JKN DR RIZKI; 5.2.1.201804062320 4 179862
1#1#vvip#3#50788#0.0#2018-06-02 13:17:13#0#09:24:10#09:24:10#00:00:00 1
9cb4b5905d45786f8a8ec29ad912eea0 0 0 841429 0 0
2939896 0 0 0 0 4385263 0 0 0 0 0
3201126 B 3 BS 1 15/05/2018 16/05/2018 04/03/1947 0 2
1 J44.1;K21.9;R06.6 90.59;89.52;87.44 - - None None None None
J-4-17-I None None None None None None PENYAKIT PARU OBSTRUKTIF
KRONIS (RINGAN) 3688800 0 0 - 0 - 0 - 0 -
0 3688800 2264809 0 2 0 0 0 SOEBOER
0001740383109 3;JKN DR RIZKI; 5.2.1.201804062320 4 180807
1#0##0#0#0.0#2018-06-05 08:12:04#0#17:19:46#17:19:46#00:00:00 2
eed7644b787ebd02d28eca200b6a0278 0 0 384992 0 0 889652
0 0 0 0 700165 0 0 0 0 290000
3201126 B 3 BS 1 16/05/2018 16/05/2018 16/08/1971 0 2
- 0 - 0 - 0 - 0 2216400 2705795 0
1 0 0 0 KHODIJAH D397042 46 17075 RACHMAWATI
5.2.1.201804062320 4 180877 1#0##0#0#0.0#2018-06-05
08:15:43#0#00:00:00#00:00:00#00:00:00 1 8928049245d875921a991a3469aacad2
0 0 715980 0 0 1523800 0 0 0 0 466015
0 0 0 0 0
3201126 B 3 BS 1 15/05/2018 16/05/2018 22/04/1993 0 2
2392700 0 0 - 0 - 0 - 0 - 0
2392700 1979667 0 2 0 0 0 YESSI SUPRIATININGSIH
0001014256394 3;JKN DR RIZKI; 5.2.1.201804062320 4 180376
1#0##0#0#0.0#2018-06-05 08:27:31#0#08:58:26#08:58:26#00:00:00 1
253412ce6a0b0cb6948ea2e1a9cbb4f9 0 0 273635 0 0
1024521 0 0 0 0 681511 0 0 0 0 0
3201126 B 3 BS 1 12/05/2018 16/05/2018 22/11/1954 0 2
- 0 - 0 - 0 - 0 1517500 5649981 0
5 0 0 0 MARYATI D390392 63 23182 DR MAYSAMIRAWATI
4 180019 1#0##0#0#0.0#2018-06-05
08:36:55#0#00:00:00#00:00:00#12:00:00 1 3b2b02a6c44a313caaa603f42d2b70ae
0 0 557179 0 0 3382177 0 0 0 0
1710625 0 0 0 0 0
3201126 B 1 BS 1 14/05/2018 16/05/2018 07/05/2018 0 1
0 - 0 - 0 - 0 - 0 5886000 4025239
0 3 0 0 0 BAYI NY. SUBEKTI SULISTYAWATI D397937 0
TANTIYO S;16137 5.2.1.201804062320 4 186452 1#0##0#0#0.0#2018-
06-05 09:54:26#0#00:00:00#00:00:00#00:00:00 1
0b09fa47c5069bd5be515a293f522db9 0 0 529740 0 0 160666
0 0 0 0 2026833 0 0 0 0 1308000
3201126 B 2 BS 1 12/05/2018 16/05/2018 03/04/1960 0 1
1 I63.8;G81.9;E78.5;I10 87.03;90.59;89.52 - - None None None
- 0 - 0 8291400 8548330 0 5 0 0 0
HANDOYO PUTRO D395155 58 21223 DR MAYSAMIRAWATI SPS
0138R0170518V004477 0001471245502 3;JKN DR RIZKI; 5.2.2.201806040537
4 180177 1#0##0#0#0.0#2018-09-06
18:31:46#0#15:09:24#15:09:24#00:00:00 2 f8c72d041597b6329d944881b75d3fab
0 0 1018054 0 0 4420039 0 0 0 0
3110237 0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 16/05/2018 08/02/1967 0 1
1 E11.2;J22;D63.8;I11.9 99.04 - - None None None None N-4-
LAIN (SEDANG) 6330300 0 0 - 0 - 0 - 0 -
0 6330300 3943347 0 3 0 0 0 SURJO D392983
3;JKN DR RIZKI; 5.2.2.201806040537 4 180302 1#0##0#0#0.0#2018-
09-06 18:35:31#0#19:55:32#19:55:32#12:00:00 2
d7f99738d3e9f8c735f424aa55b2aab2 0 0 709388 0 0
1434983 0 0 0 0 1798976 0 0 0 0 0
3201126 B 1 BS 1 13/05/2018 16/05/2018 24/10/2016 0 2
1 A49.9;N39.9;J06.9 87.44 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 3747176 0 4 0 0 0 BY. NY. NIA
ISTIANI D348027 1 566 DR AULIA TANGKARI, SPA 0138R0170518V004072
0002249799783 3;JKN DR RIZKI; 5.2.2.201806040537 4 179998
1#0##0#0#0.0#2018-09-06 18:37:23#0#00:00:00#00:00:00#00:00:00 2
1286867010a7fe33f555d38f37c38384 0 0 338858 0 0 776176
0 0 0 0 2632142 0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 16/05/2018 04/06/1942 0 1
1 I95.9;E16.2;I63.9;A49.9;G81.9 87.03;90.59;89.52 - - None None
- 0 - 0 8139800 3819408 0 1 0 0 0
NURUDIN D343853 75 27740 DR AHMAD HIBBAN A WRIYA
0138R0170518V005409 0000061031237 3;JKN DR RIZKI; 5.2.2.201806040537
4 180934 1#0##0#0#0.0#2018-09-06
18:40:04#0#00:00:00#00:00:00#00:00:00 2 4b5b0529e99d95fec6017d7d16526884
0 0 406990 0 0 2873550 0 0 0 0 538868
0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 16/05/2018 04/01/1996 0 1
4 A41.9;I48;R57.2 - - - None None None None A-4-10-II
0 - 0 - 0 - 0 - 0 4330300 3298881
0 1 0 0 0 ABDURRAHIM D011460 22 8168 DR DICKI
PRATAMA 0138R0170518V005165 0001456868305 3;JKN DR RIZKI;
5.2.2.201806040537 4 180826 1#0##0#0#0.0#2018-09-06
19:01:24#0#00:00:00#00:00:00#00:00:00 2 d683a04ea24eb4ca9bdf82f2029edd3c
0 0 216515 0 0 2577551 0 0 0 0 504815
0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 16/05/2018 14/09/1936 0 1
4 E87.5;R57.2;J22 - - - None None None None E-4-11-I
2954900 0 0 - 0 - 0 - 0 - 0
2954900 2750701 0 1 0 0 0 MUDJIONO D061958
DR RIZKI; 5.2.2.201806040537 4 180824 1#0##0#0#0.0#2018-09-06
19:18:41#0#00:00:00#00:00:00#00:00:00 2 0a984b4595cd919b3a0e27d79077d3f9
0 0 439974 0 0 1405775 0 0 0 0 486952
0 0 0 0 418000
3201126 B 1 BS 1 14/05/2018 16/05/2018 27/08/1982 0 2
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 5012745 0 3 0 0 0 IIN INAYAH D323922
DR RIZKI; 5.2.2.201806040537 4 179865 1#0##0#0#0.0#2018-09-06
19:33:32#0#09:26:18#09:26:18#00:00:00 2 1d30e2c747a16626dec7618607610522
0 0 345275 0 0 1970533 0 0 0 0
2696937 0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 16/05/2018 02/12/1979 0 2
1 N39.0;D26.0 - - - None None None None N-4-12-I None
2871200 0 0 - 0 - 0 - 0 - 0
2871200 4117402 0 3 0 0 0 SHANTY KARTIKA SANDI
E001719 38 14043 DR. ARU ARIADNO, SPPD 0138R0170518V004643
0000197589126 3;JKN DR RIZKI; 5.2.2.201806040537 4 180305
1#0##0#0#0.0#2018-09-06 19:34:29#0#20:34:42#20:34:42#00:00:00 2
876a44a75fe6ac7b8af2b1cc6181c85a 0 0 431297 0 0
2083242 0 0 0 0 1602863 0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 16/05/2018 11/06/1955 0 1
7040000 0 0 - 0 - 0 - 0 - 0
7040000 743971 0 1 0 0 0 HERRY SOEGITO
D286677 62 22985 DR AHMAD HIBBAN A WRIYA 0138r0170518v005496
0001454847489 3;JKN DR RIZKI; 5.2.2.201806040537 4 181056
1#0##0#0#0.0#2018-09-26 16:07:24#0#15:53:05#15:53:05#00:00:00 2
1f27bfda7d145466ff5e1f3ff2914b17 0 0 352000 0 0 54300
0 0 0 0 337671 0 0 0 0 0
3201126 B 2 BS 1 15/05/2018 16/05/2018 25/01/1958 0 2
1 K29.5;Q40.1;K31.1 45.16 - - None None None None K-4-11-II
3955700 0 0 - 0 - 0 - 0 - 0
3955700 6568214 0 2 0 0 0 RODIAH D154678
60 22025 DR ARU, SPPD 0138R0170518V005123 0001456655938 3;JKN
DR RIZKI; 5.2.1.201804062320 4 180809 1#0##0#0#0.0#2018-09-28
10:10:23#0#17:57:29#17:57:29#00:00:00 3 5bff9575af0b663143b7642e208dc09e
0 0 832408 0 0 1598610 0 0 0 0
2388196 0 0 0 0 1749000
3201126 B 1 BS 1 07/05/2018 16/05/2018 10/10/1943 0 1
1 E63.1;I13.0;N18.5;F03;R90.0 87.03 - - None None None None
- 0 - 0 8768000 15551842 0 10 0 0 0
TEUKU ZOELFICAR BITEH H D071745 74 27238 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170518V002386 0001382953926 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 178695 1#0##0#0#0.0#2018-09-28
13:53:36#0#20:54:13#20:54:13#00:00:00 2 ea7785c8f7fbcfe3cb0acfb9e858cff4
0 0 1280970 0 0 5762962 0 0 0 0
8507910 0 0 0 0 0
3201126 B 1 BS 1 15/05/2018 16/05/2018 22/10/1966 0 1
1 M54.59;R10.4 90.59;89.52 - - None None None None M-4-
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 4488143 0 2 0 0 0 ALBERI D391568
51 18833 DR ARU, SPPD 0138R0170518V004659 0001629201745 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 180313 1#0##0#0#0.0#2018-
09-28 15:03:04#0#00:00:00#00:00:00#00:00:00 2
7ca32a10b8b534ed2ba76a4d4b2dd0a8 0 0 518678 0 0
1306848 0 0 0 0 2662617 0 0 0 0 0
3201126 B 1 BS 1 13/05/2018 16/05/2018 14/06/1984 0 2
0 0 - 0 - 0 - 0 - 0 6981500
25428248 0 4 0 0 0 RIZNAHAYATI A216596 33 12386
DR NELWATI, SPOG 0138R0170518V004067 0000060494444 3;JKN DR RIZKI;
5.2.2.201806040537 4 228585 1#1#vvip#4#18446748#0.0#2018-09-29
15:27:20#0#00:00:00#00:00:00#00:00:00 1 2f491ee7055db9c95ad02d0dedf40951
0 25428248 0 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 15/05/2018 16/05/2018 31/12/1968 0 1
1 I12.0;J18.9 93.94 - - None None None None N-4-10-III None
(BERAT) 8508800 0 0 - 0 - 0 - 0 - 0
8508800 4588953 0 2 0 0 0 INDRAWAN RUSMAN
0001621275952 3;JKN DR RIZKI; 5.2.2.201806040537 4 180811
1#0##0#0#0.0#2018-10-01 12:04:14#0#19:27:23#19:27:23#00:00:00 2
263fc8ed707dbb520bf469b9b0d922af 0 0 573641 0 0
1316350 0 0 0 0 2698962 0 0 0 0 0
3201126 B 1 BS 1 15/05/2018 17/05/2018 11/03/1970 0 2
1 D25.9;N85.1 68.29 - - None None None None W-1-20-I None
None None None None None PROSEDUR PADA RAHIM & ADNEKSA (RINGAN)
11569900 0 0 - 0 - 0 - 0 - 0
11569900 14895498 0 3 0 0 0 SINAR ASRI DINARY
IRAWATI D397729 48 17597 DR ERDIYAN, SPOG 0138R0170518V004831
0001742248991 3;JKN DR RIZKI; 5.2.1.201804062320 4 180457
1#0##0#0#0.0#2018-05-28 10:07:22#0#09:56:00#09:56:00#00:00:00 1
16f6a756b461be7b278fbcb7f7ff396a 0 7096000 3054660 0 0
3590366 0 0 0 0 1085472 0 0 0 0 69000
3201126 B 1 BS 1 15/05/2018 17/05/2018 30/12/1988 0 2
0 0 - 0 - 0 - 0 - 0 6981500
12910010 0 3 0 0 0 WIDIAYU DESTHESYA D347412 29
10728 DR A. DJAENUDDIN, SPOG 0138R0170518V005329 0001718856494 3;JKN
DR RIZKI; 5.2.1.201804062320 4 180886 1#0##0#0#0.0#2018-05-28
10:10:12#0#00:00:00#00:00:00#00:00:00 1 26a9bd48396fa35fe9ff11efb62489e8
0 7098900 2356895 0 0 2311635 0 0 0 0
945580 0 0 0 0 197000
3201126 B 1 BS 1 14/05/2018 17/05/2018 31/12/1952 0 2
1 I72.1;I12.0;D63.8;I27.0 39.52;99.04 - - None None None None
0 - 0 26871300 27374010 0 4 0 0 0
SUTIYEM D324160 65 23875 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V004431 0000060714033 3;JKN DR RIZKI; 5.2.1.201804062320
4 180104 1#0##0#0#0.0#2018-05-28
11:02:42#0#14:09:28#14:09:28#00:00:00 1 8f7c365c78323c60dd06e9c2a5f0ac27
0 10483600 9842492 0 0 4194768 0 0 0 0
2784150 0 0 0 0 69000
3201126 B 2 BS 1 15/05/2018 17/05/2018 08/05/2018 0 1
0 - 0 - 0 - 0 - 0 5045200 3325275
0 3 0 0 0 BAYI NY INTAN HENDRINNA D398571 0 7
DR KRISTON SILITONGA, SPA 0138R0170518V004660 0002429269716 3;JKN
DR RIZKI; 5.2.1.201804062320 4 180314 1#0##0#0#0.0#2018-05-28
11:15:48#0#00:00:00#00:00:00#00:00:00 1 d09ec21a1f900b37a26f8876536077f6
0 0 507068 0 0 203666 0 0 0 0
2274541 0 0 0 0 340000
3201126 B 2 BS 1 15/05/2018 17/05/2018 15/05/2018 2832 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3217939 0 3 0 0 0 BAYI NY LINDAWATI PURBA
D398581 0 0 DR SONNY KUSUMA YULIARSO, SPA 0138R0170518V004973
0002458780119 3;JKN DR RIZKI; 5.2.1.201804062320 4 180624
1#0##0#0#0.0#2018-05-28 11:24:16#0#13:52:23#13:52:23#00:00:00 1
bd219426efd8d29f01b5e15846351c20 0 0 729921 0 0 88899
0 0 0 0 2399119 0 0 0 0 0
3201126 B 1 BS 1 14/05/2018 17/05/2018 15/05/1950 0 1
1 D29.1;R33;I11.9;N39.0 60.29 - - None None None None V-1-
(SEDANG) 17977700 0 0 - 0 - 0 - 0 - 0
17977700 25600848 0 4 0 0 0 DAYAT SUHARNO
0001300629363 3;JKN DR RIZKI; 5.2.1.201804062320 4 179968
1#0##0#0#0.0#2018-05-28 11:34:31#0#10:40:56#10:40:56#00:00:00 1
edf1efcce4671f8df784dcdfe5a55f12 0 10847600 3590468 0 0
5121780 0 0 0 0 4796000 0 0 0 0
1245000
3201126 B 1 BS 1 16/05/2018 17/05/2018 22/07/1942 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 11150882 0 2 0 0 0 NURHARYONO
0138R0170518V005498 0001257881196 3;JKN DR RIZKI; 5.2.1.201804062320
4 181048 1#0##0#0#0.0#2018-05-28
11:44:57#0#15:47:12#15:47:12#12:00:00 1 83221d2dadcb67b9277add746ed6983f
0 6468200 2619183 0 0 1189002 0 0 0 0
805497 0 0 0 0 69000
3201126 B 1 BS 1 14/05/2018 17/05/2018 29/07/2017 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4268254 0 4 0 0 0 JOEVANCA RISARTA
SIMANJUNTAK AN D376511 0 289 DR OTTY MITHA S, SPA
0138R0170518V004632 0002270709977 3;JKN DR RIZKI; 5.2.1.201804062320
4 181740 1#0##0#0#0.0#2018-05-28
12:54:52#0#00:00:00#00:00:00#00:00:00 1 960383f96900517ad3fbe3edd04037be
0 0 269459 0 0 745063 0 0 0 0
3083732 0 0 0 0 170000
3201126 B 3 BS 1 15/05/2018 17/05/2018 09/01/1972 0 1
1 M79.66;I83.0 38.59 - - None None None None I-1-17-II
(SEDANG) 17066700 0 0 - 0 - 0 - 0 - 0
17066700 13897033 0 3 0 0 0 ARDIANSYAH D385096
0001335250721 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180816
1#0##0#0#0.0#2018-05-30 16:34:30#0#00:00:00#00:00:00#12:00:00 1
02cbf5d917f6046a2dd388f8a355bdcd 0 5132800 4778676 0 0
2931405 0 0 0 0 985152 0 0 0 0 69000
3201126 B 3 BS 1 12/05/2018 17/05/2018 17/10/1947 0 1
1 G82.2;J18.9 93.94 - - None None None None G-4-10-III None
None None None None None KECEDERAAN & GANGGUAN TULANG BELAKANG (BERAT)
7324600 0 0 - 0 - 0 - 0 - 0
7324600 5038895 0 6 0 0 0 GILING PURBA
0001257806586 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179774
1#0##0#0#0.0#2018-05-30 16:40:34#0#21:24:47#21:24:47#00:00:00 1
a93472be1fa24de62e8a2ca4e20ad8f8 0 0 550712 0 0
2344395 0 0 0 0 2143788 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 17/05/2018 21/12/1941 0 2
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 2235708 0 4 0 0 0 HAMSINAH NY D398488
0001385436194 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180308
1#0##0#0#0.0#2018-05-30 16:41:49#0#22:43:17#22:43:17#00:00:00 1
f6315cf3f79ea2cae84753e62d9fc45a 0 0 603017 0 0 494930
0 0 0 0 1137761 0 0 0 0 0
3201126 B 3 BS 1 13/05/2018 17/05/2018 28/02/1948 0 1
None None None None None ATHEROSKLEROSIS (BERAT) 4178900 0 0
- 0 - 0 - 0 - 0 4178900 2801883 0
5 0 0 0 MUNIR D398421 70 25642 DR SUPONO SPJP
0138R0170518V004027 0001014303519 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 179928 1#0##0#0#0.0#2018-05-30
16:47:14#0#10:21:06#10:21:06#00:00:00 1 4bb47f78357d65ce0ca8e965bd8cdeda
0 0 469870 0 0 807712 0 0 0 0
1524301 0 0 0 0 0
3201126 B 3 BS 1 15/05/2018 17/05/2018 09/08/1992 0 2
0 0 - 0 - 0 - 0 - 0 4986800
20433750 0 3 0 0 0 FARADINA SHELLA AGUSTA NY
0001794574034 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180524
1#1#vvip#3#15446950#0.0#2018-05-30 16:55:48#0#10:36:55#10:36:55#00:00:00
2 f77f07df41e599d73cb0aed765bffdd4 0 9306600 6488000 0
0 2968150 0 0 0 0 1346000 0 0 0 0
325000
3201126 B 3 BS 1 15/05/2018 17/05/2018 15/05/2018 3366 1
3655700 0 0 - 0 - 0 - 0 - 0
3655700 2830698 0 3 0 0 0 0002453635844
0002453635844 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180959
1#0##0#0#0.0#2018-05-30 16:57:52#0#14:13:25#14:13:25#00:00:00 1
1e6dfcbd2084e5bb02421173fcb38230 0 0 368013 0 0 88899
0 0 0 0 2373786 0 0 0 0 0
3201126 B 3 BS 1 13/05/2018 17/05/2018 28/02/1965 0 2
1 E14.5;L03.1;A41.9 86.22 - - None None None None I-4-15-III
LAIN (BERAT) 7317500 0 0 - 0 - 0 - 0 -
0 7317500 10777852 0 5 0 0 0 EEM D398426
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179784
1#0##0#0#0.0#2018-05-30 17:04:58#0#08:34:11#08:34:11#00:00:00 1
5db2ab78ac4bffa8cc2aa7f2d75459f1 0 3581500 1912612 0 0
4433647 0 0 0 0 781093 0 0 0 0 69000
3201126 B 3 BS 1 16/05/2018 17/05/2018 14/07/1973 0 1
- 0 - 0 19332400 9063574 0 2 0 0 0
MUHAMMAD NUH D398701 44 16377 SRI KUNMARTINI.DR,SPPD
0138R0170518V005569 0000368559731 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181091 1#0##0#0#0.0#2018-05-30
18:17:55#0#20:20:09#20:20:09#00:00:00 1 a1fdd2be8cb3128defcf6bbcf3fa2409
0 3438800 1906030 0 0 2980800 0 0 0 0
668944 0 0 0 0 69000
3201126 B 3 BS 1 15/05/2018 17/05/2018 26/08/1946 0 1
1 S09.9;H81.1 - - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 3043100 1969077 0
3 0 0 0 EDDY MUCHTAR D398613 71 26195 DR NURUL
KOMARI SPS 0138R0170518V005363 0001309300187 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 180925 1#0##0#0#0.0#2018-05-30
18:22:04#0#00:00:00#00:00:00#00:00:00 1 e4e76b83b51d74dc9469c72d140e2db9
0 0 326879 0 0 961380 0 0 0 0 680818
0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 17/05/2018 27/11/1982 0 1
INTERNAL (RINGAN) 4315600 0 0 - 0 - 0 - 0 -
0 4315600 6757401 0 2 0 0 0 ARTABAN MARADONGAN
0001263246208 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180828
1#0##0#0#0.0#2018-05-30 18:24:07#0#05:53:48#05:53:48#00:00:00 1
5fb2a4c24fa415119714e3ed66083a5c 0 0 1208368 0 0
1517760 0 0 0 0 3886273 0 0 0 0 145000
3201126 B 3 BS 1 16/05/2018 17/05/2018 23/04/1974 0 1
- 0 8908800 9326834 0 2 0 0 0 AFRIZAL
0002100686308 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181084
1#0##0#0#0.0#2018-05-30 18:36:27#0#17:20:37#17:20:37#00:00:00 1
a51f1075ba4bc219a764fa9591ae4f1e 0 3438800 1923848 0 0
3209019 0 0 0 0 686167 0 0 0 0 69000
3201126 B 3 BS 1 17/05/2018 17/05/2018 09/07/2017 0 1
2 A41.9;R57.2;G04.2 96.05 - - None None None None A-4-10-III
0 - 0 - 0 - 0 - 0 5838600 5967292
0 1 0 0 0 MUHAMMAD NAUFAL FAIQ D398734 0 312
DR NIKEN PRABHA DUHITA 0138R0170518V005584 0002263634313 3;JKN DR
RIZKI; 5.2.1.201804062320 4 181099 1#0##0#0#0.0#2018-06-04
11:52:33#0#00:00:00#00:00:00#00:00:00 1 67787fcd52dbfcd20750b2989c80adb2
0 0 463745 0 0 4066163 0 0 0 0 679384
0 0 0 0 758000
3201126 B 3 BS 1 16/05/2018 17/05/2018 01/04/1981 0 2
1 O80.9;Z37.0;I84.5 73.59 - - None None None None O-6-13-I
0 0 - 0 - 0 - 0 - 0 1674900
3525966 0 2 0 0 0 HERWINA D397890 37 13559
DR FERRI SABARUDDIN SPOG 0138R0170518V005166 0000513152886 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 180827 1#0##0#0#0.0#2018-
06-05 09:37:39#0#05:04:17#05:04:17#00:00:00 1
10d6085010c3c6c387ea7dda99255ee1 0 0 387980 0 0 954715
0 0 0 0 2114271 0 0 0 0 69000
3201126 B 2 BS 1 14/05/2018 17/05/2018 20/05/1942 0 2
0 - 0 - 0 - 0 - 0 5014700 3875552
0 4 0 0 0 RAMIJATI D327908 75 27753 DR BAMBANG
5.2.1.201804062320 4 180073 1#0##0#0#0.0#2018-06-05
09:38:57#0#12:59:12#12:59:12#00:00:00 1 176f592c93668a3570fd7fd7a32a2cd3
0 0 713024 0 0 862987 0 0 0 0
2299541 0 0 0 0 0
3201126 B 1 BS 1 14/05/2018 17/05/2018 10/10/1987 0 2
0 0 - 0 - 0 - 0 - 0 6981500
27979578 0 4 0 0 0 PANCA SETIAWATI D379318 30
TANTIYO S;16137 5.2.2.201806040537 4 180294
1#1#vvip#4#20998078#0.0#2018-06-05 10:45:26#0#16:38:32#16:38:32#00:00:00
1 3a8602a5c22ce51937ee08d2c390c152 0 11300200 9359000 0
0 5777378 0 0 0 0 1346000 0 0 0 0
197000
3201126 B 3 BS 1 14/05/2018 17/05/2018 02/04/2018 0 2
4 Q24.9;J18.0;R65.1;A41.9 - - - None None None None I-4-
(BERAT) 7295800 0 0 - 0 - 0 - 0 - 0
7295800 16822785 0 4 1 0 0 SAYIDAH FATIMAH ALAWIYAH
D398292 0 42 DR NOVIK BUDIWARDHANA, SPA 84N50500140518
3276034204180001 3;JKN DR RIZKI; 5.2.2.201806040537 4 181358
1#0##0#0#0.0#2018-06-06 11:23:57#0#15:17:44#15:17:44#00:00:00 1
846e771c5acc40fe0d267c1e94a9d099 0 0 16822785 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 14/05/2018 17/05/2018 06/03/1989 0 2
1 N39.0;N23;K80.8 - - - None None None None N-4-12-I
2871200 0 0 - 0 - 0 - 0 - 0
2871200 4406521 0 4 0 0 0 DENIA HARTANTI
0001877501597 3;JKN DR RIZKI; 5.2.2.201806040537 4 190983
1#0##0#0#0.0#2018-06-18 10:46:53#1#00:00:00#00:00:00#00:00:00 1
3d9bb1008551ae74b1145e1054d09912 0 0 335340 0 1388745
2368159 0 0 0 0 288277 0 0 0 26000 0
3201126 B 1 BS 1 13/05/2018 17/05/2018 13/05/2018 2751 1
None None None None None NEONATAL, BBL > 2499 GR DENGAN
KONGENITAL/INFEKSI PERINATAL (RINGAN) 3473000 0 0 - 0 -
0 - 0 - 0 3473000 4954709 0 5 0 0
0 BAYI NY ELSA MELYAWATI SAFITRI D398458 0 0
KRISTYANINGESTI,DR.SPA 0138R0170518V004312 0002458218655 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 180029 1#0##0#0#0.0#2018-
07-04 15:50:57#0#11:20:44#11:20:44#00:00:00 1
8fd067814ac0b6caa4d1a72ff5be882b 0 0 351570 0 0 999999
0 0 0 0 3474140 0 0 0 0 129000
3201126 B 3 BS 1 16/05/2018 17/05/2018 16/05/1957 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 7009474 0 2 0 0 0 NAMI D395836
0001338440207 3;JKN DR RIZKI; 5.2.2.201806040537 4 180928
1#0##0#0#0.0#2018-09-06 19:07:54#0#00:00:00#00:00:00#00:00:00 2
93d176b1f3182601d965031d0a1c6ca0 0 3438800 931100 0 0
2036010 0 0 0 0 534564 0 0 0 0 69000
3201126 B 3 BS 1 17/05/2018 17/05/2018 09/12/1962 0 2
1 I64;G81.9;I10 87.03;96.05 - - None None None None G-4-
- 0 - 0 - 0 - 0 4888600 8768460 0
1 0 0 0 ROSELINA MANIK D398738 55 20248 DR NIKEN
PRABHA DUHITA 0138R0170518V005582 0000061111091 3;JKN DR RIZKI;
5.2.2.201806040537 4 181098 1#0##0#0#0.0#2018-09-06
19:09:04#0#00:00:00#00:00:00#00:00:00 3 32ab6e90be22ba74ad29aa0bdbad8dbb
0 0 244430 0 0 7661392 0 0 0 0 862638
0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 17/05/2018 17/08/1977 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 10886268 0 2 0 0 0 AGUS SALIM
0138R0170518V005526 0001428740133 3;JKN DR RIZKI; 5.2.2.201806040537
4 181083 1#0##0#0#0.0#2018-09-06
19:29:00#0#16:49:44#16:49:44#00:00:00 2 3ee64f5690393f8ce00074c1b5b11276
0 0 3135780 0 0 3865302 0 0 0 0
3850686 0 0 0 0 34500
3201126 B 3 BS 1 15/05/2018 17/05/2018 08/03/2016 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 2247241 0 3 0 0 0 ADRIAN PUTRA
KUSUMA D373057 2 798 DR DICKI PRATAMA 0138R0170518V005156
0002274575905 3;JKN DR RIZKI; 5.2.2.201806040537 4 180822
1#0##0#0#0.0#2018-09-06 19:31:22#0#00:00:00#00:00:00#00:00:00 2
1af9c99cded7c4e91d817118b0841a62 0 0 149350 0 0
1661875 0 0 0 0 436016 0 0 0 0 0
3201126 B 2 BS 1 04/05/2018 17/05/2018 04/05/2018 2492 2
1 P22.9;P36.9 96.72 - - None None None None P-8-06-II None
- 0 17712000 58434446 0 14 0 0 0 BY NY ROSITA
RIANTYH BASYA D397750 0 0 DR AULIA TANGKARI, SPA
0138R0170518V002791 0002446028458 3;JKN DR RIZKI; 5.2.2.201806040537
4 178976 1#0##0#0#0.0#2018-09-26
17:46:55#0#16:04:41#16:04:41#00:00:00 3 0e904f6367fdb07b386d279da541546d
0 0 2382267 0 0 21507179 0 0 0 0
16397000 0 0 0 0 18148000
3201126 B 3 BS 1 16/05/2018 17/05/2018 01/09/1953 0 1
1 K30;I25.0 - - - None None None None K-4-18-I None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1607579 0 2 0 0 0 YADI SALEH D347585
0000512763952 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 180819
1#0##0#0#0.0#2018-09-28 15:08:45#0#01:11:49#01:11:49#12:00:00 2
e43752f4f261ef16963e5e68f1bbf3a0 0 0 418193 0 0 269217
0 0 0 0 920169 0 0 0 0 0
3201126 B 2 BS 1 17/05/2018 18/05/2018 25/08/1987 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 4968102 0 2 0 0 0 SUSI DAMAYANTI
0001627459187 3;JKN DR RIZKI; 5.2.1.201804062320 4 181412
1#0##0#0#0.0#2018-05-28 11:17:10#0#21:33:36#21:33:36#00:00:00 1
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0 0 0 0 3154516 0 0 0 0 34500
3201126 B 2 BS 1 15/05/2018 18/05/2018 10/06/1975 0 1
0 - 0 - 0 - 0 4101100 4942907 0 4
0 0 0 RUSDI ALI D398577 42 15680 DR HERY TIERA, SPU
0138R0170518V004807 0000045259086 3;JKN DR RIZKI; 5.2.1.201804062320
4 180406 1#0##0#0#0.0#2018-05-28
11:25:57#0#09:08:37#09:08:37#00:00:00 1 c182caeb162a524fab4b1310cd0563ec
0 0 422099 0 0 2151440 0 0 0 0
2369368 0 0 0 0 0
3201126 B 1 BS 1 13/05/2018 18/05/2018 21/02/1959 0 2
1 I72.1;I12.0;A41.9 39.52;99.21;39.95 - - None None None None
I-1-20-III None None None None None None PROSEDUR SISTIM PEREDARAN
- 0 28247300 29193039 0 6 0 0 0 ROSIYATI
0138R0170518V004029 0000044937145 3;JKN DR RIZKI; 5.2.1.201804062320
4 179892 1#0##0#0#0.0#2018-05-28
11:28:18#0#09:47:29#09:47:29#12:00:00 1 6311468a60fdbb030b0736431cb707f6
0 11865600 8261222 0 0 4461817 0 0 0 0
4535400 0 0 0 0 69000
3201126 B 1 BS 1 14/05/2018 18/05/2018 23/11/1980 0 2
0 0 - 0 - 0 - 0 - 0 6981500
21887005 0 5 0 0 0 LIZA NOWIANTY D161675 37
13686 DR ARJU A, SPOG 0138R0170518V004601 0001620769959 3;JKN DR
RIZKI; 5.2.1.201804062320 4 180297 1#1#vip#5#5236125#75.0#2018-
05-28 11:56:31#0#18:04:43#18:04:43#00:00:00 1
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3533753 0 0 0 0 1301000 0 0 0 0 197000
3201126 B 1 BS 1 14/05/2018 18/05/2018 21/01/1942 0 1
1 I63.9;M75.0;G81.9;I10 87.03;90.59;89.52 - - None None None
- 0 - 0 9673300 8591854 0 5 0 0 0
ANDRIES HERLING OROH D387263 76 27872 DR NURUL KOMARI SPS
0138R0170518V004985 0001281475225 3;JKN DR RIZKI; 5.2.1.201804062320
4 180618 1#0##0#0#0.0#2018-05-28
12:02:16#0#00:00:00#00:00:00#12:00:00 1 b053ac852696aacede2b6bed9ad60b7f
0 0 1020330 0 0 3078440 0 0 0 0 0
0 0 4493084 0 0
3201126 B 1 BS 1 12/05/2018 18/05/2018 24/03/1939 0 2
1 H81.1;E87.1;I63.9;G81.9;I10;R63.8;K20;G40.9 87.03;87.44 - -
None None None None U-4-11-III None None None None None None
DYSEQUILIBRIUM (BERAT) 3250500 0 0 - 0 - 0 -
0 - 0 3250500 9933210 0 7 0 0 0
MARYANAH D356663 79 28904 DR NURUL KOMARI SPS
0138R0170518V004019 0001438668257 3;JKN DR RIZKI; 5.2.1.201804062320
4 179885 1#0##0#0#0.0#2018-05-28
12:08:34#0#09:44:07#09:44:07#00:00:00 1 c869679e13c32af7e5166e4218e3da01
0 0 504545 0 0 3291329 0 0 0 0
5797336 0 0 0 0 340000
3201126 B 1 BS 1 17/05/2018 18/05/2018 05/02/1969 0 1
(SEDANG) 26871300 0 0 - 0 - 0 - 0 - 0
26871300 13722654 0 2 0 0 0 M YUNUS D395655
3;JKN DR RIZKI; 5.2.1.201804062320 4 181292 1#0##0#0#0.0#2018-
05-28 12:54:12#0#00:00:00#00:00:00#00:00:00 1
3aa31c9e7467c28a4deea947dc4f2101 0 6468200 5374260 0 0
837450 0 0 0 0 973744 0 0 0 0 69000
3201126 B 1 BS 1 16/05/2018 18/05/2018 12/02/1992 0 1
1 K30;N20.1 - - - None None None None K-4-18-II None
3432200 0 0 - 0 - 0 - 0 - 0
3432200 5117927 0 3 0 0 0 MUDZAKKIR ABDUH
0001125411399 3;JKN DR RIZKI; 5.2.1.201804062320 4 180821
1#0##0#0#0.0#2018-05-28 12:56:10#0#00:00:00#00:00:00#00:00:00 1
08531275f6be24266dd790a166ddf198 0 0 847310 0 0
1566799 0 0 0 0 2703818 0 0 0 0 0
3201126 B 3 BS 1 17/05/2018 18/05/2018 01/06/1952 0 1
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3139980 0 2 0 0 0 SATAR TN
0000511411612 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181799
1#0##0#0#0.0#2018-05-30 17:02:16#0#16:18:19#16:18:19#00:00:00 1
cdec899dd34e9965e3025fe975bc7505 0 0 424889 0 0
1064422 0 0 0 0 1650669 0 0 0 0 0
3201126 B 3 BS 1 15/05/2018 18/05/2018 21/02/1973 0 2
1 K80.8;N30.9 - - - None None None None B-4-14-II None
None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (SEDANG)
4899600 0 0 - 0 - 0 - 0 - 0
4899600 3014780 0 4 0 0 0 DEWI KARTIKASARI
0001272478994 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180813
1#0##0#0#0.0#2018-05-30 17:03:34#0#21:16:53#21:16:53#00:00:00 1
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1395069 0 0 0 0 1188729 0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 18/05/2018 29/09/2016 0 2
3613200 0 0 - 0 - 0 - 0 - 0
0002276507823 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180823
1#0##0#0#0.0#2018-05-30 17:26:26#0#00:00:00#00:00:00#12:00:00 1
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2935363 0 0 0 0 1103999 0 0 0 0 0
3201126 B 3 BS 1 13/05/2018 18/05/2018 01/08/1992 0 2
(SEDANG) 8857200 0 0 - 0 - 0 - 0 - 0
8857200 12021744 0 6 0 0 0 MISYANI D398444
25 9416 YASMIN SURYANDARI BACHTIAR. DR. SPB 0138R0170518V004053
0000522539515 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180007
1#0##0#0#0.0#2018-05-30 17:31:27#0#00:00:00#00:00:00#00:00:00 1
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5922107 0 0 0 0 862469 0 0 0 0 69000
3201126 B 3 BS 1 14/05/2018 18/05/2018 20/01/1970 0 2
1 L97;E11.2;I11.0 86.60 - - None None None None L-1-30-III
None None None None None None PEMINDAHAN KULIT TANPA LUKA BAKAR (BERAT)
19510300 0 0 - 0 - 0 - 0 - 0
19510300 13277711 0 5 0 0 0 ANIH D388414 48
TANTIYO S;16137 5.2.1.201804062320 4 179858 1#0##0#0#0.0#2018-
05-30 18:20:44#0#09:20:54#09:20:54#12:00:00 1
568526ef255d70ee0b6122416de3d6b9 0 3957800 5681966 0 0
2674310 0 0 0 0 894635 0 0 0 0 69000
3201126 B 3 BS 1 16/05/2018 18/05/2018 15/07/1985 0 2
1 O80.9;O13;O60.1;Z37.4 73.59 - - None None None None O-6-
0 0 - 0 - 0 - 0 - 0 1982500
3830704 0 3 0 0 0 SRI SUPATMI D398722 32 11993
TANTIYO S;16137 5.2.1.201804062320 4 181094 1#0##0#0#0.0#2018-
05-30 18:35:30#0#00:00:00#00:00:00#00:00:00 1
2b3b616a2346cf65b7bf71482133e0b8 0 0 387980 0 0
1064517 0 0 0 0 2122207 0 0 0 0 256000
3201126 B 2 BS 1 16/05/2018 18/05/2018 13/09/2016 0 2
(SEDANG) 3304700 0 0 - 0 - 0 - 0 - 0
3304700 2607650 0 3 0 0 0 KHANZA NAYYARA INDRA
0002260134898 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180902
1#0##0#0#0.0#2018-05-31 11:51:24#0#00:00:00#00:00:00#12:00:00 1
062e352dd0e7f3cf6675087f729bfb9a 0 0 350423 0 0 545633
0 0 0 0 1711594 0 0 0 0 0
3201126 B 1 BS 1 17/05/2018 18/05/2018 24/01/1966 0 1
1 E11.2;I12.0;D63.8 38.95;99.04 - - None None None None N-1-
- 0 12472300 13401365 0 2 0 0 0 DWI
HANDAYANI D398755 52 19106 SRI KUNMARTINI.DR,SPPD 0138R0170518V005806
0002228653091 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181289
1#0##0#0#0.0#2018-05-31 12:52:57#0#00:00:00#00:00:00#00:00:00 1
f31a74febc416a2fe0f29dbcea597d83 0 0 2647238 0 0
3836402 0 0 0 0 6848725 0 0 0 0 69000
3201126 B 3 BS 1 18/05/2018 18/05/2018 24/05/1981 0 1
1 K21.0;A01.0;F41.8 45.16 - - None None None None K-4-12-III
0 0 - 0 - 0 - 0 - 0 6781600
6036876 0 1 0 0 0 DENI KUSNANDAR D397683 36
TANTIYO S;16137 5.2.1.201804062320 4 181430 1#0##0#0#0.0#2018-
05-31 16:45:03#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1516436 0 0 0 0 1749000
3201126 B 3 BS 1 17/05/2018 18/05/2018 30/06/1959 0 2
- 0 8908800 10260475 0 2 0 0 0 ENTING
0001212360309 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181332
1#0##0#0#0.0#2018-05-31 16:47:04#0#14:53:07#14:53:07#00:00:00 1
07d27caa680bb7b40f685403d249591c 0 3062500 3248691 0 0
3133038 0 0 0 0 747246 0 0 0 0 69000
3201126 B 3 BS 1 17/05/2018 18/05/2018 01/12/1961 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 1808640 0 2 0 0 0 MARYANI d390224
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181406
1#0##0#0#0.0#2018-05-31 16:47:56#0#20:44:44#20:44:44#12:00:00 1
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0 0 0 0 583822 0 0 0 0 128000
3201126 B 3 BS 1 15/05/2018 18/05/2018 05/05/1942 0 1
1 D29.1;N39.0 - - - None None None None V-4-11-II None
TUMOR (SEDANG) 4954900 0 0 - 0 - 0 - 0 -
0 4954900 4310211 0 4 0 0 0 ABUT D398562
3;JKN DR RIZKI; 5.2.1.201804062320 4 180315 1#0##0#0#0.0#2018-
06-02 10:21:55#0#00:00:00#00:00:00#00:00:00 1
c164a0f89794f12285d1b4ca867dafbf 0 0 498941 0 0
2451294 0 0 0 0 1359976 0 0 0 0 0
3201126 B 2 BS 1 16/05/2018 18/05/2018 05/05/2018 0 2
0 - 0 - 0 - 0 - 0 5045200 3688005
0 3 0 0 0 MEHRUNISA HARSYAHIRA d397846 0 11
DR NOVIK BUDIWARDHANA, SPA 0138R0170518V005575 0002456518138 3;JKN
DR RIZKI; 5.2.1.201804062320 4 181095 1#0##0#0#0.0#2018-06-02
13:38:06#0#00:00:00#00:00:00#00:00:00 1 98a5ab160e1a8facf1e49f8fd8d3bb0d
0 1621271 454068 0 0 160666 0 0 0 0
0 0 0 0 0 1452000
3201126 B 1 BS 1 15/05/2018 18/05/2018 15/05/2018 2696 2
0 - 0 - 0 5910700 7286571 0 4 0 0
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0138R0170518V005974 0002459601011 3;JKN DR RIZKI; 5.2.1.201804062320
4 181399 1#0##0#0#0.0#2018-06-02
13:50:22#0#00:00:00#00:00:00#00:00:00 1 9ee0afd926dbba6a27b06b0c4f1a1c5d
0 0 460620 0 0 2545259 0 0 0 0
4280692 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 18/05/2018 31/12/1945 0 2
4 J22;A41.9;R57.2 99.60 - - None None None None J-4-21-III
0 - 0 6291000 3086701 0 1 0 0 0 KASINI
0000061026041 3;JKN DR RIZKI; 5.2.1.201804062320 4 181712
1#0##0#0#0.0#2018-06-04 11:41:59#0#12:01:08#12:01:08#00:00:00 1
e18aabe5f37b6e1ef0631f540e3f6f1b 0 0 320985 0 0
2274782 0 0 0 0 490934 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 18/05/2018 01/02/1967 0 2
4 K74.6;B19.0 - - - None None None None B-4-13-III None
None None None None None GANGGUAN HATI LAIN-LAIN (BERAT) 6747200
0 0 - 0 - 0 - 0 - 0 6747200
3556194 0 1 0 0 0 SUHAEMI D394139 51 18734
DR IRVAN VERYADI 0138R0170518V006269 0002446000929 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 181715 1#0##0#0#0.0#2018-06-04
16:23:33#0#00:00:00#00:00:00#00:00:00 1 d8e4a9406121570cad0f0d044eaa7e5f
0 0 607248 0 0 2427298 0 0 0 0 521648
0 0 0 0 0
3201126 B 1 BS 1 08/05/2018 18/05/2018 04/11/1942 0 2
1 G91.2;N18.5;A41.9 39.95;38.95 - - None None None None N-1-
- 0 - 0 27065300 36008035 0 11 1 4 0
D.MARYATI D138258 75 27579 DR. ARU ARIADNO, SPPD
0138R0170518V002411 0001728641586 3;JKN DR RIZKI; 5.2.1.201804062320
4 178707 1#0##0#0#0.0#2018-06-05
09:34:26#0#04:02:28#04:02:28#12:00:00 1 3a77ac2948949c563bcca760aa75fbf4
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12923000 0 0 0 0 5214000
3201126 B 3 BS 1 17/05/2018 18/05/2018 06/07/1952 0 2
1 L03.9;E13.8;I44.2;A41.9 - - - None None None None L-4-
12-III None None None None None None PERADANGAN KULIT/CELLULITIS (BERAT)
7665300 0 0 - 0 - 0 - 0 - 0
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TANTIYO S;16137 5.2.1.201804062320 4 181423 1#0##0#0#0.0#2018-
06-05 10:04:07#0#00:00:00#00:00:00#12:00:00 1
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1583386 0 0 0 0 468358 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 18/05/2018 26/03/1961 0 2
1 N18.5;K30;D63.8 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3017183 0 1 0 0 0 ERNA MARDIANA NY
0000093184075 3;JKN DR RIZKI; 5.2.2.201806040537 4 181719
1#0##0#0#0.0#2018-09-06 19:11:40#0#00:00:00#00:00:00#00:00:00 2
53941ba18bbb3264620157efc186ed76 0 0 165690 0 0
1208857 0 0 0 0 1642636 0 0 0 0 0
3201126 B 3 BS 1 17/05/2018 18/05/2018 27/11/1953 0 1
- 0 - 0 19332400 16641191 0 2 0 0 0
POEDJADI D392300 64 23547 DEDY PRATAMA,SPBV 0138R0170518V005931
0001212186791 3;JKN DR RIZKI; 5.2.2.201806040537 4 181366
1#0##0#0#0.0#2018-09-06 19:13:55#0#15:45:03#15:45:03#12:00:00 2
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8127955 0 0 0 0 1164676 0 0 0 0
2128000
3201126 B 3 BS 1 17/05/2018 18/05/2018 27/12/1961 0 2
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 15589804 0 2 0 0 0 ASIYAH NY
0000367389009 3;JKN DR RIZKI; 5.2.2.201806040537 4 181290
1#0##0#0#0.0#2018-09-06 19:17:54#0#12:52:38#12:52:38#00:00:00 2
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6939630 0 0 0 0 1095894 0 0 0 0 69000
3201126 B 2 BS 1 16/05/2018 18/05/2018 26/07/1973 0 1
1 J90;N18.5 34.91 - - None None None None J-4-20-I None
5568600 0 0 - 0 - 0 - 0 - 0
5568600 3043786 0 3 0 0 0 SUMARTANA D369438
0001101686411 3;JKN DR RIZKI; 5.2.2.201806040537 4 181093
1#0##0#0#0.0#2018-09-06 19:20:43#0#21:41:12#21:41:12#00:00:00 3
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3201126 B 1 BS 1 17/05/2018 18/05/2018 20/05/1964 0 2
1 N18.5;D63.8;T82.4;E14.9 39.42 - - None None None None N-1-
- 0 - 0 27065300 12415718 0 2 0 0 0
TRIYANTI NUZILOWATI D308061 53 19720 DR IRFIANSYAH LESMANA DR
SPBTKV 0138R0170518V005792 0001314142683 3;JKN DR RIZKI;
5.2.2.201806040537 4 181800 1#0##0#0#0.0#2018-09-28
09:49:54#0#16:25:04#16:25:04#00:00:00 2 76c29441553199fdebf66d98af9352f3
0 5896000 2547460 0 0 3015015 0 0 0 0
888243 0 0 0 0 69000
3201126 B 3 BS 1 17/05/2018 18/05/2018 26/04/1992 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 6695416 0 2 0 0 0 FAUZIAH ISNAINI
0001740009205 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 181815
1#0##0#0#0.0#2018-09-28 15:13:17#0#20:38:29#20:38:29#00:00:00 2
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1847498 0 0 0 0 3804818 0 0 0 0 69000
3201126 B 2 BS 1 18/05/2018 19/05/2018 11/09/1958 0 1
1 I50.9;E14.9;I21.2;R57.0 89.52 - - None None None None I-4-
5968400 0 0 - 0 - 0 - 0 - 0
5968400 4616059 0 2 0 0 0 SUMAEDI D398816
0001904849447 3;JKN DR RIZKI; 5.2.1.201804062320 4 181420
1#0##0#0#0.0#2018-05-25 14:07:41#0#05:35:48#05:35:48#00:00:00 1
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1609972 0 0 0 0 2073985 0 0 0 0 0
3201126 B 2 BS 1 16/05/2018 19/05/2018 12/06/1960 0 1
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0000039408131 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181087
1#0##0#0#0.0#2018-05-31 11:42:50#0#18:16:29#18:16:29#12:00:00 1
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1059600 0 0 0 0 2339036 0 0 0 0 580000
3201126 B 2 BS 1 14/05/2018 19/05/2018 05/06/1993 0 2
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16262974 0 6 0 0 0 FITYANTI D364483 24 9109
DR ATJANG S, SPOG 0138R0170518V004079 0002060358939 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 179869 1#0##0#0#0.0#2018-05-31
11:45:01#0#09:28:01#09:28:01#00:00:00 1 d9d7eeda4ad45333925e62393d68f03d
0 6558500 3557168 0 0 4678373 0 0 0 0
1399933 0 0 0 0 69000
3201126 B 2 BS 1 15/05/2018 19/05/2018 02/04/1948 0 2
1 E11.5;I25.1;I11.0;E16.2;S42.20 90.59;89.52;93.53 - - None
None None None I-4-15-III None None None None None None PENYAKIT
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- 0 - 0 - 0 8781000 13452631 0 5 0
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11:46:37#0#06:44:46#06:44:46#12:00:00 1 711e0e0bf429c9b242618aa08de2be54
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3201126 B 2 BS 1 17/05/2018 19/05/2018 06/11/1961 0 1
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1#0##0#0#0.0#2018-05-31 11:48:38#0#00:00:00#00:00:00#00:00:00 1
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19-II None None None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG
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1#0##0#0#0.0#2018-05-31 11:50:34#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 2 BS 1 17/05/2018 19/05/2018 14/08/1993 0 2
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10517431 0 3 0 0 0 ARLINDA ROSDIANA D287566 24
TANTIYO S;16137 5.2.1.201804062320 4 181404 1#0##0#0#0.0#2018-
05-31 11:57:31#0#20:07:42#20:07:42#00:00:00 1
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2033057 0 0 0 0 1134221 0 0 0 0 197000
3201126 B 2 BS 1 17/05/2018 19/05/2018 17/05/2018 3046 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1099116 0 3 0 0 0 BAYI NY ARLINDA ROSDIANA
d398817 0 0 DR GUNAWAN S, SPA 0138R0170518V006487
0002459893296 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181809
1#0##0#0#0.0#2018-05-31 12:01:50#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 1 BS 1 16/05/2018 19/05/2018 02/10/1953 0 1
1 I63.9;R13;E13.8;E78.5 - - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-05-31 12:44:24#0#19:57:59#19:57:59#00:00:00 1
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3201126 B 1 BS 1 16/05/2018 19/05/2018 16/08/1944 0 2
(RINGAN) 4639400 0 0 - 0 - 0 - 0 - 0
4639400 6917792 0 4 0 0 0 SUHARTI D020590
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181607
1#0##0#0#0.0#2018-05-31 12:49:09#0#00:00:00#00:00:00#00:00:00 1
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2900180 0 0 0 0 3257066 0 0 0 0 290000
3201126 B 1 BS 1 18/05/2018 19/05/2018 17/09/2011 0 1
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2925900 3860725 0 2 0 0 0 ADITYA SURYA FAUZIE
0001328716181 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181717
1#1#vvip#2#934825#0.0#2018-05-31 12:51:32#0#03:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 16/05/2018 19/05/2018 07/06/1974 0 1
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3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180848
1#0##0#0#0.0#2018-05-31 16:26:09#0#00:00:00#00:00:00#12:00:00 1
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3809500 0 0 0 0 792866 0 0 0 0 217500
3201126 B 3 BS 1 18/05/2018 19/05/2018 03/05/1968 0 1
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0138R0170518V006320 0002287444465 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181721 1#0##0#0#0.0#2018-05-31
16:27:13#0#14:03:03#14:03:03#00:00:00 1 cb49f5cb691afb617e658ed1917fcbb2
0 3438800 1844760 0 0 1864280 0 0 0 0
586499 0 0 0 0 69000
3201126 B 3 BS 1 15/05/2018 19/05/2018 28/04/1971 0 2
1 J18.0;E07.9;I50.0 - - - None None None None J-4-16-II
(SEDANG) 5077500 0 0 - 0 - 0 - 0 - 0
5077500 4419568 0 5 0 0 0 ELLEN AFRIDAH
0002199045238 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180812
1#0##0#0#0.0#2018-05-31 16:30:51#0#20:57:37#20:57:37#00:00:00 1
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2075962 0 0 0 0 1543631 0 0 0 0 290000
3201126 B 3 BS 1 16/05/2018 19/05/2018 01/03/1996 0 1
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4 0 0 0 ZAKARIA D027395 22 8111 DR CATUR BANUAJI
SPS 0138R0170518V005152 0001743661067 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 180820 1#0##0#0#0.0#2018-05-31
16:33:55#0#00:00:00#00:00:00#00:00:00 1 996f035515a91f099c1e4fe901a25102
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1373526 0 0 0 0 290000
3201126 B 3 BS 1 17/05/2018 19/05/2018 10/10/1978 0 2
1 D01.0;D63.0 45.23;99.04 - - None None None None K-4-10-II
0 0 - 0 - 0 - 0 - 0 7062900
7556160 0 3 0 0 0 SANEM BT. NALIH D398241 39
14464 DR ZULFAN, SPPD 0138R0170518V005718 0001729406518 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 181170 1#0##0#0#0.0#2018-
05-31 16:42:17#0#09:16:15#09:16:15#00:00:00 1
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2125992 0 0 0 0 2251828 0 0 0 0
1749000
3201126 B 3 BS 1 11/05/2018 19/05/2018 31/12/1949 0 1
1 E87.6;D29.1;I25.0;I13.0;I95.9;Z95.0 - - - None None None
ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 - 0 -
0 6293300 13015012 0 9 1 5 0 SAMIN HS
0001459427095 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 179656
1#0##0#0#0.0#2018-05-31 16:52:50#0#23:37:54#23:37:54#12:00:00 1
d7686d01a1f0bb6a38561e12b2d1f737 0 0 376101 0 0
6043462 0 0 0 0 4219449 0 0 0 0
2376000
3201126 B 1 BS 1 17/05/2018 19/05/2018 17/08/1966 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 21092386 0 3 0 0 0 NY.SRI TUJILASIH
0138R0170518V005999 0000036465963 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181413 1#0##0#0#0.0#2018-06-04
08:35:17#0#00:00:00#00:00:00#00:00:00 1 d4be6dbea4b3672d70f2f1f45348142c
0 6813700 3573832 0 0 9258854 0 0 0 0
1301000 0 0 0 0 145000
3201126 B 1 BS 1 17/05/2018 19/05/2018 22/08/2002 0 2
0 0 - 0 - 0 - 0 - 0 3349800
4360556 0 3 0 0 0 HANI ADISTIA D398771 15
TANTIYO S;16137 5.2.1.201804062320 4 181519 1#0##0#0#0.0#2018-
06-04 15:05:51#0#00:00:00#00:00:00#00:00:00 1
69e0034939960a85c6797894bab5c5db 0 0 354482 0 0
1351804 0 0 0 0 2654270 0 0 0 0 0
3201126 B 1 BS 1 18/05/2018 19/05/2018 17/10/1942 0 1
- 0 4903800 2689210 0 2 0 0 0 MARKUS ATIM
0001456387648 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181421
1#0##0#0#0.0#2018-06-04 15:19:57#0#06:15:38#06:15:38#00:00:00 1
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3201126 B 3 BS 1 18/05/2018 19/05/2018 31/12/1950 0 2
1 I63.9;E87.6;R13;R40.2 - - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5622932 0 2 0 0 0 MARIAM HARIS
0001209004119 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 181813
1#0##0#0#0.0#2018-06-05 10:35:28#0#19:44:19#19:44:19#00:00:00 2
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4054221 0 0 0 0 656855 0 0 0 0 290000
3201126 B 3 BS 1 18/05/2018 19/05/2018 23/07/1962 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 3266415 0 2 0 0 0 SUPARTI D398862
irene; 5.2.2.201806040537 4 181814 1#0##0#0#0.0#2018-08-13
10:49:06#0#20:03:21#20:03:21#00:00:00 2 67880a8372bbc1c016cd5176a7dcb82b
0 0 245190 0 0 2518534 0 0 0 0 502691
0 0 0 0 0
3201126 B 2 BS 1 15/05/2018 19/05/2018 01/04/1987 0 2
1 I64;G81.9 87.03;90.59;89.52 - - None None None None G-4-
- 0 - 0 - 0 - 0 5866300 4706575 0
5 0 0 0 ROSSANTI D204242 31 11367 DR AL RASYID SPS
0138R0170518V004737 0001633806123 3;JKN DR RIZKI; 5.2.2.201806040537
4 180318 1#0##0#0#0.0#2018-09-06
19:27:38#0#07:34:34#07:34:34#00:00:00 2 16a89be3d7b9742f3080819e2fc96a77
0 0 882140 0 0 965528 0 0 0 0
2858907 0 0 0 0 0
3201126 B 1 BS 1 13/05/2018 19/05/2018 10/01/1943 0 1
4 J44.0;J96.9;E87.8;I50.0;A41.9 96.05;96.72 - - None None None
None J-1-02-III None None None None None None VENTILASI MEKANIKAL LONG
TERM TANPA TRAKEOSTOMI (BERAT) 92864200 0 0 - 0 - 0
- 0 - 0 92864200 48878366 0 7 1 2 24
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0138R0170518V004044 0001309254186 3;JKN DR RIZKI; 5.2.1.201804062320
4 179856 1#0##0#0#0.0#2018-09-26
17:53:40#0#09:19:06#09:19:06#00:00:00 2 e678fed7affb61bcf89d347f65a3931b
0 0 10469060 0 0 22151306 0 0 0 0
8464000 0 0 0 0 7794000
3201126 B 3 BS 1 13/05/2018 19/05/2018 06/03/1955 0 2
1 I64;E14.8;G81.9 - - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 5586119 0
7 0 0 0 INDRATY ENDANG TJTIROWATY D170087 63 23079
DR AL RASYID SPS 0138R0170518V004049 0001421222106 3;JKN DR RIZKI;
5.2.2.201806040537 4 179845 1#0##0#0#0.0#2018-09-26
19:03:01#0#09:11:35#09:11:35#00:00:00 2 6d66c5056400cc81334e3e78fbaa50b2
0 0 743950 0 0 2609722 0 0 0 0
2232447 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 19/05/2018 24/04/1962 0 1
1 I13.1;D63.8;T82.4 99.04;39.27 - - None None None None N-1-
- 0 - 0 19332400 8238433 0 2 0 0 0
SUHADI D382531 56 20478 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V006204 0001278846731 3;JKN DR RIZKI; 5.2.1.201804062320
4 181592 1#0##0#0#0.0#2018-09-28
09:55:20#0#00:00:00#00:00:00#12:00:00 2 41afd5ea0ed399c18da151f8c78e3b15
0 3438800 1853030 0 0 2262640 0 0 0 0
614963 0 0 0 0 69000
3201126 B 3 BS 1 18/05/2018 19/05/2018 18/06/1964 0 1
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2 0 0 0 AGUS IRWAN D398876 53 19692 DR ADRIAN HANDARU
0138R0170518V006534 0000511001728 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 181826 1#0##0#0#0.0#2018-09-28
15:15:19#0#08:28:57#08:28:57#00:00:00 2 175d6608698b098330447999153f651d
0 0 178780 0 0 2255346 0 0 0 0 488579
0 0 0 0 128000
3201126 B 2 BS 1 14/05/2018 19/05/2018 12/12/1954 0 1
0 - 0 - 0 - 0 - 0 12482300 7111224
0 6 0 0 0 THAMRIN ARIFIN TN D398530 63 23164 DR
5.2.2.201806040537 4 180312 1#0##0#0#0.0#2018-10-01
09:01:44#0#00:00:00#00:00:00#00:00:00 3 f376338435750180fa00719d5e1b7b24
0 0 1176407 0 0 2315097 0 0 0 0
3313720 0 0 0 0 306000
3201126 B 1 BS 1 15/05/2018 20/05/2018 01/12/1943 0 2
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6 0 0 0 RATU DEWI NURJANI,HJ D311545 74 27194 DR
PRIYO SUNARTO , SPJP 0138R0170518V005142 0000060967427 3;JKN DR RIZKI;
5.2.1.201804062320 4 180814 1#0##0#0#0.0#2018-05-25
13:55:53#0#21:48:26#21:48:26#00:00:00 1 5a58fac53824f84457f528ed010a5fa4
0 0 374802 0 0 965707 0 0 0 0
4765991 0 0 0 0 0
3201126 B 1 BS 1 17/05/2018 20/05/2018 09/08/2015 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4344812 0 4 0 0 0 INAYAH PUTRI HARDI
D315322 2 1012 DR HUDA, SPA 0138R0170518V005577
0001905894257 3;JKN DR RIZKI; 5.2.1.201804062320 4 181097
1#0##0#0#0.0#2018-05-25 14:02:39#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 1 BS 1 18/05/2018 20/05/2018 28/01/1984 0 2
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19191419 0 3 0 0 0 YENI D132859 34 12529 DR FX
BHIMANTORO, SPOG 0138R0170518V006161 0001652609698 3;JKN DR RIZKI;
5.2.1.201804062320 4 181508 1#0##0#0#0.0#2018-05-25
14:05:03#0#00:00:00#00:00:00#00:00:00 1 8dee9dac41fe401dbd05c297dae409cc
0 8289400 6488000 0 0 2891019 0 0 0 0
1326000 0 0 0 0 197000
3201126 B 2 BS 1 14/05/2018 20/05/2018 15/08/1949 0 2
1 J18.9;B90.9 87.44 - - None None None None J-4-16-I None
4335900 0 0 - 0 - 0 - 0 - 0
4335900 10358308 0 7 0 0 0 SORMIANNA SIBORO
0002049104193 3;JKN DR RIZKI; 5.2.1.201804062320 4 180075
1#0##0#0#0.0#2018-05-25 14:19:27#0#13:09:25#13:09:25#12:00:00 1
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3437720 0 0 0 0 6399246 0 0 0 0 0
3201126 B 2 BS 1 18/05/2018 20/05/2018 18/05/2018 3150 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1416478 0 3 0 0 0 BAYI NY MUTHI'AH HANIF
0002459890247 3;JKN DR RIZKI; 5.2.1.201804062320 4 181718
1#0##0#0#0.0#2018-05-25 14:21:25#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 15/05/2018 20/05/2018 14/03/1976 0 1
(BERAT) 18011700 0 0 - 0 - 0 - 0 - 0
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0001765957149 3;JKN DR RIZKI; 5.2.1.201804062320 4 181197
1#0##0#0#0.0#2018-05-25 14:27:58#0#00:00:00#00:00:00#12:00:00 1
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4843763 0 0 0 0 7432210 0 0 0 0 145000
3201126 B 2 BS 1 17/05/2018 20/05/2018 29/09/1989 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 11109476 0 4 0 0 0 MUTHIAH HANIF
0002059415627 3;JKN DR RIZKI; 5.2.1.201804062320 4 181403
1#0##0#0#0.0#2018-05-25 14:29:31#0#19:48:21#19:48:21#00:00:00 1
1dbdd9746fb94cdf080c26f001839f74 0 5477400 2516481 0 0
2080807 0 0 0 0 837788 0 0 0 0 197000
3201126 B 2 BS 1 17/05/2018 20/05/2018 24/06/1989 0 2
0 0 - 0 - 0 - 0 - 0 2379000
8774486 0 4 0 0 0 YUSTINA YAKU DANGA D379671
28 10554 DR. SITI AZIZAH SPOG 0138R0170518V005719 0002449250335
3;JKN DR RIZKI; 5.2.1.201804062320 4 181169 1#0##0#0#0.0#2018-
05-25 14:31:19#0#09:14:56#09:14:56#00:00:00 1
85849aefbe10cc709c6538f76383e389 0 0 1092632 0 0
3172122 0 0 0 0 4124732 0 0 0 0 385000
3201126 B 3 BS 1 18/05/2018 20/05/2018 12/08/1968 0 2
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0002451000789 3;JKN DR RIZKI; 5.2.1.201804062320 4 181808
1#0##0#0#0.0#2018-05-25 14:35:58#0#18:54:03#18:54:03#00:00:00 1
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4848226 0 0 0 0 3901989 0 0 0 0 69000
3201126 B 3 BS 1 18/05/2018 20/05/2018 07/12/1979 0 2
5405200 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.1.201804062320 4 181444 1#0##0#0#0.0#2018-
05-25 14:38:48#0#08:48:42#08:48:42#00:00:00 1
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2325732 0 0 0 0 620161 0 0 0 0 325000
3201126 B 3 BS 1 16/05/2018 20/05/2018 27/08/2007 0 1
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1#0##0#0#0.0#2018-05-25 14:45:40#0#18:37:02#18:37:02#00:00:00 1
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2075429 0 0 0 0 1505598 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 20/05/2018 02/06/1998 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1534864 0 3 0 0 0 SALIMATUSADIAH
0000516856386 3;JKN DR RIZKI; 5.2.1.201804062320 4 181804
1#0##0#0#0.0#2018-05-25 14:46:35#0#17:36:04#17:36:04#00:00:00 1
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3201126 B 3 BS 1 17/05/2018 20/05/2018 07/09/1958 0 2
1 I63.9;I10;I25.0;G81.9 87.03 - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
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0001268373879 3;JKN DR RIZKI; 5.2.1.201804062320 4 181408
1#0##0#0#0.0#2018-05-31 15:05:31#0#20:51:33#20:51:33#00:00:00 1
54d8b78f8e70916a45d350b48ebe2f94 0 0 428857 0 0
2511880 0 0 0 0 0 0 0 0 0 1266757
3201126 B 3 BS 1 13/05/2018 20/05/2018 17/08/1953 0 1
1 A16.2;J18.9;I12.0;A41.9;N39.0;I69.4 87.44;87.03 - - None None
None None J-4-15-III None None None None None None PERADANGAN DAN
INFEKSI PERNAFASAN (BERAT) 6970400 0 0 - 0 - 0 -
0 - 0 6970400 10341592 0 8 0 0 0 MAMAN
RAHMAN D396810 64 23645 DR BETTY DWI L, SPPD 0138R0170518V004068
0000512020056 3;JKN DR RIZKI; 5.2.1.201804062320 4 180536
1#0##0#0#0.0#2018-05-31 15:27:48#0#10:43:26#10:43:26#00:00:00 1
c5901c2568368caf974dbeb54793f2e5 0 0 630773 0 0
6990766 0 0 0 0 2720053 0 0 0 0 0
3201126 B 3 BS 1 17/05/2018 20/05/2018 02/05/1968 0 2
1 E14.9;H81.3;R63.0 - - - None None None None E-4-10-I
0 - 0 3502700 6061443 0 4 0 0 0 NUR
HAYATI D398801 50 18277 DR. ARU ARIADNO, SPPD 0138R0170518V005995
0000512289404 3;JKN DR RIZKI; 5.2.1.201804062320 4 181409
1#0##0#0#0.0#2018-05-31 16:13:24#0#21:09:24#21:09:24#00:00:00 2
44ff9d8cca6d739fb2c1be32ffff4c86 0 0 368243 0 0
4305157 0 0 0 0 1388043 0 0 0 0 0
3201126 B 3 BS 1 19/05/2018 20/05/2018 10/06/1967 0 2
- 0 8908800 9716512 0 2 0 0 0 NURWITA
0138R0170518V006537 0001212590226 3;JKN DR RIZKI; 5.2.1.201804062320
4 181831 1#0##0#0#0.0#2018-05-31
16:14:23#0#00:00:00#00:00:00#12:00:00 2 c59814b86282aac126b38dc0ceacbd78
0 3062500 1853030 0 0 4054822 0 0 0 0
711660 0 0 0 0 34500
3201126 B 1 BS 1 19/05/2018 20/05/2018 13/11/1952 0 1
- 0 - 0 27065300 16931888 0 2 0 0 0
SUJATMAN HADI SANTOSO D391530 65 23928 DR IRFIANSYAH LESMANA DR
SPBTKV 0138R0170518V006557 0000036424719 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181878 1#0##0#0#0.0#2018-05-31
17:52:33#0#11:26:19#11:26:19#12:00:00 1 05bebf752ad586ebdda87c7b70fb4097
0 5896000 5629582 0 0 4188112 0 0 0 0
1183694 0 0 0 0 34500
3201126 B 2 BS 1 18/05/2018 20/05/2018 13/03/1980 0 2
(SEDANG) 6486300 0 0 - 0 - 0 - 0 - 0
6486300 10988948 0 3 0 0 0 TETI SITI MARIAH
D398825 38 13945 DR ARIS WAHJU, SPOG 0138R0170518V006283
0002419829302 3;JKN DR RIZKI; 5.2.1.201804062320 4 181716
1#0##0#0#0.0#2018-06-02 13:27:51#0#00:00:00#00:00:00#00:00:00 2
be0de0c9b30771d3a1af20101a5ae46d 0 5269900 2143753 0 0
2533392 0 0 0 0 844903 0 0 0 0 197000
3201126 B 1 BS 1 19/05/2018 20/05/2018 10/07/1948 0 1
- 0 12472300 12886070 0 2 0 0 0 PAULUS
DIDIDJAJA SETIAWAN D398940 69 25515 DR SRI KUNMARTINI, SPPD
0138R0170518V006594 0001448136224 3;JKN DR RIZKI; 5.2.1.201804062320
4 181920 1#0##0#0#0.0#2018-06-02
13:43:32#0#15:24:53#15:24:53#00:00:00 1 d39d1cd20f6246aeb520750a659072ff
0 5896000 2647244 0 0 3354812 0 0 0 0
919014 0 0 0 0 69000
3201126 B 1 BS 1 19/05/2018 20/05/2018 07/12/1955 0 1
1 E14.6;D29.1;N39.0 - - - None None None None E-4-10-II
0 - 0 6852200 3290197 0 2 0 0 0
BAMBANG JOKO SUSILO D205630 62 22809 DR ZULFAN, SPPD
0138R0170518V006506 0001339260107 3;JKN DR RIZKI; 5.2.1.201804062320
4 181822 1#0##0#0#0.0#2018-06-02
13:44:46#0#01:23:20#01:23:20#12:00:00 1 5f341cdc11b5f6bad00556192fc939d1
0 0 338858 0 0 1148092 0 0 0 0
1803247 0 0 0 0 0
3201126 B 2 BS 1 18/05/2018 20/05/2018 18/05/2018 2605 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1276843 0 3 0 0 0 TETI SITI MARIAH BY NY
0002447266408 3;JKN DR RIZKI; 5.2.1.201804062320 4 182307
1#0##0#0#0.0#2018-06-04 12:23:56#0#13:18:37#13:18:37#00:00:00 1
878476702922fbd51bab9a27655ab17e 0 0 414312 0 0 156499
0 0 0 0 706032 0 0 0 0 0
3201126 B 1 BS 1 16/05/2018 20/05/2018 16/06/2017 0 2
1 A41.9;D61.8 99.05;99.04 - - None None None None A-4-10-III
0 - 0 - 0 - 0 - 0 8174100 14212426
0 5 0 0 0 KAYLA NAZIFA D379593 0 334 DR
VERA MUNA MANOE, SPA 0138R0170518V005514 0002258819954 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 181080 1#0##0#0#0.0#2018-06-04
15:23:40#0#16:24:40#16:24:40#00:00:00 2 1b6b5d023d013f5b8c5b61d074cc5c6e
0 0 341080 0 0 6267561 0 0 0 0
5619785 0 0 0 0 1984000
3201126 B 2 BS 1 17/05/2018 20/05/2018 06/03/1999 0 2
1 J20.9;J45.9 - - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 3358200 0 0 - 0 - 0 - 0
- 0 3358200 3426266 0 4 0 0 0 NABILLA DWI
ANINDITA D342718 19 7012 DR BOBBY DRASTYAWAN SPPA
0138R0170518V006170 0001793420561 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181502 1#0##0#0#0.0#2018-06-05
09:41:28#0#00:00:00#00:00:00#00:00:00 1 595183a8488d0ba7b6e4789002c4dfb4
0 0 355238 0 0 1305880 0 0 0 0
1765148 0 0 0 0 0
3201126 B 1 BS 1 17/05/2018 20/05/2018 19/09/1980 0 2
(RINGAN) 6981500 0 0 - 0 - 0 - 0 - 0
6981500 23772864 0 4 0 0 0 SULASI NUR FAUZIAH, SKM.
d394047 37 13754 DR AFRA FONDA SPOG 0138R0170518V005982
0001226471319 3;JKN DR RIZKI; 5.2.2.201806040537 4 181402
1#0##0#0#0.0#2018-06-18 10:56:44#1#19:24:35#19:24:35#00:00:00 1
57ddc790f58657600301b17e89ce1f10 0 0 8866487 0 7579147
5531430 0 0 0 0 1470800 0 0 325000 0
0
3201126 B 3 BS 1 19/05/2018 20/05/2018 12/10/1940 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 15082377 0 2 0 0 0 MUNYANIH
0002020722862 3;JKN DR RIZKI; 5.2.2.201806040537 4 181824
1#0##0#0#0.0#2018-09-25 14:48:14#0#00:00:00#00:00:00#00:00:00 3
6b44a451a146f118c50a2e87c6f0d571 0 3062500 4059804 0 0
6848375 0 0 0 0 1042698 0 0 0 0 69000
3201126 B 3 BS 1 19/05/2018 20/05/2018 17/10/1968 0 2
1 T82.4;F29;I12.0 39.42 - - None None None None N-1-12-II
- 0 8908800 15024928 0 2 0 0 0 PONIRAH
0001211539116 3;JKN DR RIZKI; 5.2.2.201806040537 4 181823
1#0##0#0#0.0#2018-09-25 14:52:12#0#00:00:00#00:00:00#00:00:00 2
cd3e9acd79de1fa02959235a6f220dc5 0 3062500 4059804 0 0
6829185 0 0 0 0 1038939 0 0 0 0 34500
3201126 B 3 BS 1 21/05/2018 21/05/2018 26/04/1992 0 2
- 0 8908800 8134594 0 1 0 0 0 FAUZIAH
ISNAINI D398807 26 9521 SRI KUNMARTINI.DR,SPPD 0138R0170518V006916
0001740009205 3;JKN DR RIZKI; 5.2.1.201804062320 4 182162
1#0##0#0#0.0#2018-05-31 16:05:41#0#10:42:47#10:42:47#00:00:00 1
9fa2cc90e438a8c8c1c5434484baba7e 0 3265800 1906030 0 0
2285594 0 0 0 0 608170 0 0 0 0 69000
3201126 B 1 BS 1 21/05/2018 21/05/2018 19/01/1984 0 2
0 - 0 - 0 - 0 - 0 3247500 5579945
0 1 0 0 0 MELVA JANIANTY SIMORANGKIR D398532 34
12541 DR ARU, SPPD 0138R0170518V006979 0001325246444 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 182297 1#0##0#0#0.0#2018-
05-31 17:30:59#0#12:16:48#12:16:48#00:00:00 1
e890bccafc67f7292764250ffb97ed64 0 0 962300 0 0 844102
0 0 0 0 2024543 0 0 0 0 1749000
3201126 B 2 BS 1 20/05/2018 21/05/2018 12/04/1952 0 1
1 N18.5;D63.8;E13.2 38.95 - - None None None None N-1-12-II
- 0 10690500 11287366 0 2 0 0 0 LAMRI BIN
UKON ATMADJA D329026 66 24144 SRI KUNMARTINI.DR,SPPD
0138R0170518V006678 0000042985258 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181963 1#0##0#0#0.0#2018-05-31
17:50:18#0#22:59:00#22:59:00#00:00:00 1 1943ee35cb65d074cb3718ab0b55d96f
0 0 2276624 0 0 4137716 0 0 0 0
4838526 0 0 0 0 34500
3201126 B 1 BS 1 19/05/2018 21/05/2018 28/05/1997 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4968150 0 3 0 0 0 YOSSY KUSUMA WINATA
D398898 20 7661 DR ARU, SPPD 0138R0170518V006554
0002195934669 3;JKN DR RIZKI; 5.2.1.201804062320 4 182459
1#0##0#0#0.0#2018-06-02 10:13:21#0#14:55:15#14:55:15#00:00:00 2
a12801644a164a0c2b7449115d701292 0 0 263331 0 0
2010800 0 0 0 0 2694019 0 0 0 0 0
3201126 B 2 BS 1 20/05/2018 21/05/2018 03/04/1957 0 2
None None None None None GASTRITIS & ULKUS PEPTIKUM (BERAT) 4746800
0 0 - 0 - 0 - 0 - 0 4746800
5629641 0 2 0 0 0 RAMLAH MAGDALENA SIREGAR NY
0001284047627 3;JKN DR RIZKI; 5.2.1.201804062320 4 181957
1#0##0#0#0.0#2018-06-02 13:34:51#0#21:48:55#21:48:55#00:00:00 1
e28865f20e516ef22e016f200089ef2f 0 0 1382104 0 0 489243
0 0 0 0 2009294 0 0 0 0 1749000
3201126 B 1 BS 1 18/05/2018 21/05/2018 17/01/1959 0 2
1 M51.2;E78.5;M21.37 - - - None None None None M-4-
17-II None None None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG BELAKANG
(SEDANG) 7221000 0 0 - 0 - 0 - 0 - 0
7221000 10206624 0 4 0 0 0 TATIK WINARSIH
0000072612549 3;JKN DR RIZKI; 5.2.1.201804062320 4 181734
1#0##0#0#0.0#2018-06-02 13:46:33#0#14:37:19#14:37:19#12:00:00 1
51d88a641bfdfbda35cd488dedcd03ab 0 0 956506 0 0
3456395 0 0 0 0 5793723 0 0 0 0 0
3201126 B 1 BS 1 19/05/2018 21/05/2018 14/12/1955 0 2
- 0 12472300 14099877 0 3 0 0 0 TENDY
LUMBANTORUAN D341184 62 22802 DEDY PRATAMA,SPBV 0138R0170518V006614
0000060481574 3;JKN DR RIZKI; 5.2.1.201804062320 4 181927
1#0##0#0#0.0#2018-06-02 13:57:41#0#20:44:53#20:44:53#00:00:00 1
e164b39eabe1c7c3efe04e599367c3cf 0 6241500 2594238 0 0
4171717 0 0 0 0 1023422 0 0 0 0 69000
3201126 B 1 BS 1 20/05/2018 21/05/2018 20/05/1964 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 3825411 0 2 0 0 0 TRIYANTI NUZILOWATI
0001314142683 3;JKN DR RIZKI; 5.2.1.201804062320 4 181931
1#0##0#0#0.0#2018-06-02 13:58:39#0#07:36:43#07:36:43#00:00:00 1
2274758cd15d2abed99e14ceaeebd501 0 0 631490 0 0
1355660 0 0 0 0 1838261 0 0 0 0 0
3201126 B 1 BS 1 19/05/2018 21/05/2018 29/01/1956 0 1
- 0 - 0 - 0 - 0 5005900 4436527 0
3 0 0 0 KARYANTO D344004 62 22756 DR SUPONO SPJP
0138R0170518V006500 0000041115633 3;JKN DR RIZKI; 5.2.1.201804062320
4 181818 1#0##0#0#0.0#2018-06-02
14:00:29#0#00:00:00#00:00:00#00:00:00 1 1546b9b041855b810c036cc136094f08
0 0 503531 0 0 1273756 0 0 0 0
2659240 0 0 0 0 0
3201126 B 1 BS 1 15/05/2018 21/05/2018 05/12/1954 0 1
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 17426245 0 7 0 0 0 DJAU,HARDI DHARMAWAN
0001465377232 3;JKN DR RIZKI; 5.2.1.201804062320 4 180805
1#0##0#0#0.0#2018-06-02 14:04:23#0#17:19:21#17:19:21#12:00:00 1
83f8ed837ece0459d31d67e428d54220 0 9351000 1936084 0 0
4302226 0 0 0 0 1416035 0 0 0 0 420900
3201126 B 1 BS 1 20/05/2018 21/05/2018 29/09/1957 0 2
0 - 0 - 0 - 0 - 0 3247500 5950770
0 2 0 0 0 JUMINTEN D261874 60 22148 DR ZULFAN,
SPPD 0138R0170518V006674 0001301632468 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181960 1#0##0#0#0.0#2018-06-04
15:28:11#0#22:31:22#22:31:22#00:00:00 1 df76612408f224b50009827e1ac3acd4
0 0 1025300 0 0 802167 0 0 0 0
2374303 0 0 0 0 1749000
3201126 B 2 BS 1 20/05/2018 21/05/2018 30/09/1962 0 2
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 59400982 0 2 0 0 0 HARIYATI
0000122520418 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181940
1#0##0#0#0.0#2018-06-04 16:03:05#0#11:40:46#11:40:46#00:00:00 1
2a7833b1cf3a050959e1db10de7a2b2c 0 8986000 8297960 0 0
33272022 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 2 BS 1 18/05/2018 21/05/2018 20/08/2001 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4057496 0 4 0 0 0 ALYA AGUSTIEN
D398850 16 6115 DR ARU, SPPD 0138R0170518V006477
0001658141278 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181806
1#0##0#0#0.0#2018-06-05 09:14:11#0#17:49:42#17:49:42#00:00:00 1
9a2db1c2fea820d797d07fbb1c87e331 0 0 278711 0 0
1504841 0 0 0 0 2103944 0 0 0 0 170000
3201126 B 3 BS 1 19/05/2018 21/05/2018 20/07/2015 0 2
0 0 - 0 - 0 - 0 - 0 8672000
8925923 0 3 0 0 0 NATTAYA TISYA SAMUEL D398971
2 1034 DR MARQUEE KENNY TUMBELAKA SPOT 0138R0170518V006606
0002071676981 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181925
1#0##0#0#0.0#2018-06-05 09:17:02#0#17:03:14#17:03:14#00:00:00 1
cdd2044ff8163e657961925ec6e2f689 0 0 1495700 0 0 818284
0 0 0 0 6466939 0 0 0 0 145000
3201126 B 2 BS 1 04/05/2018 21/05/2018 15/06/1970 0 2
1 E14.4;I11.0 - - - None None None None G-4-17-III None
None None None None None GANGUAN SARAF KRANIAL DAN PERIFER (BERAT)
9167300 0 0 - 0 - 0 - 0 - 0
9167300 54711232 0 18 0 0 0 AISAH D397703 47
DR RIZKI; 5.2.2.201806040537 4 178036 1#0##0#0#0.0#2018-06-05
10:26:52#0#20:42:19#20:42:19#00:00:00 1 84dafbf0eda5935fdd3c5f51686c1cc0
0 0 1197726 0 0 29540506 0 0 0 0
15468000 0 0 0 0 8505000
3201126 B 1 BS 1 14/04/2018 21/05/2018 06/04/2018 0 1
1 J18.9;J99.8;A41.9 96.05;96.72 - - None None None None J-1-
- 0 92864200 1000000 0 38 1 4 100 BY NY DEDE
SUPRIYANTI D395286 0 8 DR AULIA TANGKARI, SPA 0138R0170418V004908
0002449388439 3;JKN irene; 5.2.2.201806040537 4 171586
1#0##0#0#0.0#2018-08-10 12:54:41#0#00:00:00#00:00:00#00:00:00 2
74478a348aca4f9614d97c285f27f223 1000000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 18/05/2018 21/05/2018 02/04/1943 0 2
- 0 - 0 - 0 - 0 2124500 6816936 0
4 0 0 0 SANUDAH D263937 75 27440 DR. ARU ARIADNO,
4 181680 1#0##0#0#0.0#2018-09-10
11:34:57#0#11:27:25#11:27:25#12:00:00 2 c9dc15bd4ce8236fbe1c8f3c8d511de3
0 0 518678 0 0 2702290 0 0 0 0
3595968 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 21/05/2018 10/12/1951 0 2
2954900 0 0 - 0 - 0 - 0 - 0
2954900 5954804 0 8 0 0 0 NURHAYATI ISHAQ
0000060837243 3;JKN DR RIZKI; 5.2.2.201806040537 4 179836
1#0##0#0#0.0#2018-09-10 11:43:34#0#09:06:48#09:06:48#12:00:00 2
99f6d3c65e9c2ac18a0981c0c5e03a31 0 0 672397 0 0
2762840 0 0 0 0 2519567 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 21/05/2018 01/08/1954 0 1
1 A09.9;A49.9;J18.0 87.44 - - None None None None K-4-17-III
(BERAT) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 3084748 0 4 0 0 0 SUKIRMAN D398855
63 23301 DR ARU, SPPD 0138R0170518V006469 0001281348663 3;JKN
DR RIZKI; 5.2.2.201806040537 4 181803 1#0##0#0#0.0#2018-09-10
11:49:14#0#17:22:40#17:22:40#00:00:00 2 f7ab05fb02322cbed3282001d13ebba5
0 0 257183 0 0 1547759 0 0 0 0
1279806 0 0 0 0 0
3201126 B 2 BS 1 16/05/2018 21/05/2018 19/08/1993 0 2
1 D84.9;B58.2 87.03 - - None None None None D-4-14-III None
LAIN-LAIN (BERAT) 7698500 0 0 - 0 - 0 - 0 -
0 7698500 11069063 0 6 0 0 0 SUSANTI
0000387842332 3;JKN DR RIZKI; 5.2.2.201806040537 4 181092
1#0##0#0#0.0#2018-09-25 12:54:57#0#21:11:41#21:11:41#00:00:00 2
c5ebcbaf741da7ce23866db433883e05 0 0 2198259 0 0
5298160 0 0 0 0 3572644 0 0 0 0 0
3201126 B 3 BS 1 17/05/2018 21/05/2018 17/06/1977 0 1
1 S09.7;S06.41;S02.0;G96.1 01.24;99.04 - - None None None
None G-1-10-III None None None None None None KRANIOTOMI (BERAT)
22563700 0 0 - 0 - 0 - 0 - 0
22563700 23562237 0 5 0 0 0 MOH SYAFII D398707
40 14944 DR ARNANDA SPBS 0138R0170518V005579 0001781606114 3;JKN
DR RIZKI; 5.2.1.201804062320 4 181096 1#0##0#0#0.0#2018-09-26
18:09:47#0#02:05:47#02:05:47#00:00:00 2 b9185ccfc35294cc58957c20c4f4db9c
0 6075800 8433836 0 0 6848601 0 0 0 0
1301000 0 0 0 0 903000
3201126 B 2 BS 1 20/05/2018 22/05/2018 08/11/2017 0 1
- 0 - 0 - 0 - 0 3187000 2122092 0
3 0 0 0 AZRIL ARKHANSYAH AN D399030 0 193 DR
NOVIK BUDIWARDHANA, SPA 0138R0170518V006672 0002144757993 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 181958 1#0##0#0#0.0#2018-05-31
16:54:16#0#21:57:46#21:57:46#00:00:00 1 43c79a6f33ced94689aca0a9a555e1a1
0 0 339830 0 0 309934 0 0 0 0
1472328 0 0 0 0 0
3201126 B 2 BS 1 20/05/2018 22/05/2018 07/12/1994 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10626387 0 3 0 0 0 DEWI DAMAYANTI D135814 23
8565 DR RAHMADSYAH SPOG 0138R0170518V006652 0001260129543 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 181947 1#0##0#0#0.0#2018-
05-31 16:55:25#0#00:00:00#00:00:00#00:00:00 1
9d842d3a3f81b7c8dce7ac4f23711c68 0 5269900 2242753 0 0
2036550 0 0 0 0 811184 0 0 0 0 266000
3201126 B 2 BS 1 20/05/2018 22/05/2018 10/05/1981 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 13404339 0 3 0 0 0 SAIDAH D399014
37 13524 DR ARI K, SPOG 0138R0170518V006641 0001741865837 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 181941 1#0##0#0#0.0#2018-
05-31 16:56:11#0#00:00:00#00:00:00#00:00:00 1
d3e6c7d24f94cbb51ce56822777d9b47 0 5269900 2350205 0 0
4525315 0 0 0 0 992919 0 0 0 0 266000
3201126 B 1 BS 1 16/05/2018 22/05/2018 06/09/2007 0 1
1 K56.0;R11 88.76 - - None None None None K-4-15-I None
3705200 0 0 - 0 - 0 - 0 - 0
3705200 9313557 0 7 0 0 0 AHMAD IBRAHIM
0001309148561 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 180825
1#0##0#0#0.0#2018-05-31 17:02:42#0#00:00:00#00:00:00#00:00:00 1
e49ecf37374f716a2480dad8652c28bb 0 0 386468 0 0
2824791 0 0 0 0 6102298 0 0 0 0 0
3201126 B 1 BS 1 20/05/2018 22/05/2018 09/01/1993 0 2
0 0 - 0 - 0 - 0 - 0 6981500
12667113 0 3 0 0 0 NURUL AINI D228840 25 9262
DR ARI KUSUMA JANUARTO, DR. SPOG 0138R0170518V006638 0002428457681
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181939
1#0##0#0#0.0#2018-05-31 17:03:35#0#11:12:49#11:12:49#00:00:00 1
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1900628 0 0 0 0 954690 0 0 0 0 266000
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2405100 0 0 - 0 - 0 - 0 - 0
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0001169983001 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181820
1#0##0#0#0.0#2018-05-31 17:04:50#0#00:00:00#00:00:00#00:00:00 1
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(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
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D228053 68 24885 DR ARU, SPPD 0138R0170518V006598
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1#0##0#0#0.0#2018-05-31 17:08:31#0#15:31:12#15:31:12#00:00:00 1
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3201126 B 1 BS 1 18/05/2018 22/05/2018 11/07/1972 0 1
1 A15.3;J91 - - - None None None None J-4-15-I None
6071100 0 0 - 0 - 0 - 0 - 0
6071100 7455239 0 5 0 0 0 JULFICHER CARLO MASSIE
0002375550786 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181418
1#0##0#0#0.0#2018-05-31 17:11:37#0#02:09:23#02:09:23#00:00:00 1
80165d6f9da181bf12d1e1e0e89c5bda 0 0 599399 0 0
1970214 0 0 0 0 4533726 0 0 0 351900
0
3201126 B 1 BS 1 19/05/2018 22/05/2018 27/12/1976 0 2
1 J45.9;J20.8 90.59;89.52;93.94 - - None None None None J-4-
18-I None None None None None None ASTHMA & BRONKIOLITIS (RINGAN)
3116300 0 0 - 0 - 0 - 0 - 0
3116300 7936971 0 4 0 0 0 DESI ELLIYANA
D026362 41 15118 DR BOBBY SP.P 0138R0170518V006578
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1#1#vvip#4#4820671#0.0#2018-05-31 17:18:09#0#13:41:52#13:41:52#00:00:00
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1747914 0 0 0 0 5645241 0 0 0 0 0
3201126 B 2 BS 1 20/05/2018 22/05/2018 20/05/2018 2853 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1440810 0 3 0 0 0 DEWI DAMAYANTI BY NY
0002460218343 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182190
1#0##0#0#0.0#2018-05-31 17:48:20#0#11:11:33#11:11:33#00:00:00 1
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0 0 0 0 914859 0 0 0 0 0
3201126 B 1 BS 1 20/05/2018 22/05/2018 20/05/2018 2974 1
5118000 0 0 - 0 - 0 - 0 - 0
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d399026 0 0 DR HANDARMI, SPA 0138R0170518V006913
0002448116673 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182163
1#0##0#0#0.0#2018-05-31 17:49:21#0#10:43:11#10:43:11#00:00:00 1
30a35fc76f0e74f4503d9190cf78c538 0 0 480120 0 0 105329
0 0 0 0 1451883 0 0 0 0 0
3201126 B 1 BS 1 17/05/2018 22/05/2018 24/02/1962 0 1
(SEDANG) 8555800 0 0 - 0 - 0 - 0 - 0
8555800 11378406 0 6 0 0 0 NASRULLAH d398789
0001429044827 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181410
1#0##0#0#0.0#2018-05-31 17:51:25#0#21:12:08#21:12:08#00:00:00 1
6356df0b6df08e1651982251b4affdfb 0 0 823022 0 0
4525002 0 0 0 0 5434382 0 0 0 0 596000
3201126 B 3 BS 1 21/05/2018 22/05/2018 12/09/1954 0 2
1 E10.2;I12.0 39.27;99.17 - - None None None None N-1-12-II
- 0 8908800 7810737 0 2 0 0 0 SURATI
0138R0170518V007003 0002258651439 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182303 1#0##0#0#0.0#2018-06-04
08:04:48#0#13:02:09#13:02:09#12:00:00 1 038a3223506f0505d53ba0a9a731516e
0 3438800 1834760 0 0 1881194 0 0 0 0
586983 0 0 0 0 69000
3201126 B 1 BS 1 20/05/2018 22/05/2018 03/04/1999 0 2
1 N39.0;N83.0 - - - None None None None N-4-12-I None
3349800 0 0 - 0 - 0 - 0 - 0
3349800 4009613 0 3 0 0 0 ANASTASIA CHRISTIE
D398289 19 6987 DR ARU, SPPD 0138R0170518V006644
0000049505848 3;JKN DR RIZKI; 5.2.1.201804062320 4 181942
1#0##0#0#0.0#2018-06-04 08:22:08#0#00:00:00#00:00:00#00:00:00 1
177d0a91a215b77a5ae11ce926159af4 0 0 532482 0 0 845820
0 0 0 0 2631311 0 0 0 0 0
3201126 B 1 BS 1 21/05/2018 22/05/2018 10/02/1964 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 15420724 0 2 0 0 0 MAIN D393429
0000041305206 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182572
1#0##0#0#0.0#2018-06-04 08:36:49#0#00:00:00#00:00:00#12:00:00 1
8b1f00845c9ad418413a40e858a69302 0 5550500 1268340 0 0
7448052 0 0 0 0 1084832 0 0 0 0 69000
3201126 B 1 BS 1 21/05/2018 22/05/2018 07/05/1944 0 1
1 T82.4;I12.0;I44.2 39.42 - - None None None None N-1-12-II
- 0 12472300 11093728 0 2 0 0 0 TJOK R
SUDARSANA D390476 74 27042 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V006974 0001842099311 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182285 1#0##0#0#0.0#2018-06-04
08:39:15#0#12:02:35#12:02:35#12:00:00 2 ca26703702c464e5120dc9b140bea4fa
0 5896000 2771961 0 0 1555009 0 0 0 0
801758 0 0 0 0 69000
3201126 B 1 BS 1 21/05/2018 22/05/2018 30/12/1990 0 1
1 C20 45.23 - - None None None None K-4-10-I None None
- 0 - 0 - 0 - 0 6881700 8468877 0
2 0 0 0 HAMZAH MUHAMMAD IHSAN D397168 27 10004 DR.
5.2.1.201804062320 4 182571 1#0##0#0#0.0#2018-06-04
09:06:28#0#00:00:00#00:00:00#00:00:00 1 1b8a8380444ab90f7655d395cc633814
0 0 2032876 0 0 1832462 0 0 0 0
2854539 0 0 0 0 1749000
3201126 B 2 BS 1 21/05/2018 22/05/2018 02/02/1977 0 1
0 - 0 - 0 - 0 - 0 14653000 19899880
0 2 0 0 0 AHMAD TUASAMU D370410 41 15083 DR
TANTIYO S;16137 5.2.1.201804062320 4 181970 1#0##0#0#0.0#2018-
06-04 09:46:00#0#08:00:38#08:00:38#00:00:00 2
1b66c849ff8664111bb7c959eebac770 0 9004000 2930600 0 0
4120280 0 0 0 0 1276000 0 0 0 0
2569000
3201126 B 3 BS 1 21/05/2018 22/05/2018 20/04/1946 0 1
2 A41.9;N18.5 - - - None None None None A-4-10-I None
- 0 - 0 - 0 - 0 2534700 1814281 0
2 0 0 0 WONG JOENG KUAN D189269 72 26329 DR YOHANES
DWINANDA R P 0138R0170518V007183 0001379938307 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182574 1#0##0#0#0.0#2018-06-04
10:54:24#0#18:21:39#18:21:39#00:00:00 1 486644855531d79674bebdd0f3555f11
0 0 126735 0 0 298855 0 0 0 0 477691
0 0 0 0 911000
3201126 B 3 BS 1 21/05/2018 22/05/2018 20/02/1955 0 1
1 G70.0;G82.5;J22 87.44 - - None None None None G-4-11-III
(BERAT) 8922900 0 0 - 0 - 0 - 0 - 0
8922900 2285310 0 2 0 0 0 SOCHIB SANUSI
0001270256556 3;JKN DR RIZKI; 5.2.1.201804062320 4 182584
1#0##0#0#0.0#2018-06-04 11:05:01#0#00:00:00#00:00:00#00:00:00 1
edf89121e51d976a080ce129c24ce6f1 0 0 421658 0 0
1120646 0 0 0 0 615006 0 0 0 0 128000
3201126 B 3 BS 1 21/05/2018 22/05/2018 06/12/1977 0 1
1 M24.54;S62.8 78.60;82.35 - - None None None None M-1-
40-I None None None None None None EKSISI LOKAL DAN PENGANGKATAN ALAT
0 - 0 4315600 9010331 0 2 0 0 0 IMAN
TAUFIK D395661 40 14776 DR MARQUEE KENNY TUMBELAKA SPOT
0138R0170518V006975 0002445681756 3;JKN DR RIZKI; 5.2.1.201804062320
4 182287 1#0##0#0#0.0#2018-06-04
11:48:53#0#12:02:47#12:02:47#00:00:00 1 fa4be81da6f6291e5b494973a85ad85b
0 0 1708368 0 0 1032502 0 0 0 0
6269461 0 0 0 0 0
3201126 B 2 BS 1 20/05/2018 22/05/2018 20/05/2018 2758 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1430709 0 3 0 0 0 SAIDAH BY NY
0002460166222 3;JKN DR RIZKI; 5.2.1.201804062320 4 182139
1#0##0#0#0.0#2018-06-04 12:24:42#0#10:09:40#10:09:40#00:00:00 1
54ff0349ffb771e5af807499cea61703 0 0 414312 0 0 102199
0 0 0 0 914198 0 0 0 0 0
3201126 B 2 BS 1 21/05/2018 22/05/2018 15/08/1978 0 1
1 G40.9;R90.0 87.03 - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 3187000 2427158
0 2 0 0 0 MAHMUD D390290 39 14524 DR NURUL
5.2.1.201804062320 4 182264 1#0##0#0#0.0#2018-06-04
12:26:18#0#00:00:00#00:00:00#12:00:00 1 70b6e800a18d866abe74da5534feb12d
0 0 339830 0 0 892542 0 0 0 0
1194786 0 0 0 0 0
3201126 B 1 BS 1 18/05/2018 22/05/2018 01/01/1966 0 2
1 I63.9;R51 - - - None None None None G-4-14-I None
(RINGAN) 7018400 0 0 - 0 - 0 - 0 - 0
7018400 8584422 0 5 0 0 0 JUMENAH d327153
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181816
1#0##0#0#0.0#2018-06-04 15:07:46#0#21:06:49#21:06:49#00:00:00 1
de8f8bba05440fe09c7c891bc74f8a88 0 0 386918 0 0
4050406 0 0 0 0 4147098 0 0 0 0 0
3201126 B 1 BS 1 22/05/2018 22/05/2018 02/02/1990 0 2
1 O14.1;R31 - - - None None None None W-4-16-II None
0 - 0 - 0 - 0 - 0 4059300 3774932
0 1 0 0 0 ADE DALA MARLINA D088120 28 10336 DR
NELWATI, SPOG 0138R0170518V007212 0002328511522 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182597 1#0##0#0#0.0#2018-06-04
15:08:43#0#00:00:00#00:00:00#00:00:00 1 5989319082b53472ebc2110d2ac05e73
0 0 471337 0 0 1549637 0 0 0 0
1071958 0 0 0 0 682000
3201126 B 2 BS 1 18/05/2018 22/05/2018 29/10/2017 0 1
1 R62.0;R50.9 - - - None None None None E-4-10-I None
- 0 4203300 4807276 0 5 0 0 0 JAFEER ADHAM
MISHALL SUHENO D398897 0 201 DR RIANITA SYAMSU, SPA
0138R0170518V006497 0002375519387 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 181817 1#0##0#0#0.0#2018-06-04
16:16:40#0#00:00:00#00:00:00#00:00:00 1 798318e6248d6c9d976ecb94830804d6
0 0 266858 0 0 1669923 0 0 0 0
2360495 0 0 0 0 510000
3201126 B 2 BS 1 21/05/2018 22/05/2018 22/01/1985 0 2
9649200 0 0 - 0 - 0 - 0 - 0
9649200 12603678 0 2 0 0 0 RATU BILQIUIST R
D381844 33 12172 DR SIDHI,SPU 0138R0170518V006817
0001190520584 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182001
1#0##0#0#0.0#2018-06-04 16:18:48#0#08:20:00#08:20:00#12:00:00 1
bf11b64eb13b6af417ebaac7bfa07ad3 0 7031500 1148308 0 0
474330 0 0 0 0 880540 0 0 0 0
3069000
3201126 B 3 BS 1 21/05/2018 22/05/2018 22/11/1975 0 1
- 0 8908800 8616470 0 2 0 0 0 ALI NURDIN
0138R0170518V007194 0000367599306 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182578 1#0##0#0#0.0#2018-06-04
16:28:43#0#00:00:00#00:00:00#00:00:00 1 252061d22f2e6ba4686a542b5a7cda94
0 0 1853030 0 0 2736946 0 0 0 0
3991994 0 0 0 0 34500
3201126 B 3 BS 1 16/05/2018 22/05/2018 05/12/2017 0 1
- 0 - 0 - 0 - 0 2655900 4301358 0
7 0 0 0 BAYI NY. NUR'AINI D384027 0 162 DR RASTRA,
SPA 0138R0170518V005307 0002318610385 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 180857 1#0##0#0#0.0#2018-06-04
16:35:47#0#09:15:38#09:15:38#12:00:00 1 ac8474749360c6cadff64332bee95bcc
0 0 292031 0 0 1520930 0 0 0 0
2148397 0 0 0 0 340000
3201126 B 3 BS 1 18/05/2018 22/05/2018 13/03/1977 0 2
1 J18.0;I50.0;K30;I25.9 93.94 - - None None None None J-4-
(SEDANG) 5077500 0 0 - 0 - 0 - 0 - 0
5077500 4856194 0 5 0 0 0 DARSINAH D398814
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181751
1#0##0#0#0.0#2018-06-05 09:13:01#0#14:53:05#14:53:05#00:00:00 1
2afe28df14ecb21bf9a23d0d18530b25 0 0 500624 0 0
2696875 0 0 0 0 1658695 0 0 0 0 0
3201126 B 1 BS 1 15/05/2018 22/05/2018 13/12/1950 0 1
1 D29.1;A41.9 60.29 - - None None None None V-1-14-III None
None None None None None PENGANGKATAN PROSTAT MELALUI URETRA (BERAT)
22448400 0 0 - 0 - 0 - 0 - 0
22448400 44110850 0 8 0 0 0 SETYO SOESANTO
0000041413061 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 180341
1#0##0#0#0.0#2018-06-05 10:18:54#0#00:00:00#00:00:00#00:00:00 1
6b3f0670d8f10e3cd1bcf44920c7e643 0 13975600 8530392 0 0
15361147 0 0 0 0 4701711 0 0 0 0
1542000
3201126 B 2 BS 1 19/05/2018 22/05/2018 23/05/1957 0 2
0 - 0 - 0 51950600 71828720 0 4 0 0
0 NANA SURYANA NY D333673 60 22276 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170518V006596 0000042582914 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 181922 1#0##0#0#0.0#2018-08-03
09:41:37#0#15:33:35#15:33:35#00:00:00 3 4bfa0f6a8200c99bdb6677bdeda01a7f
0 9816000 8297960 0 0 44451760 0 0 0 0
1276000 0 0 0 0 7987000
3201126 B 1 BS 1 14/05/2018 22/05/2018 31/12/1947 0 1
1 I50.0;N17.9;E87.5;I95.9 38.95;39.95 - - None None None None
- 0 - 0 27065300 23114346 0 9 1 5 0
SUMARSA D328626 70 25702 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170518V004651 0001435563009 3;JKN irene; 5.2.2.201806040537
4 180310 1#0##0#0#0.0#2018-08-13
09:15:39#0#00:00:00#00:00:00#00:00:00 2 3aa9c0270768ec9fee9691c0c20ca86b
0 9442500 4074139 0 0 6523207 0 0 0 0
1276000 0 0 0 0 1798500
3201126 B 2 BS 1 15/05/2018 22/05/2018 27/04/1970 0 2
4 I63.9;E14.1;I10;G82.5 96.71 - - None None None None J-1-
KOMPLEKS (BERAT) 34963000 0 0 - 0 - 0 - 0 -
0 34963000 29739692 0 8 1 7 24 RISYANTI
0001194073986 3;JKN irene; 5.2.2.201806040537 4 180612
1#0##0#0#0.0#2018-08-13 09:42:03#0#11:56:33#11:56:33#00:00:00 3
6752c0df106f5950811bedbc67510826 0 0 3750300 0 0
11499392 0 0 0 0 8210000 0 0 0 0
6280000
3201126 B 1 BS 1 18/05/2018 22/05/2018 09/07/1953 0 1
1 I64;E14.9;G81.9 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 6844000 6920869 0
5 0 0 0 ISKANDAR D324336 64 23689 DR AL RASYID SPS
0138R0170518V006481 0000037537582 3;JKN DR RIZKI; 5.2.2.201806040537
4 181807 1#0##0#0#0.0#2018-09-10
11:51:07#0#18:40:42#18:40:42#12:00:00 2 089ab635a3a8f710b50c33d058b310a2
0 0 870597 0 0 2012005 0 0 0 0
4038267 0 0 0 0 0
3201126 B 3 BS 1 21/05/2018 22/05/2018 18/04/1949 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 61340370 0 2 0 0 0 H.BUCHORI
0001739971956 3;JKN DR RIZKI; 5.2.2.201806040537 4 181972
1#0##0#0#0.0#2018-09-10 11:52:58#0#00:00:00#00:00:00#12:00:00 2
51953237fe08e05340b6115228ba8458 0 7996000 5144120 0 0
39355250 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 17/05/2018 22/05/2018 04/01/1937 0 2
1 I13.2;K21.9;E87.5 93.94;87.44 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
5500981 0 6 0 0 0 ROHINI D398803 81 29718
SRI KUNMARTINI.DR,SPPD 0138R0170518V006003 0001014503411 3;JKN DR
RIZKI; 5.2.2.201806040537 4 181416 1#0##0#0#0.0#2018-09-12
11:05:20#0#22:51:59#22:51:59#00:00:00 3 b9f33dc9c2d2326f97f221e84a69b443
0 0 374804 0 0 3425300 0 0 0 0
1700877 0 0 0 0 0
3201126 B 3 BS 1 14/05/2018 23/05/2018 31/12/1950 0 1
1 I21.3;R57.0;I48;I11.0 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 24287791 0 10 0 0 0 NIWAN D371788 67
24606 DR SUPONO 0138R0170518V004820 0002197426263 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 180448 1#0##0#0#0.0#2018-06-04
07:58:54#0#09:47:01#09:47:01#12:00:00 1 2ddb18b524c0ea7e88e1b41139495905
0 0 905952 0 0 9509839 0 0 0 0
8473000 0 0 0 0 5399000
3201126 B 3 BS 1 22/05/2018 23/05/2018 01/03/1968 0 1
1 I12.0;N13.3 - - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 1658705 0 2 0 0 0 HERMAN d399168
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183024
1#0##0#0#0.0#2018-06-04 08:12:44#0#00:00:00#00:00:00#00:00:00 1
a61d21f4df5c70be50deafe6e7937cd0 0 0 351242 0 0 646950
0 0 0 0 660513 0 0 0 0 0
3201126 B 3 BS 1 21/05/2018 23/05/2018 04/04/1977 0 2
LAIN-LAIN (SEDANG) 3857000 0 0 - 0 - 0 - 0
- 0 3857000 3949942 0 3 0 0 0 SAFITRI
0000512820685 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182581
1#0##0#0#0.0#2018-06-04 08:15:47#0#00:00:00#00:00:00#00:00:00 1
d61c3656b6e4b36d69495e80e6490959 0 0 400130 0 0
2562905 0 0 0 0 986907 0 0 0 0 0
3201126 B 2 BS 1 21/05/2018 23/05/2018 14/07/1959 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 5206369 0 3 0 0 0 SARJANI D339833
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182579
1#0##0#0#0.0#2018-06-04 09:08:01#0#20:30:32#20:30:32#00:00:00 1
dfe41e3c648d06d94e51424d209e9aa4 0 0 446265 0 0
1801750 0 0 0 0 2830354 0 0 0 0 128000
3201126 B 2 BS 1 22/05/2018 23/05/2018 06/06/1960 0 1
- 0 - 0 23198900 19002502 0 2 0 0 0
PAMBUDI D392026 57 21169 SRI KUNMARTINI.DR,SPPD
0138R0170518V007431 0001300191445 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182976 1#0##0#0#0.0#2018-06-04
09:12:09#0#12:25:46#12:25:46#12:00:00 1 b2987d46e28dc672efa048fb207a5820
0 4911100 4878371 0 0 7888031 0 0 0 0
1256000 0 0 0 0 69000
3201126 B 2 BS 1 20/05/2018 23/05/2018 27/12/1956 0 2
1 I50.0;A49.9;H81.1 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
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(RINGAN) 8041000 0 0 - 0 - 0 - 0 - 0
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1854980 0 0 0 0 948953 0 0 0 0
3069000
3201126 B 3 BS 1 22/05/2018 23/05/2018 07/11/2012 0 1
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LP D398787 5 2022 DR CATUR SUZANTARA 0138R0170518V007260
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3201126 B 3 BS 1 23/05/2018 23/05/2018 31/12/1943 0 2
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0 - 0 8672200 3512055 0 1 0 0 0 UNTUNG
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1#0##0#0#0.0#2018-06-04 11:32:36#0#11:06:37#11:06:37#00:00:00 1
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2061719 0 0 0 0 0
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None None K-4-12-II None None None None None None GANGGUAN ESOFAGUS
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1749000
3201126 B 1 BS 1 20/05/2018 23/05/2018 27/02/1950 0 1
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1#0##0#0#0.0#2018-06-04 15:04:43#0#08:57:38#08:57:38#00:00:00 1
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4308000
3201126 B 1 BS 1 21/05/2018 23/05/2018 09/05/1955 0 2
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3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182119
1#0##0#0#0.0#2018-06-04 15:10:58#0#09:54:29#09:54:29#00:00:00 1
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1301000 0 0 0 0 69000
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1#0##0#0#0.0#2018-06-04 15:26:51#0#20:11:04#20:11:04#00:00:00 1
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3201126 B 2 BS 1 20/05/2018 23/05/2018 31/05/1976 0 1
1 K80.8;K76.0;R11 90.59;89.52;88.76 - - None None None None
B-4-14-II None None None None None None GANGGUAN SALURAN EMPEDU LAIN-
LAIN (SEDANG) 5879600 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-06-04 16:07:42#0#00:00:00#00:00:00#00:00:00 1
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1603677 0 0 0 0 2342229 0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 23/05/2018 17/09/1952 0 1
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 8052637 0 8 0 0 0 YURSAL DAHLAN
D398664 65 23982 DR CATUR BANUAJI SPS 0138R0170518V005371
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1#0##0#0#0.0#2018-06-04 16:25:26#0#00:00:00#00:00:00#00:00:00 1
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1670000
3201126 B 3 BS 1 18/05/2018 23/05/2018 14/03/2015 0 1
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D360737 3 1161 DR CATUR S, SPB 0138R0170518V006489
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1#0##0#0#0.0#2018-06-04 16:32:47#0#19:39:05#19:39:05#00:00:00 1
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4115178 0 0 0 0 865527 0 0 0 0 298000
3201126 B 2 BS 1 21/05/2018 23/05/2018 21/05/2018 2607 2
4386800 0 0 - 0 - 0 - 0 - 0
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0 0 DR HANDARMI, SPA 0138R0170518V007426 0002451320111 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 182974
1#1#kelas_1#3#731200#0.0#2018-06-05 09:25:46#0#12:15:52#12:15:52#00:00:00
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76539 0 0 0 0 2635290 0 0 0 0 0
3201126 B 1 BS 1 22/05/2018 23/05/2018 26/05/1958 0 2
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TIERA, SPU 0138R0170518V007355 0000040857917 3;JKN irene;
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09:20:31#0#09:46:08#09:46:08#12:00:00 2 ceb5be143e860c21f95bea7430acff0d
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1752132 0 0 0 0 0
3201126 B 3 BS 1 18/05/2018 23/05/2018 18/05/2018 1885 1
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ANAH D398893 0 0 DR AULIA TANGKARI, SPA 0138R0170518V007122
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1#0##0#0#0.0#2018-08-13 10:38:47#0#00:00:00#00:00:00#00:00:00 2
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2267000
3201126 B 3 BS 1 23/05/2018 23/05/2018 02/12/1945 0 1
4 I67.9;E14.1;I50.0;R57.0 99.60 - - None None None None G-4-
LAIN-LAIN (BERAT) 6240100 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-08-13 10:49:45#0#09:55:12#09:55:12#00:00:00 2
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1#0##0#0#0.0#2018-09-10 12:03:55#0#00:00:00#00:00:00#00:00:00 2
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7987000
3201126 B 2 BS 1 21/05/2018 23/05/2018 20/07/1968 0 2
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DR SUPONO SPJP 0138R0170518V007205 0000044161918 3;JKN DR RIZKI;
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12:09:00#0#00:00:00#00:00:00#00:00:00 3 01e9627ef91910731b6639d41c71ec07
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None O-6-10-II None None None None None None OPERASI PEMBEDAHAN
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2273962 0 0 0 0 772331 0 0 0 0 453000
3201126 B 3 BS 1 17/05/2018 23/05/2018 25/08/1951 0 1
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DR PRIYO SUNARTO , SPJP 0138R0170518V005970 0001794942854 3;JKN DR
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12:18:43#0#17:41:12#17:41:12#00:00:00 2 b115591e8df9db1e9d587909e38f9fd5
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D091333 38 14135 DR ENDANG T. K, SPOG 0138R0170518V006664
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1#1#vvip#3#24063094#0.0#2018-09-12 10:49:35#0#00:00:00#00:00:00#00:00:00
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197000
3201126 B 1 BS 1 21/05/2018 23/05/2018 07/07/1957 0 2
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1#0##0#0#0.0#2018-09-25 12:24:40#0#00:00:00#00:00:00#12:00:00 2
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29884060 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 22/05/2018 23/05/2018 12/10/1940 0 2
1 I13.1;T82.4 39.42 - - None None None None N-1-12-III None
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-09-25 14:31:28#0#23:05:06#23:05:06#00:00:00 2
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3201126 B 1 BS 1 19/05/2018 23/05/2018 15/10/1950 0 2
1 I64;R13;G81.9;A41.9 - - - None None None None G-4-
- 0 - 0 - 0 - 0 9659700 7710131 0
5 0 0 0 SALMIATI D398943 67 24688 DR HARDI PRANATA
4 181924 1#0##0#0#0.0#2018-09-26
18:12:22#0#15:58:36#15:58:36#00:00:00 2 3ed0f53a69ca573d161cea6e56cab937
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4435401 0 0 0 0 0
3201126 B 1 BS 1 20/05/2018 23/05/2018 22/10/1973 0 1
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20-I None None None None None None PROSEDUR SALURAN URIN ATAS (RINGAN)
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0001618065786 3;JKN DR RIZKI; 5.2.1.201804062320 4 181935
1#0##0#0#0.0#2018-10-02 10:56:56#0#08:52:42#08:52:42#00:00:00 5
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3306827 0 0 0 0 16691000 0 0 0 0 0
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6981500 0 0 - 0 - 0 - 0 - 0
6981500 19503747 0 4 0 0 0 TRI OKTAVIANI
D399149 22 8238 DR FX BHIMANTORO, SPOG 0138R0170518V007202
0001737319702 3;JKN DR RIZKI; 5.2.1.201804062320 4 182587
1#1#vvip#4#12522247#0.0#2018-06-02 10:14:12#0#22:12:06#22:12:06#00:00:00
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325000
3201126 B 3 BS 1 22/05/2018 24/05/2018 08/06/1977 0 2
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1#0##0#0#0.0#2018-06-04 08:03:01#0#23:56:49#23:56:49#00:00:00 1
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3201126 B 3 BS 1 21/05/2018 24/05/2018 15/12/1956 0 1
1 E14.5;M86.56 86.69;84.11 - - None None None None L-1-
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0001772148969 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182575
1#0##0#0#0.0#2018-06-04 08:20:25#0#19:38:47#19:38:47#12:00:00 1
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2143855 0 0 0 0 787772 0 0 0 0 69000
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D399201 0 0 DR RASTRA, SPA 0138R0170518V007939
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1#0##0#0#0.0#2018-06-04 08:21:03#0#12:38:39#12:38:39#00:00:00 1
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3201126 B 3 BS 1 22/05/2018 24/05/2018 05/09/1967 0 2
1 A01.0;K30;R51 - - - None None None None A-4-14-I
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0001840181016 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183190
1#0##0#0#0.0#2018-06-04 08:21:17#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 1 BS 1 22/05/2018 24/05/2018 06/06/2015 0 1
1 E86;R11 - - - None None None None E-4-11-I None
4136800 0 0 - 0 - 0 - 0 - 0
4136800 2392747 0 3 0 0 0 CANGGIH HAFIZH
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0001890804958 3;JKN DR RIZKI; 5.2.1.201804062320 4 184455
1#0##0#0#0.0#2018-06-04 08:36:29#0#00:00:00#00:00:00#00:00:00 2
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3201126 B 1 BS 1 22/05/2018 24/05/2018 22/05/2018 3488 2
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d399203 0 0 DR RASTRA, SPA 0138R0170518V008344
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1#1#vip#3#0#0.0#2018-06-04 08:40:20#0#09:11:28#09:11:28#00:00:00 1
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3201126 B 1 BS 1 22/05/2018 24/05/2018 03/04/1952 0 1
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D341984 66 24155 DR ARU, SPPD 0138R0170518V007669
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1#0##0#0#0.0#2018-06-04 08:41:18#0#00:00:00#00:00:00#00:00:00 1
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1191247 0 0 0 0 1817151 0 0 0 0 0
3201126 B 1 BS 1 21/05/2018 24/05/2018 31/12/1988 0 2
1 M51.1;M62.35 - - - None None None None M-4-17-I
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
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5058500 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-06-04 08:49:19#0#09:13:24#09:13:24#00:00:00 1
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7569000
3201126 B 1 BS 1 23/05/2018 24/05/2018 05/01/1951 0 1
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7569000
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12840969 0 3 0 0 0 SRI WULANDARI D324566 32
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 182595
1#0##0#0#0.0#2018-06-04 08:59:14#0#00:32:43#00:32:43#00:00:00 1
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1#0##0#0#0.0#2018-06-04 09:09:39#0#00:00:00#00:00:00#12:00:00 1
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HUDA HILMAN 0138R0170518V007193 0002235358978 3;JKN TANTIYO S;16137
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09:10:19#0#00:00:00#00:00:00#00:00:00 1 1a3e3baba3ddb772fc37deb0065ef4b4
0 0 339830 0 0 1107684 0 0 0 0
2068521 0 0 0 0 0
3201126 B 2 BS 1 23/05/2018 24/05/2018 16/05/1976 0 1
1 N23 - - - None None None None N-4-13-I None None
0 - 0 - 0 - 0 4101100 1638457 0 2
0 0 0 HENDRO RIKIRIANTO D399293 42 15347 DR SIDDHI ANDIKA,
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5.2.1.201804062320 4 183637 1#0##0#0#0.0#2018-06-04
09:47:08#0#00:00:00#00:00:00#00:00:00 1 e8941f5ca17489f2da5c28388a5424d4
0 0 475099 0 0 227669 0 0 0 0 935689
0 0 0 0 0
3201126 B 2 BS 1 22/05/2018 24/05/2018 14/06/1993 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10294652 0 3 0 0 0 ANNISA UKHTI MUSLIMAH D032318
0001471518922 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183200
1#0##0#0#0.0#2018-06-04 09:48:13#0#00:00:00#00:00:00#00:00:00 1
60ef33d5670eba88fac4fd3a2943794e 0 5062400 2090753 0 0
2155017 0 0 0 0 789482 0 0 0 0 197000
3201126 B 3 BS 1 23/05/2018 24/05/2018 16/04/1955 0 1
0 - 0 - 0 - 0 - 0 4144700 1859849
0 2 0 0 0 ROJAK SAMAD D345953 63 23048 DR AGOES
5.2.1.201804062320 4 183218 1#0##0#0#0.0#2018-06-04
11:08:41#0#07:48:14#07:48:14#00:00:00 1 0f40c86d63f273784c1ce1722253b9c0
0 0 426023 0 0 760154 0 0 0 0 673672
0 0 0 0 0
3201126 B 3 BS 1 23/05/2018 24/05/2018 03/07/1955 0 1
- 0 - 0 19332400 8186801 0 2 0 0 0
SANWANIH D398117 62 22970 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V008079 0001210525896 3;JKN DR RIZKI; 5.2.1.201804062320
4 183630 1#0##0#0#0.0#2018-06-04
11:20:37#0#00:00:00#00:00:00#00:00:00 1 9b5c4821007181f131eb4faa78cffb51
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4075385 0 0 0 0 69000
3201126 B 3 BS 1 23/05/2018 24/05/2018 16/09/1947 0 1
1 N18.3;A41.9;R57.2 - - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 4248157 0 2 0 0 0 SUPARMAN
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1#0##0#0#0.0#2018-06-04 11:24:48#0#16:12:59#16:12:59#00:00:00 1
73579a4d06d186d6a43040b9e0957cf4 0 0 303885 0 0
3377355 0 0 0 0 566917 0 0 0 0 0
3201126 B 3 BS 1 24/05/2018 24/05/2018 04/02/1957 0 2
1 E11.2;K21.9 - - - None None None None N-4-16-I None
(RINGAN) 3695900 0 0 - 0 - 0 - 0 - 0
3695900 1563985 0 1 0 0 0 IFAH LATIFAH
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1#0##0#0#0.0#2018-06-04 11:27:19#0#14:25:27#14:25:27#12:00:00 1
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0 0 0 0 391317 0 0 0 0 0
3201126 B 3 BS 1 22/05/2018 24/05/2018 05/07/1967 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 7379127 0 3 0 0 0 SADIYAH
0000367911652 3;JKN DR RIZKI; 5.2.1.201804062320 4 183197
1#0##0#0#0.0#2018-06-04 11:37:36#0#00:00:00#00:00:00#00:00:00 1
afa4cff00a55958fc6e5adcc1d2b5c1b 0 0 974100 0 0
2271980 0 0 0 0 4064047 0 0 0 0 69000
3201126 B 2 BS 1 22/05/2018 24/05/2018 31/10/1952 0 1
None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN KAKI (RINGAN)
18306300 0 0 - 0 - 0 - 0 - 0
18306300 14400035 0 3 0 0 0 NURSAL CHANDRA
0138R0170518V007518 0001312201438 3;JKN DR RIZKI; 5.2.1.201804062320
4 183051 1#0##0#0#0.0#2018-06-04
12:49:20#0#14:27:03#14:27:03#12:00:00 1 eb795e927f3c61868321dfe0986857dc
0 0 5125764 0 0 2557213 0 0 0 0
6613558 0 0 0 0 103500
3201126 B 2 BS 1 22/05/2018 24/05/2018 07/03/1969 0 2
1 E11.2;A49.9;I11.9 39.27 - - None None None None N-1-12-I
- 0 5208600 13668408 0 3 0 0 0 ROSADAH
0001620598983 3;JKN DR RIZKI; 5.2.1.201804062320 4 182978
1#0##0#0#0.0#2018-06-04 12:56:27#0#12:51:56#12:51:56#00:00:00 1
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2444742 0 0 0 0 6276295 0 0 0 0 69000
3201126 B 1 BS 1 22/05/2018 24/05/2018 07/06/2016 0 1
1 P83.5 61.2 - - None None None None V-1-12-I None None
(RINGAN) 12096300 0 0 - 0 - 0 - 0 - 0
12096300 11689315 0 3 0 0 0 ALBY EZRA FEBRIEL
0002208150369 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183192
1#0##0#0#0.0#2018-06-05 09:19:22#0#00:00:00#00:00:00#12:00:00 1
fea055b6f7aa2e17582937c6393f2243 0 6259500 3386964 0 0
1153129 0 0 0 0 820722 0 0 0 0 69000
3201126 B 3 BS 1 21/05/2018 24/05/2018 06/07/1949 0 1
1 I50.0;J18.0 93.94 - - None None None None I-4-12-III None
0 - 0 - 0 - 0 - 0 4973600 6752156
0 4 0 0 0 ASMAWIH D399148 68 25156 DR ARU, SPPD
0138R0170518V007192 0000061115196 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182576 1#0##0#0#0.0#2018-06-05
09:36:33#0#00:00:00#00:00:00#00:00:00 1 0da8c68f080076d425076886df2b6c50
0 0 374804 0 0 3131122 0 0 0 0
3246230 0 0 0 0 0
3201126 B 2 BS 1 20/05/2018 24/05/2018 15/04/1990 0 2
0 0 - 0 - 0 - 0 - 0 5984100
25681976 0 5 0 0 0 MURNI D157064 28 10262 DR
NELWATI, SPOG 0138R0170518V006661 0001293594996 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 181953 1#1#vvip#5#19697876#0.0#2018-06-05
10:23:15#0#00:00:00#00:00:00#00:00:00 1 f7ac7aa467f2536758c3ccd478f23132
0 8973200 9470300 0 0 5642665 0 0 0 0
1398811 0 0 0 0 197000
3201126 B 3 BS 1 24/05/2018 24/05/2018 25/05/1942 0 1
2955200 0 0 - 0 - 0 - 0 - 0
2955200 2424257 0 1 0 0 0 M DJUSA D399361
75 27758 DR LIDYA SANTALIA 0138R0170518V008528 0001264971688 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 184155 1#0##0#0#0.0#2018-
06-05 10:25:58#0#16:36:35#16:36:35#00:00:00 1
f72eb3555a0c05f7697a50f97fcb066f 0 0 206865 0 0
1769796 0 0 0 0 447596 0 0 0 0 0
3201126 B 3 BS 1 11/05/2018 24/05/2018 15/06/2017 0 2
1 I95.9;A41.9;A09.0;R50.9;J99.8;E42 - - - None None None
- 0 8139800 28540620 0 14 1 2 0 AZIZIAH
SALSABILA RAMADHANI D391380 0 330 DR NOVIK BUDIWARDHANA, SPA
0138R0170518V003886 0002435462616 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 179652 1#0##0#0#0.0#2018-06-05
10:28:57#0#21:30:33#21:30:33#00:00:00 1 f1c8ae0108f1647ef2af1ad198acd0d4
0 0 866980 0 0 11478140 0 0 0 0
10476500 0 0 0 0 5719000
3201126 B 1 BS 1 23/05/2018 24/05/2018 28/06/1960 0 2
1 I13.1;A49.9;K21.9 39.27 - - None None None None N-1-12-I
- 0 6076700 11112165 0 2 0 0 0 NUR HIDAYAH
0000039771437 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 183541
1#0##0#0#0.0#2018-08-04 14:53:35#0#13:51:36#13:51:36#00:00:00 2
e54c2bd2c0306a463925623e5f9724c1 0 6468200 1321340 0 0
2450661 0 0 0 0 802964 0 0 0 0 69000
3201126 B 3 BS 1 23/05/2018 24/05/2018 22/12/1967 0 1
- 0 8908800 10014067 0 2 0 0 0 WAHYU
WINDRADI D399274 50 18415 SRI KUNMARTINI.DR,SPPD 0138R0170518V008001
0002375862524 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 183550
1#0##0#0#0.0#2018-08-04 14:54:55#0#14:01:24#14:01:24#00:00:00 2
7832a72910025cf48e86918a28fd247e 0 3062500 1923848 0 0
4227593 0 0 0 0 731126 0 0 0 0 69000
3201126 B 1 BS 1 19/05/2018 24/05/2018 05/08/2006 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 6867819 0 6 0 0 0 AUREAL NAWRAH PURNAMA
C209689 11 4305 DR RASTRA, SPA 0138R0170518V006612
0001335362578 3;JKN irene; 5.2.2.201806040537 4 181926
1#0##0#0#0.0#2018-08-13 09:25:24#0#19:52:11#19:52:11#00:00:00 2
085b43c45b764e26b60c6bf2f841a6db 0 0 316331 0 0
1055691 0 0 0 0 4815797 0 0 0 0 680000
3201126 B 2 BS 1 19/05/2018 24/05/2018 03/03/1961 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 13663333 0 6 0 0 0 MASWPUL D398993
3;JKN DR RIZKI; 5.2.2.201806040537 4 182084 1#0##0#0#0.0#2018-
09-10 11:16:22#0#09:18:03#09:18:03#00:00:00 2
a0f6a82bf97580a7ac3a9c525a969023 0 6363600 2951810 0 0
3274560 0 0 0 0 969863 0 0 0 0 103500
3201126 B 3 BS 1 21/05/2018 24/05/2018 23/11/2017 0 1
0 - 0 - 0 - 0 - 0 2225900 3820883
0 4 0 0 0 MUHAMMAD ADRIEL F AN D399046 0 179
DR RASTRA, SPA 0138R0170518V006683 0002313026684 3;JKN DR RIZKI;
5.2.2.201806040537 4 181966 1#0##0#0#0.0#2018-09-10
11:18:51#0#01:19:25#01:19:25#00:00:00 3 d42fb4887122d6820fb3610f5f2af450
0 0 378188 0 0 1944731 0 0 0 0
1327964 0 0 0 0 170000
3201126 B 2 BS 1 23/05/2018 24/05/2018 17/10/1985 0 1
1 Z53.0;K40.9;I13.2 - - - None None None None Z-4-12-III
KESEHATAN LAIN-LAIN (BERAT) 7274400 0 0 - 0 - 0 -
0 - 0 7274400 4401354 0 2 0 0 0 SAPRUL
HADI SATRIA D319169 32 11906 E. SURYA POHAN 0138R0170518V007694
0001281304427 3;JKN DR RIZKI; 5.2.2.201806040537 4 183212
1#0##0#0#0.0#2018-09-10 12:25:48#0#00:00:00#00:00:00#00:00:00 2
48ef3a143ab809b09ac62d03d6848631 0 0 400130 0 0
1521035 0 0 0 0 2480189 0 0 0 0 0
3201126 B 3 BS 1 20/05/2018 24/05/2018 11/08/1958 0 2
1 E14.8;J22;R63.0 - - - None None None None E-4-10-I
0 - 0 3502700 5395363 0 5 0 0 0 HAYATI
D399036 59 21832 DR ARU, SPPD 0138R0170518V006667 000173402831
3;JKN DR RIZKI; 5.2.2.201806040537 4 181955 1#0##0#0#0.0#2018-
09-29 12:37:26#0#21:35:27#21:35:27#00:00:00 2
9b3bb937d0a5d08929e480af280d745d 0 0 616661 0 0
3171234 0 0 0 0 1607468 0 0 0 0 0
3201126 B 1 BS 1 23/05/2018 25/05/2018 18/07/1995 0 2
1 D24 85.21;85.12 - - None None None None L-1-50-I None
0 0 - 0 - 0 - 0 - 0 9150100
12326291 0 3 0 0 0 WIDI NINGTYAS PANGESTI D204505
3;JKN DR RIZKI; 5.2.1.201804062320 4 183640 1#0##0#0#0.0#2018-
06-02 09:00:48#0#00:00:00#00:00:00#00:00:00 1
3c259262fcb09083c2977008ba0ccb6f 0 6241500 2562028 0 0
2325370 0 0 0 0 907393 0 0 0 0 290000
3201126 B 1 BS 1 24/05/2018 25/05/2018 13/11/1952 0 1
1 A41.9;E11.2 - - - None None None None A-4-10-II None
None None None None None SEPTIKEMIA (SEDANG) 6062400 0 0
- 0 - 0 - 0 - 0 6062400 3413933 0
2 0 0 0 SUJATMAN HADI SANTOSO D391530 65 23933 SRI
KUNMARTINI.DR,SPPD 0138R0170518V008418 0000036424719 3;JKN DR RIZKI;
5.2.1.201804062320 4 183997 1#0##0#0#0.0#2018-06-02
09:03:53#0#12:15:27#12:15:27#12:00:00 1 9d2aba83951e64bed17f012fe1c46c90
0 0 818792 0 0 783800 0 0 0 0
1811341 0 0 0 0 0
3201126 B 2 BS 1 25/05/2018 25/05/2018 08/08/1977 0 1
- 0 10690500 10822908 0 1 0 0 0 NURDIN
0001238945692 3;JKN DR RIZKI; 5.2.1.201804062320 4 184167
1#0##0#0#0.0#2018-06-02 09:14:55#0#00:27:45#00:27:45#00:00:00 1
a5e7ad95c3d9f009616a083135da5a60 0 0 2298005 0 0
3647762 0 0 0 0 4808141 0 0 0 0 69000
3201126 B 1 BS 1 23/05/2018 25/05/2018 23/05/2018 3040 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1818592 0 3 0 0 0 CHAERUNIDA ANGGUN S BY
NY D399327 0 0 DR TRI LESTARI, SPA 0138R0170518V008767
0002461642288 3;JKN DR RIZKI; 5.2.1.201804062320 4 184266
1#0##0#0#0.0#2018-06-04 08:23:08#0#10:38:36#10:38:36#00:00:00 1
888de726e2e7b01ec2a1f6beac9459dc 0 0 499620 0 0 88899
0 0 0 0 1230073 0 0 0 0 0
3201126 B 1 BS 1 21/05/2018 25/05/2018 27/02/1960 0 1
1 N21.0;D29.1;N35.8 57.0;59.8;58.22;58.5 - - None None None
None N-1-40-I None None None None None None PROSEDUR PADA URETRA DAN
- 0 11257400 22746056 0 5 0 0 0 FIRDAUS
PERMANA D393050 58 21268 DR SIDDHI ANDIKA, SPU 0138R0170518V006824
0001728982664 3;JKN DR RIZKI; 5.2.1.201804062320 4 182022
1#0##0#0#0.0#2018-06-04 08:27:12#0#08:34:22#08:34:22#12:00:00 1
245a270e72770ac80b540352569e6c40 0 11174600 3264646 0 0
3667810 0 0 0 0 1301000 0 0 0 0
3338000
3201126 B 1 BS 1 23/05/2018 25/05/2018 08/09/1992 0 2
(RINGAN) 6981500 0 0 - 0 - 0 - 0 - 0
6981500 11943896 0 3 0 0 0 CHAERUNIDA ANGGUN
SEPTIANI D399316 25 9388 DR ARIS WAHJU, SPOG 0138R0170518V008174
0000208198045 3;JKN DR RIZKI; 5.2.1.201804062320 4 183639
1#0##0#0#0.0#2018-06-04 08:34:24#0#00:00:00#00:00:00#00:00:00 1
6a068848b346f5e427e4290aad99ff36 0 6753400 2480710 0 0
1605410 0 0 0 0 907376 0 0 0 0 197000
3201126 B 1 BS 1 20/05/2018 25/05/2018 26/07/1945 0 2
1 E13.6;I10;R63.0 87.44 - - None None None None E-4-10-I
0 - 0 4903800 7949845 0 6 0 0 0
KAROLAND SILITONGA D300807 72 26596 DR ARU, SPPD
0138R0170518V006653 0000045040149 3;JKN DR RIZKI; 5.2.1.201804062320
4 181948 1#0##0#0#0.0#2018-06-04
08:38:01#0#00:00:00#00:00:00#00:00:00 1 c41360bfa975aca248f7a186bc470f2a
0 0 494342 0 0 2223420 0 0 0 0
5232083 0 0 0 0 0
3201126 B 3 BS 1 22/05/2018 25/05/2018 27/08/1990 0 2
0 0 - 0 - 0 - 0 - 0 2392700
3491070 0 4 0 0 0 SITI FATIMAH D399171 27
10130 DR MOHAMMAD JOHAN SPU 0138R0170518V007667 0000814014718 3;JKN
DR RIZKI; 5.2.1.201804062320 4 183201 1#0##0#0#0.0#2018-06-04
11:12:38#0#00:00:00#00:00:00#00:00:00 1 eae0664a6dd799b28aa0d23325451d44
0 0 377647 0 0 2070035 0 0 0 0
1043388 0 0 0 0 0
3201126 B 3 BS 1 23/05/2018 25/05/2018 11/12/1967 0 1
1 I20.0;I50.0;I48;E11.5 89.52;90.59 - - None None None None
I-4-20-II None None None None None None ANGINA PEKTORIS DAN NYERI
DADA (SEDANG) 4854000 0 0 - 0 - 0 - 0 -
0 4854000 6116183 0 3 1 2 0 MULYANA
d381131 50 18426 DR EKA GINANJAR SPPD 0138R0170518V007696
0001457567932 3;JKN DR RIZKI; 5.2.1.201804062320 4 183213
1#0##0#0#0.0#2018-06-04 11:23:28#0#05:39:53#05:39:53#12:00:00 1
4bf34f416722efb138e5d1c512004fca 0 0 632429 0 0
2290630 0 0 0 0 2435124 0 0 0 0 758000
3201126 B 3 BS 1 22/05/2018 25/05/2018 01/03/1958 0 1
0 0 - 0 - 0 - 0 - 0 3575600
3111192 0 4 0 0 0 SAIFUL D387312 60 21997
DR CELLY ANANTARIA. SPJP 0138R0170518V007662 0001014240396 3;JKN
DR RIZKI; 5.2.1.201804062320 4 183199 1#0##0#0#0.0#2018-06-04
11:35:25#0#00:00:00#00:00:00#12:00:00 1 1cff5afa7caa837867f62c5209622c94
0 0 480804 0 0 1435352 0 0 0 0
1195036 0 0 0 0 0
3201126 B 3 BS 1 21/05/2018 25/05/2018 08/10/2016 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 3033633 0 5 0 0 0 MAHESA ARYA SAPUTRA
D399095 1 590 DR RASTRA, SPA 0138R0170518V007335
0002067466217 3;JKN DR RIZKI; 5.2.1.201804062320 4 182707
1#0##0#0#0.0#2018-06-04 11:50:31#0#08:53:14#08:53:14#00:00:00 1
d29520b26b636eefbf31b206c0f12218 0 0 281492 0 0 872679
0 0 0 0 1539462 0 0 0 0 340000
3201126 B 2 BS 1 21/05/2018 25/05/2018 23/03/1940 0 1
1 I63.9;J18.9;G81.9;R47.0 87.03;87.44 - - None None None None
0 - 0 10406600 14774447 0 5 1 2 0 DADANG
HERMAN TN D399048 78 28548 DR MAYSAM I., SPS 0138R0170518V006687
0000060765399 3;JKN DR RIZKI; 5.2.1.201804062320 4 181967
1#0##0#0#0.0#2018-06-04 12:23:16#0#03:09:28#03:09:28#00:00:00 1
7ce020ff1525c716cdd567b7f9c22a3d 0 0 920220 0 0
6779274 0 0 0 0 4800953 0 0 0 0
2274000
3201126 B 2 BS 1 23/05/2018 25/05/2018 27/07/1939 0 2
1 K92.1;D64.9 99.04 - - None None None None K-4-18-II None
2941900 0 0 - 0 - 0 - 0 - 0
2941900 5048416 0 3 0 0 0 MIMI SURATMI
D396672 78 28790 DR ARU, SPPD 0138R0170518V007683
0000060818578 3;JKN DR RIZKI; 5.2.1.201804062320 4 183208
1#0##0#0#0.0#2018-06-04 12:25:26#0#00:00:00#00:00:00#00:00:00 1
e411c72b826e0a1e32c65fa987daf1e0 0 0 869596 0 0
2307550 0 0 0 0 1871270 0 0 0 0 0
3201126 B 2 BS 1 23/05/2018 25/05/2018 20/01/1959 0 1
1 A49.9;A41.9;N18.5;D63.8;I50.0 99.04 - - None None None None
A-4-14-II None None None None None None PENYAKIT INFEKSI BAKTERI DAN
PARASIT LAIN-LAIN (SEDANG) 3304700 0 0 - 0 - 0 -
0 - 0 3304700 4051643 0 3 0 0 0 MOKH.
MASKUR D392480 59 21673 SRI KUNMARTINI.DR,SPPD 0138R0170518V008173
0001882347118 3;JKN DR RIZKI; 5.2.1.201804062320 4 183638
1#0##0#0#0.0#2018-06-04 12:27:34#0#00:00:00#00:00:00#12:00:00 1
cde66d19a261d02da4534840aa525cf4 0 0 709388 0 0
1743694 0 0 0 0 1598561 0 0 0 0 0
3201126 B 2 BS 1 23/05/2018 25/05/2018 23/05/2018 3336 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1458743 0 3 0 0 0 BAYI NY WENDA RINGGA
RISNATA D399251 0 0 DR OTTY MITHA S, SPA 0138R0170518V008543
0002461488647 3;JKN DR RIZKI; 5.2.1.201804062320 4 184158
1#0##0#0#0.0#2018-06-04 12:28:59#0#00:00:00#00:00:00#00:00:00 1
fcca8108e84c0d0d5144a6eb8e7f4f26 0 0 433812 0 0 88899
0 0 0 0 936032 0 0 0 0 0
3201126 B 2 BS 1 21/05/2018 25/05/2018 15/10/1961 0 2
1 A41.9;E11.8 83.39 - - None None None None M-1-50-II None
None None None None None PROSEDUR JARINGAN LUNAK (SEDANG) 10617200
0 0 - 0 - 0 - 0 - 0 10617200
12792677 0 5 0 0 0 TIOH ROHAETI D391873 56
20672 DR HENDRIEK SP B 0138R0170518V007196 0000205500993 3;JKN DR
RIZKI; 5.2.1.201804062320 4 182580 1#0##0#0#0.0#2018-06-04
12:32:46#0#00:00:00#00:00:00#12:00:00 1 4de03f38c3e48bfd5ab2f9d807405e05
0 5476600 3035439 0 0 3298734 0 0 0 0
912904 0 0 0 0 69000
3201126 B 2 BS 1 22/05/2018 25/05/2018 07/07/1983 0 2
1 I50.0;I05.9;I48;M17.9 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4973600
5566802 0 4 0 0 0 RINAH YULIANAH D397435 34
3;JKN DR RIZKI; 5.2.1.201804062320 4 182596 1#0##0#0#0.0#2018-
06-04 12:35:55#0#00:52:01#00:52:01#00:00:00 1
ce14829e8b71c2f95827e9beeb83b885 0 0 420932 0 0
1994687 0 0 0 0 2410183 0 0 0 0 741000
3201126 B 2 BS 1 22/05/2018 25/05/2018 29/04/2013 0 2
- 0 - 0 - 0 - 0 3187000 2778916 0
4 0 0 0 AQILA NADHIFA SALSABILA A309948 5 1849 DR
KRISTON SILITONGA, SPA 0138R0170518V007656 0001738598883 3;JKN DR RIZKI;
5.2.1.201804062320 4 183196 1#0##0#0#0.0#2018-06-04
12:37:03#0#19:32:23#19:32:23#00:00:00 1 8535b48113e7c2b63c12a28b8ada809b
0 0 339830 0 0 716288 0 0 0 0
1722798 0 0 0 0 0
3201126 B 2 BS 1 22/05/2018 25/05/2018 12/12/1990 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 10864368 0 4 0 0 0 WENDA RINGGA RISNATA
D378306 27 10023 DR NELWATI, SPOG 0138R0170518V007652
0001640462815 3;JKN DR RIZKI; 5.2.1.201804062320 4 183193
1#0##0#0#0.0#2018-06-04 12:39:45#0#00:00:00#00:00:00#00:00:00 1
1c53ca26ada9c5c4294eca94bfec870d 0 5459400 2570481 0 0
2072734 0 0 0 0 761753 0 0 0 0 0
3201126 B 2 BS 1 16/05/2018 25/05/2018 03/10/1955 0 2
1 E11.5;I44.1 90.59;89.52 - - None None None None I-4-15-II
LAIN (SEDANG) 7317500 0 0 - 0 - 0 - 0 -
0 7317500 24693249 0 10 0 0 0 SITI CHOTIMAH NY
0000060671799 3;JKN DR RIZKI; 5.2.1.201804062320 4 180818
1#0##0#0#0.0#2018-06-04 12:45:20#0#00:33:23#00:33:23#00:00:00 1
7392ff1e25c68438fb262cd159c61cef 0 0 1536676 0 0
8828673 0 0 0 0 14327900 0 0 0 0 0
3201126 B 2 BS 1 22/05/2018 25/05/2018 21/08/2017 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2769804 0 4 0 0 0 MUHAMAD NAUFAL PRADIPTA
D375148 0 274 DR RASTRA, SPA 0138R0170518V007643
0002444211527 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183191
1#0##0#0#0.0#2018-06-05 09:20:39#0#00:00:00#00:00:00#00:00:00 1
084779310c60bda5eb7ab4618c54a6bc 0 0 238535 0 0 511567
0 0 0 0 2019702 0 0 0 0 0
3201126 B 3 BS 1 25/05/2018 25/05/2018 21/08/1956 0 2
2 I63.9;G81.9;I50.0 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5030886 0 1 0 0 0 TIHAWA
0000511629557 3;JKN irene; 5.2.1.201804062320 4 184283
1#0##0#0#0.0#2018-06-05 16:18:01#0#10:48:05#10:48:05#00:00:00 2
af73fbdb10d2f6bc6bdc1cde89327325 0 0 303885 0 0
3367878 0 0 0 0 618123 0 0 0 0 741000
3201126 B 2 BS 1 23/05/2018 25/05/2018 11/02/2017 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2704049 0 3 0 0 0 ARSAKHA VIRENDRA SHAFWAN
d399255 1 466 DR OTTY MITHA S, SPA 0138R0170518V007938
0002248726059 3;JKN DR RIZKI; 5.2.2.201806040537 4 183524
1#0##0#0#0.0#2018-06-18 11:11:48#0#12:05:11#12:05:11#00:00:00 1
42f1a221c4809626b0e7177af83b43e0 0 0 238535 0 0 747614
0 0 0 0 1717900 0 0 0 0 0
3201126 B 3 BS 1 25/05/2018 25/05/2018 15/05/1945 0 1
4 E87.2;J81;I50.0 - - - None None None None E-4-11-III
6293300 0 0 - 0 - 0 - 0 - 0
6293300 2961183 0 1 0 0 0 MANSUR D343614
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 184170
1#0##0#0#0.0#2018-08-29 20:40:19#0#06:21:17#06:21:17#00:00:00 1
a2a982f0031cc24b4b70504d18665b3b 0 0 314665 0 0
1106796 0 0 0 0 500722 0 0 0 0
1039000
3201126 B 3 BS 1 24/05/2018 25/05/2018 10/05/1955 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 9797885 0 2 0 0 0 ABDUL MUNI
D399337 63 23025 DR ARU, SPPD 0138R0170518V008381
0001458664547 3;JKN DR RIZKI; 5.2.2.201806040537 4 183872
1#0##0#0#0.0#2018-09-10 12:29:01#0#10:25:35#10:25:35#00:00:00 3
d68f4c216c3c026c8e936bb416eee3fd 0 0 1906030 0 0
4043372 0 0 0 0 3779483 0 0 0 0 69000
3201126 B 2 BS 1 23/05/2018 25/05/2018 21/03/1956 0 1
0 - 0 - 0 - 0 - 0 4290800 7012677
0 3 1 1 0 SUKIRNO D396717 62 22708 EKA GINANJAR
0138R0170518V007693 0001148400213 3;JKN DR RIZKI; 5.2.2.201806040537
4 183211 1#0##0#0#0.0#2018-09-10
12:52:53#0#05:10:22#05:10:22#00:00:00 2 19e04af5782ffe7a304f893d782c18b8
0 0 813320 0 0 2460084 0 0 0 0
2563273 0 0 0 0 1176000
3201126 B 2 BS 1 24/05/2018 25/05/2018 23/02/1965 0 2
- 0 - 0 - 0 4915400 4230867 0 2 0
0 0 TUTY HARTINI D049782 53 19448 DR MAYSAMIRAWATI SPS
0138R0170518V008425 0001148411463 3;JKN DR RIZKI; 5.2.2.201806040537
4 183998 1#0##0#0#0.0#2018-09-10
12:58:37#0#12:51:23#12:51:23#12:00:00 2 2281411a5f613b88cd14cfba84994f76
0 0 417689 0 0 2210392 0 0 0 0
1312786 0 0 0 0 290000
3201126 B 3 BS 1 25/05/2018 25/05/2018 01/07/1970 0 1
1 E14.2;J18.0;D63.8;I11.9 99.04;38.95 - - None None None None
- 0 - 0 19332400 8089947 0 1 0 0 0
SUFIRMAN D367294 47 17495 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V008748 0000512797623 3;JKN DR RIZKI; 5.2.1.201804062320
4 184239 1#0##0#0#0.0#2018-09-10
13:04:38#0#10:02:13#10:02:13#00:00:00 2 3bb4110ce2a73c0e214a163ef7f79a42
0 3438800 1870848 0 0 2081050 0 0 0 0
630249 0 0 0 0 69000
3201126 B 3 BS 1 24/05/2018 25/05/2018 19/05/2018 2999 2
3655700 0 0 - 0 - 0 - 0 - 0
3655700 3274927 0 2 1 2 0 ANISA BY NY d399356
3;JKN DR RIZKI; 5.2.2.201806040537 4 184030 1#0##0#0#0.0#2018-
09-12 11:11:32#0#14:09:11#14:09:11#00:00:00 2
22aa10d895780a7f840a937d0b3521aa 0 0 382013 0 0 160666
0 0 0 0 1594248 0 0 0 0 1138000
3201126 B 3 BS 1 25/05/2018 25/05/2018 08/06/1992 0 2
0 - 0 - 0 - 0 - 0 4204300 6212258
0 1 0 0 0 LIDIA FITRI D253085 25 9482 DR YOHANES
DWINANDA R P 0138R0170518V008583 0001861984067 3;JKN DR RIZKI;
5.2.2.201806040537 4 184673 1#0##0#0#0.0#2018-09-25
12:38:57#0#14:50:53#14:50:53#12:00:00 2 308085888fc8af75068d7bceb73e3e28
0 0 210215 0 0 4377634 0 0 0 0 713409
0 0 0 0 911000
3201126 B 2 BS 1 25/05/2018 25/05/2018 30/11/1972 0 2
1 I85.0;K74.0 45.16;89.52 - - None None None None K-4-12-II
0 0 - 0 - 0 - 0 - 0 4919200
5388687 0 1 0 0 0 SITI SUWARSIH D050729 45
RIZKI; 5.2.2.201806040537 4 184271 1#0##0#0#0.0#2018-09-28
10:16:19#0#10:41:41#10:41:41#00:00:00 3 641a6591b875cbe869508a176a77fd15
0 0 1108824 0 0 794832 0 0 0 0
1736031 0 0 0 0 1749000
3201126 B 2 BS 1 23/05/2018 25/05/2018 06/09/2016 0 1
1 N39.0;Q89.1;E90 - - - None None None None N-4-12-I
2871200 0 0 - 0 - 0 - 0 - 0
2871200 2685802 0 3 0 0 0 CALON BAYI NY NURUL
FATMAWATI D347783 1 624 DR OTTY MITHA S, SPA 0138R0170518V008088
0002083264942 3;JKN DR RIZKI; 5.2.2.201806040537 4 183633
1#0##0#0#0.0#2018-09-28 14:41:33#0#00:00:00#00:00:00#00:00:00 2
3cc5d32416960b5a57f5797c8b3c7a84 0 0 599759 0 0 369336
0 0 0 0 1716707 0 0 0 0 0
3201126 B 3 BS 1 23/05/2018 26/05/2018 24/12/1999 0 1
None None None None None PERADANGAN GINJAL (SEDANG) 4444500 0
0 - 0 - 0 - 0 - 0 4444500 6914169
0 4 0 0 0 DINDA HAFIDZ RAMADANA D049227 18 6725
5.2.1.201804062320 4 183641 1#0##0#0#0.0#2018-06-02
08:41:04#0#00:00:00#00:00:00#00:00:00 2 56369605bcc297f02e4388d8a02f44fb
0 0 289034 0 0 5181306 0 0 0 0
1443829 0 0 0 0 0
3201126 B 3 BS 1 22/05/2018 26/05/2018 01/02/1954 0 1
1 D29.1 60.29;90.59;88.76;89.52 - - None None None None V-1-
14-I None None None None None None PENGANGKATAN PROSTAT MELALUI URETRA
(RINGAN) 8837900 0 0 - 0 - 0 - 0 - 0
8837900 19297989 0 5 0 0 0 SAININ d396245
3;JKN DR RIZKI; 5.2.1.201804062320 4 182898 1#0##0#0#0.0#2018-
06-02 08:45:13#0#11:04:32#11:04:32#00:00:00 1
3b57f1cb9a3c6f1e397c05b7a2c5b09e 0 5565300 2562991 0 0
6459698 0 0 0 0 1301000 0 0 0 0
3409000
3201126 B 3 BS 1 19/05/2018 26/05/2018 16/10/2002 0 1
- 0 - 0 - 0 - 0 3874400 12527416 0
8 0 0 0 ADI NURRUDIN AN D398995 15 5694 DR RASTRA,
4 181929 1#0##0#0#0.0#2018-06-02
08:46:47#0#23:05:45#23:05:45#00:00:00 1 be9d258f81e87aa07e92238a09375776
0 4309900 1612394 0 0 5665071 0 0 0 0
905551 0 0 0 0 34500
3201126 B 3 BS 1 23/05/2018 26/05/2018 13/01/1997 0 1
1 D64.9;I84.9 99.04 - - None None None None D-4-13-I None
- 0 2987000 4489292 0 4 0 0 0 ILYAS
SYAIFUL MALIK d399294 21 7800 DR ARU, SPPD 0138R0170518V008378
0002302795642 3;JKN DR RIZKI; 5.2.1.201804062320 4 183847
1#0##0#0#0.0#2018-06-02 08:50:17#0#10:13:33#10:13:33#00:00:00 1
1a9c12a6abe1458bca70c71269a87be4 0 0 374830 0 0
3005770 0 0 0 0 1108692 0 0 0 0 0
3201126 B 3 BS 1 24/05/2018 26/05/2018 01/04/1960 0 1
1 I50.0;I48;K30 89.52 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4144700
2198179 0 3 0 0 0 DAHLAN ISKANDAR D394167 58
3;JKN DR RIZKI; 5.2.1.201804062320 4 183766 1#0##0#0#0.0#2018-
06-02 08:51:36#0#09:06:01#09:06:01#12:00:00 1
adc0ceab2aaf832067e55fcbdbae7a47 0 0 426023 0 0 523350
0 0 0 0 958806 0 0 0 0 290000
3201126 B 1 BS 1 23/05/2018 26/05/2018 14/01/1966 0 1
0 0 - 0 - 0 - 0 - 0 5164300
9397838 0 4 0 0 0 SUHENDRA D306892 52 19122
DR MOHAMAD NIZAM ERHAMZA SPP 0138R0170518V007688 0000060502555 3;JKN
DR RIZKI; 5.2.1.201804062320 4 183209
1#1#vvip#4#4233538#0.0#2018-06-02 08:55:06#0#03:29:36#03:29:36#00:00:00
1 836bb0725e2f59cf152f055c0d55eeea 0 0 866377 0 0
2994649 0 0 0 0 5246812 0 0 0 0 290000
3201126 B 1 BS 1 25/05/2018 26/05/2018 24/08/1948 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 13766285 0 2 0 0 0 ALOYSIUS NUGROHO
0138R0170518V008889 0000060934509 3;JKN DR RIZKI; 5.2.1.201804062320
4 184372 1#0##0#0#0.0#2018-06-02
09:02:40#0#14:15:37#14:15:37#00:00:00 1 0cfacac7f76f4b5624b515c84d33e487
0 5896000 2619183 0 0 3915504 0 0 0 0
976598 0 0 0 0 359000
3201126 B 2 BS 1 23/05/2018 26/05/2018 21/11/1963 0 1
1 H81.1;M54.22;K29.7 90.59;89.52 - - None None None None
U-4-11-I None None None None None None DYSEQUILIBRIUM (RINGAN)
1821000 0 0 - 0 - 0 - 0 - 0
1821000 3457386 0 4 0 0 0 ADE SUHARDIMAN
0001261076253 3;JKN DR RIZKI; 5.2.1.201804062320 4 183636
1#0##0#0#0.0#2018-06-02 09:05:54#0#18:31:55#18:31:55#12:00:00 1
28edeff3c2e83ecb907c323f8bd8766c 0 0 216890 0 0
1175812 0 0 0 0 2064684 0 0 0 0 0
3201126 B 2 BS 1 23/05/2018 26/05/2018 25/06/1971 0 2
1 A49.9;R51;R11 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 4231799 0 4 0 0 0 FININTA
SIAGIAN d084666 46 17134 DR ARU, SPPD 0138R0170518V007956
0001457727996 3;JKN DR RIZKI; 5.2.1.201804062320 4 183526
1#0##0#0#0.0#2018-06-02 09:13:50#0#12:51:21#12:51:21#00:00:00 1
cbe56f57a049afdc963b547cbed974a5 0 0 431297 0 0
1477655 0 0 0 0 2322847 0 0 0 0 0
3201126 B 1 BS 1 22/05/2018 26/05/2018 21/06/2008 0 1
10909500 0 0 - 0 - 0 - 0 - 0
10909500 21737494 0 5 0 0 0 ZAKKYA YAHYA ALFAREZI
0001644319923 3;JKN DR RIZKI; 5.2.1.201804062320 4 183189
1#1#vvip#5#10827994#0.0#2018-06-02 10:16:06#0#00:00:00#00:00:00#00:00:00
2 250d9b72316ea21e1fc04af422dbb389 0 11195400 5834487 0
0 3261607 0 0 0 0 1301000 0 0 0 0
145000
3201126 B 3 BS 1 25/05/2018 26/05/2018 04/02/1957 0 2
2 N18.5;G93.4;R40.2 96.05 - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 5218235 0 2 0 0 0 IFAH LATIFAH
0000041718734 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184465
1#0##0#0#0.0#2018-06-04 10:25:25#0#20:53:55#20:53:55#12:00:00 2
5f88ca0b1afc77ccdc90d20e3015092a 0 0 647493 0 0
3940362 0 0 0 0 630380 0 0 0 0 0
3201126 B 3 BS 1 26/05/2018 26/05/2018 20/07/1963 0 1
1 L03.9;A41.9;I50.0;R57.2;N17.9 - - - None None None None
L-4-12-III None None None None None None PERADANGAN KULIT/CELLULITIS
(BERAT) 7665300 0 0 - 0 - 0 - 0 - 0
7665300 6079508 0 1 0 0 0 ABDUL SOMAD D399468
TANTIYO S;16137 5.2.1.201804062320 4 184473 1#0##0#0#0.0#2018-
06-04 10:26:31#0#01:36:49#01:36:49#00:00:00 1
cd7f1b727631f2530838b3fbcc346c1d 0 0 689877 0 0
4702906 0 0 0 0 686725 0 0 0 0 0
3201126 B 3 BS 1 26/05/2018 26/05/2018 04/06/1971 0 1
0 0 - 0 - 0 - 0 - 0 4202600
1472789 0 1 0 0 0 HENDRIK JACOBUS LEANDER D399511
TANTIYO S;16137 5.2.1.201804062320 4 184672 1#0##0#0#0.0#2018-
06-04 10:59:16#0#14:43:09#14:43:09#00:00:00 1
77592501391262c208f415fb7bee030c 0 0 210130 0 0 164832
0 0 0 0 335477 0 0 0 762350 0
3201126 B 1 BS 1 16/05/2018 26/05/2018 28/02/1960 0 1
1 E14.5;A41.9;I63.9 86.28 - - None None None None I-4-15-III
LAIN (BERAT) 10244500 0 0 - 0 - 0 - 0 -
0 10244500 28919750 0 11 0 0 0 SARJANTA
BARIHANDANA d398690 58 21262 DR NURUL KOMARI SPS 0138R0170518V005545
0002440790752 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181085
1#0##0#0#0.0#2018-06-04 12:10:55#0#00:00:00#00:00:00#00:00:00 2
24167a526cd91021f751934c5d050075 0 12931000 3740000 0 0
8718750 0 0 0 0 1256000 0 0 0 0
2274000
3201126 B 2 BS 1 25/05/2018 26/05/2018 24/03/1995 0 1
0 - 0 - 0 - 0 4101100 1999515 0 2
0 0 0 ROSI RESKI D399407 23 8463 SRI KUNMARTINI.DR,SPPD
0138R0170518V009008 0001462895818 3;JKN irene; 5.2.1.201804062320
4 184456 1#0##0#0#0.0#2018-06-06
09:18:22#0#00:00:00#00:00:00#00:00:00 2 2bc99f5e5bc0ea54bc8f2d9da36eaba2
0 0 422099 0 0 618107 0 0 0 0 959309
0 0 0 0 0
3201126 B 1 BS 1 25/05/2018 26/05/2018 11/09/1953 0 2
0 - 0 - 0 - 0 - 0 3247500 6097857
0 2 0 0 0 ROMA CHRYSTA MANURUNG D396055 64 23632
DR ARU, SPPD 0138R0170518V009027 0000055744378 3;JKN irene;
5.2.1.201804062320 4 184460 1#0##0#0#0.0#2018-06-06
09:22:03#0#00:00:00#00:00:00#00:00:00 2 5e90e77b41ac9b980ff91624d5451b45
0 0 1025300 0 0 919632 0 0 0 0
2403925 0 0 0 0 1749000
3201126 B 3 BS 1 26/05/2018 26/05/2018 05/06/1948 0 2
0 - 0 - 0 - 0 - 0 10401900 2327153
0 1 0 0 0 YANAH D385516 69 25557 DR DINI DANIATY
0138R0170518V009466 0001730518222 3;JKN irene; 5.2.1.201804062320
4 184910 1#0##0#0#0.0#2018-06-06
09:23:53#0#00:00:00#00:00:00#12:00:00 2 eb5c0536a3ea9c401c106c3fe8a0ff47
0 0 520095 0 0 1365814 0 0 0 0 441244
0 0 0 0 0
3201126 B 1 BS 1 26/05/2018 26/05/2018 01/03/2012 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 2469591 0 1 0 0 0 AQMARUL IKHSAN
0001274835126 3;JKN irene; 5.2.2.201806040537 4 184499
1#0##0#0#0.0#2018-08-13 09:24:57#0#08:54:28#08:54:28#00:00:00 2
1e24ca2e6a0f8a9c75694b4c0bfdb38a 0 0 376362 0 0
1124667 0 0 0 0 968562 0 0 0 0 0
3201126 B 2 BS 1 24/05/2018 26/05/2018 13/07/1974 0 1
0 - 0 - 0 - 0 4101100 4047375 0 3
0 0 0 AHMAD ZAINI TN D399329 43 16021 DR HERY TIERA, SPU
0138R0170518V008197 0001654293216 3;JKN irene; 5.2.2.201806040537
4 183646 1#0##0#0#0.0#2018-08-13
09:35:24#0#03:23:46#03:23:46#00:00:00 2 c653f3076bd8e8c6efbaaa97be963a1e
0 0 475099 0 0 1766494 0 0 0 0
1805782 0 0 0 0 0
3201126 B 2 BS 1 23/05/2018 26/05/2018 23/08/2009 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3840079 0 4 0 0 0 RASYA KHALISA ZAHIRA
D399242 8 3195 DR RASTRA, SPA 0138R0170518V007690
0001422404008 3;JKN irene; 5.2.2.201806040537 4 183210
1#0##0#0#0.0#2018-08-13 09:40:22#0#00:00:00#00:00:00#00:00:00 2
156e1933fc95d916ec3ee0748f1a3820 0 0 278711 0 0
1094148 0 0 0 0 2297220 0 0 0 170000
0
3201126 B 3 BS 1 26/05/2018 26/05/2018 12/11/1987 0 2
- 0 - 0 - 0 - 0 2168300 3000000 0
1 0 0 0 DARA ANDIA NOVIANI D399469 30 11153 DR
ERDIYAN, SPOG 0138R0170518V009064 0002333612553 3;JKN irene;
5.2.2.201806040537 4 186109 1#0##0#0#0.0#2018-08-13
10:39:23#0#00:00:00#00:00:00#00:00:00 2 cfdb779ba425a1685313054d002b09c3
0 0 3000000 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 25/05/2018 26/05/2018 28/02/1967 0 1
- 0 12472300 13102104 0 2 0 0 0 ARIEF
RACHMAN HAKIM D093472 51 18714 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170518V008744 0001404442833 3;JKN DR RIZKI; 5.2.2.201806040537
4 184309 1#0##0#0#0.0#2018-09-10
12:31:54#0#11:10:53#11:10:53#00:00:00 2 8cc7acb1582626ea4e2fffe82c699c3e
0 6468200 2619183 0 0 2987574 0 0 0 0
958147 0 0 0 0 69000
3201126 B 2 BS 1 24/05/2018 26/05/2018 05/07/1974 0 2
1 I13.1;A49.9;D63.8;T82.4 39.42;99.04 - - None None None None
- 0 - 0 23198900 9473415 0 3 0 0 0
KARTINI D062831 43 16029 DR SRI KUMARTINI 0138R0170518V008562
0001258749393 3;JKN DR RIZKI; 5.2.2.201806040537 4 184160
1#0##0#0#0.0#2018-09-25 14:37:35#0#20:01:17#20:01:17#00:00:00 2
d49030d83697152c685901d5466846af 0 4646600 2298005 0 0
1764054 0 0 0 0 695756 0 0 0 0 69000
3201126 B 1 BS 1 26/05/2018 26/05/2018 28/08/1956 0 2
3 E11.5;L03.9 - - - None None None None I-4-15-I None
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 3199810 0 1 0 0 0 MAYAR D399472 61
22551 DEDY PRATAMA,SPBV 0138R0170518V009056 0001459030689 3;JKN DR
RIZKI; 5.2.2.201806040537 4 184684 1#0##0#0#0.0#2018-09-26
18:15:56#0#20:35:14#20:35:14#00:00:00 3 41a9310595b447142076e9ad953cc83f
0 0 617777 0 0 1565700 0 0 0 0
1016333 0 0 0 0 0
3201126 B 2 BS 1 24/05/2018 27/05/2018 01/08/1956 0 1
1 E14.4 - - - None None None None G-4-17-I None None
None None None None GANGUAN SARAF KRANIAL DAN PERIFER (RINGAN)
5397100 0 0 - 0 - 0 - 0 - 0
5397100 4273049 0 4 0 0 0 BUDIARTO D399370
61 22576 DR ARU, SPPD 0138R0170518V008558 0000042169263 3;JKN
DR RIZKI; 5.2.1.201804062320 4 184159 1#0##0#0#0.0#2018-06-02
09:33:27#0#00:00:00#00:00:00#00:00:00 1 9c5f63da0f32542b760798841548bb7b
0 0 431297 0 0 1723707 0 0 0 0
2118045 0 0 0 0 0
3201126 B 2 BS 1 26/05/2018 27/05/2018 01/08/1945 0 2
1 I20.9;R10.4;I11.0 89.52 - - None None None None I-4-20-III
8448000 0 0 - 0 - 0 - 0 - 0
8448000 1618600 0 2 0 0 0 SURJATI,NY D261480
0000060705584 3;JKN DR RIZKI; 5.2.1.201804062320 4 184679
1#0##0#0#0.0#2018-06-02 09:44:21#0#00:00:00#00:00:00#00:00:00 2
7a2979111b5f4ccaaee80648f6a3dd0f 0 0 238535 0 0 445675
0 0 0 0 934390 0 0 0 0 0
3201126 B 2 BS 1 24/05/2018 27/05/2018 12/05/1997 0 2
1 N39.0;R11;J02.9;J40 - - - None None None None N-4-
12-I None None None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN)
2871200 0 0 - 0 - 0 - 0 - 0
2871200 4965774 0 4 0 0 0 MEGA SILVIA ANGGRAINI
D363592 21 7682 DR ARU, SPPD 0138R0170518V008194
0000000540066 3;JKN DR RIZKI; 5.2.1.201804062320 4 183645
1#0##0#0#0.0#2018-06-02 09:47:54#0#02:47:52#02:47:52#00:00:00 1
2e53c139141fad1565ca9acf240126c7 0 0 338039 0 0
2256871 0 0 0 0 2370864 0 0 0 0 0
3201126 B 2 BS 1 24/05/2018 27/05/2018 29/12/1995 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 11511745 0 4 0 0 0 DEBY AYU FAUZIAH NN
0002140310428 3;JKN DR RIZKI; 5.2.1.201804062320 4 184164
1#0##0#0#0.0#2018-06-02 09:49:03#0#22:59:18#22:59:18#00:00:00 1
94ed33bc5c3d3d404e3444b634e1eedd 0 5533600 2858300 0 0
2096740 0 0 0 0 954105 0 0 0 0 69000
3201126 B 1 BS 1 24/05/2018 27/05/2018 03/11/1979 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 20207882 0 4 0 0 0 HENY FITRIYANTI
0001744479898 3;JKN DR RIZKI; 5.2.1.201804062320 4 184161
1#1#vvip#4#13226382#0.0#2018-06-02 09:55:17#0#00:00:00#00:00:00#00:00:00
1 ad83f62df8691fdc09f616ea2a61d2a5 0 8858900 6488000 0
0 3387982 0 0 0 0 1276000 0 0 0 0
197000
3201126 B 3 BS 1 25/05/2018 27/05/2018 06/03/1997 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 12247174 0 3 0 0 0 FAHRI HUSAENI
0000510950564 3;JKN DR RIZKI; 5.2.1.201804062320 4 184168
1#0##0#0#0.0#2018-06-02 10:00:26#0#01:31:08#01:31:08#00:00:00 1
6efb1bfeb99fd3c05b5beb2b08574f54 0 3611800 4405813 0 0
3283344 0 0 0 0 877217 0 0 0 0 69000
3201126 B 1 BS 1 24/05/2018 27/05/2018 06/06/1983 0 2
1 M05.2;M32.9 - - - None None None None M-4-16-I None
0 0 - 0 - 0 - 0 - 0 3978000
6297190 0 4 0 0 0 LUFTHIA ANDINI MATARA DALIE
0000042147191 3;JKN DR RIZKI; 5.2.1.201804062320 4 184157
1#0##0#0#0.0#2018-06-02 10:18:56#0#00:00:00#00:00:00#00:00:00 1
0286473bdb30452da51666a04857d1b6 0 0 464020 0 0
2616704 0 0 0 0 3216466 0 0 0 0 0
3201126 B 1 BS 1 25/05/2018 27/05/2018 16/01/1955 0 2
- 0 12472300 13699558 0 3 0 0 0 WAGINEM CH
0000061090356 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184334
1#0##0#0#0.0#2018-06-04 10:00:03#0#12:57:24#12:57:24#00:00:00 1
fd9ad1de4d7e93c11d15e56e2a8ab4d1 0 6587000 2647238 0 0
3399087 0 0 0 0 997233 0 0 0 0 69000
3201126 B 3 BS 1 23/05/2018 27/05/2018 01/01/1974 0 2
1 C53.9;N13.0;M79.65 - - - None None None None W-4-
10-II None None None None None None TUMOR SISTEM REPRODUKSI WANITA (SEDANG)
5153200 0 0 - 0 - 0 - 0 - 0
5153200 3986267 0 5 0 0 0 SUWARTI D385389
44 16213 DR ARU, SPPD 0138R0170518V008153 0001014256754 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 183635 1#0##0#0#0.0#2018-
06-04 10:04:03#0#00:00:00#00:00:00#12:00:00 1
e3378364d577b7153921c1f7e0b85d88 0 0 413584 0 0
2057399 0 0 0 0 1515284 0 0 0 0 0
3201126 B 1 BS 1 23/05/2018 27/05/2018 12/06/1981 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4807666 0 5 0 0 0 SAOMAH D399305
36 13494 DR ARU, SPPD 0138R0170518V008180 0001406109532 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 183642 1#0##0#0#0.0#2018-
06-04 10:06:21#0#22:48:44#22:48:44#00:00:00 1
543d527a0a3f829fa08d3060eb8c59a4 0 0 316331 0 0
1026815 0 0 0 0 3464520 0 0 0 0 0
3201126 B 3 BS 1 26/05/2018 27/05/2018 22/08/1967 0 2
- 0 8908800 10696961 0 2 0 0 0 IMAH
0138R0170518V009103 0000510954309 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 184513 1#0##0#0#0.0#2018-06-04
10:14:21#0#09:16:26#09:16:26#00:00:00 1 1e2124d19d59f5135f78e75794eb302a
0 3062500 1887760 0 0 4901900 0 0 0 0
775801 0 0 0 0 69000
3201126 B 3 BS 1 26/05/2018 27/05/2018 09/01/1945 0 1
1 I21.3;J81 - - - None None None None I-4-10-III None
0 - 0 - 0 - 0 - 0 10401900 2889350
0 2 0 0 0 DACHLAN SOLEIMAN D375777 73 26800 DR
WIDHI DEWANTA K AJI 0138R0170518V009170 0001337114968 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 184680 1#0##0#0#0.0#2018-06-04
10:55:56#0#18:42:26#18:42:26#12:00:00 1 90ab3d61ac6c75180b9255a1b5d16155
0 0 520095 0 0 1473232 0 0 0 0 478023
0 0 0 0 418000
3201126 B 3 BS 1 26/05/2018 27/05/2018 04/01/1960 0 1
0 - 0 - 0 - 0 - 0 10401900 3701606
0 2 0 0 0 SYARIF HIDAYAT D399562 58 21327 DR
WIDHI DEWANTA K AJI 0138R0170518V009180 0001014182469 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 184687 1#0##0#0#0.0#2018-06-04
11:12:48#0#00:00:00#00:00:00#00:00:00 1 ef5d7166e7bebb50c7e50390e96162e4
0 0 520095 0 0 2522350 0 0 0 0 531161
0 0 0 0 128000
3201126 B 1 BS 1 27/05/2018 27/05/2018 10/08/1993 0 2
- 0 - 0 - 0 - 0 3035600 1729264 0
1 0 0 0 ANNISA RIZQI NURMANIAR D390496 24 9056 DR.
SITI AZIZAH SPOG 0138R0170518V009204 0001965182725 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 184704 1#0##0#0#0.0#2018-06-04
12:14:52#0#07:34:09#07:34:09#00:00:00 1 c3910c5373606fff0a4e4731eb154100
0 0 289457 0 0 501678 0 0 0 0 938129
0 0 0 0 0
3201126 B 1 BS 1 25/05/2018 27/05/2018 25/05/2018 3231 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2971517 0 3 0 0 0 BAYI NY HENI FITRIYANTI
d399404 0 0 DR AULIA TANGKARI, SPA 0138R0170518V008803
0002461928409 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184323
1#1#vip#3#0#0.0#2018-06-05 09:24:05#0#00:00:00#00:00:00#00:00:00 1
10533690889f4198c0c7610fe3369682 0 0 499620 0 0 88899
0 0 0 0 2382998 0 0 0 0 0
3201126 B 2 BS 1 25/05/2018 27/05/2018 05/08/2015 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 5200843 0 3 0 0 0 MUHAMMAD GIBRAN AYUBI
0001875187664 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 184463
1#0##0#0#0.0#2018-06-05 10:42:48#0#00:00:00#00:00:00#00:00:00 1
a14fbb4424fdaa2f5ffda8b48301a3a7 0 3053500 493024 0 0
1169077 0 0 0 0 416242 0 0 0 0 69000
3201126 B 2 BS 1 25/05/2018 27/05/2018 17/10/2017 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9363050 0 3 0 0 0 FILIO FARZANA SHAZFA
0002297953888 3;JKN irene; 5.2.1.201804062320 4 184461
1#0##0#0#0.0#2018-06-06 09:08:35#0#00:00:00#00:00:00#00:00:00 2
73bbd7d8b7673f1bc66f608446c5a25c 0 5140800 1910143 0 0
1604571 0 0 0 0 638536 0 0 0 0 69000
3201126 B 2 BS 1 26/05/2018 27/05/2018 16/11/1983 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 13290879 0 2 0 0 0 AHMAD DZULFAHMI
RIDHO D396477 34 12610 DR DEDY PRATAMA SPBV 0138R0170518V009110
0001515749152 3;JKN irene; 5.2.1.201804062320 4 184554
1#0##0#0#0.0#2018-06-06 09:09:05#0#10:06:10#10:06:10#00:00:00 3
f11732593ea54f16288dd102263fdc5c 0 4439100 1094720 0 0
6757562 0 0 0 0 930497 0 0 0 0 69000
3201126 B 2 BS 1 25/05/2018 27/05/2018 21/11/2012 0 1
(RINGAN) 10368300 0 0 - 0 - 0 - 0 - 0
10368300 7866438 0 3 0 0 0 FARAS NADIM RIZA
d398315 5 2011 DR CATUR S, SPB 0138R0170518V009037
0002258076521 3;JKN irene; 5.2.1.201804062320 4 184467
1#0##0#0#0.0#2018-06-06 09:09:20#0#00:00:00#00:00:00#00:00:00 2
e13b390e8d2ccb00761145cd735f11d4 0 4605000 1240820 0 0
1360991 0 0 0 0 590627 0 0 0 0 69000
3201126 B 1 BS 1 25/05/2018 27/05/2018 26/05/2016 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 11426547 0 3 0 0 0 KEVIN ADHYASTHA AL
GHIFARI d395770 1 729 DR CATUR SUZANTARA 0138R0170518V009029
0002041504514 3;JKN irene; 5.2.1.201804062320 4 184462
1#0##0#0#0.0#2018-06-06 09:12:44#0#00:00:00#00:00:00#00:00:00 2
3ad611b6a1f3c563f845210ed6ae140e 0 6841700 2228505 0 0
1463811 0 0 0 0 823531 0 0 0 0 69000
3201126 B 1 BS 1 25/05/2018 27/05/2018 28/04/2018 0 2
1 M79.82 86.3 - - None None None None L-1-40-I None
None None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH KULIT DAN
PAYUDARA (RINGAN) 6969900 0 0 - 0 - 0 - 0 -
0 6969900 10142965 0 3 0 0 0 BAYI NY ISMI
BADRIYYAH d398300 0 27 DR CATUR SUZANTARA 0138R0170518V009034
0002454722199 3;JKN irene; 5.2.1.201804062320 4 184464
1#0##0#0#0.0#2018-06-06 09:12:57#0#00:00:00#00:00:00#00:00:00 2
54583a701b2e68bc9c48abbfb34daac5 0 6188500 2021271 0 0
1159136 0 0 0 0 739558 0 0 0 0 34500
3201126 B 3 BS 1 26/05/2018 27/05/2018 04/04/1977 0 2
1 N93.9;D62 69.09;99.04 - - None None None None W-1-11-II
SERVIK (SEDANG) 2538700 0 0 - 0 - 0 - 0 -
0 2538700 4418593 0 2 0 0 0 SAFITRI
0000512820685 3;JKN irene; 5.2.1.201804062320 4 186108
1#0##0#0#0.0#2018-06-06 09:15:16#0#00:00:00#00:00:00#00:00:00 2
e037fa7e314b71f62bdfcba65faffa03 0 0 760168 0 0 815900
0 0 0 0 2773525 0 0 0 0 69000
3201126 B 3 BS 1 25/05/2018 27/05/2018 24/04/2018 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 7347948 0 3 0 0 0 BAYI NY FINA SEPTINA
0002453334006 3;JKN irene; 5.2.1.201804062320 4 184459
1#0##0#0#0.0#2018-06-06 09:15:48#0#00:00:00#00:00:00#00:00:00 2
6b9e253d03f15d5e376c0aa5b854712f 0 3531400 1536920 0 0
1653921 0 0 0 0 556707 0 0 0 0 69000
3201126 B 3 BS 1 24/05/2018 27/05/2018 22/10/2017 0 2
1 L51.2;A09.9 - - - None None None None L-4-10-I None
None None None None None PENYAKIT KULIT MAYOR (RINGAN) 1762300 0
0 - 0 - 0 - 0 - 0 1762300 4641986
0 4 0 0 0 CUT RAHIMAH KEUMALA PUTRI D399364 0
DR RIZKI; 5.2.2.201806040537 4 186246 1#0##0#0#0.0#2018-06-19
10:49:54#0#00:00:00#00:00:00#00:00:00 1 95e62144b3aa5301fdc1fbbd866abd18
0 0 211607 0 0 1060198 0 0 0 0
3200181 0 0 0 0 170000
3201126 B 1 BS 1 23/05/2018 27/05/2018 26/08/1993 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 21096067 0 5 0 0 0 ESTER FARARA PAUNED
D377328 24 9036 DR FX BHIMANTORO, SPOG 0138R0170518V008031
0000369128529 3;JKN irene; 5.2.2.201806040537 4 183568
1#0##0#0#0.0#2018-06-26 12:13:00#1#12:09:53#00:00:00#00:00:00 2
3610ce0c26a5820686e90815075d86e7 0 7505640 7346920 0 0
3979907 0 0 0 0 1424600 0 0 839000 0
0
3201126 B 1 BS 1 23/05/2018 27/05/2018 26/03/1961 0 2
1 I13.1;A49.9;E87.6;T82.4 38.95;88.76;88.74;39.95 - - None None
- 0 - 0 - 0 27065300 28155631 0 5 0
0 0 ERNA MARDIANA NY D348686 57 20877 SRI KUNMARTINI.DR,SPPD
0138R0170518V007679 0000093184075 3;JKN irene; 5.2.2.201806040537
4 183207 1#1#vvip#5#1090331#0.0#2018-08-13
09:22:46#0#00:45:04#00:45:04#00:00:00 2 7580db58918600f3e4199ba0fb400d68
0 8532000 4498000 0 0 10346381 0 0 0 0
4744750 0 0 0 34500 0
3201126 B 2 BS 1 26/05/2018 27/05/2018 05/07/1964 0 1
1 E11.2;A49.9;I10;T82.4 39.53 - - None None None None I-1-
LAIN-LAIN (BERAT) 24212000 0 0 - 0 - 0 - 0 -
0 24212000 11175613 0 2 0 0 0 BANTA AYUSAN
d389649 53 19683 DR DEDY PRATAMA SPBV 0138R0170518V009066
0001874825436 3;JKN irene; 5.2.2.201806040537 4 184691
1#0##0#0#0.0#2018-08-13 09:44:53#0#23:04:40#23:04:40#12:00:00 2
d7d4fdd75da3f0819edebd2dcb336c53 0 4911100 4030698 0 0
1372700 0 0 0 0 792115 0 0 0 69000 0
3201126 B 3 BS 1 22/05/2018 27/05/2018 15/01/2012 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4811246 0 6 0 0 0 BENNY SAPUTRA SIHOMBING
D277075 6 2319 DR RASTRA, SPA 0138R0170518V007217
0001268165035 3;JKN irene; 5.2.2.201806040537 4 182599
1#0##0#0#0.0#2018-08-13 10:15:49#0#00:00:00#00:00:00#12:00:00 2
108c6328889870f6e125756816f72d96 0 0 378188 0 0
2514304 0 0 0 0 1918754 0 0 0 0 0
3201126 B 2 BS 1 26/05/2018 27/05/2018 01/07/1950 0 1
0 - 0 - 0 - 0 - 0 7609600 12161304
0 2 0 0 0 SUSILOADI D344555 67 24801 DR AGOES
5.2.2.201806040537 4 184493 1#0##0#0#0.0#2018-09-06
11:52:51#0#08:47:02#08:47:02#00:00:00 3 da94c0e302f3e05c16c7eda01d55aaf9
0 3555000 1521920 0 0 4232785 0 0 0 0
851599 0 0 0 0 2000000
3201126 B 1 BS 1 26/05/2018 27/05/2018 20/08/1951 0 1
0 - 0 - 0 - 0 - 0 17095200 15023767
0 2 0 0 0 ATJANG SUKARJA D286364 66 24386 DR
AGOES KOOSHARTORO SPPD 0138R0170518V009148 0001874729529 3;JKN DR RIZKI;
5.2.2.201806040537 4 184671 1#0##0#0#0.0#2018-09-06
11:55:26#0#14:21:25#14:21:25#00:00:00 3 cf5a520ddd9518d1e4b7669567d35a7d
0 4777000 3419040 0 0 3571727 0 0 0 0
1256000 0 0 0 0 2000000
3201126 B 2 BS 1 24/05/2018 27/05/2018 04/01/1943 0 2
1 I67.6;J01.1;R51 87.03 - - None None None None G-4-26-I
LAIN (RINGAN) 4304800 0 0 - 0 - 0 - 0 -
0 4304800 3659674 0 4 0 0 0 NINGSIH NY
0000060694795 3;JKN DR RIZKI; 5.2.2.201806040537 4 184163
1#0##0#0#0.0#2018-09-10 11:30:23#0#22:39:53#22:39:53#00:00:00 2
72120e935f3c29ef8b27fbd5d8584fe9 0 0 654580 0 0 927176
0 0 0 0 2077918 0 0 0 0 0
3201126 B 1 BS 1 24/05/2018 27/05/2018 21/02/1998 0 2
1 S90.9 86.04 - - None None None None L-4-13-I None None
None None None None TRAUMA PADA KULIT, JARINGAN BAWAH KULIT DAN PAYUDARA
(RINGAN) 3337300 0 0 - 0 - 0 - 0 - 0
3337300 11227041 0 4 0 0 0 FEBRIANA SAFITRI
0000038232303 3;JKN DR RIZKI; 5.2.2.201806040537 4 183976
1#0##0#0#0.0#2018-09-10 12:45:42#0#11:38:39#11:38:39#00:00:00 2
8543e5507e3d53257b8ee80f196fd2f5 0 7278000 750064 0 0
2319498 0 0 0 0 810479 0 0 0 0 69000
3201126 B 3 BS 1 25/05/2018 28/05/2018 16/08/2008 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3643018 0 4 0 0 0 LEONA SYAKILLA AGUSTIN
0001740633502 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184454
1#0##0#0#0.0#2018-06-04 11:00:19#0#16:03:40#16:03:40#00:00:00 1
047cc0d008139b89a243bcc370f07158 0 0 241100 0 0
1915590 0 0 0 0 1316328 0 0 0 0 170000
3201126 B 3 BS 1 26/05/2018 28/05/2018 15/06/1941 0 1
1 K81.0;R63.0 90.59;89.52 - - None None None None B-4-14-I
(RINGAN) 4199800 0 0 - 0 - 0 - 0 - 0
4199800 3636215 0 3 0 0 0 HASAN RIPAN D399476
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184598
1#0##0#0#0.0#2018-06-04 11:15:08#0#11:13:10#11:13:10#00:00:00 1
9578a90a2dd9e2f6751b613276cb74f6 0 0 368243 0 0
2215089 0 0 0 0 1052883 0 0 0 0 0
3201126 B 2 BS 1 26/05/2018 28/05/2018 20/01/1959 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 5760420 0 3 0 0 0 MOKH. MASKUR
D392480 59 21676 DR ARU, SPPD 0138R0170518V009176
0001882347118 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184685
1#0##0#0#0.0#2018-06-04 11:18:10#0#00:00:00#00:00:00#12:00:00 1
f9b64530042302fe35d4b332b3bc8407 0 0 499265 0 0
3550805 0 0 0 0 1710346 0 0 0 0 0
3201126 B 2 BS 1 27/05/2018 28/05/2018 21/03/1989 0 1
0 - 0 - 0 - 0 - 0 3545800 5968332
0 2 0 0 0 CHRISTOFORUS P GILLY D390954 29 10659
DR ZULFAN, SPPD 0138R0170518V009236 0001479101578 3;JKN TANTIYO
S;16137 5.2.1.201804062320 4 184721 1#0##0#0#0.0#2018-06-04
11:24:05#0#00:00:00#00:00:00#12:00:00 1 f8a4a991d366112a3ee23b6368a08648
0 0 992824 0 0 1299556 0 0 0 0
1961452 0 0 0 0 1714500
3201126 B 2 BS 1 24/05/2018 28/05/2018 15/01/1944 0 2
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 7641031 0 5 0 0 0 AMSIAH
0001260441178 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183978
1#0##0#0#0.0#2018-06-04 11:25:32#0#11:40:14#11:40:14#00:00:00 1
291a32a8a7af0c0388916b05ffdb07cc 0 0 965054 0 0
3625096 0 0 0 0 3050881 0 0 0 0 0
3201126 B 1 BS 1 24/05/2018 28/05/2018 23/08/1988 0 2
0 0 - 0 - 0 - 0 - 0 6981500
25878335 0 5 0 0 0 ARIK BINTARI D025603 29
10866 DR AFRA FONDA SPOG 0138R0170518V008565 0002039872961 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 184162
1#1#vvip#5#18896835#0.0#2018-06-04 11:33:56#0#21:51:27#21:51:27#00:00:00
1 58aa6a74f49bd2831bb8a518776bf1d5 0 10268200 8817000 0
0 5270135 0 0 0 0 1326000 0 0 0 0
197000
3201126 B 1 BS 1 27/05/2018 28/05/2018 29/05/1990 0 2
0 - 0 - 0 - 0 - 0 9150100 9232613
0 2 0 0 0 DEVI ARYANI D399111 27 10225 RACHMAWATI
DR,SPB(K)ONK 0138R0170518V009240 0002048660943 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 184724 1#0##0#0#0.0#2018-06-04
11:38:06#0#00:00:00#00:00:00#00:00:00 1 e7a1cc56a96fb9412eb71debec93f7fb
0 0 1830020 0 0 1222090 0 0 0 0
6180503 0 0 0 0 0
3201126 B 1 BS 1 21/05/2018 28/05/2018 03/03/1977 0 2
0 - 0 - 0 - 0 - 0 5886000 9151197
0 8 0 0 0 NURSAMSI D339225 41 15054 DR ARU, SPPD
0138R0170518V007208 0001662627903 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 182593 1#0##0#0#0.0#2018-06-04
11:42:08#0#23:54:50#23:54:50#00:00:00 1 64016e667b26ab6a3675a2e3d0c51cd7
0 0 641600 0 0 2401565 0 0 0 0
6108032 0 0 0 0 0
3201126 B 1 BS 1 26/05/2018 28/05/2018 05/12/1959 0 1
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 4458412 0 3 0 0 0 SOHIBUL MUSIR
0001765964632 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184472
1#0##0#0#0.0#2018-06-04 11:43:37#0#00:00:00#00:00:00#00:00:00 1
e2a678d3de9f724eda33d965b66160c2 0 0 754840 0 0
1042900 0 0 0 0 2660672 0 0 0 0 0
3201126 B 1 BS 1 22/05/2018 28/05/2018 10/03/1952 0 2
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 9531295 0 7 0 0 0 MARDINAH
d399200 66 24179 DR MAYSAMIRAWATI SPS 0138R0170518V007660
0000041800601 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183198
1#0##0#0#0.0#2018-06-04 11:45:02#0#00:00:00#00:00:00#00:00:00 1
83f86889350f750d3379f55da3586732 0 0 1020330 0 0
2739922 0 0 0 0 5771043 0 0 0 0 0
3201126 B 3 BS 1 26/05/2018 28/05/2018 23/12/1989 0 1
1 D62;I84.4 99.04;90.59 - - None None None None D-4-13-I
0 - 0 2987000 3146490 0 3 0 0 0
MUHAMMAD HAFIZ D399556 28 10381 DR E SURYA POHAN DR SPB KBD
0138R0170518V009161 0001739769952 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 184675 1#0##0#0#0.0#2018-06-04
12:36:09#0#00:00:00#00:00:00#00:00:00 2 ed42945956df369295891f4679be8882
0 0 273635 0 0 1852010 0 0 0 0
1020845 0 0 0 0 0
3201126 B 1 BS 1 28/05/2018 28/05/2018 31/10/1977 0 2
- 0 - 0 - 0 - 0 3103000 3371939 0
5.2.1.201804062320 4 184845 1#0##0#0#0.0#2018-06-04
13:11:05#0#10:04:04#10:04:04#12:00:00 1 6e9c634d0db0a9c89eb7a13689d6eb16
0 0 279270 0 0 2017770 0 0 0 0
1074899 0 0 0 0 0
3201126 B 3 BS 1 28/05/2018 28/05/2018 14/05/1970 0 2
- 0 - 0 - 0 - 0 2216400 6646421 0
5.2.1.201804062320 4 184898 1#0##0#0#0.0#2018-06-04
13:18:20#0#11:01:32#11:01:32#12:00:00 2 0e0678ca32454a4799d781ff7dbadce0
0 0 199476 0 0 5689342 0 0 0 0 757603
0 0 0 0 0
3201126 B 2 BS 1 25/05/2018 28/05/2018 29/12/1959 0 2
1 I50.0;I25.0;K21.9 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
3200929 0 4 0 0 0 SITANINGDYAH LINA GUNAWANTI
D099406 58 21332 DR PRIYO SUNARTO , SPJP 0138R0170518V009039
0001135387078 3;JKN irene; 5.2.1.201804062320 4 184468
1#0##0#0#0.0#2018-06-06 09:29:35#0#22:00:43#22:00:43#12:00:00 2
d91a329825faeb9374f2b9ce01ef7403 0 0 439172 0 0 713850
0 0 0 0 2047907 0 0 0 0 0
3201126 B 3 BS 1 25/05/2018 28/05/2018 24/10/1983 0 2
5405200 0 0 - 0 - 0 - 0 - 0
5405200 11506224 0 4 0 0 0 DIANA D399459 34
12632 DR ARIS WAHJU, SPOG 0138R0170518V009020 0001014206038 3;JKN
irene; 5.2.1.201804062320 4 184458 1#0##0#0#0.0#2018-06-06
09:33:23#0#00:00:00#00:00:00#00:00:00 2 ae5fcb86ca185195c81b6094eb6c9bd0
0 4321000 2260216 0 0 3268264 0 0 0 0
863744 0 0 0 0 793000
3201126 B 3 BS 1 25/05/2018 28/05/2018 11/12/2017 0 1
1 N39.0;H60.8 - - - None None None None N-4-12-I None
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2975542 0 4 0 0 0 BY NY TENI D399431
3;JKN DR RIZKI; 5.2.2.201806040537 4 184978 1#0##0#0#0.0#2018-
06-19 10:47:46#0#13:29:36#13:29:36#00:00:00 1
79f835034f3c6eec98a9a2a6d5a2d890 0 0 475343 0 0
1320537 0 0 0 0 1009662 0 0 0 0 170000
3201126 B 3 BS 1 27/05/2018 28/05/2018 31/12/1950 0 1
2 I21.3;J44.1;I50.0 90.59;89.52 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 7219300
5277823 0 2 0 0 0 NIWAN D371788 67 24619 DR
AHMAD HIBBAN A WRIYA 0138R0170518V009197 0002197426263 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 184697 1#0##0#0#0.0#2018-08-03
08:43:26#0#00:00:00#00:00:00#12:00:00 3 5583f3ba1bd26ef607b3f9257a738f33
0 0 360965 0 0 3541580 0 0 0 0 634278
0 0 0 0 741000
3201126 B 3 BS 1 27/05/2018 28/05/2018 04/07/1954 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 5415402 0 2 0 0 0 HELDEM PASYA
0001276821865 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 184718
1#0##0#0#0.0#2018-08-04 15:18:39#0#00:00:00#00:00:00#00:00:00 3
008ea8a3174e6c570f12b1ceb0da1237 0 0 371889 0 0
3812234 0 0 0 0 643279 0 0 0 0 588000
3201126 B 1 BS 1 27/05/2018 28/05/2018 01/04/1954 0 1
1 L03.1;I82.9 - - - None None None None L-4-12-II None
3245500 0 0 - 0 - 0 - 0 - 0
3245500 10054936 0 2 1 2 0 FUADAMIN D399576
0001336067109 3;JKN irene; 5.2.2.201806040537 4 184696
1#0##0#0#0.0#2018-08-13 09:27:10#0#00:00:00#00:00:00#00:00:00 2
e0cd0c537bc5c19348d3ba3d66105db1 0 0 261638 0 0
5388498 0 0 0 0 2429800 0 0 0 0
1975000
3201126 B 3 BS 1 27/05/2018 28/05/2018 07/05/1977 0 2
None None None None None GANGGUAN SISTEM PEMBULUH DARAH LAIN-LAIN
(RINGAN) 2795900 0 0 - 0 - 0 - 0 - 0
2795900 2624476 0 2 0 0 0 MUTIARA INDAH LIDINI
0001727179064 3;JKN irene; 5.2.2.201806040537 4 184726
1#0##0#0#0.0#2018-08-13 10:06:59#0#20:53:18#20:53:18#12:00:00 2
b25dce95bcf5a52f2df04a37b5d60fb0 0 0 139795 0 0
1733986 0 0 0 0 460695 0 0 0 0 290000
3201126 B 1 BS 1 27/05/2018 28/05/2018 05/05/1953 0 1
1 I25.0;I08.9;I50.0;N18.5;J45.9 88.55;36.07 - - YY02 None None
0 - 0 - 0 46734600 72511755 0 2 0 0
0 SYAMSUDIN D370559 65 23763 DR AZRI NURIZAL SPPD KKV
0138R0170518V009198 0000037949231 3;JKN DR RIZKI; 5.2.2.201806040537
4 184698 1#0##0#0#0.0#2018-09-06
11:47:57#0#00:00:00#00:00:00#00:00:00 3 bf5ec4c65567d9ce9431400088df3fd9
0 10062000 7201760 0 0 46402995 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 25/05/2018 28/05/2018 01/02/1976 0 1
- 0 - 0 - 0 6844000 6073351 0 4 0
0 0 JACK SUBARJA SE D123363 42 15454 DR MAYSAM I., SPS
0138R0170518V009044 0000037290969 3;JKN DR RIZKI; 5.2.2.201806040537
4 184470 1#0##0#0#0.0#2018-09-10
12:33:01#0#23:03:17#23:03:17#00:00:00 2 1f1b6ac6e96eab67f4a1663f73a65002
0 0 754840 0 0 2552189 0 0 0 0
2766322 0 0 0 0 0
3201126 B 2 BS 1 20/05/2018 28/05/2018 12/08/1958 0 2
1 I61.9;G91.0;G81.9;E87.6;I10 02.34 - - None None None None
G-1-11-II None None None None None None PROSEDUR VENTRICULAR SHUNT
(SEDANG) 25929100 0 0 - 0 - 0 - 0 - 0
25929100 53149401 0 9 0 0 0 MAMAH D399005 59
21831 DR NURUL KOMARI SPS 0138R0170518V006658 0001336359622 3;JKN
DR RIZKI; 5.2.2.201806040537 4 181951 1#0##0#0#0.0#2018-09-10
12:37:45#0#00:00:00#00:00:00#00:00:00 3 5e531e8d9d50861c865aa126ce57cc26
0 10834100 14614373 0 0 20091928 0 0 0 0
1301000 0 0 0 0 6308000
3201126 B 3 BS 1 27/05/2018 28/05/2018 01/06/1960 0 1
1 E10.5 99.17;90.59;89.52 - - None None None None I-4-15-I
LAIN (RINGAN) 4482300 0 0 - 0 - 0 - 0 -
0 4482300 1897656 0 2 0 0 0 JAMIN D399581
DR RIZKI; 5.2.2.201806040537 4 184693 1#0##0#0#0.0#2018-09-10
12:48:09#0#00:00:00#00:00:00#00:00:00 2 63134cd1c452c12257cdcbe25c9d577b
0 0 601811 0 0 645699 0 0 0 0 650146
0 0 0 0 0
3201126 B 3 BS 1 25/05/2018 28/05/2018 07/10/1968 0 1
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3597351 0 4 0 0 0 JOKO WASPODO
0001449158815 3;JKN DR RIZKI; 5.2.2.201806040537 4 184190
1#0##0#0#0.0#2018-09-10 12:51:53#0#09:20:11#09:20:11#00:00:00 2
48bb96627060576de4562da976868cda 0 0 504179 0 0
1779831 0 0 0 0 1313341 0 0 0 0 0
3201126 B 3 BS 1 24/05/2018 28/05/2018 15/06/1959 0 1
1 I21.3;E14.1;I11.9;D63.8 99.04 - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 9704751 0 5 0 0 0 ARIN D398681 58
RIZKI; 5.2.2.201806040537 4 184154 1#0##0#0#0.0#2018-09-25
12:27:50#0#00:00:00#00:00:00#00:00:00 2 0f33b54582461595f1fb6722aa72476d
0 0 1040190 0 0 5027171 0 0 0 0
2879390 0 0 0 0 758000
3201126 B 3 BS 1 22/05/2018 28/05/2018 25/11/2015 0 2
1 G40.9;G80.0 93.94 - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 2655900 8688130
0 7 0 0 0 ERISKA NUR AULIA PUTRI d399163 2 909
RIZKI; 5.2.2.201806040537 4 182993 1#0##0#0#0.0#2018-09-28
14:36:29#0#13:38:45#13:38:45#00:00:00 2 f0078bea5e3a97d66a361fafb3f5995c
0 0 409850 0 0 5842898 0 0 0 0
2435382 0 0 0 0 0
3201126 B 1 BS 1 25/05/2018 28/05/2018 05/07/1962 0 1
1 D13.6;K83.1 90.59;89.52 - - None None None None B-4-12-II
None None None None None None GANGGUAN PANKREAS SELAIN TUMOR (SEDANG)
9058100 0 0 - 0 - 0 - 0 - 0
9058100 5468725 0 4 0 0 0 RUKMANA D399140
55 20413 DR ARU, SPPD 0138R0170518V009036 0000061110123 3;JKN
DR RIZKI; 5.2.2.201806040537 4 184466 1#0##0#0#0.0#2018-09-29
11:59:44#0#00:00:00#00:00:00#00:00:00 2 2d06868717301e167297af811aa31109
0 0 912932 0 0 1393526 0 0 0 0
3162267 0 0 0 0 0
3201126 B 1 BS 1 27/05/2018 28/05/2018 06/05/1939 0 1
0 - 0 - 0 - 0 - 0 10107000 9705418
0 2 0 0 0 MACHMUD ISMAIL D399587 79 28876 DR
DICKY KARUNDENG 0138R0170518V009213 0000060594772 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 184712 1#0##0#0#0.0#2018-10-10
16:54:56#0#00:00:00#00:00:00#00:00:00 1 895ae00d77b1ee4e861dc59ef970d2f3
0 0 1018322 0 0 6280162 0 0 0 0
1746000 0 0 0 660934 0
3201126 B 3 BS 1 25/05/2018 29/05/2018 15/05/1953 0 1
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 3863422 0 5 0 0 0 SOPIAN D395148
65 23751 DR ARU, SPPD 0138R0170518V008906 0000385772409 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 184388 1#0##0#0#0.0#2018-
06-04 12:32:09#0#00:00:00#00:00:00#00:00:00 1
8d9ceb530ea2e30e5bd3809ca1435ba7 0 0 207620 0 0
2062055 0 0 0 0 1593747 0 0 0 0 0
3201126 B 3 BS 1 27/05/2018 29/05/2018 15/05/1990 0 2
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2824741 0 3 0 0 0 WIDI ALFI D399582
TANTIYO S;16137 5.2.1.201804062320 4 184875 1#0##0#0#0.0#2018-
06-04 12:37:14#0#00:00:00#00:00:00#00:00:00 1
76ecfe09f8c067dbfb32b03f960eb057 0 0 268343 0 0
1556602 0 0 0 0 999796 0 0 0 0 0
3201126 B 2 BS 1 26/05/2018 29/05/2018 23/07/1986 0 2
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 4624969 0 4 0 0 0 CHOLILAH D399482
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184621
1#0##0#0#0.0#2018-06-04 12:51:05#0#11:28:12#11:28:12#00:00:00 1
99997ac72b2f68eecbcc0fed65c81d5a 0 0 422099 0 0
1854302 0 0 0 0 2348568 0 0 0 0 0
3201126 B 1 BS 1 22/05/2018 29/05/2018 31/12/1946 0 2
1 E13.6;K60.2;R33 - - - None None None None E-4-10-I
0 - 0 4903800 9902490 0 8 0 0 0
NURYATI D397291 71 26075 DR. ARU ARIADNO, SPPD
0138R0170518V007513 0002329583016 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 183031 1#0##0#0#0.0#2018-06-04
13:42:14#0#14:14:35#14:14:35#00:00:00 1 a5b48193ed71b073291a2e15733f5c6a
0 0 631242 0 0 2337940 0 0 0 0
6933308 0 0 0 0 0
3201126 B 1 BS 1 26/05/2018 29/05/2018 30/08/2017 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3193737 0 4 0 0 0 EL ZIDAN ZULKARNAIN
0002282043519 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184692
1#0##0#0#0.0#2018-06-04 14:38:39#0#23:41:57#23:41:57#00:00:00 1
ae4ff0fda4fb24b9b8309853ed409a91 0 0 269459 0 0 346342
0 0 0 0 2577936 0 0 0 0 0
3201126 B 1 BS 1 27/05/2018 29/05/2018 26/12/1949 0 1
1 N40;N39.0 90.59;89.52 - - None None None None V-4-11-II
- 0 6936800 5339997 0 3 0 0 0 IBRAHIM
SASTRAWINATA,DRS,MM D399590 68 24989 DR MOHAMMAD JOHAN SPU
0138R0170518V009220 0000042626608 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 184716 1#0##0#0#0.0#2018-06-04
14:40:06#0#00:00:00#00:00:00#00:00:00 1 ce822ef8be85529245f3ba450743c9b8
0 0 1145546 0 0 982105 0 0 0 0
3212346 0 0 0 0 0
3201126 B 1 BS 1 23/05/2018 29/05/2018 19/08/1977 0 1
1 A16.2;E11.9 93.94 - - None None None None J-4-15-I None
6071100 0 0 - 0 - 0 - 0 - 0
6071100 9196993 0 7 0 0 0 AGUS BAMBANG SUHARTONO
d399232 40 14887 DR MOHAMAD NIZAM ERHAMZA SPP 0138R0170518V007680
0001772774076 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183206
1#0##0#0#0.0#2018-06-04 14:41:56#0#00:00:00#00:00:00#00:00:00 1
ebe948605eea5afbaa83f782a3cd2f90 0 0 599399 0 0
2502922 0 0 0 0 6094672 0 0 0 0 0
3201126 B 2 BS 1 27/05/2018 29/05/2018 07/07/2003 0 1
1 N23 88.76 - - None None None None N-4-13-I None None
0 - 0 - 0 - 0 4101100 4179465 0 3
0 0 0 TEGAR PUTRA NOVANDI D053895 14 5438 DR HENDRIEK
S, SPB 0138R0170518V009217 0001465062232 3;JKN irene;
5.2.1.201804062320 4 184715 1#0##0#0#0.0#2018-06-06
09:35:26#0#00:00:00#00:00:00#00:00:00 2 d73c502d4e7f4a73d976675ef741bb13
0 0 238535 0 0 2126507 0 0 0 0
1814423 0 0 0 0 0
3201126 B 2 BS 1 28/05/2018 29/05/2018 07/07/1939 0 1
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 66198870 0 2 0 0 0 MUHAMAD RAIS
0000060601509 3;JKN irene; 5.2.1.201804062320 4 184785
1#0##0#0#0.0#2018-06-06 09:35:53#0#00:00:00#00:00:00#00:00:00 2
3da0b9faa0c25371e5b9fcebdf10ae27 0 0 8244960 0 0
40122910 0 0 0 0 10262000 0 0 0 0
7569000
3201126 B 1 BS 1 28/05/2018 29/05/2018 13/09/1949 0 1
0 - 0 - 0 - 0 - 0 17095200 15305750
0 2 0 0 0 DIDI AFFANDI.K D105815 68 25094 DR
AZRI NURIZAL SPPD KKV 0138R0170518V009376 0001421639572 3;JKN irene;
5.2.1.201804062320 4 184759 1#0##0#0#0.0#2018-06-06
09:37:37#0#00:00:00#00:00:00#00:00:00 2 6793846d8649ecce576f4016723ce1dc
0 4777000 3419040 0 0 3883710 0 0 0 0
1226000 0 0 0 0 2000000
3201126 B 3 BS 1 26/05/2018 29/05/2018 27/12/1957 0 1
1 N11.1;N39.0;I11.0 - - - None None None None N-4-12-III
5062600 0 0 - 0 - 0 - 0 - 0
5062600 2817132 0 4 0 0 0 KHODIJAH D399564
0001457483016 3;JKN irene; 5.2.1.201804062320 4 184678
1#0##0#0#0.0#2018-06-06 09:39:21#0#00:00:00#00:00:00#00:00:00 2
4ecdac83e4d3cbfe1ce2f901ffb1e919 0 0 508634 0 0
1132700 0 0 0 0 1175798 0 0 0 0 0
3201126 B 3 BS 1 28/05/2018 29/05/2018 10/07/1974 0 1
1 I64;R40.2 99.60 - - None None None None G-4-15-II None
- 0 - 0 - 0 4888600 5349519 0 2 0
0 0 GUNAWAN D399657 43 16028 DR DICKY KARUNDENG
0138R0170518V009703 0001907591771 3;JKN irene; 5.2.1.201804062320
4 185065 1#0##0#0#0.0#2018-06-06
09:39:34#0#18:54:15#18:54:15#00:00:00 2 3bc7a9320e6e90805c588d29317bfb08
0 0 439974 0 0 3213576 0 0 0 0 656969
0 0 0 0 1039000
3201126 B 3 BS 1 28/05/2018 29/05/2018 02/02/1937 0 2
4 I95.9;J96.0;R40.2;R57.0 - - - None None None None I-4-
LAIN-LAIN (BERAT) 8139800 0 0 - 0 - 0 - 0 -
0 8139800 4149586 0 2 0 0 0 NONON BACAS
D279666 81 29700 DR MUHAMMAD RIZKI YUWANA 0138R0170518V009699
0000060955852 3;JKN irene; 5.2.1.201804062320 4 185063
1#0##0#0#0.0#2018-06-06 09:39:46#0#18:16:43#18:16:43#00:00:00 2
e16ca5b1a544fa392a28d26552f564e7 0 0 732582 0 0
1799536 0 0 0 0 578468 0 0 0 0
1039000
3201126 B 2 BS 1 26/05/2018 29/05/2018 17/05/2011 0 2
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 3434184 0 4 0 0 0 CALLYSTA AULIA PRASTITA
D349439 7 2566 DR HUDA HILMAN 0138R0170518V009139
0001273515581 3;JKN DR RIZKI; 5.2.2.201806040537 4 184660
1#0##0#0#0.0#2018-06-19 10:40:17#0#00:00:00#00:00:00#00:00:00 1
9d6e77ac9cb4011484cd5bda8f00ce09 0 0 238535 0 0 924983
0 0 0 0 2270666 0 0 0 0 0
3201126 B 3 BS 1 25/05/2018 29/05/2018 17/08/1975 0 1
0 - 0 - 0 - 0 - 0 4973600 11283109
0 5 1 3 0 ADNI D399441 42 15622 DR AGOES
KOOSHARTORO SPPD-KKV 0138R0170518V009042 0000511080917 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 184469 1#0##0#0#0.0#2018-08-04
14:36:13#0#22:46:53#22:46:53#00:00:00 4 6c046df9795ec0e85e86d3bdde8bffcf
0 0 426023 0 0 4937331 0 0 0 0
2882000 0 0 2274000 763755 0
3201126 B 1 BS 1 29/05/2018 29/05/2018 15/01/1989 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 3000000 0 1 0 0 0 TRI LESTARI
MULYATININGSIH D398133 29 10726 DR AFRA FONDA SPOG
0138R0170518V009766 0001628859519 3;JKN irene; 5.2.2.201806040537
4 185087 1#0##0#0#0.0#2018-08-13
09:29:02#0#09:07:50#09:07:50#00:00:00 2 fc775969f5384caf9f0491db119d81cb
0 0 3000000 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 3 BS 1 28/05/2018 29/05/2018 26/09/1976 0 1
1 N18.5;I50.0 - - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
D239322 41 15219 DR ARU, SPPD 0138R0170518V009617
0001743628138 3;JKN irene; 5.2.2.201806040537 4 185005
1#0##0#0#0.0#2018-08-13 10:37:06#0#14:57:54#14:57:54#00:00:00 2
7160318f57762d34edd6a788d9d4d1fa 0 0 351242 0 0 406980
0 0 0 0 1880903 0 0 0 0 0
3201126 B 1 BS 1 27/05/2018 29/05/2018 04/09/1984 0 1
0 - 0 - 0 - 0 4784600 4149392 0 3
0 0 0 REZA TAUFIK HIDAYAT,ST D364137 33 12318 DR MOHAMMAD
JOHAN SPU 0138R0170518V009210 0001774066735 3;JKN DR RIZKI;
5.2.2.201806040537 4 184709 1#0##0#0#0.0#2018-09-06
11:25:39#0#00:00:00#00:00:00#00:00:00 3 7546a27e9b81310a90e232b7897d499a
0 0 572372 0 0 936564 0 0 0 0
2640456 0 0 0 0 0
3201126 B 1 BS 1 24/05/2018 29/05/2018 30/01/1964 0 2
1 K43.0;N99.4;H81.1 53.69 - - None None None None K-1-12-II
None None None None None None PROSEDUR HERNIA TIDAK TERMASUK INGUINAL &
FEMORAL (SEDANG) 6255300 0 0 - 0 - 0 - 0 -
0 6255300 17203377 0 6 0 0 0 ERNA MARANTIKA
0000005169159 3;JKN DR RIZKI; 5.2.2.201806040537 4 183647
1#0##0#0#0.0#2018-09-26 10:57:42#0#06:20:52#06:20:52#00:00:00 2
97a546825385db89e3216d6c9891b05a 0 9250200 3571228 0 0
3111494 0 0 0 0 1201455 0 0 0 0 69000
3201126 B 2 BS 1 12/05/2018 29/05/2018 02/05/1950 0 1
1 E11.5;T87.4;N40;N39.9;A41.9 90.59;89.52;86.22 - - None None
None None I-4-15-III None None None None None None PENYAKIT PEMBULUH
DARAH PERIFER DAN LAIN-LAIN (BERAT) 8781000 0 0 - 0 - 0
- 0 - 0 8781000 34729436 0 18 0 0 0
SUDARNO D393327 68 24847 DR DEDY PRATAMA SPBV
0138R0170518V004000 0000060929774 3;JKN DR RIZKI; 5.2.2.201806040537
4 179765 1#0##0#0#0.0#2018-10-01
11:14:16#0#18:20:33#18:20:33#12:00:00 2 d59a923345d99e626dd5c05103ad6b0c
0 1474000 2487950 0 0 0 0 0 0 0
12423600 0 0 1224000 17119886 0
3201126 B 2 BS 1 28/05/2018 30/05/2018 27/04/1952 0 1
1 K51.9;K57.9;I84.1;K62.6 45.23 - - None None None None K-4-
0 - 0 - 0 4780000 2000000 0 3 0 0
0 DADAY A.MURAD D399248 66 24137 DR BETTY DWI L, SPPD
0138R0170518V009732 0001337031156 3;JKN TANTIYO S;16137
5.2.1.201804062320 4 185077 1#0##0#0#0.0#2018-06-04
14:49:01#0#00:00:00#00:00:00#00:00:00 1 5ad4e91b9772db14e156d445183ee94a
0 2000000 0 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 28/05/2018 30/05/2018 28/05/2018 2515 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2102355 0 3 0 0 0 ASTUTI HARTANTI BY NY
D399638 0 0 DR. TRI LESTARI 0138R0170518V009659
0002462597752 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 185054
1#0##0#0#0.0#2018-06-04 14:55:25#0#15:58:03#15:58:03#00:00:00 1
1c1e291571694bd4e1920a2751f06cac 0 0 499620 0 0 146598
0 0 0 0 1456137 0 0 0 0 0
3201126 B 1 BS 1 27/05/2018 30/05/2018 25/03/1951 0 2
0 0 - 0 - 0 - 0 - 0 5883600
5235974 0 4 0 0 0 MARIAM NURIAH D399580 67
24535 DR AZRI SPJP 0138R0170518V009202 0001458548976 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 184701 1#0##0#0#0.0#2018-
06-04 14:59:20#0#00:00:00#00:00:00#00:00:00 1
07da1f71e288712e2c6322e0168da5ab 0 0 582524 0 0
2343000 0 0 0 0 368540 0 0 0 1941910
0
3201126 B 1 BS 1 27/05/2018 30/05/2018 05/02/1985 0 2
1 O82.9;Z37.0;O99.0;O72.0 74.0 - - None None None None O-6-
7567300 0 0 - 0 - 0 - 0 - 0
7567300 13379259 0 4 0 0 0 NINA SUKMANAH
D399268 33 12164 DR BAGUS T, SPOG 0138R0170518V009239
0000173526546 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184723
1#0##0#0#0.0#2018-06-04 15:02:25#0#00:00:00#00:00:00#00:00:00 1
5561ed0800264b1f675bbbe0f8973b65 0 7426400 2560209 0 0
2219371 0 0 0 0 976279 0 0 0 197000
0
3201126 B 3 BS 1 27/05/2018 30/05/2018 05/10/1963 0 2
0 - 0 - 0 - 0 - 0 6535800 4438194
0 4 0 0 0 SUSANA E MARGARETHA d399430 54 19958
TANTIYO S;16137 5.2.1.201804062320 4 184861 1#0##0#0#0.0#2018-
06-04 15:29:40#0#10:17:45#10:17:45#00:00:00 1
2e7558440d54483608ffead4164e07b2 0 0 1334160 0 0
2095685 0 0 0 0 1008349 0 0 0 0 0
3201126 B 3 BS 1 27/05/2018 30/05/2018 12/07/1942 0 1
1 A01.0;D29.1;N18.5;N20.0 - - - None None None None A-4-
LAIN-LAIN (SEDANG) 2753900 0 0 - 0 - 0 - 0
- 0 2753900 3224499 0 4 0 0 0 KIYAR
0001295660531 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184725
1#0##0#0#0.0#2018-06-04 15:38:24#0#00:00:00#00:00:00#12:00:00 1
8a16eafd7156d32ba48609253c6cffbb 0 0 300851 0 0
1721199 0 0 0 0 1202449 0 0 0 0 0
3201126 B 3 BS 1 27/05/2018 30/05/2018 28/09/1938 0 2
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 2750551 0 4 0 0 0 MURIAH SITI D399602
3;JKN TANTIYO S;16137 5.2.1.201804062320 4 184720
1#0##0#0#0.0#2018-06-04 15:39:16#0#00:00:00#00:00:00#00:00:00 1
70a0a5b9c91b6670ed8466f30fd477b8 0 0 296404 0 0
1282704 0 0 0 0 1171443 0 0 0 0 0
3201126 B 3 BS 1 27/05/2018 30/05/2018 16/07/1970 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 4940627 0 4 0 0 0 NY NURLAELA D399583
47 17482 DR ARU 0138R0170518V009193 0001208388385 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 184695 1#0##0#0#0.0#2018-
06-05 09:33:08#0#00:00:00#00:00:00#00:00:00 1
e3c9df309e06a4eb4b7f1b9fa3f21a80 0 0 378188 0 0
3161220 0 0 0 0 1401219 0 0 0 0 0
3201126 B 1 BS 1 23/05/2018 30/05/2018 10/06/1956 0 1
1 C95.9;D69.6 - - - None None None None C-4-11-II None
None None None None None LIMFOMA & LEUKEMIA NON AKUT (SEDANG)
8295000 0 0 - 0 - 0 - 0 - 0
8295000 12399868 0 8 0 0 0 TONNY SOELISTIO
D399084 61 22627 DR ARU, SPPD 0138R0170518V007968
0001459307722 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 183527
1#0##0#0#0.0#2018-06-05 09:35:13#0#13:05:03#13:05:03#00:00:00 1
2f0f492b8dcb91e33d374da321020bd7 0 0 372374 0 0
4942288 0 0 0 0 7085206 0 0 0 0 0
3201126 B 2 BS 1 28/05/2018 30/05/2018 08/07/1961 0 1
1 N20.1;Q62.1;I10;N39.8 58.1;59.8 - - None None None None
- 0 9649200 17195924 0 3 0 0 0 ASMAWIH
0001468454027 3;JKN irene; 5.2.1.201804062320 4 184732
1#0##0#0#0.0#2018-06-06 09:58:18#0#00:00:00#00:00:00#00:00:00 3
721cf850498864a7995a19cfdc68ba3c 0 7446500 2701776 0 0
2687260 0 0 0 0 1291388 0 0 0 0
3069000
3201126 B 3 BS 1 28/05/2018 30/05/2018 05/06/1955 0 1
1 N40;I10;D62 60.29;99.04 - - None None None None V-1-14-II
(SEDANG) 12841200 0 0 - 0 - 0 - 0 - 0
12841200 17940858 0 3 0 0 0 WAGIMAN D380692
62 23003 DR MOHAMMAD JOHAN SPU 0138R0170518V009280 0000511107041
3;JKN irene; 5.2.1.201804062320 4 184730 1#0##0#0#0.0#2018-
06-06 10:01:49#0#06:45:31#06:45:31#12:00:00 3
6ba31cc2b4847cd4ff24819d84d178f5 0 5219300 2474612 0 0
5703245 0 0 0 0 1274701 0 0 0 0
3269000
3201126 B 3 BS 1 29/05/2018 30/05/2018 30/07/1988 0 1
3697100 0 0 - 0 - 0 - 0 - 0
3697100 6234295 0 2 0 0 0 RUMANTIKA SRI ASTUTI
0001640071247 3;JKN DR RIZKI; 5.2.2.201806040537 4 185100
1#0##0#0#0.0#2018-06-13 10:07:39#0#20:26:41#20:26:41#00:00:00 1
4ade9cadf89eeb00c45cf62a436818d7 0 2976000 1088188 0 0
1541256 0 0 0 0 483851 0 0 0 0 145000
3201126 B 1 BS 1 27/05/2018 30/05/2018 16/02/2016 0 2
LAIN (RINGAN) 3917900 0 0 - 0 - 0 - 0 -
0 3917900 5669055 0 4 0 0 0 ALESHA AINAYYA
KHAIRUNNISA AL-ARHAM D399588 2 831 DR OTTY MITHA S, SPA
0138R0170518V009207 0002275665445 3;JKN DR RIZKI; 5.2.2.201806040537
4 184705 1#0##0#0#0.0#2018-06-19
10:43:23#0#00:00:00#00:00:00#00:00:00 2 a31fb526ef393056dd2bb4739546aaca
0 0 405611 0 0 1742571 0 0 0 0
3520873 0 0 0 0 0
3201126 B 1 BS 1 27/05/2018 30/05/2018 15/11/1934 0 2
4 D38.1;K30;I48 87.44 - - None None None None J-4-21-II
0 - 0 6311700 6713514 0 4 0 0 0 NANI
SUMARNI IDRIS d371873 83 30509 DR AZRI NURIZAL SPPD KKV
0138R0170518V009230 0000039242327 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 184719 1#0##0#0#0.0#2018-08-03
08:48:14#0#00:00:00#00:00:00#12:00:00 2 d09167ee97bb602dd9e978af845dbdaf
0 0 470546 0 0 2709266 0 0 0 0
3243702 0 0 0 0 290000
3201126 B 3 BS 1 30/05/2018 30/05/2018 17/10/1947 0 1
2 E16.2;D64.9;I64;E87.6;G81.9 99.04 - - None None None None
- 0 - 0 6262900 8494568 0 1 0 0 0
GILING PURBA D394893 70 25793 DR DINI DANIATY
0138R0170518V009830 0001257806586 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 185114 1#0##0#0#0.0#2018-08-04
08:57:56#0#00:00:00#00:00:00#00:00:00 3 b518794d02aa3ba77724f42ba9a8e5bd
0 0 936171 0 0 5826678 0 0 0 0 862719
0 0 0 0 869000
3201126 B 1 BS 1 30/05/2018 30/05/2018 22/04/1966 0 1
- 0 5784900 2866141 0 1 0 0 0 JOHN TUA TN
0001423898605 3;JKN irene; 5.2.2.201806040537 4 185630
1#0##0#0#0.0#2018-08-13 09:27:52#0#16:10:25#16:10:25#00:00:00 2
988d4d5d4309d21441c21d38fb1da3c0 0 0 520641 0 0
1129000 0 0 0 0 1216500 0 0 0 0 0
3201126 B 2 BS 1 29/05/2018 30/05/2018 17/09/1953 0 2
4 I64;I25.0;K25.3;G81.9;R57.0;R40.2 96.71;87.03 - - None None
- 0 - 0 34963000 12330597 0 2 1 0 24
SRI NGADIYEM ZN D399698 64 23630 DR NURUL KOMARI SPS
0138R0170518V009748 0000060570819 3;JKN irene; 5.2.2.201806040537
4 185084 1#0##0#0#0.0#2018-08-13
09:39:34#0#00:33:46#00:33:46#00:00:00 2 9448539b2eccfbf155fde1e876331662
0 0 2417700 0 0 5218222 0 0 0 0
2739675 0 0 0 0 1955000
3201126 B 3 BS 1 28/05/2018 30/05/2018 10/06/1977 0 2
7792500 0 0 - 0 - 0 - 0 - 0
7792500 10180745 0 3 0 0 0 ELLY ROSITA D199612
3;JKN irene; 5.2.2.201806040537 4 184728 1#0##0#0#0.0#2018-
08-13 10:13:59#0#00:23:57#00:23:57#00:00:00 2
d4c2c28500561b31f6029ffe8ece491c 0 0 2578750 0 0
3530465 0 0 0 0 4002530 0 0 0 69000 0
3201126 B 2 BS 1 25/05/2018 30/05/2018 11/12/1943 0 1
0 0 - 0 - 0 - 0 - 0 4426600
7866562 0 6 0 0 0 DANIEL SUMAKUD D317512 74
27194 DR MOHAMAD NIZAM ERHAMZA SPP 0138R0170518V009049 0001379095558
3;JKN DR RIZKI; 5.2.2.201806040537 4 184471 1#0##0#0#0.0#2018-
09-10 12:41:18#0#23:33:43#23:33:43#00:00:00 2
8b0557ca000c86d16fc423cd3f191a3d 0 0 601370 0 0
4199557 0 0 0 0 540635 0 0 0 2525000
0
3201126 B 3 BS 1 29/05/2018 30/05/2018 01/05/1975 0 2
1 E04.1;R59.1 06.11 - - None None None None E-4-13-I None
3697100 0 0 - 0 - 0 - 0 - 0
3697100 6558049 0 2 0 0 0 SITI ALMINAH
0000511590273 3;JKN DR RIZKI; 5.2.2.201806040537 4 185099
1#0##0#0#0.0#2018-09-12 11:19:05#0#19:28:21#19:28:21#00:00:00 3
a614a5faee9a38549e5b01cb07c107e3 0 2976000 1508976 0 0
1558556 0 0 0 0 514517 0 0 0 0 0
3201126 B 2 BS 1 28/05/2018 30/05/2018 03/08/1985 0 1
1 A49.9;J18.0 87.44 - - None None None None A-4-14-III None
(BERAT) 3965700 0 0 - 0 - 0 - 0 - 0
3965700 5268311 0 3 0 0 0 BAHARUDDIN D396792
32 11986 DR ARU, SPPD 0138R0170518V009713 0002050169736 3;JKN
DR RIZKI; 5.2.2.201806040537 4 185066 1#0##0#0#0.0#2018-09-25
12:35:31#0#19:16:59#19:16:59#00:00:00 2 531f89fd529a1adafecbbee135756493
0 0 1615508 0 0 1974647 0 0 0 0
1678156 0 0 0 0 0
3201126 B 3 BS 1 28/05/2018 30/05/2018 03/07/2017 0 1
1 K52.2;R62.0 - - - None None None None K-4-17-II None
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 2467892 0 3 0 0 0 RAFFI AHMAD SANJAYA
0002136053608 3;JKN DR RIZKI; 5.2.2.201806040537 4 185075
1#0##0#0#0.0#2018-09-28 14:33:05#0#21:43:58#21:43:58#00:00:00 2
07d595d91bf71ed62119c6179f99cd3d 0 0 281492 0 0
1302949 0 0 0 0 713451 0 0 0 0 170000
3201126 B 2 BS 1 28/05/2018 31/05/2018 09/05/1995 0 2
1 O82.9;O42.0;Z37.0;O33.0 74.0 - - None None None None O-6-
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10854414 0 4 0 0 0 ARYANTI MAIYUNI
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1#0##0#0#0.0#2018-06-05 08:13:20#0#16:34:04#16:34:04#00:00:00 1
16a046ed49e75fee3bd1db2062bc729b 0 5684900 2117753 0 0
1949659 0 0 0 0 836102 0 0 0 0 266000
3201126 B 2 BS 1 26/05/2018 31/05/2018 30/05/1953 0 1
1 D29.1;N39.0 60.29 - - None None None None V-1-14-II None
None None None None None PENGANGKATAN PROSTAT MELALUI URETRA (SEDANG)
15409500 0 0 - 0 - 0 - 0 - 0
15409500 21896105 0 6 0 0 0 ABAS SUDJAI D399317
64 23737 MOHAMMAD JOHAN 0138R0170518V009185 0000060869867 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 184690 1#0##0#0#0.0#2018-
06-05 08:32:15#0#22:39:40#22:39:40#00:00:00 1
366035b5ff88c5c1e2bd220fe339ea69 0 8484000 4521755 0 0
4215350 0 0 0 0 4606000 0 0 0 0 69000
3201126 B 2 BS 1 30/05/2018 31/05/2018 28/02/1972 0 2
SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0 -
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0001265490652 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 185640
1#0##0#0#0.0#2018-06-05 08:34:56#0#17:59:13#17:59:13#12:00:00 1
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1354165 0 0 0 0 1229603 0 0 0 0 0
3201126 B 2 BS 1 29/05/2018 31/05/2018 09/02/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
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AZZAHIR D377226 2 840 DR AULIA TANGKARI, SPA 0138R0170518V009769
0001968079768 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 185088
1#0##0#0#0.0#2018-06-05 08:35:48#0#09:16:52#09:16:52#12:00:00 1
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3201126 B 2 BS 1 29/05/2018 31/05/2018 12/03/1994 0 2
0 0 - 0 - 0 - 0 - 0 5984100
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DR FX BHIMANTORO, SPOG 0138R0170518V009800 0002040670596 3;JKN
TANTIYO S;16137 5.2.1.201804062320 4 185097 1#0##0#0#0.0#2018-
06-05 08:39:14#0#17:29:12#17:29:12#00:00:00 1
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2446875 0 0 0 0 791344 0 0 0 0 197000
3201126 B 2 BS 1 21/05/2018 31/05/2018 07/10/1935 0 2
1 I21.3;E87.6;I95.9;I50.0;I48;R57.0 99.04 - - None None None
None I-4-10-III None None None None None None INFARK MYOKARD AKUT
(BERAT) 12482300 0 0 - 0 - 0 - 0 - 0
12482300 30965031 0 11 1 2 0 SIAUW SU LIEN
0001457370786 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 181965
1#0##0#0#0.0#2018-06-05 09:00:49#0#00:25:32#00:25:32#00:00:00 1
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15102802 0 0 0 0 9407000 0 0 0 0
5154000
3201126 B 2 BS 1 29/05/2018 31/05/2018 23/12/1981 0 2
1743400 0 0 - 0 - 0 - 0 - 0
1743400 3557401 0 3 0 0 0 METTY LESTARI
0000036467291 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 185085
1#0##0#0#0.0#2018-06-05 09:03:58#0#00:00:00#00:00:00#00:00:00 1
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1573774 0 0 0 0 1773727 0 0 0 0 0
3201126 B 2 BS 1 29/05/2018 31/05/2018 29/05/2018 2619 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1458743 0 3 0 0 0 BAYI NY. POPPIE. M
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0002458424913 3;JKN TANTIYO S;16137 5.2.1.201804062320 4 185506
1#0##0#0#0.0#2018-06-05 09:06:54#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 0 0 0 0 1024931 0
3201126 B 1 BS 1 28/05/2018 31/05/2018 10/11/1962 0 2
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 5037955 0 4 0 0 0 SITI RAMLAN D055841
55 20288 DR ARU, SPPD 0138R0170518V009736 0000061100436 3;JKN
DR RIZKI; 5.2.2.201806040537 4 185078 1#0##0#0#0.0#2018-06-13
09:08:31#0#00:00:00#00:00:00#00:00:00 1 e1a54d58316c3db3bdd4db9ccab4c0c6
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329586 0 0 0 26000 0
3201126 B 1 BS 1 27/05/2018 31/05/2018 07/11/1956 0 2
1 E11.6;M54.59;R63.0 - - - None None None None E-4-
0 - 0 4903800 7679298 0 5 0 0 0
ROSMERY TAMBUNAN D3502611 61 22481 DR SOEGIONO, SPPD
0138R0170518V009238 0001793559238 3;JKN DR RIZKI; 5.2.2.201806040537
4 184722 1#0##0#0#0.0#2018-06-13
09:17:07#0#00:00:00#00:00:00#00:00:00 2 69bb931cb9a06f18ef30f8ec4aaeb2a8
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502384 0 0 0 26000 0
3201126 B 1 BS 1 29/05/2018 31/05/2018 29/05/2018 3238 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2965097 0 3 0 0 0 BAYI NY ISVENTINA
d399725 0 0 DR TRI LESTARI, SPA 0138R0170518V010532
0002463280773 3;JKN DR RIZKI; 5.2.2.201806040537 4 185973
1#0##0#0#0.0#2018-06-13 10:35:46#0#12:07:18#12:07:18#00:00:00 1
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3201126 B 3 BS 1 31/05/2018 31/05/2018 06/11/1970 0 2
4 N18.5;T82.4 93.57;99.60 - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 1475362 0 1 0 0 0 MAIMUNAH
0000168357317 3;JKN DR RIZKI; 5.2.2.201806040537 4 185656
1#0##0#0#0.0#2018-06-18 15:30:35#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 2 BS 1 29/05/2018 31/05/2018 23/10/1943 0 2
1 E11.9;I25.0;I10;A49.9;I63.9;S42.30 88.21;87.44;87.03 - - None
None None None E-4-10-III None None None None None None PENYAKIT
KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK (BERAT) 7515400 0 0 -
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5.2.2.201806040537 4 185083 1#0##0#0#0.0#2018-06-19
15:17:42#0#00:23:28#00:23:28#00:00:00 1 df5026919d2a9fab26673635fc5c8bb5
0 0 538738 0 0 2941734 0 0 0 0
1892503 0 0 0 0 0
3201126 B 1 BS 1 28/05/2018 31/05/2018 09/11/1965 0 1
1 I63.8;J41.0;E13.9 - - - None None None None G-4-14-I
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 5936469 0 4 0 0 0 MULYADI BUTAR-
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1#0##0#0#0.0#2018-07-04 14:06:31#0#09:44:12#09:44:12#00:00:00 2
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3201126 B 1 BS 1 28/05/2018 31/05/2018 29/10/2017 0 1
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 4216478 0 4 0 0 0 ABDURRAHMAN AMMAR
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1#0##0#0#0.0#2018-07-04 14:07:53#0#16:45:46#16:45:46#00:00:00 2
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3201126 B 1 BS 1 29/05/2018 31/05/2018 29/05/2018 2650 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2061547 0 3 0 0 0 BY. NY. TRI LESTARI
MULYATININGSIH D399723 0 0 DR. TRI LESTARI 0138R0170518V010037
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1#0##0#0#0.0#2018-07-04 14:08:13#0#00:00:00#00:00:00#00:00:00 2
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3201126 B 1 BS 1 28/05/2018 31/05/2018 08/11/1962 0 1
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0 4 0 0 0 MANGARA SITANGGANG TN D398838 55 20290
DR RISMAN S, SPTHT 0138R0170518V009730 0000038716907 3;JKN irene;
5.2.1.201804062320 4 185076 1#0##0#0#0.0#2018-07-04
14:08:40#0#21:47:32#21:47:32#00:00:00 2 4a416847f5f9607af03c210eabe039a0
0 0 1276216 0 0 3071275 0 0 0 0
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3201126 B 1 BS 1 28/05/2018 31/05/2018 19/04/1984 0 2
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0 4 0 0 0 ISVENTINA NY D393349 34 12457 DR
NINING H, SPOG 0138R0170518V009740 0000203597875 3;JKN irene;
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14:09:05#0#23:01:53#23:01:53#00:00:00 2 db3fffdfaa5606667e418c9750c62212
0 8271400 6488000 0 0 4108691 0 0 0 0
1326000 0 0 0 0 69000
3201126 B 3 BS 1 29/05/2018 31/05/2018 26/11/2000 0 2
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HENDRIEK S, SPB 0138R0170518V009806 0000511299911 3;JKN irene;
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15:11:17#0#00:00:00#00:00:00#00:00:00 2 0b92ee38f75ccf763ee99c4521280343
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3201126 B 1 BS 1 28/05/2018 31/05/2018 09/08/1948 0 1
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6844000 0 0 - 0 - 0 - 0 - 0
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3201126 B 3 BS 1 25/05/2018 31/05/2018 01/11/1970 0 1
1 I61.9;G81.9;I10;E78.5;E79.0 87.44;87.03 - - None None None
None G-4-13-II None None None None None None PERDARAHAN INTRA KRANIAL
0 - 0 5153300 8058381 0 7 0 0 0 PAUL
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1#0##0#0#0.0#2018-08-13 09:54:57#0#18:56:25#18:56:25#00:00:00 2
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0
3201126 B 3 BS 1 19/05/2018 31/05/2018 03/03/1953 0 2
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KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-08-13 10:13:33#0#01:08:44#01:08:44#12:00:00 2
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2803000
3201126 B 1 BS 1 28/05/2018 31/05/2018 15/05/1952 0 2
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10909500 15726965 0 4 0 0 0 INDRIANINGRUM
0001771429915 3;JKN DR RIZKI; 5.2.2.201806040537 4 184949
1#0##0#0#0.0#2018-09-06 11:23:15#0#11:44:35#11:44:35#12:00:00 3
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3201126 B 2 BS 1 25/05/2018 31/05/2018 23/03/1955 0 2
1 I20.0;I13.1;D63.8 99.04 - - None None None None I-4-20-II
5824800 0 0 - 0 - 0 - 0 - 0
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0001843511747 3;JKN DR RIZKI; 5.2.2.201806040537 4 184354
1#0##0#0#0.0#2018-09-06 11:51:10#0#13:48:39#13:48:39#00:00:00 2
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3201126 B 3 BS 1 24/05/2018 31/05/2018 16/03/1988 0 1
4199800 0 0 - 0 - 0 - 0 - 0
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0002323350257 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 184165
1#0##0#0#0.0#2018-10-10 16:46:09#0#23:07:25#23:07:25#00:00:00 1
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3201126 B 1 BS 1 22/05/2018 01/06/2018 11/11/1959 0 1
1 E11.5;I11.0;I25.1 90.59;89.52 - - None None None None I-4-
LAIN-LAIN (BERAT) 10244500 0 0 - 0 - 0 - 0 -
0 10244500 25833182 0 11 0 0 0 EKO PRIHARTONO
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1#1#vvip#11#15588682#0.0#2018-06-12 14:55:43#0#00:00:00#00:00:00#00:00:00
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0
3201126 B 2 BS 1 29/05/2018 01/06/2018 25/05/1985 0 2
5984100 0 0 - 0 - 0 - 0 - 0
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0001734041529 3;JKN DR RIZKI; 5.2.2.201806040537 4 185106
1#0##0#0#0.0#2018-06-12 15:05:15#0#22:41:11#22:41:11#00:00:00 1
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3201126 B 3 BS 1 26/05/2018 01/06/2018 01/01/1969 0 1
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1#0##0#0#0.0#2018-06-12 15:28:47#0#00:00:00#00:00:00#00:00:00 2
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3201126 B 1 BS 1 27/05/2018 01/06/2018 07/05/1958 0 1
1 K52.8;K30 - - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 3084786 0 6 0 0 0 PARNINGOTAN SIMARMATA TN
D068556 60 21935 DR ARU, SPPD 0138R0170518V009215
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1#0##0#0#0.0#2018-06-12 15:33:34#0#12:56:11#12:56:11#00:00:00 1
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3201126 B 1 BS 1 30/05/2018 01/06/2018 25/05/1982 0 2
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DR RIZKI; 5.2.2.201806040537 4 185174 1#0##0#0#0.0#2018-06-12
15:54:42#0#08:58:16#08:58:16#00:00:00 1 2c7cdec642e9c1f18e8f992ac784be9d
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3201126 B 3 BS 1 29/05/2018 01/06/2018 11/06/1953 0 2
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5.2.2.201806040537 4 185093 1#0##0#0#0.0#2018-06-13
09:01:03#0#00:00:00#00:00:00#00:00:00 1 79271acf2ad24a66c013164555083aea
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305473 0 0 0 26000 0
3201126 B 3 BS 1 28/05/2018 01/06/2018 21/06/2003 0 1
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2090000 2078512 0 5 0 0 0 BAREND SOUISA
D056229 14 5455 DR RASTRA, SPA 0138R0170518V009673
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1#0##0#0#0.0#2018-06-13 09:28:02#0#16:16:30#16:16:30#00:00:00 1
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3201126 B 2 BS 1 29/05/2018 01/06/2018 22/12/1990 0 2
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D384701 27 10020 DR MAMAN HILMAN 0138R0170518V009808
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1#0##0#0#0.0#2018-06-13 10:06:29#0#00:00:00#00:00:00#00:00:00 3
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3201126 B 3 BS 1 31/05/2018 01/06/2018 17/03/1972 0 2
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0001264472122 3;JKN DR RIZKI; 5.2.2.201806040537 4 186120
1#0##0#0#0.0#2018-06-13 10:18:00#0#22:26:48#22:26:48#12:00:00 1
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3201126 B 2 BS 1 30/05/2018 01/06/2018 30/05/2018 2868 1
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4386800 1416478 0 3 0 0 0 BAYI NY. DESI MARTHA
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1#0##0#0#0.0#2018-06-13 10:44:07#0#00:00:00#00:00:00#00:00:00 2
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1#0##0#0#0.0#2018-06-13 14:18:32#0#00:00:00#00:00:00#00:00:00 2
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1#0##0#0#0.0#2018-06-13 14:26:53#0#02:05:16#02:05:16#00:00:00 1
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3201126 B 3 BS 1 30/05/2018 01/06/2018 28/04/2008 0 1
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0 4315600 8932236 0 3 0 0 0 MOSESFERDYANTA
TARIGAN D395738 10 3684 DR MARQUEE KENNY TUMBELAKA SPOT
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4 185316 1#0##0#0#0.0#2018-06-18
11:14:29#0#00:00:00#00:00:00#00:00:00 1 9161ac1cf1f407caef9b8c75c914ffc9
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1160352 0 0 0 0 69000
3201126 B 2 BS 1 30/05/2018 01/06/2018 25/01/1957 0 1
- 0 51950600 59306175 0 3 0 0 0 WIDIHARDJO
SOESANTO D399103 61 22405 DR AZRI NURIZAL SPPD KKV
0138R0170518V010024 0001458583481 3;JKN DR RIZKI; 5.2.2.201806040537
4 185318 1#0##0#0#0.0#2018-06-18
11:33:10#0#00:00:00#00:00:00#00:00:00 1 70254161da824d8af20031236b385541
0 9004000 8244960 0 0 33187215 0 0 0 0
1301000 0 0 0 0 7569000
3201126 B 2 BS 1 30/05/2018 01/06/2018 01/03/1949 0 1
0 - 0 - 0 - 0 - 0 14653000 12959930
0 3 0 0 0 MAKMUR YUNUS D300813 69 25292 DR
5.2.2.201806040537 4 185116 1#0##0#0#0.0#2018-06-18
11:34:36#0#00:00:00#00:00:00#00:00:00 1 3886d27f7b13609908df27aa4c2f8b90
0 3555000 2930600 0 0 3570484 0 0 0 0
903846 0 0 0 0 2000000
3201126 B 3 BS 1 28/05/2018 01/06/2018 03/11/2012 0 1
0 - 0 - 0 - 0 3043100 3635585 0 5
0 0 0 FADLI ALAZHARI D399623 5 2032 DR RASTRA, SPA
0138R0170518V009259 0001740603969 3;JKN DR RIZKI; 5.2.2.201806040537
4 184729 1#0##0#0#0.0#2018-06-18
11:46:03#0#04:19:48#04:19:48#00:00:00 1 8838dfd20e6f6fc49a2ffbaa95d7137a
0 0 379879 0 0 1676864 0 0 0 0
1578842 0 0 0 0 0
3201126 B 3 BS 1 29/05/2018 01/06/2018 21/07/1968 0 2
2646600 0 0 - 0 - 0 - 0 - 0
2646600 3840157 0 4 0 0 0 SATRIA A.N PARIS
0001730565178 3;JKN DR RIZKI; 5.2.2.201806040537 4 185082
1#0##0#0#0.0#2018-06-18 15:51:36#0#00:00:00#00:00:00#00:00:00 1
d2d08bbc59ff41a8bae2b81864ba4a03 0 0 132330 0 0
2110602 0 0 0 0 558225 0 0 0 0
1039000
3201126 B 2 BS 1 28/05/2018 01/06/2018 17/12/2015 0 2
SICKLE (RINGAN) 3584400 0 0 - 0 - 0 - 0 -
0 3584400 2904817 0 5 0 0 0 ADEEVA AFSHEEN
MYESHA D339916 2 893 DR VERA MUNA MANOE, SPA 0138R0170518V009692
0001898497269 3;JKN DR RIZKI; 5.2.2.201806040537 4 185060
1#0##0#0#0.0#2018-06-19 10:54:33#0#17:09:24#17:09:24#00:00:00 1
91351e45d6b4171d15efca17ac7f730b 0 0 322596 0 0
1563686 0 0 0 0 1018535 0 0 0 0 0
3201126 B 1 BS 1 24/05/2018 01/06/2018 16/12/1936 0 1
1 N18.9;D63.8;R63.0;F03;E87.6;J18.0 99.04 - - None None None
None N-4-10-III None None None None None None TUMOR GINJAL & SALURAN
URIN & GAGAL GINJAL (BERAT) 8508800 0 0 - 0 - 0 -
0 - 0 8508800 25814745 0 9 0 0 0
DJAMILUDDIN NASUTION H, SH,MM D352241 81 29744 DR. ARU ARIADNO, SPPD
0138R0170518V008575 0000060786527 3;JKN DR RIZKI; 5.2.2.201806040537
4 184166 1#1#vvip#9#17305945#0.0#2018-06-19
11:08:58#0#23:38:41#23:38:41#00:00:00 1 2b4bf4d7d50c26fc64fa449fbf09baba
0 0 1192580 0 0 13289165 0 0 0 0
7842000 0 0 0 0 3491000
3201126 B 1 BS 1 28/05/2018 01/06/2018 06/05/2008 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5265228 0 5 0 0 0 AQILLAH ADINDA SHAFITRI
D343240 10 3674 DR RASTRA, SPA 0138R0170518V009738
0001774278033 3;JKN DR RIZKI; 5.2.2.201806040537 4 185079
1#0##0#0#0.0#2018-06-19 11:11:27#0#22:52:35#22:52:35#00:00:00 1
bcb29d46587605f2c0cb762ec1be9e08 0 0 316331 0 0
1114443 0 0 0 0 3494454 0 0 0 0 340000
3201126 B 1 BS 1 26/05/2018 01/06/2018 23/08/1966 0 1
0 - 0 9673300 10435912 0 7 0 0 0 MOH
MUSLIH D399541 51 18904 DR MAYSAMIRAWATI SPS 0138R0170518V009155
0000038464132 3;JKN DR RIZKI; 5.2.2.201806040537 4 184674
1#0##0#0#0.0#2018-06-19 11:15:31#0#00:00:00#00:00:00#00:00:00 2
5cc4af54d28f5276a280333a25512867 0 0 1020330 0 0
3239859 0 0 0 0 6175723 0 0 0 0 0
3201126 B 1 BS 1 29/05/2018 01/06/2018 21/07/1986 0 1
6071100 0 0 - 0 - 0 - 0 - 0
6071100 14313965 0 4 0 0 0 NURUL KOMAR D356606
3;JKN DR RIZKI; 5.2.2.201806040537 4 185086
1#1#vvip#4#8242865#0.0#2018-06-19 11:35:19#0#00:00:00#00:00:00#00:00:00
1 d5b8a16e41c7bfcf3fc720671bfe6786 0 0 1408000 0 0
6291537 0 0 0 0 6614428 0 0 0 0 0
3201126 B 3 BS 1 28/05/2018 01/06/2018 16/03/1972 0 2
1 I20.0;R07.4;K30;I10 89.52 - - None None None None I-4-
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1613811 0 5 0 0 0 ANING SULESTYOWATI
0000060506717 3;JKN DR RIZKI; 5.2.2.201806040537 4 185081
1#0##0#0#0.0#2018-06-19 11:49:20#0#00:00:00#00:00:00#00:00:00 1
36097f5d7fb8f3bad59b1f67c2fc5682 0 0 210130 0 0 719105
0 0 0 0 394576 0 0 0 0 290000
3201126 B 3 BS 1 29/05/2018 01/06/2018 05/03/1943 0 1
1 D02.2;I21.3 89.52;93.94 - - None None None None J-4-14-III
None None None None None None TUMOR PARU (BERAT) 8762000 0
0 - 0 - 0 - 0 - 0 8762000 6358642
0 4 0 0 0 H FADULLAH TN D399708 75 27479 DR
ANGGA TOMALA PUTRA 0138R0170518V009776 0001211510092 3;JKN DR RIZKI;
5.2.2.201806040537 4 185089 1#0##0#0#0.0#2018-06-19
11:57:35#0#11:55:32#11:55:32#00:00:00 2 69324834ed9889a40edefbe3e2221c97
0 0 788580 0 0 3808076 0 0 0 0 722986
0 0 0 0 1039000
3201126 B 1 BS 1 30/05/2018 01/06/2018 03/05/1984 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12097069 0 3 0 0 0 NOVI YANTI D282644
3;JKN DR RIZKI; 5.2.2.201806040537 4 185646 1#0##0#0#0.0#2018-
06-19 14:41:15#0#19:56:13#19:56:13#00:00:00 1
c18e0567a85d0704e94b97df8c83922b 0 6407900 2463895 0 0
2160877 0 0 0 0 867397 0 0 0 0 197000
3201126 B 2 BS 1 28/05/2018 01/06/2018 06/04/1939 0 1
1 N40;R33;I10;E14.9 60.29;90.59;89.52 - - None None None None
V-1-14-I None None None None None None PENGANGKATAN PROSTAT MELALUI
URETRA (RINGAN) 10605500 0 0 - 0 - 0 - 0 -
0 10605500 22426326 0 5 0 0 0 ENTOG TEGUH
RAHARDJO D395847 79 28907 DR SIDHI,SPU 0138R0170518V009312
0001290337661 3;JKN DR RIZKI; 5.2.2.201806040537 4 184731
1#0##0#0#0.0#2018-06-19 14:43:06#0#00:00:00#00:00:00#00:00:00 1
b24012554b7737a3ba07be8bdc9ec382 0 8276500 3022540 0 0
6557286 0 0 0 0 4501000 0 0 0 0 69000
3201126 B 2 BS 1 30/05/2018 01/06/2018 23/08/1994 0 2
- 0 - 0 - 0 - 0 2601900 3058688 0
3 0 0 0 JALIATUL RAHMI D341880 23 8681 DR FERRI
SABARUDDIN SPOG 0138R0170518V010261 0000017502917 3;JKN DR RIZKI;
5.2.2.201806040537 4 185634 1#0##0#0#0.0#2018-06-19
14:45:06#0#17:17:40#17:17:40#12:00:00 1 114ab8f59ecedd48ba8bc24679e0a0af
0 0 412171 0 0 1094916 0 0 0 0
1551601 0 0 0 0 0
3201126 B 3 BS 1 26/05/2018 01/06/2018 19/09/1943 0 1
1 J18.9;I11.0 87.44 - - None None None None J-4-16-III None
6419700 0 0 - 0 - 0 - 0 - 0
6419700 6251082 0 7 0 0 0 EDWARD EVERT LOEN
0001460485754 3;JKN DR RIZKI; 5.2.2.201806040537 4 184686
1#0##0#0#0.0#2018-06-19 15:10:18#0#00:00:00#00:00:00#00:00:00 1
aa948e408fd390fab5ea07b3e3872abe 0 0 500624 0 0
2981009 0 0 0 0 2189449 0 0 0 0 580000
3201126 B 1 BS 1 30/05/2018 01/06/2018 17/08/1960 0 2
1 R63.0;R51 - - - None None None None E-4-10-I None
- 0 4903800 3511603 0 3 0 0 0 VICTORINA A
L D120761 57 21105 DR ARU, SPPD 0138R0170518V010270
0000041835982 3;JKN DR RIZKI; 5.2.2.201806040537 4 185639
1#0##0#0#0.0#2018-06-19 15:12:07#0#17:44:50#17:44:50#00:00:00 1
aff4ccd8964c8ca73432528eb0c5605d 0 0 546272 0 0 712100
0 0 0 0 2253231 0 0 0 0 0
3201126 B 3 BS 1 31/05/2018 01/06/2018 03/05/1986 0 2
0 - 0 - 0 - 0 - 0 2319600 4763229
0 2 0 0 0 AMALIA ROSADI NY D244086 32 11716 DR
5.2.2.201806040537 4 185659 1#0##0#0#0.0#2018-06-20
08:56:06#0#07:46:08#07:46:08#00:00:00 1 db26e40b15e7dbd35f31b9d8cc3a4a1a
0 0 459784 0 0 768332 0 0 0 0
1786113 0 0 0 0 1749000
3201126 B 2 BS 1 29/05/2018 01/06/2018 07/05/1973 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3415867 0 4 0 0 0 YASMIN D399714
DR RIZKI; 5.2.2.201806040537 4 185090 1#0##0#0#0.0#2018-06-20
09:49:04#0#12:14:18#12:14:18#00:00:00 1 404c27ea18b322b86cb9d6579ac43698
0 0 278711 0 0 867688 0 0 0 0
2269468 0 0 0 0 0
3201126 B 3 BS 1 31/05/2018 01/06/2018 02/06/1970 0 2
1 J46;R40.2;A49.9 93.94 - - None None None None J-4-18-II
2969700 0 0 - 0 - 0 - 0 - 0
2969700 2711850 0 2 0 0 0 TATI PURYANTI
0000157230189 3;JKN DR RIZKI; 5.2.2.201806040537 4 186114
1#0##0#0#0.0#2018-06-23 09:40:51#0#19:40:43#19:40:43#00:00:00 1
80cd22d97ad8b12b16ccce51616313ff 0 0 148485 0 0
1583954 0 0 0 0 484411 0 0 495000 0
0
3201126 B 3 BS 1 22/05/2018 01/06/2018 03/02/1930 0 1
1 I25.0;I08.9;I11.0;D64.9 88.55;36.07;99.04 - - YY02 None None
0 - 0 - 0 45079800 63931647 0 11 0 0
0 BOY TANGKILISAN D311760 88 32250 DR AZRI NURIZAL SPPD KKV
0138R0170518V007281 0001311737545 3;JKN DR RIZKI; 5.2.2.201806040537
4 182602 1#0##0#0#0.0#2018-06-25
10:10:03#0#07:33:33#07:33:33#00:00:00 1 808d598d58e175d65191b557d3794d1b
0 9887500 6870800 0 0 36761347 0 0 0 0
1226000 0 0 9186000 0 0
3201126 B 2 BS 1 19/05/2018 01/06/2018 03/10/2012 0 2
1 J18.0;A41.9 87.44;93.94 - - None None None None J-4-16-III
7703700 0 0 - 0 - 0 - 0 - 0
7703700 23127226 0 14 0 0 0 SILVIA REVALIANA
D324209 5 2054 DR RASTRA, SPA 0138R0170518V006595
0001817834253 3;JKN DR RIZKI; 5.2.2.201806040537 4 181918
1#0##0#0#0.0#2018-07-04 09:09:07#0#14:53:41#14:53:41#00:00:00 1
c35d729670c4a050efbdd291631c1987 0 0 746332 0 0
10994394 0 0 0 0 9112500 0 0 0 0
2274000
3201126 B 1 BS 1 28/05/2018 01/06/2018 21/05/1974 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 6178327 0 5 0 0 0 TRIANI RAHMAWATI
D058830 44 16078 DR ARU, SPPD 0138R0170518V009725
0000038663493 3;JKN DR RIZKI; 5.2.2.201806040537 4 185074
1#0##0#0#0.0#2018-07-04 09:33:20#0#21:02:55#21:02:55#12:00:00 1
fd7556f0124da656232cfdd423f74e68 0 0 361898 0 0
1826739 0 0 0 0 3989690 0 0 0 0 0
3201126 B 2 BS 1 28/05/2018 01/06/2018 17/02/1953 0 1
1 I13.1;I25.0;J44.9 89.52 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4366864 0 5 0 0 0 YUSPI D298708
3;JKN ECHI; 5.2.2.201806040537 4 185067 1#0##0#0#0.0#2018-07-27
08:43:08#0#19:32:19#19:32:19#00:00:00 3 e4980db34a81f292e5ae7f9727738b7b
0 0 500624 0 0 1237057 0 0 0 0
2629183 0 0 0 0 0
3201126 B 3 BS 1 01/06/2018 01/06/2018 19/09/1973 0 1
1 I64;F20.9 - - - None None None None G-4-15-I None
- 0 - 0 - 0 4096200 2601727 0 1 0
0 0 ARI PURNOMO D004071 44 16326 DR IRVAN VERYADI
0138R0170618V000042 0001739600482 3;JKN ECHI; 5.2.2.201806040537
4 186140 1#0##0#0#0.0#2018-07-27
08:43:32#0#00:00:00#00:00:00#00:00:00 2 62e241570ef2b8ac751e594c63173487
0 0 250655 0 0 1891866 0 0 0 0 459206
0 0 0 0 0
3201126 B 3 BS 1 29/05/2018 01/06/2018 17/03/2010 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 4138388 0 4 0 0 0 ALFATHIRA
0001265724505 3;JKN ECHI; 5.2.2.201806040537 4 185103
1#0##0#0#0.0#2018-07-27 08:43:56#0#21:40:22#21:40:22#12:00:00 2
47aab0da69fe8d1f2458fffee2e24269 0 0 268830 0 0
2870322 0 0 0 0 999236 0 0 0 0 0
3201126 B 3 BS 1 29/05/2018 01/06/2018 13/02/2018 0 1
1 Z53.0;Z93.3 - - - None None None None Z-4-12-I None
0 - 0 1876700 2179621 0 4 0 0 0 AZRIEL
SHARIQ ZHAFRAN D394538 0 105 DR ASRI DWI R, SPB
0138R0170518V009799 0002315857678 3;JKN ECHI; 5.2.2.201806040537
4 185096 1#0##0#0#0.0#2018-07-27
08:44:28#0#17:22:14#17:22:14#12:00:00 3 267343332b7ca120f91c58f071d3aa2e
0 0 1095705 0 0 389324 0 0 0 0 694592
0 0 0 0 0
3201126 B 3 BS 1 30/05/2018 01/06/2018 29/08/1983 0 2
0 - 0 - 0 - 0 - 0 2899500 3710189
0 3 0 0 0 SRI MARYATI D398000 34 12693 DR. SITI
AZIZAH SPOG 0138R0170518V009825 0002432643625 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 185109 1#0##0#0#0.0#2018-08-03
09:15:23#0#01:11:22#01:11:22#00:00:00 2 1cb238fe919b0dc81fe2101d2443f729
0 0 313955 0 807000 1807511 0 0 0 0
268723 0 0 513000 0 0
3201126 B 1 BS 1 26/05/2018 01/06/2018 07/04/1956 0 2
1 I64;J18.9;G81.9 87.44;87.03 - - None None None None G-4-
- 0 - 0 - 0 - 0 9659700 16183313 0
7 0 0 0 ELY DIAR D304033 62 22694 DR MAYSAMIRAWATI
5.2.2.201806040537 4 185073 1#0##0#0#0.0#2018-08-04
10:17:03#0#20:53:57#20:53:57#00:00:00 2 97ee23bc4e02dbf305de64c06ab16755
0 0 1388520 0 0 8782572 0 0 0 0
6012221 0 0 0 0 0
3201126 B 2 BS 1 29/05/2018 01/06/2018 29/05/2018 3040 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1323281 0 4 0 0 0 ZIAN RAMADHAN
0002462804054 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 185644
1#0##0#0#0.0#2018-08-04 10:20:37#0#19:40:53#19:40:53#00:00:00 2
96232cd2ebbb8144aaf21e9d0938703d 0 0 394812 0 0 88899
0 0 0 0 839570 0 0 0 0 0
3201126 B 1 BS 1 29/05/2018 01/06/2018 23/12/1985 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 18400836 0 4 0 0 0 DIAH PUSPITA WARDHANI NY
0001644003336 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 185108
1#1#vvip#3#11419336#0.0#2018-08-04 10:26:30#0#00:02:34#00:02:34#00:00:00
3 b0200487cb43289927590f18037e27d5 0 8289400 5619264 0
0 2915172 0 0 0 0 1466000 0 0 0 111000
0
3201126 B 1 BS 1 30/05/2018 01/06/2018 30/05/2018 2760 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3344133 0 3 0 0 0 DIAH PUSPITA WARDHANI BY
NY D399808 0 0 DR RIANITA SYAMSU, SPA 0138R0170518V010744
0002463467894 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186112
1#1#vip#3#0#0.0#2018-08-04 10:29:01#0#17:34:12#17:34:12#00:00:00 3
a077bf615dd51ec873857e644a9579a9 0 0 499620 0 2115000
437138 0 0 0 0 218775 0 0 0 73600 0
3201126 B 2 BS 1 30/05/2018 01/06/2018 02/10/1961 0 2
1 E11.2;D63.8;E87.1;I10 38.95;39.95;99.04 - - None None None
0 - 0 - 0 10690500 11567064 0 3 0 0
0 ETTY PURWANINGSIH D399799 56 20694 DR BETTY DWI L, SPPD
0138R0170518V010300 0000173829947 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 185647 1#0##0#0#0.0#2018-08-04
10:42:09#0#20:23:45#20:23:45#00:00:00 2 e4d566b3060c8af02a0d54a5eb127a6b
0 4042100 1906030 0 0 3586960 0 0 0 0
1962974 0 0 0 0 69000
3201126 B 3 BS 1 26/05/2018 01/06/2018 01/01/1963 0 1
1 C22.0;I98.3;K74.6;D62 99.04;42.33;88.01 - - None None None
None B-4-11-II None None None None None None TUMOR SISTEM
HEPATOBILLIARI DAN PANCREAS (SEDANG) 6824900 0 0 - 0 -
0 - 0 - 0 6824900 25853594 0 7 1 0
0 BONAR HUTAHAYAN D399474 55 20234 DR. ARU ARIADNO, SPPD
0138R0170518V009059 0001739678005 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 184475 1#0##0#0#0.0#2018-10-02
15:06:01#0#02:35:12#02:35:12#00:00:00 2 89d0f74b7153e0a1d6c565a99aa7745e
0 0 7068204 0 0 8938390 0 0 0 0
4144000 0 0 0 0 5703000
3201126 B 1 BS 1 27/05/2018 01/06/2018 06/12/1953 0 2
5879800 0 0 - 0 - 0 - 0 - 0
5879800 14686728 0 6 1 6 0 SRI DARUKI d399586
0001845230837 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 184711
1#0##0#0#0.0#2018-10-02 15:14:21#0#12:37:46#12:37:46#00:00:00 2
816ab40f60cbb20f7a1bad88da583e4b 0 0 556531 0 0
7427383 0 0 0 0 5766814 0 0 0 0 936000
3201126 B 3 BS 1 30/05/2018 01/06/2018 31/07/1955 0 1
- 0 2987000 2981813 0 3 0 0 0 S. SUMANTA
0000510844026 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 185472
1#0##0#0#0.0#2018-10-02 15:28:32#0#00:00:00#00:00:00#00:00:00 2
f4ccf9dff9f22cdb7a1a81d87995c8f2 0 0 445941 0 0
1525800 0 0 0 0 1010072 0 0 0 0 0
3201126 B 3 BS 1 30/05/2018 01/06/2018 10/02/1986 0 1
1 M24.54;T92.8 86.84;78.60 - - None None None None M-1-
0 - 0 4315600 9918996 0 3 0 0 0 ELAN
SUKARLAN D397696 32 11797 DR MARQUEE KENNY TUMBELAKA SPOT
0138R0170518V010044 0000511014644 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 185401 1#0##0#0#0.0#2018-10-02
15:38:05#0#11:28:43#11:28:43#00:00:00 2 f225c7e90b1cb86138312e44362e6111
0 5827000 2719544 0 0 697546 0 0 0 0
674906 0 0 0 0 0
3201126 B 3 BS 1 31/05/2018 01/06/2018 05/04/1963 0 1
0 - 0 - 0 - 0 3417600 1976758 0 2
0 0 0 SABENIH D399888 55 20145 DR MOHAMMAD JOHAN SPU
0138R0170518V010713 0001336593982 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186111 1#0##0#0#0.0#2018-10-02
16:37:50#0#17:03:33#17:03:33#00:00:00 2 1657080c8ce873f12783135cea79a865
0 0 423980 0 0 871457 0 0 0 0 681321
0 0 0 0 0
3201126 B 1 BS 1 25/05/2018 01/06/2018 10/04/1935 0 1
None None None None None OSTEOMIELITIS (RINGAN) 7835800 0 0
- 0 - 0 - 0 - 0 7835800 6298001 0
8 0 0 0 PAIMAN TAMBI SYAMSYUDDIN D385512 83 30361
DR RAY HENDRY, SPOT 0138R0170518V008741 0001732948424 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 184218 1#0##0#0#0.0#2018-
10-10 17:19:54#0#09:47:46#09:47:46#12:00:00 1
170d4e0e68e08446ab924d1b7047358f 0 0 1251125 0 0
3735857 0 0 0 0 873000 0 0 0 438019
0
3201126 B 1 BS 1 30/05/2018 02/06/2018 15/10/1986 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 18693628 0 4 0 0 0 ADZNI IRHAMNA AESQY
0001665796083 3;JKN DR RIZKI; 5.2.2.201806040537 4 185649
1#1#vvip#3#11712128#0.0#2018-06-13 11:08:23#0#23:04:02#23:04:02#00:00:00
1 05065fbcd960cd706f84ed28b151251d 0 8289400 6488000 0
0 2371228 0 0 0 0 1348000 0 0 0 0
197000
3201126 B 1 BS 1 28/05/2018 02/06/2018 21/08/1970 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 14264584 0 6 0 0 0 SRI SISWANTI
0000042069251 3;JKN DR RIZKI; 5.2.2.201806040537 4 184882
1#1#vvip#6#11859484#0.0#2018-06-13 11:23:23#0#00:00:00#00:00:00#00:00:00
1 cfeac29fc7d1595c3b0f2aa3a0c4e692 0 0 912417 0 0
4459970 0 0 0 0 8892197 0 0 0 0 0
3201126 B 3 BS 1 30/05/2018 02/06/2018 07/02/1952 0 2
4199800 0 0 - 0 - 0 - 0 - 0
4199800 3451840 0 4 0 0 0 KURYATI D365091
3;JKN DR RIZKI; 5.2.2.201806040537 4 185642 1#0##0#0#0.0#2018-
06-13 13:50:35#0#18:31:52#18:31:52#00:00:00 1
12b6bce58fd917e9fd6ebfcf2c19f098 0 0 261764 0 0
1972755 0 0 0 0 1217321 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 02/06/2018 15/03/1952 0 2
None None None None MASALAH BAGIAN PUNGGUNG/PINGGANG BELAKANG (RINGAN)
5162900 0 0 - 0 - 0 - 0 - 0
5162900 2942292 0 2 0 0 0 ITJAH AISAH D349295
3;JKN DR RIZKI; 5.2.2.201806040537 4 186141 1#0##0#0#0.0#2018-
06-13 14:15:06#0#00:00:00#00:00:00#00:00:00 1
2d407e8583987260f5538191bc2563a5 0 0 517661 0 0 644145
0 0 0 0 1780486 0 0 0 0 0
3201126 B 1 BS 1 30/05/2018 02/06/2018 05/12/1974 0 1
9855000 0 0 - 0 - 0 - 0 - 0
9855000 16694381 0 4 0 0 0 S. PARASIAN SINAGA, SE
0001423618468 3;JKN DR RIZKI; 5.2.2.201806040537 4 185120
1#0##0#0#0.0#2018-06-18 11:17:04#0#00:00:00#00:00:00#00:00:00 1
d1c1a79f7bcf45ff9e2ab5ff7027ba17 0 7850200 2857950 0 0
4358075 0 0 0 0 1193156 0 0 0 0 435000
3201126 B 2 BS 1 30/05/2018 02/06/2018 12/12/1949 0 2
1 I48;J02.9;R63.0;M79.1 87.44 - - None None None None I-4-
19-I None None None None None None GANGGUAN KONDUKSI & ARITMIA JANTUNG
(RINGAN) 4697800 0 0 - 0 - 0 - 0 - 0
4697800 4469226 0 4 0 0 0 SONTI RAJA GUK GUK
D174379 68 25006 DR ARU, SPPD 0138R0170518V010290
0001969937032 3;JKN DR RIZKI; 5.2.2.201806040537 4 185643
1#0##0#0#0.0#2018-06-18 11:41:00#0#18:56:07#18:56:07#12:00:00 1
5feeff773bc0a5d248290f3741626ade 0 0 746333 0 0
1592014 0 0 0 0 2130879 0 0 0 0 0
3201126 B 1 BS 1 27/05/2018 02/06/2018 29/08/1959 0 1
1 C18.9 45.23 - - None None None None K-4-10-I None None
- 0 - 0 - 0 - 0 6881700 16059701 0
7 0 0 0 DARWIN D022203 58 21456 DR ARU, SPPD
0138R0170518V009222 0000042706721 3;JKN DR RIZKI; 5.2.2.201806040537
4 184717 1#0##0#0#0.0#2018-06-18
11:53:29#0#00:00:00#00:00:00#00:00:00 2 fe96a359d74ee9a1744d445cbf2fb9eb
0 0 2374592 0 0 4573974 0 0 0 0
7286135 0 0 0 0 1825000
3201126 B 1 BS 1 27/05/2018 02/06/2018 27/06/1985 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 13897256 0 7 0 0 0 ASTUTI HARTANTI
A247255 32 12022 DR NELWATI, SPOG 0138R0170518V009249
0000201007629 3;JKN DR RIZKI; 5.2.2.201806040537 4 184727
1#0##0#0#0.0#2018-06-19 10:52:50#0#21:41:58#21:41:58#12:00:00 1
89429da22b40bf1db7387dd27cb8f60a 0 7080900 3226415 0 0
2367775 0 0 0 0 1025166 0 0 0 0 197000
3201126 B 2 BS 1 31/05/2018 02/06/2018 26/02/2018 0 2
- 0 - 0 - 0 - 0 2601900 1973030 0
3 0 0 0 DEWI INDRIANI NY D399484 0 94 DR NINING H,
SPOG 0138R0170518V010767 0001745412311 3;JKN DR RIZKI; 5.2.2.201806040537
4 186125 1#0##0#0#0.0#2018-06-20
10:08:47#0#23:13:21#23:13:21#00:00:00 1 ca076117b6f5523ce7fc80ad40fb99a3
0 0 537171 0 0 237782 0 0 0 0
1198077 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 02/06/2018 05/09/1992 0 1
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 2450739 0 2 0 0 0 RADEN YUDO WICAKSONO
PRAKOSO d399958 25 9400 DR. ARU ARIADNO, SPPD 0138R0170618V000073
0001655239588 3;JKN DR RIZKI; 5.2.2.201806040537 4 186153
1#0##0#0#0.0#2018-06-20 14:52:43#0#00:00:00#00:00:00#00:00:00 1
a5f17a9b996dde8fef20e80a0258adcf 0 0 234000 0 0 813910
0 0 0 0 1402829 0 0 0 0 0
3201126 B 1 BS 1 28/05/2018 02/06/2018 15/09/1968 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 14820319 0 6 0 0 0 BUDI TN D017558
49 18152 DR ARU, SPPD 0138R0170518V009532 0002047291841 3;JKN
DR RIZKI; 5.2.2.201806040537 4 184979
1#1#vip#6#2194425#75.0#2018-06-20 16:03:51#0#13:30:48#13:30:48#00:00:00
1 6a3eadf6590e5fcd7f1e3aef064b2394 0 0 513829 0 0
5642936 0 0 0 0 8663554 0 0 0 0 0
3201126 B 2 BS 1 31/05/2018 02/06/2018 14/08/1967 0 2
- 0 3584400 3600594 0 3 0 0 0 ADE ARNESAH
D399853 50 18553 DR ARU, SPPD 0138R0170518V010509
0001260782133 3;JKN DR RIZKI; 5.2.2.201806040537 4 185828
1#0##0#0#0.0#2018-06-20 16:07:41#0#00:00:00#00:00:00#00:00:00 1
ecaee576841d76dd081791c5881806bf 0 0 375896 0 0
1448165 0 0 0 0 1776533 0 0 0 0 0
3201126 B 2 BS 1 02/06/2018 02/06/2018 11/05/1932 0 2
1 I21.2;E87.1;E87.5 89.52 - - None None None None I-4-10-II
0 0 - 0 - 0 - 0 - 0 8663100
8936467 0 1 0 0 0 DJAMILAH HJ NY D396056 86
31433 DR ANGGA TOMALA PUTRA 0138R0170618V000145 0000060809455 3;JKN
DR RIZKI; 5.2.2.201806040537 4 186202 1#0##0#0#0.0#2018-06-23
10:33:45#0#10:04:12#10:04:12#00:00:00 1 3642c2d6cfcbfb72326c1462a7cb1553
0 0 779679 0 0 7283159 0 0 0 0 873629
0 0 0 0 0
3201126 B 3 BS 1 30/05/2018 02/06/2018 15/07/2017 0 2
2 I50.0;Q25.0;J18.8 96.71;99.04;87.44 - - None None None None
- 0 29135800 2318050 0 4 1 4 48 AERILYN
JAZILA SAKHI AN D399754 0 319 DR NOVIK BUDIWARDHANA, SPA
0138R0170518V009995 0002298931582 3;JKN ECHI; 5.2.2.201806040537
4 185252 1#0##0#0#0.0#2018-07-27
09:02:46#0#09:59:36#09:59:36#00:00:00 2 01834fa63a28e02519725e8429fd75d8
0 0 2318050 0 0 0 0 0 0 0 0 0
0 0 0 0
3201126 B 1 BS 1 28/05/2018 02/06/2018 11/07/1966 0 1
4 I46.9;E11.2;K71.2;A16.2;K12.1;E87.8 87.44;89.52;99.60 - - None
None None None I-4-14-II None None None None None None CARDIAC
ARREST, TIDAK DIKETAHUI (SEDANG) 4976100 0 0 - 0 - 0
- 0 - 0 4976100 13256875 0 6 0 0 0
VICKY MALAIHOLLO, S.SOS D320569 51 18949 DR. ARU ARIADNO, SPPD
0138R0170518V009721 0000163802103 3;JKN ECHI; 5.2.2.201806040537
4 185069 1#1#vvip#6#8280775#0.0#2018-07-27
09:03:11#0#19:46:46#19:46:46#00:00:00 3 85838d3ab09083570d219a045a5ea8f7
0 0 1132329 0 0 6269274 0 0 0 0
5855272 0 0 0 0 0
3201126 B 3 BS 1 30/05/2018 02/06/2018 15/06/1953 0 2
1 I64;E11.9 87.03;89.52;87.44 - - None None None None G-4-
- 0 - 0 - 0 - 0 4096200 4107101 0
4 0 0 0 ROSANIH D399745 64 23725 DR MAYSAMIRAWATI
5.2.2.201806040537 4 185110 1#0##0#0#0.0#2018-08-03
08:57:05#0#01:14:20#01:14:20#00:00:00 2 a623852758e99c8fdbf9f82cce2bf886
0 0 743950 0 0 2016462 0 0 0 0
1346689 0 0 0 0 0
3201126 B 1 BS 1 31/05/2018 02/06/2018 21/12/2007 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 5264172 0 3 0 0 0 IQBAL MARLOPO
0001335363658 3;JKN DR RIZKI; 5.2.2.201806040537 4 186110
1#0##0#0#0.0#2018-09-06 11:24:23#0#16:49:22#16:49:22#12:00:00 3
3255df6ee26e9e1017e69f814ba0526f 0 0 429362 0 0
2121425 0 0 0 0 2713385 0 0 0 0 0
3201126 B 3 BS 1 30/05/2018 02/06/2018 07/04/1964 0 2
1 K76.0;R10.1 88.76;89.52 - - None None None None B-4-13-I
4204300 0 0 - 0 - 0 - 0 - 0
4204300 2975140 0 4 0 0 0 USNAH D355315 54
TANTIYO S;16137 5.2.2.201806040537 4 186280 1#0##0#0#0.0#2018-
10-02 16:56:26#0#16:27:34#16:27:34#00:00:00 2
4b3030be96f658c10b3c842dfc441722 0 0 440802 0 0
1348203 0 0 0 0 1186135 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 02/06/2018 24/01/1966 0 1
1 N18.5;E11.9;N30.9 39.27;99.04 - - None None None None N-1-
- 0 12472300 12363058 0 2 0 0 0 DWI
HANDAYANI D398755 52 19121 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V000023 0002228653091 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186132 1#0##0#0#0.0#2018-10-02
17:12:06#0#00:00:00#00:00:00#00:00:00 2 8c3a4b16829d4a39d544f281ce29df9b
0 6468200 2494460 0 0 2466600 0 0 0 0
864798 0 0 0 0 69000
3201126 B 2 BS 1 29/05/2018 02/06/2018 22/03/1943 0 2
1 G41.9;I63.9;J18.9;L89.9;L27.0 87.03;87.44 - - None None None
None G-4-22-III None None None None None None SERANGAN KEJANG (BERAT)
4758000 0 0 - 0 - 0 - 0 - 0
4758000 12722566 0 5 0 0 0 LATIFAH D303901
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 185092
1#0##0#0#0.0#2018-10-10 17:10:05#0#00:00:00#00:00:00#00:00:00 1
2dc13876aa005d33cc2173ab6db4f0c7 0 0 882140 0 858317
5915109 0 0 0 0 3261000 0 0 0 1806000
0
3201126 B 3 BS 1 01/06/2018 03/06/2018 27/07/1992 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8488986 0 3 0 0 0 DIBA WULANDA
0138R0170618V000004 0001771677977 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186129 1#0##0#0#0.0#2018-06-12
14:50:11#0#02:32:46#02:32:46#00:00:00 2 6d6b4ca6f7e87bef059e84fe49023355
0 3534500 1708644 0 0 2358488 0 0 0 0
332000 0 0 0 555354 0
3201126 B 1 BS 1 31/05/2018 03/06/2018 12/06/1950 0 2
1 K21.9;A01.0;I11.9 - - - None None None None K-4-12-III
0 0 - 0 - 0 - 0 - 0 9494200
3958277 0 4 0 0 0 GANDA BASA SITUMEANG D399903
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186122
1#0##0#0#0.0#2018-06-12 14:53:27#0#00:00:00#00:00:00#00:00:00 1
35d609d1fe92aa917a66b7388a91bbc4 0 0 425312 0 0 905012
0 0 0 0 2343000 0 0 0 284953 0
3201126 B 2 BS 1 01/06/2018 03/06/2018 06/05/1944 0 2
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 2424717 0 3 0 0 0 MASNAH
0001341265689 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186135
1#0##0#0#0.0#2018-06-12 15:04:36#0#00:00:00#00:00:00#00:00:00 1
9d5b8a035b11f80b59ca3c5690d901ae 0 0 431297 0 0
1993420 0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 31/05/2018 03/06/2018 25/06/1947 0 2
1 E87.1;I11.0;M54.22 - - - None None None None E-4-
(BERAT) 8810600 0 0 - 0 - 0 - 0 - 0
8810600 5842882 0 4 0 0 0 M. RUMIA TAMBUNAN
0001788650155 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186117
1#0##0#0#0.0#2018-06-12 15:10:35#0#20:50:45#20:50:45#00:00:00 1
f673fe538e3438eabc9c5bf47ddcaae2 0 0 962567 0 0
2129070 0 0 0 0 2343000 0 0 0 408245
0
3201126 B 1 BS 1 31/05/2018 03/06/2018 04/07/1988 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 19404497 0 4 0 0 0 MERRY SUSANTI
0002250429693 3;JKN DR RIZKI; 5.2.2.201806040537 4 186116
1#1#vvip#4#12422997#0.0#2018-06-20 10:51:12#0#20:41:26#20:41:26#00:00:00
2 843bb7a03128a6927fc4cee7dfac9b7f 0 8289400 6542000 0
0 3060097 0 0 0 0 1316000 0 0 0 0
197000
3201126 B 2 BS 1 02/06/2018 03/06/2018 12/10/1950 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 6402919 0 2 0 0 0 LELLY MURNI D313998
0001258096691 3;JKN DR RIZKI; 5.2.2.201806040537 4 186165
1#0##0#0#0.0#2018-06-20 14:50:39#0#00:00:00#00:00:00#00:00:00 1
fca75005e4a3cc013394d0beb2211978 0 0 941996 0 0
1158040 0 0 0 0 3308883 0 0 0 0 994000
3201126 B 1 BS 1 31/05/2018 03/06/2018 31/05/1961 0 2
1 I63.9;G81.9;I13.1;R77.0 87.03;87.44 - - None None None None
0 - 0 9673300 8299882 0 4 0 0 0 UMMI
TAMANNY ZURRI NY D399740 56 20819 DR NURUL KOMARI SPS
0138R0170518V010605 0000061110685 3;JKN DR RIZKI; 5.2.2.201806040537
4 185976 1#0##0#0#0.0#2018-06-20
16:06:38#0#13:35:45#13:35:45#00:00:00 1 27c84570682575fbc31a0c15161341df
0 0 1117063 0 0 3489836 0 0 0 0
3692983 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 03/06/2018 11/12/1984 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 11860832 0 3 0 0 0 SRI RAHAYU NY
0001460796862 3;JKN DR RIZKI; 5.2.2.201806040537 4 186685
1#0##0#0#0.0#2018-06-20 16:58:30#0#14:26:49#14:26:49#00:00:00 1
022ac60bff08803ccb2575fe8f0b110e 0 6407900 2446895 0 0
1933095 0 0 0 0 806942 0 0 0 0 266000
3201126 B 1 BS 1 01/06/2018 03/06/2018 01/06/2018 2892 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2971741 0 3 0 0 0 MERLYN BY NY
0002451508751 3;JKN DR RIZKI; 5.2.2.201806040537 4 186679
1#0##0#0#0.0#2018-06-20 17:14:56#0#14:24:27#14:24:27#00:00:00 1
c7ceebc6636b0827f6c093f2e1248340 0 0 499829 0 0 88899
0 0 0 0 2383013 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 03/06/2018 01/06/2018 3004 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2971517 0 3 0 0 0 MERRY SUSANTI BY NY
0002355975156 3;JKN DR RIZKI; 5.2.2.201806040537 4 186626
1#0##0#0#0.0#2018-06-20 17:16:24#0#11:56:41#11:56:41#00:00:00 1
8c6f69cdbb64708663db70a02d041048 0 0 499620 0 0 88899
0 0 0 0 2382998 0 0 0 0 0
3201126 B 3 BS 1 01/06/2018 03/06/2018 01/10/1939 0 1
1 D29.1 - - - None None None None V-4-11-I None None
(RINGAN) 3692900 0 0 - 0 - 0 - 0 - 0
3692900 4169936 0 3 0 0 0 HINDARMAN D369085
78 28733 DR ARU, SPPD 0138R0170618V000067 0001014206319 3;JKN
DR RIZKI; 5.2.2.201806040537 4 186151 1#0##0#0#0.0#2018-06-20
17:42:13#0#00:00:00#00:00:00#00:00:00 1 06030664242553f5e9b6f55f1452002d
0 0 395034 0 0 2421702 0 0 0 0
1353197 0 0 0 0 0
3201126 B 1 BS 1 31/05/2018 03/06/2018 04/01/1992 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 19421473 0 4 0 0 0 MERLYN PURBA WIJAYA NY
0002429566301 3;JKN DR RIZKI; 5.2.2.201806040537 4 186121
1#1#vvip#4#12439973#0.0#2018-06-20 18:01:40#0#22:45:52#22:45:52#00:00:00
1 7f2ac070ea481f3650cbb7a7b39d8a6f 0 8289400 6605000 0
0 3034073 0 0 0 0 1296000 0 0 0 0
197000
3201126 B 1 BS 1 01/06/2018 03/06/2018 10/02/2009 0 2
- 0 - 0 - 0 - 0 5424200 12317044 0
3 0 0 0 AMIRA RIDHA ANSYARI D162994 9 3398 DR
ASRI RAHMAWATI SPB 0138R0170618V000028 0001892717796 3;JKN DR RIZKI;
5.2.2.201806040537 4 186136 1#0##0#0#0.0#2018-06-20
18:04:54#0#00:00:00#00:00:00#00:00:00 2 2692ead72d990cb8931d8224f6fcc900
0 7187200 1634776 0 0 2468280 0 0 0 0
881788 0 0 0 0 145000
3201126 B 2 BS 1 01/06/2018 03/06/2018 12/12/2015 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2439214 0 3 0 0 0 RAYYA VARISHA ANGGODO
0002080882888 3;JKN DR RIZKI; 5.2.2.201806040537 4 186144
1#0##0#0#0.0#2018-06-20 18:06:16#0#16:21:13#16:21:13#00:00:00 3
4aff42c66cb9b64d7aa38c4d5f96335c 0 0 238534 0 0 500105
0 0 0 0 1700575 0 0 0 0 0
3201126 B 2 BS 1 01/06/2018 03/06/2018 19/12/2014 0 1
10406400 0 0 - 0 - 0 - 0 - 0
10406400 14512144 0 3 0 0 0 MUHAMAD RAFIF ALBAIHAQI
AN D399949 3 1260 DR BENNY H T, SPOT 0138R0170618V000069
0001817497484 3;JKN DR RIZKI; 5.2.2.201806040537 4 186152
1#0##0#0#0.0#2018-06-21 14:59:09#0#22:43:06#22:43:06#00:00:00 1
027ed51ead5c5b759a202dc35febd2f9 0 7765000 4570856 0 0
1005895 0 0 0 0 1025393 0 0 0 0 145000
3201126 B 1 BS 1 31/05/2018 03/06/2018 10/05/1951 0 2
1 D64.9;I10 99.04 - - None None None None D-4-13-I None
- 0 4181800 6035112 0 4 0 0 0 HJ.SITI
DJAMILAH D399912 67 24493 DR ARU, SPPD 0138R0170518V010766
0000042971084 3;JKN DR RIZKI; 5.2.2.201806040537 4 186123
1#0##0#0#0.0#2018-06-21 15:05:10#0#00:00:00#00:00:00#00:00:00 1
e149ae65d76d4f1f3405063ebd42418a 0 0 429362 0 0
2841930 0 0 0 0 2763820 0 0 0 0 0
3201126 B 3 BS 1 03/06/2018 03/06/2018 15/06/1969 0 1
1 K30;R57.0 89.52 - - None None None None K-4-18-III None
2941900 0 0 - 0 - 0 - 0 - 0
2941900 3737760 0 1 0 0 0 PARUDI D397320
DR RIZKI; 5.2.2.201806040537 4 186299 1#0##0#0#0.0#2018-06-23
09:52:50#0#13:26:25#13:26:25#00:00:00 1 c5aa12bdd66e807176bc3f77f369aa38
0 0 166650 0 0 3037584 0 0 0 0 533526
0 0 0 0 0
3201126 B 3 BS 1 03/06/2018 03/06/2018 11/10/1963 0 1
1 E87.6;R57.0 89.52 - - None None None None E-4-11-III None
6293300 0 0 - 0 - 0 - 0 - 0
6293300 5044080 0 1 0 0 0 WAHYA D400082 54
19959 DR RICO ADITYA 0138R0170618V000218 0002203075449 3;JKN DR
RIZKI; 5.2.2.201806040537 4 186290 1#0##0#0#0.0#2018-06-23
10:18:57#0#00:00:00#00:00:00#00:00:00 1 d144cc336e3f7f9915bac83f069fedfd
0 0 314665 0 0 3274428 0 0 0 0 636987
0 0 818000 0 0
3201126 B 1 BS 1 25/05/2018 03/06/2018 25/05/2018 1742 1
1 P07.3;P07.1;P05.9 - - - None None None None P-8-12-I
- 0 13541500 12163653 0 10 0 0 0 ARIK BINTARI
BY NY D399414 0 0 DR AULIA TANGKARI, SPA 0138R0170518V008914
0002462034655 3;JKN ECHI; 5.2.2.201806040537 4 201510
1#0##0#0#0.0#2018-07-27 09:04:39#0#00:00:00#00:00:00#00:00:00 2
7acd21705d74c002fa37ed7a41ff8964 0 0 1354150 0 0 637750
0 0 0 0 8631753 0 0 0 0 1540000
3201126 B 2 BS 1 01/06/2018 03/06/2018 05/09/2005 0 1
1743400 0 0 - 0 - 0 - 0 - 0
1743400 3174393 0 3 0 0 0 SAMUEL ANGELO PUTRA
ITRAN D285714 12 4652 DR RASTRA, SPA 0138R0170618V000065
0001868688191 3;JKN ECHI; 5.2.2.201806040537 4 186150
1#0##0#0#0.0#2018-07-27 09:05:00#0#00:00:00#00:00:00#00:00:00 2
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1423316 0 0 0 0 1541171 0 0 0 0 0
3201126 B 3 BS 1 24/05/2018 03/06/2018 21/03/1965 0 1
TRAUMATIK (BERAT) 6111900 0 0 - 0 - 0 - 0 -
0 6111900 27157788 0 11 1 1 10 SUGITO
0001273417626 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 184233
1#0##0#0#0.0#2018-08-04 12:14:02#0#09:57:32#09:57:32#00:00:00 2
df859aed99b39529270ccef1d9d22da3 0 0 811978 0 0
14791810 0 0 0 0 7399000 0 0 0 4155000
0
3201126 B 1 BS 1 02/06/2018 03/06/2018 27/07/1954 0 1
1 I10;R04.0 - - - None None None None I-4-17-II None
None None None None None HIPERTENSI (SEDANG) 3107600 0 0
- 0 - 0 - 0 - 0 3107600 3426437 0
2 0 0 0 YAYAT SUTARYAT TN D399961 63 23321 DR ARU, SPPD
0138R0170618V000094 0001308139705 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186161 1#0##0#0#0.0#2018-10-02
17:13:54#0#06:15:55#06:15:55#00:00:00 2 3c07fc9e51b5de1b7d69bec4f62eab37
0 0 372338 0 0 1241940 0 0 0 0
1812159 0 0 0 0 0
3201126 B 3 BS 1 02/06/2018 03/06/2018 15/07/1963 0 2
1 I12.0;J81 38.95 - - None None None None N-1-12-III None
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 7749270 0 2 0 0 0 SRI RUMTINI
0001270744582 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186279
1#0##0#0#0.0#2018-10-02 17:28:07#0#15:01:28#15:01:28#00:00:00 2
7835f7ce648d6c5ac0d6451cd17734e5 0 3618800 974100 0 0
2554408 0 0 0 0 532962 0 0 0 0 69000
3201126 B 3 BS 1 03/06/2018 03/06/2018 06/05/1951 0 1
1 I95.9;R57.0;K30 89.52 - - None None None None I-4-24-III
(BERAT) 8139800 0 0 - 0 - 0 - 0 - 0
8139800 5441245 0 1 0 0 0 SUBARI. S D400091
TANTIYO S;16137 5.2.2.201806040537 4 186296 1#0##0#0#0.0#2018-
10-08 09:25:28#0#00:00:00#00:00:00#00:00:00 2
e1caf090bca0aa5fb645625ec74f0c64 0 0 488390 0 0
3471886 0 0 0 0 662969 0 0 0 0 818000
3201126 B 2 BS 1 02/06/2018 04/06/2018 16/05/1975 0 2
0 - 0 - 0 - 0 - 0 2601900 2726499
0 3 0 0 0 NINING KUSTANTI NY D400020 43 15723
DR ARI KUSUMA JANUARTO, DR. SPOG 0138r0170618v000165 0001298274039
3;JKN DR RIZKI; 5.2.2.201806040537 4 186257 1#0##0#0#0.0#2018-
06-20 10:12:14#0#12:32:04#12:32:04#00:00:00 1
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0 0 0 0 1737369 0 0 0 0 128000
3201126 B 1 BS 1 02/06/2018 04/06/2018 02/01/1986 0 2
5883600 0 0 - 0 - 0 - 0 - 0
5883600 4125284 0 3 0 0 0 HENI EKA NINGSIH
0001635174235 3;JKN DR RIZKI; 5.2.2.201806040537 4 186286
1#0##0#0#0.0#2018-06-20 10:49:30#0#00:00:00#00:00:00#00:00:00 2
0b82fd4cde49b6db9e8604d2d32cb771 0 0 582524 0 0
1249382 0 0 0 0 2293378 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 04/06/2018 10/01/1951 0 1
1 J18.0;I10;K30 - - - None None None None J-4-16-I
(RINGAN) 5058500 0 0 - 0 - 0 - 0 - 0
5058500 5365001 0 3 0 0 0 RUBIANTO,H,B.SC,BBA
D388514 67 24615 DR YUNITA ARLINY SPP 0138R0170618V000199
0000043454259 3;JKN DR RIZKI; 5.2.2.201806040537 4 186281
1#1#vvip#3#306501#0.0#2018-06-20 11:12:47#0#19:12:40#19:12:40#12:00:00 1
29aacfcd90ceb290328601f8378258da 0 0 938236 0 0 812284
0 0 0 0 3614481 0 0 0 0 0
3201126 B 3 BS 1 31/05/2018 04/06/2018 21/12/1968 0 2
1 L40.9;E14.9 - - - None None None None L-4-10-I None
None None None None None PENYAKIT KULIT MAYOR (RINGAN) 1762300 0
0 - 0 - 0 - 0 - 0 1762300 2936997
0 5 0 0 0 WASTIKAH D359554 49 18058 DR. ARU
5.2.2.201806040537 4 186113 1#0##0#0#0.0#2018-06-20
11:14:33#0#19:19:34#19:19:34#00:00:00 1 c051074102baddb7492d8e5ff2fb7a64
0 0 368243 0 0 1122114 0 0 0 0
1446640 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 04/06/2018 21/05/1958 0 1
1 I63.9;R13 87.03 - - None None None None G-4-14-II None
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 6614241 0 4 0 0 0 HARY BASUKI D399941
3;JKN DR RIZKI; 5.2.2.201806040537 4 186138 1#0##0#0#0.0#2018-
06-20 13:27:52#0#00:00:00#00:00:00#00:00:00 1
eab8bc12cb6c9ccca1819d29aca36e32 0 0 923597 0 0
2107937 0 0 0 0 3582707 0 0 0 0 0
3201126 B 2 BS 1 28/05/2018 04/06/2018 29/10/2017 0 1
1 J18.0;A41.9;K59.1;E46;F82;R50.8 87.44 - - None None None
- 0 7703700 10120004 0 8 0 0 0 JAFEER ADHAM
MISHALL SUHENO D398897 0 211 DR RIANITA SYAMSU, SPA
0138R0170518V009723 0002375519387 3;JKN DR RIZKI; 5.2.2.201806040537
4 185072 1#0##0#0#0.0#2018-06-20
13:36:47#0#20:46:46#20:46:46#00:00:00 1 2c3122c4f6439373801795d4e3467a2c
0 0 746333 0 0 4513115 0 0 0 0
4520556 0 0 0 0 340000
3201126 B 2 BS 1 01/06/2018 04/06/2018 19/09/1987 0 2
3545800 0 0 - 0 - 0 - 0 - 0
3545800 4255431 0 4 0 0 0 PUTRI PERMATA
0001737584381 3;JKN DR RIZKI; 5.2.2.201806040537 4 186139
1#0##0#0#0.0#2018-06-20 13:38:54#0#00:00:00#00:00:00#00:00:00 1
be49a80b396130c1aa17a3e317c7cbcf 0 0 372122 0 0
1218916 0 0 0 0 2324393 0 0 0 0 340000
3201126 B 1 BS 1 02/06/2018 04/06/2018 02/06/2018 3751 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3355396 0 3 0 0 0 BY NY LAILA RAHMAH
0002463592162 3;JKN DR RIZKI; 5.2.2.201806040537 4 186518
1#0##0#0#0.0#2018-06-20 13:39:32#0#10:26:31#10:26:31#00:00:00 1
0e7c4b0e404dc742a2a7c99eaf7702fb 0 0 845085 0 0 102199
0 0 0 0 2408112 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 04/06/2018 26/12/1985 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 19823976 0 4 0 0 0 LAILA RAHMAH NY
0001876803219 3;JKN DR RIZKI; 5.2.2.201806040537 4 186149
1#1#vvip#4#12842476#0.0#2018-06-20 13:46:20#0#22:03:09#22:03:09#00:00:00
1 a05f1097f359a62ec5dc782554e9b147 0 8289400 6611176 0
0 3390400 0 0 0 0 1336000 0 0 0 0
197000
3201126 B 3 BS 1 01/06/2018 04/06/2018 18/11/1956 0 1
1 N18.9;R10.4;R18 - - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3303913 0 4 0 0 0 MUHAMMAD YUSUF
0001740129952 3;JKN DR RIZKI; 5.2.2.201806040537 4 186156
1#0##0#0#0.0#2018-06-20 14:30:43#0#00:00:00#00:00:00#00:00:00 2
4b310d239b08eb881a41110f816a291e 0 0 261764 0 0
2011005 0 0 0 0 1031144 0 0 0 0 0
3201126 B 1 BS 1 01/06/2018 04/06/2018 09/04/1964 0 1
1 I64;I50.0;H81.3 87.03 - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 6844000 6759249 0
4 0 0 0 ABDURRAHMAN D399937 54 19776 DR HARDI PRANATA
4 186137 1#0##0#0#0.0#2018-06-20
14:33:01#0#00:00:00#00:00:00#00:00:00 1 8e0d7e2323434605c09f7a4d56e1c331
0 0 754840 0 0 2412215 0 0 0 0
3592194 0 0 0 0 0
3201126 B 1 BS 1 31/05/2018 04/06/2018 18/01/1958 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 14471135 0 5 0 0 0 ROLAND SILITONGA
d398509 60 22048 DR HENDRIEK S, SPB 0138R0170518V010322
0000042323174 3;JKN DR RIZKI; 5.2.2.201806040537 4 185658
1#0##0#0#0.0#2018-06-20 14:35:33#0#00:00:00#00:00:00#00:00:00 1
6a4e04b6a172c6dda061758e537ab689 0 8541200 2151660 0 0
2686565 0 0 0 0 1022710 0 0 0 0 69000
3201126 B 2 BS 1 01/06/2018 04/06/2018 21/06/1987 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10349906 0 4 0 0 0 BINTANG BUTAR BUTAR
0002255161184 3;JKN DR RIZKI; 5.2.2.201806040537 4 186147
1#0##0#0#0.0#2018-06-20 14:49:12#0#19:50:55#19:50:55#00:00:00 1
b2e1d5d5c6eb2e6317298dc516d8689d 0 5477400 1974753 0 0
1897656 0 0 0 0 803097 0 0 0 0 197000
3201126 B 3 BS 1 03/06/2018 04/06/2018 06/04/1980 0 1
- 0 8908800 9724767 0 2 0 0 0 HARJANTO TN
0000557791716 3;JKN DR RIZKI; 5.2.2.201806040537 4 190535
1#0##0#0#0.0#2018-06-20 16:42:18#0#00:00:00#00:00:00#00:00:00 1
78e88905533f7f9a4673c6259a4c7ea1 0 3062500 2012936 0 0
3888131 0 0 0 0 692200 0 0 0 0 69000
3201126 B 1 BS 1 02/06/2018 04/06/2018 30/12/1960 0 2
1 H81.1;I49.3 87.03;89.52 - - None None None None U-4-11-III
None None None None None None DYSEQUILIBRIUM (BERAT) 3250500 0
0 - 0 - 0 - 0 - 0 3250500 5303284
0 3 0 0 0 NY.SRI MAWATI D378477 57 20973 DR
5.2.2.201806040537 4 186166 1#0##0#0#0.0#2018-06-20
16:43:51#0#00:00:00#00:00:00#12:00:00 1 e5b12613969a19b561997d4f65f59847
0 0 1267110 0 0 1320230 0 0 0 0
2715944 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 04/06/2018 16/08/1971 0 2
- 0 - 0 - 0 - 0 2216400 3825981 0
5.2.2.201806040537 4 186543 1#0##0#0#0.0#2018-06-20
16:46:37#0#10:57:07#10:57:07#00:00:00 1 646372549e11cd9c2e672da193f474fc
0 0 443280 0 0 2843403 0 0 0 0 539298
0 0 0 0 0
3201126 B 2 BS 1 03/06/2018 04/06/2018 07/06/1940 0 1
- 0 10690500 11210032 0 2 0 0 0 ADAM
0000059079126 3;JKN DR RIZKI; 5.2.2.201806040537 4 186293
1#0##0#0#0.0#2018-06-20 17:08:09#0#11:37:18#11:37:18#00:00:00 1
ec0761b71edb1b8d26dbe3aebde3155d 0 5091100 2404910 0 0
2855655 0 0 0 0 789367 0 0 0 0 69000
3201126 B 3 BS 1 03/06/2018 04/06/2018 23/04/1974 0 1
- 0 8908800 9452624 0 2 0 0 0 AFRIZAL
0138R0170618V000231 0002100686308 3;JKN DR RIZKI; 5.2.2.201806040537
4 186295 1#0##0#0#0.0#2018-06-20
17:10:17#0#12:06:42#12:06:42#00:00:00 1 d5dbfdde7de14d581e1789408776928a
0 3438800 1870848 0 0 3379580 0 0 0 0
694396 0 0 0 0 69000
3201126 B 1 BS 1 03/06/2018 04/06/2018 19/06/1953 0 1
- 0 - 0 12472300 13528536 0 2 0 0 0
YONO SUYONO D397689 64 23725 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V000250 0000061175733 3;JKN DR RIZKI; 5.2.2.201806040537
4 186308 1#0##0#0#0.0#2018-06-20
17:11:40#0#16:32:29#16:32:29#00:00:00 1 a4708bc0e19e57182dade32a441ca3dc
0 6468200 2619183 0 0 3411109 0 0 0 0
961044 0 0 0 0 69000
3201126 B 2 BS 1 31/05/2018 04/06/2018 01/08/1958 0 1
0 - 0 - 0 - 0 - 0 4851600 6090023
0 5 0 0 0 SUNARDI D391467 59 21853 DR ARU, SPPD
0138R0170518V010704 0001607940213 3;JKN DR RIZKI; 5.2.2.201806040537
4 186096 1#0##0#0#0.0#2018-06-20
17:18:27#0#15:41:04#15:41:04#12:00:00 1 b3c7d7f09e69727efa56652d0ad7dd80
0 0 709388 0 0 2278222 0 0 0 0
2949413 0 0 0 0 153000
3201126 B 3 BS 1 02/06/2018 04/06/2018 31/12/1958 0 2
1 I63.9;G81.9;E11.9;E78.5 87.03 - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3452014 0 3 0 0 0 SITI NASEHA
0001447969926 3;JKN DR RIZKI; 5.2.2.201806040537 4 186187
1#0##0#0#0.0#2018-06-20 17:24:57#0#00:00:00#00:00:00#00:00:00 1
3d2cb93e6a32fb585c0d90a054fa7b7c 0 0 674854 0 0
1736327 0 0 0 0 1040833 0 0 0 0 0
3201126 B 3 BS 1 02/06/2018 04/06/2018 21/04/1978 0 1
1 I12.0;J18.8;D63.8;T82.4 99.04;90.59;89.52;39.42 - - None None
- 0 - 0 - 0 19332400 9668915 0 3 0
0 0 MUHAMAD SOLEH TN D332648 40 14652 DEDY PRATAMA,SPBV
0138R0170618V000129 0001455588617 3;JKN DR RIZKI; 5.2.2.201806040537
4 186168 1#0##0#0#0.0#2018-06-25
08:49:05#0#08:48:59#08:48:59#00:00:00 1 6e401592ed35c54d316ad0a628e62b63
0 3629800 1870848 0 0 2254471 0 0 0 0
1913796 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 04/06/2018 10/08/1956 0 1
- 0 8672200 6409333 0 1 0 0 0 SUPRIYADI
D400116 61 22578 DR YOHANES DWINANDA R P 0138R0170618V000285
0001734002829 3;JKN DR RIZKI; 5.2.2.201806040537 4 186322
1#0##0#0#0.0#2018-06-26 10:32:14#0#00:00:00#00:00:00#00:00:00 1
edb241d53a92b240292b59ad875ed5ab 0 0 350655 0 0
4439376 0 0 0 0 708302 0 0 0 0 911000
3201126 B 2 BS 1 02/06/2018 04/06/2018 02/06/2018 3050 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1216880 0 3 0 0 0 BAYI NY BINTANG BUTAR
BUTAR D399975 0 0 DR NOVIK BUDIWARDHANA, SPA 0138R0170618V000448
0002463564789 3;JKN DR RIZKI; 5.2.2.201806040537 4 186462
1#0##0#0#0.0#2018-07-02 15:19:57#0#09:34:23#09:34:23#00:00:00 1
014252f7c9f901e606664d23d784ad65 0 0 214472 0 0 102199
0 0 0 0 900209 0 0 0 0 0
3201126 B 1 BS 1 29/05/2018 04/06/2018 24/04/1942 0 1
1 M71.07;E11.5 90.59;89.52;86.22 - - None None None None
M-4-21-II None None None None None None GANGGUAN SISTEM
MUSKULOSKELETAL & JA(RINGAN) PENGHUBUNG LAIN-LAIN (SEDANG) 5169800 0 0
- 0 - 0 - 0 - 0 5169800 19022549 0
7 0 0 0 AMRIL DJALIL,DRS,MSI D323338 76 27794 DR
5.2.2.201806040537 4 185098 1#0##0#0#0.0#2018-07-04
09:42:22#0#17:43:53#17:43:53#00:00:00 2 e78c0c000ee0a548733f7c4420baea63
0 9711000 1656940 0 0 5463609 0 0 0 0
1256000 0 0 0 0 935000
3201126 B 3 BS 1 03/06/2018 04/06/2018 18/05/1961 0 1
- 0 8908800 13091329 0 2 0 0 0 JHON RIZAL
D348325 57 20835 DR ARU, SPPD 0138R0170618V000243
0001281285685 3;JKN DR RIZKI; 5.2.2.201806040537 4 186302
1#0##0#0#0.0#2018-07-26 09:27:03#0#00:00:00#00:00:00#00:00:00 1
d7ecc57f85eb4cd136f150fc57cef5d3 0 3242500 2012936 0 0
6854451 0 0 0 0 912442 0 0 0 69000 0
3201126 B 2 BS 1 31/05/2018 04/06/2018 14/09/1971 0 2
1 K30;N39.0;E87.6;G82.2 - - - None None None None K-4-
(SEDANG) 2941900 0 0 - 0 - 0 - 0 - 0
2941900 4643195 0 5 0 0 0 FIETA KUSUMA DEWI
D058136 46 17061 DR DHARMAWAN, SPPD 0138R0170518V010638
0001336592338 3;JKN ECHI; 5.2.2.201806040537 4 201885
1#0##0#0#0.0#2018-07-27 09:05:36#0#00:00:00#00:00:00#00:00:00 3
af0657b0c9f68a48dbb17ce03f0963d1 0 0 507248 0 0
1616187 0 0 0 0 2349760 0 0 170000 0
0
3201126 B 1 BS 1 31/05/2018 04/06/2018 15/10/1950 0 2
1 I64;R13;E86 - - - None None None None G-4-15-II None
- 0 - 0 - 0 6844000 6694569 0 5 0
0 0 SALMIATI D398943 67 24700 DR HARDI PRANATA SPS
0138R0170518V010315 0000060688991 3;JKN DR RIZKI; 5.2.2.201806040537
4 185654 1#0##0#0#0.0#2018-08-02
16:32:00#0#00:00:00#00:00:00#00:00:00 2 4960daf04232526e104295cbf3b16ce2
0 0 754840 0 0 1570767 0 0 0 0
4368962 0 0 0 0 0
3201126 B 1 BS 1 24/05/2018 04/06/2018 18/08/1944 0 2
1 I63.9;I13.2;R40.2;G81.9;K92.0 87.03;87.44 - - None None None
- 0 - 0 12141100 24112842 0 12 1 6 0
SITI SUKAENAH D399324 73 26942 DR NURUL KOMARI SPS
0138R0170518V008188 0000061041284 3;JKN DR RIZKI; 5.2.2.201806040537
4 183643 1#0##0#0#0.0#2018-08-03
09:50:23#0#00:22:53#00:22:53#00:00:00 2 c3aacea9d0262a824de499b4ed689483
0 0 1145696 0 0 8785146 0 0 0 0
11150000 0 0 0 0 3032000
3201126 B 3 BS 1 30/05/2018 04/06/2018 01/07/2000 0 1
1 L04.2;R51 90.59 - - None None None None D-4-14-I None
LAIN-LAIN (RINGAN) 3203700 0 0 - 0 - 0 - 0
- 0 3203700 4062253 0 6 0 0 0 MAULANA
YUSUF D399763 17 6542 DR HARDI PRANATA SPS 0138R0170518V010061
0000511606091 3;JKN irene; 5.2.2.201806040537 4 185427
1#0##0#0#0.0#2018-09-10 17:00:02#0#00:00:00#00:00:00#00:00:00 4
1cc3d29a2d343fed31171e375f8b2663 0 0 394333 0 0
1798165 0 0 0 0 1869755 0 0 0 0 0
3201126 B 1 BS 1 03/06/2018 05/06/2018 27/05/2017 0 1
1 A09.9;R63.8;A49.9 - - - None None None None K-4-17-I
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 3714939 0 3 0 0 0 MAWGLI BRILLI EL JAUZA
AN D400098 1 372 DR RIANITA SYAMSU, SPA 0138R0170618V000248
0002436248823 3;JKN DR RIZKI; 5.2.2.201806040537 4 186307
1#0##0#0#0.0#2018-06-20 16:27:08#0#14:47:08#14:47:08#00:00:00 1
825383d88ae0c9919b6ab8b8914019a0 0 0 269459 0 0 833447
0 0 0 0 2612033 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 05/06/2018 11/09/1963 0 1
1 K12.1;R63.0 - - - None None None None U-4-14-I None
None None None None None PENYAKIT MULUT DAN GIGI (RINGAN) 5163500
0 0 - 0 - 0 - 0 - 0 5163500
5520700 0 4 0 0 0 IWAN GUNAWAN TN D399957 54
RIZKI; 5.2.2.201806040537 4 186158 1#0##0#0#0.0#2018-06-20
16:45:00#0#00:26:09#00:26:09#00:00:00 1 63c595fe13354c1a674c5e82b2e9cd90
0 0 338858 0 0 1670675 0 0 0 0
3511167 0 0 0 0 0
3201126 B 3 BS 1 02/06/2018 05/06/2018 11/06/1958 0 1
4336500 0 0 - 0 - 0 - 0 - 0
4336500 6723278 0 4 0 0 0 BASUKI SUPRIADI TN
0002332394864 3;JKN DR RIZKI; 5.2.2.201806040537 4 186160
1#0##0#0#0.0#2018-06-20 16:51:44#0#00:54:14#00:54:14#00:00:00 1
5e11bc79f5a9ace14cc28bac7584a2a4 0 0 443285 0 0
2598152 0 0 0 0 3681841 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 05/06/2018 03/03/1977 0 2
1 A18.3;R18 - - - None None None None K-4-18-II None
3432200 0 0 - 0 - 0 - 0 - 0
3432200 6573485 0 4 0 0 0 NURSAMSI D339225
41 15066 DR ARU, SPPD 0138R0170618V000122 0001662627903 3;JKN
DR RIZKI; 5.2.2.201806040537 4 186164 1#0##0#0#0.0#2018-06-20
17:23:18#0#00:00:00#00:00:00#00:00:00 1 974ed3e532e7db3e86857ad3ab30c85e
0 0 582740 0 0 2410704 0 0 0 0
3580041 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 05/06/2018 16/03/1972 0 2
3705200 0 0 - 0 - 0 - 0 - 0
3705200 6263001 0 4 0 0 0 ANING SULESTYOWATI
0000060506717 3;JKN DR RIZKI; 5.2.2.201806040537 4 186218
1#0##0#0#0.0#2018-06-20 17:36:10#0#00:00:00#00:00:00#00:00:00 1
590b1d847bd718d25c7827925165bd86 0 0 439468 0 0
2138804 0 0 0 0 3684729 0 0 0 0 0
3201126 B 2 BS 1 03/06/2018 05/06/2018 26/07/1973 0 1
1 J90;N18.9;B37.9 87.49;90.59;89.52;34.91 - - None None None
None J-4-20-II None None None None None None PLEURAL EFUSI DAN
PNEUMOTORAK (SEDANG) 7715900 0 0 - 0 - 0 - 0
- 0 7715900 4689611 0 3 0 0 0 SUMARTANA
0001101686411 3;JKN DR RIZKI; 5.2.2.201806040537 4 186291
1#0##0#0#0.0#2018-06-21 14:56:07#0#09:47:36#09:47:36#00:00:00 1
f22d58e782800e60b4be6cc0189e2068 0 0 1053000 0 0
1786814 0 0 0 0 1849797 0 0 0 0 0
3201126 B 2 BS 1 01/06/2018 05/06/2018 10/07/1952 0 1
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 7286400 0 5 0 0 0 MANIUR HUTABARAT
0001336036599 3;JKN DR RIZKI; 5.2.2.201806040537 4 186388
1#0##0#0#0.0#2018-06-21 15:03:58#0#08:56:55#08:56:55#00:00:00 1
4745b8ec9cfd904b9fd664d2113490e9 0 0 674855 0 0
4088865 0 0 0 0 2522680 0 0 0 0 0
3201126 B 1 BS 1 30/05/2018 05/06/2018 21/01/1960 0 1
- 0 - 0 - 0 - 0 5734600 10106425 0
7 0 0 0 ASEP SAPUTRA D182436 58 21314 DR ARU, SPPD
0138R0170518V010269 0000061130935 3;JKN DR RIZKI; 5.2.2.201806040537
4 185638 1#0##0#0#0.0#2018-06-21
16:11:28#0#17:33:17#17:33:17#00:00:00 1 cb8b62846f4cadfff9b4be4241660c11
0 0 976596 0 0 2975661 0 0 0 0
6154168 0 0 0 0 0
3201126 B 2 BS 1 03/06/2018 05/06/2018 04/02/1973 0 1
- 0 - 0 - 0 - 0 5866300 3619545 0
3 0 0 0 SUGIRI TOMO D400103 45 16555 DR NURUL
5.2.2.201806040537 4 186313 1#0##0#0#0.0#2018-06-21
16:14:17#0#00:00:00#00:00:00#00:00:00 1 d932641420efae81391a988b5960aa56
0 0 799226 0 0 1547526 0 0 0 0
1272793 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 05/06/2018 12/09/1954 0 2
1 E14.2;J91;J18.0;I11.9 38.95 - - None None None None N-1-
- 0 - 0 19332400 13469166 0 2 0 0 0
SURATI D391827 63 23276 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V000812 0002258651439 3;JKN DR RIZKI; 5.2.2.201806040537
4 186822 1#0##0#0#0.0#2018-06-28
12:02:55#0#00:00:00#00:00:00#12:00:00 1 540cc58f1ca2e2b9453a9527bc7c09bc
0 2976000 1906030 0 0 7560976 0 0 0 0
957160 0 0 0 0 69000
3201126 B 3 BS 1 04/06/2018 05/06/2018 02/03/1970 0 2
1 A16.1;E16.2;G93.4 89.52 - - None None None None J-4-15-III
None None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (BERAT)
6970400 0 0 - 0 - 0 - 0 - 0
6970400 4345147 0 2 0 0 0 TJARSINAH D400143
3;JKN DR RIZKI; 5.2.2.201806040537 4 186811 1#0##0#0#0.0#2018-
07-02 16:04:43#0#00:00:00#00:00:00#00:00:00 1
fddc5284b79272c8ced2a76a932cbca0 0 0 348520 0 0
3423365 0 0 0 0 573262 0 0 0 0 0
3201126 B 2 BS 1 31/05/2018 05/06/2018 02/10/1974 0 2
1 I74.3;E11.5;A41.9 88.66;39.50 - - None None None None I-1-
LAIN-LAIN (BERAT) 24212000 0 0 - 0 - 0 - 0 -
0 24212000 41573367 0 6 0 0 0 RITA MINARMA. H
D358049 43 15947 DR ARU, SPPD 0138R0170518V010310
0002098842118 3;JKN DR RIZKI; 5.2.2.201806040537 4 185651
1#0##0#0#0.0#2018-07-04 09:51:09#0#00:26:51#00:26:51#00:00:00 1
b5ead1f02549caebb33eca24748c61d9 0 0 5379640 0 0
27633727 0 0 0 0 6491000 0 0 0 0
2069000
3201126 B 1 BS 1 26/05/2018 05/06/2018 27/10/1952 0 2
1 E87.6;E87.1;R33;A01.0 - - - None None None None E-4-
(BERAT) 8810600 0 0 - 0 - 0 - 0 - 0
8810600 15752482 0 11 0 0 0 RUKI TAURGUN BR
HUTABARAT D399574 65 23952 DR. ARU ARIADNO, SPPD 0138R0170518V009183
0000060965998 3;JKN DR RIZKI; 5.2.2.201806040537 4 184689
1#0##0#0#0.0#2018-07-04 10:16:05#0#22:23:48#22:23:48#00:00:00 1
4934de5e52a7741d8fe6b1f1aab965e6 0 0 845954 0 0
5749992 0 0 0 0 8866536 0 0 0 0 290000
3201126 B 1 BS 1 03/06/2018 05/06/2018 06/09/2017 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 2942724 0 3 0 0 0 AL GHAZALI TSAQIB
RABBANI D376936 0 270 DR OTTY MITHA S, SPA 0138R0170618V000272
0002354402665 3;JKN ECHI; 5.2.2.201806040537 4 186319
1#0##0#0#0.0#2018-07-27 09:07:09#0#00:00:00#00:00:00#00:00:00 2
1c47785e0bb14201eec106bd1b678529 0 0 316331 0 0 845878
0 0 0 0 1780515 0 0 0 0 0
3201126 B 1 BS 1 04/06/2018 05/06/2018 15/06/1949 0 1
- 0 46734600 56441750 0 2 0 0 0 ROSLIAN
0138R0170618V000647 0001335203278 3;JKN ECHI; 5.2.2.201806040537
4 186709 1#0##0#0#0.0#2018-07-27
09:07:35#0#00:00:00#00:00:00#12:00:00 2 d6658a36f643e4dcca18b222d188320d
0 10062000 7201760 0 0 30332990 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 2 BS 1 04/06/2018 05/06/2018 28/04/2015 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4723138 0 2 0 0 0 ASHKAHF HAZARD AL
FATTAAH D399805 3 1133 DR CATUR SUZANTARA 0138R0170618V000817
0002088117145 3;JKN ECHI; 5.2.2.201806040537 4 187256
1#0##0#0#0.0#2018-07-27 09:08:05#0#00:00:00#00:00:00#00:00:00 2
cf32d542652c31caadd825df609a3bac 0 0 493024 0 0
1061624 0 0 0 0 3023490 0 0 0 145000
0
3201126 B 3 BS 1 04/06/2018 05/06/2018 20/01/1948 0 1
4 I21.3;R57.0;I46.9 96.71 - - None None None None J-1-20-III
(BERAT) 29135800 0 0 - 0 - 0 - 0 - 0
29135800 11876302 0 2 1 2 24 MUHAMAD YASIN TN
0001337513815 3;JKN ECHI; 5.2.2.201806040537 4 186636
1#0##0#0#0.0#2018-07-27 09:08:27#0#12:31:46#12:31:46#00:00:00 2
944d22f3f89591b953fd9cc934796a5c 0 0 2780222 0 0
5196126 0 0 0 0 2566954 0 0 0 0
1333000
3201126 B 3 BS 1 27/05/2018 05/06/2018 28/03/2018 0 1
1 K63.0;J22;D64.9 54.11;99.04 - - None None None None K-1-
40-II None None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN
(SEDANG) 8857200 0 0 - 0 - 0 - 0 - 0
8857200 27395220 0 10 0 0 0 BAYI NY DEWI KOMALA SARI
D394770 0 60 DR CATUR S, SPB 0138R0170518V009191
0002438966193 3;JKN DR RIZKI; 5.2.2.201806040537 4 184694
1#0##0#0#0.0#2018-08-02 16:06:45#0#01:44:57#01:44:57#12:00:00 3
fc5f38f4f8a07be30e6d6edf9277d057 0 7056400 4841007 0 0
8896812 0 0 0 0 1361001 0 0 0 0
5240000
3201126 B 3 BS 1 03/06/2018 05/06/2018 30/06/1959 0 2
1 I12.0;D63.8;J18.0 99.04;39.27 - - None None None None N-1-
- 0 - 0 19332400 8700348 0 3 0 0 0
ENTING D398768 58 21523 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V000269 0001212360309 3;JKN DR RIZKI; 5.2.2.201806040537
4 186317 1#0##0#0#0.0#2018-08-03
09:48:26#0#00:00:00#00:00:00#00:00:00 2 8f8577a4a1a63196614855debff11b50
0 3438800 2012936 0 0 2534430 0 0 0 0
645182 0 0 0 0 69000
3201126 B 3 BS 1 04/06/2018 05/06/2018 01/03/1963 0 2
1 I48;I50.0;E16.1 - - - None None None None I-4-19-II
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 1142038 0 2 0 0 0 ETY RUSMIYATI
D388394 55 20184 DR SUKMARINI 0138R0170618V000708
0000510795933 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186808
1#0##0#0#0.0#2018-08-04 15:10:38#0#00:00:00#00:00:00#12:00:00 2
b8590eb85d8af79154df8932fb763251 0 0 305565 0 0 472760
0 0 0 0 363713 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 05/06/2018 01/08/1963 0 2
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 2489307 0 2 0 0 0 TINA ELIZA D391056
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186810
1#0##0#0#0.0#2018-08-04 15:11:58#0#16:46:12#16:46:12#12:00:00 2
4fcb555e66e4a2c123fd1b34cd57f042 0 0 321905 0 0
1195550 0 0 0 0 451852 0 0 520000 0
0
3201126 B 3 BS 1 05/06/2018 05/06/2018 07/01/1949 0 1
1 I50.9;J22;R57.0 89.52;87.44 - - None None None None I-4-
4973600 0 0 - 0 - 0 - 0 - 0
4973600 2929992 0 1 0 0 0 BUDIMAN LOMBRI
D368351 69 25351 DR DICKI PRATAMA 0138r0170618v000838
0000061003765 3;JKN SURYANIH;15136 5.2.2.201806040537 4 186840
1#0##0#0#0.0#2018-10-03 14:39:36#0#02:07:17#02:07:17#00:00:00 2
860bf0b2324a084d369ab880e0befefb 0 0 151810 0 0
1386500 0 0 0 0 480682 0 0 0 0 911000
3201126 B 1 BS 1 30/05/2018 05/06/2018 17/03/1996 0 2
- 0 - 0 - 0 - 0 5424200 19062314 0
7 0 0 0 SILKA AUDIA RERINTA D173299 22 8109 DR
ARU, SPPD 0138R0170518V010544 0002048530329 3;JKN SURYANIH;15136
5.2.2.201806040537 4 185965 1#0##0#0#0.0#2018-10-03
16:01:33#0#11:58:31#11:58:31#00:00:00 3 86745bd128309083d844707ada3a7482
0 0 3434945 0 0 4770169 0 0 0 0
10788200 0 0 0 0 69000
3201126 B 1 BS 1 03/06/2018 06/06/2018 25/02/1983 0 2
(RINGAN) 6981500 0 0 - 0 - 0 - 0 - 0
6981500 23974354 0 4 0 0 0 SURYANINGSIH
0001423189372 3;JKN DR RIZKI; 5.2.2.201806040537 4 186316
1#1#vvip#4#16992854#0.0#2018-06-21 15:01:39#0#22:53:13#22:53:13#00:00:00
1 8b3b07f332e3f09e549a6a0d0f8f4094 0 9528900 8607837 0
0 4314617 0 0 0 0 1326000 0 197000 0
0 0
3201126 B 1 BS 1 05/06/2018 06/06/2018 07/08/1964 0 2
0 - 0 - 0 - 0 - 0 6963100 2527915
0 2 0 0 0 RUSIANNA BR KARO D400192 53 19660 DR
5.2.2.201806040537 4 186841 1#0##0#0#0.0#2018-06-21
15:10:22#0#02:29:12#02:29:12#00:00:00 1 ce85ddbb4fedb9ca4b1a62dd58e0aaf8
0 0 546272 0 0 228265 0 0 0 0
1753378 0 0 0 0 0
3201126 B 1 BS 1 29/05/2018 06/06/2018 30/08/1954 0 2
0 - 0 9673300 16925456 0 9 1 0 0
NURHAYATI NY D399744 63 23283 DR MAYSAM I., SPS
0138R0170518V009818 0001456506764 3;JKN DR RIZKI; 5.2.2.201806040537
4 185107 1#0##0#0#0.0#2018-06-21
15:15:51#0#23:04:03#23:04:03#00:00:00 1 81f04f8ec8689c3c4132ea72ad62adc2
0 0 1267109 0 0 5754074 0 0 0 0
7767273 0 0 0 0 2137000
3201126 B 1 BS 1 03/06/2018 06/06/2018 03/11/1941 0 2
1 J40;A01.4;I51.7;H81.3 - - - None None None None J-4-
0 - 0 8807500 5774118 0 4 0 0 0 ENING
DJUNINGSIH D400105 76 27971 DR BETTY DWI L, SPPD 0138R0170618V000257
0000060950902 3;JKN DR RIZKI; 5.2.2.201806040537 4 188001
1#0##0#0#0.0#2018-06-21 15:23:10#0#16:40:31#16:40:31#00:00:00 1
afa56707456850e9a94bf2fddc4e4b11 0 0 845675 0 0
1400697 0 0 0 0 3527746 0 0 0 0 0
3201126 B 3 BS 1 31/05/2018 06/06/2018 01/06/1960 0 1
None None None None PROSEDUR KAKI (RINGAN) 8740200 0 0 -
0 - 0 - 0 - 0 8740200 16191820 0 7
0 0 0 JAMIN D399581 57 21183 DR HENDRIEK S, SPB
0138R0170518V010669 0000511258509 3;JKN DR RIZKI; 5.2.2.201806040537
4 190597 1#0##0#0#0.0#2018-06-21
15:34:33#0#00:00:00#00:00:00#00:00:00 1 e960fb43ebb3eb9de3270ba15df2e64f
0 4303800 4390437 0 0 6118305 0 0 0 0
1310278 0 0 0 0 69000
3201126 B 1 BS 1 01/06/2018 06/06/2018 29/02/1984 0 2
1 I20.0;I11.0;J22 89.52 - - None None None None I-4-20-III
9856000 0 0 - 0 - 0 - 0 - 0
9856000 9846873 0 6 0 0 0 YURI LESMANA
d398513 34 12511 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170618V000024
0001462044418 3;JKN DR RIZKI; 5.2.2.201806040537 4 188000
1#0##0#0#0.0#2018-06-21 15:53:17#0#16:37:10#16:37:10#00:00:00 1
43ef03350f6a26f62e62c0c65d093fab 0 0 940040 0 0
2221645 0 0 0 0 5356188 0 0 0 0
1329000
3201126 B 1 BS 1 31/05/2018 06/06/2018 18/08/1958 0 2
1 I63.9;E11.9;G81.9;M24.41 87.03;87.44;88.21 - - None None
- 0 - 0 - 0 9673300 10338835 0 7 0
0 0 ASMA INTAN D399881 59 21836 DR NURUL KOMARI SPS
0138R0170518V010710 0000061060926 3;JKN DR RIZKI; 5.2.2.201806040537
4 186103 1#0##0#0#0.0#2018-06-21
16:24:38#0#16:00:46#16:00:46#00:00:00 1 4befe4101e7719367005454902257a7d
0 0 1117063 0 0 3397900 0 0 0 0
5823872 0 0 0 0 0
3201126 B 2 BS 1 03/06/2018 06/06/2018 05/04/1960 0 1
0 - 0 - 0 - 0 - 0 4290800 7650637
0 4 0 0 0 HIN BENG D391934 58 21243 DR AZRI
5.2.2.201806040537 4 186309 1#0##0#0#0.0#2018-06-23
09:32:09#0#00:00:00#00:00:00#12:00:00 1 52f78c6ecdffed2d1b7cc56b4f5fda5e
0 0 911160 0 0 4192968 0 0 0 0
2546509 0 0 0 0 0
3201126 B 3 BS 1 05/06/2018 06/06/2018 13/05/1964 0 2
- 0 8908800 8827564 0 2 0 0 0 ANI ROHANI
0138R0170618V001251 0001290203414 3;JKN DR RIZKI; 5.2.2.201806040537
4 187546 1#0##0#0#0.0#2018-06-23
11:40:04#0#00:00:00#00:00:00#00:00:00 1 6adcd9fe661611301f8dd96464530811
0 0 1853030 0 0 2919730 0 0 0 0
3985804 0 0 69000 0 0
3201126 B 3 BS 1 05/06/2018 06/06/2018 19/01/1957 0 1
1 I13.2;J18.0;D63.8;E11.9 99.04;39.27 - - None None None None
- 0 - 0 19332400 8218520 0 2 0 0 0
SUWARDI D400203 61 22417 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V001038 0001210913008 3;JKN DR RIZKI; 5.2.2.201806040537
4 187159 1#0##0#0#0.0#2018-06-25
08:39:10#0#11:13:50#11:13:50#00:00:00 1 81317a7774d2c4768040fea54d28d9c7
0 3438800 1853030 0 0 2244030 0 0 0 0
682660 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 06/06/2018 03/09/1955 0 2
1 I13.1;J18.0;D63.8;I25.0 99.04;39.27;89.52 - - None None None
0 - 0 - 0 23198900 12291486 0 2 0 0
0 SEBAH PATURU D400239 62 22921 SRI KUNMARTINI.DR,SPPD
0138R0170518V001280 0001278779646 3;JKN DR RIZKI; 5.2.2.201806040537
4 187560 1#0##0#0#0.0#2018-06-25
09:38:55#0#23:34:24#23:34:24#00:00:00 1 f91da1bcd4cb3dfb9da64d1d5cdf2cc2
0 0 2276624 0 0 4658646 0 0 0 0
5356216 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 06/06/2018 16/08/1986 0 1
1 Q43.0;K35.3 45.33 - - None None None None K-1-10-I None
None None None None None PROSEDUR NON KOMPLEKS USUS HALUS & USUS BESAR
(RINGAN) 11118700 0 0 - 0 - 0 - 0 - 0
11118700 25527682 0 5 0 0 0 SAIPUL ANWAR
D399970 31 11613 DR ARU, SPPD 0138R0170618V000118
0001728931375 3;JKN DR RIZKI; 5.2.2.201806040537 4 186163
1#0##0#0#0.0#2018-06-25 09:56:50#0#07:54:10#07:54:10#00:00:00 1
6ae1731e5f9b71d559643a31af1af1d1 0 12508000 5336764 0 0
6327918 0 0 0 0 1355000 0 0 0 0 0
3201126 B 3 BS 1 02/06/2018 06/06/2018 25/08/1967 0 1
1 I63.9;J18.9;G81.9;K30 87.44;87.03 - - None None None None
0 - 0 8672200 6308155 0 5 0 0 0
BUDIAWAN D400063 50 18544 DR NURUL KOMARI SPS
0138R0170618V000202 0000511815598 3;JKN DR RIZKI; 5.2.2.201806040537
4 186285 1#0##0#0#0.0#2018-06-25
10:07:30#0#20:54:49#20:54:49#00:00:00 1 b1686cc5917cb02bd4d641f299f7c893
0 0 674855 0 0 3966117 0 0 0 0
1667183 0 0 0 0 0
3201126 B 3 BS 1 06/06/2018 06/06/2018 15/05/1969 0 1
1 E14.1;I10;R56.8 89.52 - - None None None None E-4-10-II
0 - 0 4894400 10425131 0 1 0 0 0 ISWATI
0002287993059 3;JKN DR RIZKI; 5.2.2.201806040537 4 189029
1#0##0#0#0.0#2018-06-25 11:32:35#0#00:00:00#00:00:00#00:00:00 1
199398d7d749eac7226f5a1fbd64da52 0 0 339032 0 0
8211081 0 0 0 0 989018 0 0 0 0 886000
3201126 B 2 BS 1 04/06/2018 06/06/2018 12/06/2014 0 2
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9259110 0 3 0 0 0 SITI FATIYAH AHMAD
0002279706377 3;JKN DR RIZKI; 5.2.2.201806040537 4 186827
1#0##0#0#0.0#2018-06-26 09:55:05#0#00:00:00#00:00:00#00:00:00 1
7d9e49aa5785290450731f4cbb2e4cc6 0 0 1844276 0 0
1523298 0 0 0 0 5822536 0 0 0 0 69000
3201126 B 2 BS 1 04/06/2018 06/06/2018 07/07/2017 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2348724 0 3 0 0 0 HAZARD AL FATIH AN
0002271959166 3;JKN DR RIZKI; 5.2.2.201806040537 4 186510
1#0##0#0#0.0#2018-06-26 10:18:36#0#10:18:49#10:18:49#00:00:00 1
78789c230b84d3f12e5c7fee20cc8a3c 0 0 278711 0 0 375358
0 0 0 0 1694655 0 0 0 0 0
3201126 B 3 BS 1 06/06/2018 06/06/2018 31/12/1968 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 5283565 0 1 0 0 0 INDRAWAN RUSMAN
0001621275952 3;JKN DR RIZKI; 5.2.2.201806040537 4 187565
1#0##0#0#0.0#2018-06-26 10:29:50#0#02:25:12#02:25:12#00:00:00 1
400724af95d7adcf9329b09582df46fb 0 0 206605 0 0
2552056 0 0 0 0 1808904 0 0 0 0 716000
3201126 B 3 BS 1 06/06/2018 06/06/2018 10/02/1964 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 2282061 0 1 0 0 0 KASIYEM D375216
54 19840 DR WIDHI DEWANTA K AJI 0138r0170618v001301 0001266786584
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 187563
1#0##0#0#0.0#2018-07-02 16:44:54#0#01:47:12#01:47:12#12:00:00 1
b324d8f894a4d6f9ab453ff8d060836a 0 0 175135 0 0
1668632 0 0 0 0 438294 0 0 0 0 0
3201126 B 1 BS 1 31/05/2018 06/06/2018 02/06/1970 0 2
1 A09.9 89.52 - - None None None None K-4-17-I None None
2405100 0 0 - 0 - 0 - 0 - 0
2405100 9447921 0 7 0 0 0 SUHENNY D025511
47 17530 DR ARU, SPPD 0138R0170518V010757 0002298615221 3;JKN
DR RIZKI; 5.2.2.201806040537 4 186115 1#0##0#0#0.0#2018-07-04
10:52:21#0#19:41:43#19:41:43#12:00:00 1 d38d53ed451fdc686f1026ccf7262f17
0 0 291536 0 0 3390797 0 0 0 0
5765588 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 06/06/2018 05/06/2018 2730 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 917430 0 2 0 0 0 BAYI NY FERI YANI
d400266 0 0 DR A.D. PASARIBU SP.A 0138R0170618V001520
0002464378198 3;JKN DR RIZKI; 5.2.2.201806040537 4 187874
1#0##0#0#0.0#2018-07-11 10:24:39#0#00:00:00#00:00:00#00:00:00 1
5740de4107f22469090fce892c061c6a 0 0 414312 0 0 126499
0 0 0 0 376619 0 0 0 0 0
3201126 B 1 BS 1 04/06/2018 06/06/2018 20/05/1947 0 2
4 A41.9;R57.2;K74.6;D64.9 96.71;99.04 - - None None None None
J-1-20-II None None None None None None PROSEDUR SISTEM PERNAFASAN
NON-KOMPLEKS (SEDANG) 26415700 0 0 - 0 - 0 - 0
- 0 26415700 19493458 0 3 1 1 24 HJ. ROSPIPIT
D400178 71 25948 DR ARU, SPPD 0138R0170618V000821
0000060954546 3;JKN ECHI; 5.2.2.201806040537 4 186829
1#0##0#0#0.0#2018-07-27 09:12:49#0#00:00:00#00:00:00#00:00:00 3
0c1c2023c068f5b6458c715e08e6b87c 0 0 2694570 0 0
11968888 0 0 0 0 3327000 0 0 0 0
1503000
3201126 B 2 BS 1 05/06/2018 06/06/2018 30/05/2018 2778 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3329281 0 2 0 0 0 BAYI NY. DESI MARTHA
YANI D399755 0 6 DR RIANITA SYAMSU, SPA 0138R0170618V001072
0002442736236 3;JKN ECHI; 5.2.2.201806040537 4 187254
1#0##0#0#0.0#2018-07-27 09:13:18#0#00:00:00#00:00:00#00:00:00 2
5cfe9d9b986a92a3f997fd1b547bb812 0 0 394812 0 0 160666
0 0 0 0 1805803 0 0 0 0 968000
3201126 B 2 BS 1 03/06/2018 06/06/2018 31/05/2018 2600 1
1 P59.9;P90 99.82 - - None None None None P-8-17-III None
(BERAT) 11111500 0 0 - 0 - 0 - 0 - 0
11111500 9703361 0 4 0 0 0 BAYI NY HERLY PRATIWI
0002463775391 3;JKN ECHI; 5.2.2.201806040537 4 187251
1#0##0#0#0.0#2018-07-27 09:13:44#0#00:00:00#00:00:00#00:00:00 2
5fe3657ebad9974042de0f6a7acfa719 0 0 394812 0 0
2685750 0 0 0 0 3256799 0 0 0 0
3366000
3201126 B 3 BS 1 04/06/2018 06/06/2018 20/11/1970 0 2
1 N61;D48.6 85.12;86.04 - - None None None None L-1-50-I
None None None None None None PROSEDUR PADA PAYUDARA (RINGAN)
6535800 0 0 - 0 - 0 - 0 - 0
6535800 9080109 0 3 0 0 0 RAHMI MUHYETI
0002135249346 3;JKN ECHI; 5.2.2.201806040537 4 186823
1#0##0#0#0.0#2018-07-27 09:14:14#0#00:00:00#00:00:00#00:00:00 2
dbab2cd8bb3b483052e5b1cd8c6f2392 0 3525300 1830024 0 0
2909759 0 0 0 0 670026 0 0 0 0 145000
3201126 B 3 BS 1 02/06/2018 06/06/2018 10/01/2004 0 2
0 0 - 0 - 0 - 0 - 0 2954900
4809380 0 5 0 0 0 PRAMESTI PUTRI ADRIANTO D369060
14 5257 DR RASTRA, SPA 0138R0170618V000157 0001335349967 3;JKN
ECHI; 5.2.2.201806040537 4 186244 1#0##0#0#0.0#2018-07-27
09:14:35#0#00:00:00#00:00:00#00:00:00 2 001e0ae49b96cc30dc7de894fedc932d
0 0 371940 0 0 2101808 0 0 0 0
1655632 0 0 0 0 680000
3201126 B 2 BS 1 05/06/2018 06/06/2018 03/09/1955 0 2
1 I13.1;J18.0;D63.8;I25.0 99.04;39.27;89.52 - - None None None
0 - 0 - 0 23198900 12291486 0 2 0 0
0 SEBAH PATURU D400239 62 22921 SRI KUNMARTINI.DR,SPPD
0138R0170518V001289 0001278779646 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 187560 1#0##0#0#0.0#2018-08-04
12:50:06#0#23:34:24#23:34:24#00:00:00 2 a2760e577ec1159424e6887947167d0a
0 0 2276624 0 0 4658646 0 0 0 0
5356216 0 0 0 0 0
3201126 B 3 BS 1 05/06/2018 06/06/2018 04/07/1936 0 1
1 J22;I64;K21.9 87.03;87.44 - - None None None None J-4-
0 - 0 6291000 6797522 0 2 0 0 0
SISWADI ATMOJUWONO D400194 81 29921 DR DICKY PRATAMA
0138R0170618V000841 0002333945441 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186842 1#0##0#0#0.0#2018-08-04
15:00:07#0#02:46:56#02:46:56#00:00:00 2 a77669e109bdd49c8df1bf4f8e0208fa
0 0 368658 0 0 4937166 0 0 0 0 733698
0 0 0 0 758000
3201126 B 1 BS 1 05/06/2018 06/06/2018 13/06/1964 0 2
- 0 12472300 11930257 0 2 0 0 0 ETI YUNIARTI
0138R0170618V001104 0000060479943 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 187265 1#0##0#0#0.0#2018-08-04
15:02:06#0#13:12:30#13:12:30#00:00:00 2 cb5de7937996e67c985621731a9f9607
0 6468200 2619183 0 0 1917390 0 0 0 0
925484 0 0 0 0 0
3201126 B 1 BS 1 04/06/2018 06/06/2018 05/04/2017 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3424541 0 3 0 0 0 ALKHALIFI ZIKRI RAHMAN
0002212517125 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186492
1#0##0#0#0.0#2018-08-04 15:06:50#0#00:00:00#00:00:00#12:00:00 2
59022d9b92cc654547ab9cadd08f4d99 0 0 269459 0 0 562047
0 0 0 0 2593035 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 06/06/2018 09/11/1979 0 1
1 N13.1;A15.3 56.91;58.0 - - None None None None N-1-40-II
(SEDANG) 10919500 0 0 - 0 - 0 - 0 - 0
10919500 13229211 0 3 0 0 0 ABDUL ROSIT D399101
38 14087 DR SIDDHI ANDIKA, SPU 0138R0170618V000507 0001336921457
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186555
1#0##0#0#0.0#2018-08-04 15:09:06#0#11:07:21#11:07:21#00:00:00 2
a3099e1adcf317f17e46b27b85b6446a 0 5219300 1217160 0 0
2757289 0 0 0 0 966462 0 0 3069000 0
0
3201126 B 1 BS 1 04/06/2018 06/06/2018 23/08/2017 0 1
1 Q53.2;N51.2 62.5;64.0 - - None None None None V-1-12-I
None None None None None None PROSEDUR PADA SKROTUM DAN PROSTAT
KOMPLEK-MODERAT (RINGAN) 12096300 0 0 - 0 - 0 -
0 - 0 12096300 11904704 0 3 0 0 0 ARQAM
DZULKARNAIN ASHAN D374377 0 285 DR CATUR SUZANTARA
0138R0170618V000826 0002437140069 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186833 1#0##0#0#0.0#2018-08-04
15:14:29#0#23:12:07#23:12:07#00:00:00 2 9cc1d50f206ed0f4566a14813485f65c
0 5896000 3386964 0 0 1697928 0 0 0 0
854812 0 0 0 0 69000
3201126 B 2 BS 1 03/06/2018 06/06/2018 25/11/1996 0 1
1 G04.2;B20.5 - - - None None None None G-4-18-II None
None None None None None INFEKSI BAKTERI SISTEM SARAF (SEDANG)
7105000 0 0 - 0 - 0 - 0 - 0
7105000 5249375 0 4 0 0 0 REZA PRIYANTAMA
0001479574405 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186303
1#0##0#0#0.0#2018-08-04 15:15:39#0#14:01:59#14:01:59#00:00:00 3
f61ceb68228c24231c4eedeb2311ca83 0 0 217064 0 0
2352894 0 0 0 0 2389417 0 0 290000 0
0
3201126 B 1 BS 1 05/06/2018 06/06/2018 06/06/1964 0 1
- 0 12472300 11852905 0 2 0 0 0 SUTARYO
0138R0170618V001277 0001459258896 3;JKN ECHI; 5.2.2.201806040537
4 187549 1#0##0#0#0.0#2018-08-06
08:00:42#0#00:00:00#00:00:00#00:00:00 3 5a9df791735270f45d5fde3131dc157f
0 0 1276707 0 0 3184810 0 0 0 0
7322388 0 0 0 69000 0
3201126 B 3 BS 1 04/06/2018 06/06/2018 12/04/1971 0 1
1 N18.5;J81;K21.9;A49.9 - - - None None None None N-4-
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 4457431 0 3 0 0 0 PRIJO DJATMIKO
HADISAPUTRO D329418 47 17220 DR SRI KUNMARTINI, SPPD 0138R0170618V000825
0001272243453 3;JKN SURYANIH;15136 5.2.2.201806040537 4 186832
1#0##0#0#0.0#2018-10-03 14:20:10#0#23:08:50#23:08:50#00:00:00 2
175ebf110132e3ca1f9bd0f7831e622e 0 0 599993 0 0
1227580 0 0 0 0 1999858 0 0 0 0 630000
3201126 B 2 BS 1 05/06/2018 06/06/2018 24/02/1990 0 2
13-I None None None None None None PERSALINAN VAGINAL (RINGAN) 2009900
0 0 - 0 - 0 - 0 - 0 2009900
4435609 0 2 0 0 0 FERI YANI D386739 28 10328
DR ERDIYAN, SPOG 0138R0170618V001272 0001515839883 3;JKN
SURYANIH;15136 5.2.2.201806040537 4 187548 1#0##0#0#0.0#2018-
10-03 15:01:53#0#00:00:00#00:00:00#00:00:00 2
592c97a97c7d16d60d72b6a077265da3 0 0 528800 0 0 938429
0 0 0 0 2840380 0 0 0 0 128000
3201126 B 3 BS 1 04/06/2018 06/06/2018 10/05/1955 0 1
- 0 8908800 9421615 0 3 0 0 0 ABDUL MUNI
0138R0170618V000814 0001458664547 3;JKN SURYANIH;15136
5.2.2.201806040537 4 188005 1#0##0#0#0.0#2018-10-03
17:38:11#0#16:56:10#16:56:10#00:00:00 4 734a043840a0a16e5d21b93948b58d2c
0 3543300 1870848 0 0 3266100 0 0 0 0
741367 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 06/06/2018 03/09/1955 0 2
1 I13.1;D63.8;I25.0 99.04;39.27;89.52 - - None None None None
- 0 - 0 10690500 12291486 0 2 0 0 0
SEBAH PATURU D400239 62 22921 SRI KUNMARTINI.DR,SPPD
0138R0170618V001289 0001278779646 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 187560 1#0##0#0#0.0#2018-10-05
09:33:36#0#23:34:24#23:34:24#00:00:00 4 2f566d07248b9d498d84747abc5144cd
0 0 2276624 0 0 4658646 0 0 0 0
5356216 0 0 0 0 0
3201126 B 3 BS 1 05/06/2018 06/06/2018 19/03/1963 0 1
1 I12.0;D63.8;J90;A16.1 99.04;39.27 - - None None None None
- 0 - 0 19332400 10995079 0 2 0 0 0
IYUS SUPRIYATNA D400206 55 20167 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V001262 0001212068428 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 187547 1#0##0#0#0.0#2018-10-05
10:34:51#0#00:00:00#00:00:00#00:00:00 2 cd859d7a689974bba22f917ff12172d5
0 3438800 3866480 0 0 2845495 0 0 0 0
844304 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 07/06/2018 16/11/1952 0 1
9856000 0 0 - 0 - 0 - 0 - 0
9856000 10077021 0 6 0 0 0 YAN STEVANUS ADHIWIJAYA
0001312333784 3;JKN DR RIZKI; 5.2.2.201806040537 4 186277
1#0##0#0#0.0#2018-06-23 10:16:27#0#13:45:29#13:45:29#00:00:00 1
dc1b5071b42dd3465dcb928779b17844 0 0 664604 0 0
3594154 0 0 0 0 5370963 0 0 447300 0
0
3201126 B 1 BS 1 03/06/2018 07/06/2018 29/11/1963 0 1
1 I21.0;I50.0;I25.0;I64;E11.9 89.52;99.17;93.19 - - None None
AKUT (BERAT) 14562700 0 0 - 0 - 0 - 0 -
0 14562700 7275032 0 5 0 0 0 DRS. PARLUHUTAN
MARPAUNG D336081 54 19910 DR BAMBANG DWIPUTRA SPJP
0138R0170618V000262 0000199353723 3;JKN DR RIZKI; 5.2.2.201806040537
4 186314 1#0##0#0#0.0#2018-06-23
10:42:12#0#00:00:00#00:00:00#00:00:00 1 7e12cb1330e4e6882f00f261a37f2a27
0 0 1267111 0 0 2381984 0 0 0 0
3625937 0 0 0 0 0
3201126 B 1 BS 1 05/06/2018 07/06/2018 16/10/2017 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3963488 0 3 0 0 0 GITA KASIH SIANIPAR
0002297864485 3;JKN DR RIZKI; 5.2.2.201806040537 4 186843
1#0##0#0#0.0#2018-06-25 08:30:16#0#06:07:27#06:07:27#00:00:00 1
fbacb12bcfc5e6c509cad074730968fc 0 0 269459 0 0 725735
0 0 0 0 2628294 0 0 0 340000 0
3201126 B 2 BS 1 05/06/2018 07/06/2018 13/04/2011 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2593584 0 3 0 0 0 CILLA ZETTIRA
KHAIRUNNISA D365617 7 2610 DR OTTY MITHA S, SPA 0138R0170618V000975
0001649962462 3;JKN DR RIZKI; 5.2.2.201806040537 4 186963
1#0##0#0#0.0#2018-06-25 08:59:07#0#09:12:49#09:12:49#00:00:00 1
7e0396273a7ac4036e6da35e120fd3fc 0 0 311408 0 0 571502
0 0 0 0 1710674 0 0 0 0 0
3201126 B 3 BS 1 01/06/2018 07/06/2018 10/04/1980 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 8859717 0 7 0 0 0 ROMIAN SIANIPAR
0002462033114 3;JKN DR RIZKI; 5.2.2.201806040537 4 187779
1#0##0#0#0.0#2018-06-25 09:01:54#0#00:00:00#00:00:00#00:00:00 1
aeecee0cd68c849f4df8d55826fbc2dc 0 0 378188 0 0
5831421 0 0 0 0 2360108 0 0 290000 0
0
3201126 B 3 BS 1 04/06/2018 07/06/2018 05/03/1954 0 1
- 0 - 0 - 0 - 0 4888600 3634187 0
4 0 0 0 R. MACHDUM EFENDI DACHLAN D400174 64 23467
DR MAYSAM I., SPS 0138R0170618V000823 0001470052776 3;JKN DR RIZKI;
5.2.2.201806040537 4 186831 1#0##0#0#0.0#2018-06-25
09:13:11#0#22:37:14#22:37:14#00:00:00 1 700fd406967d351c5140ff33b4557d92
0 0 557179 0 0 1847757 0 0 0 0
1229251 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 07/06/2018 01/06/1959 0 1
1 J18.0;E14.9;B49;I11.9 99.17;90.59;89.52 - - None None None
None J-4-16-II None None None None None None SIMPLE PNEUMONIA &
WHOOPING COUGH (SEDANG) 5077500 0 0 - 0 - 0 - 0
- 0 5077500 4003643 0 4 0 0 0 JAELANI
0000512989514 3;JKN DR RIZKI; 5.2.2.201806040537 4 186820
1#0##0#0#0.0#2018-06-25 09:36:12#0#00:00:00#00:00:00#00:00:00 1
2e7679facd55d87d68ad4514659d7c13 0 0 368243 0 0
2381979 0 0 0 0 1253421 0 0 0 0 0
3201126 B 1 BS 1 05/06/2018 07/06/2018 22/06/1986 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4831825 0 3 0 0 0 SOTARDODO AC TAMBUNAN
D112990 31 11671 DR ARU, SPPD 0138R0170618V000831
0001460042313 3;JKN DR RIZKI; 5.2.2.201806040537 4 186836
1#0##0#0#0.0#2018-06-25 09:36:53#0#01:16:47#01:16:47#00:00:00 1
3a4bbac81700873519be6bf34195791d 0 0 236051 0 0
1910673 0 0 0 0 2685101 0 0 0 0 0
3201126 B 1 BS 1 04/06/2018 07/06/2018 03/03/1954 0 2
0 - 0 - 0 - 0 - 0 9150100 19664165
0 4 0 0 0 TJUTJU SUMARNI D359389 64 23469
RIZKI; 5.2.2.201806040537 4 186819 1#0##0#0#0.0#2018-06-25
09:39:50#0#00:00:00#00:00:00#00:00:00 1 adeb7b7e8c5902d324617598bf5f42e0
0 10138100 2625028 0 0 5092537 0 0 0 0
1808500 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 07/06/2018 15/10/1959 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3640113 0 4 0 0 0 ASIH SUBEKTI
0002050320071 3;JKN DR RIZKI; 5.2.2.201806040537 4 186826
1#0##0#0#0.0#2018-06-25 09:40:51#0#00:00:00#00:00:00#12:00:00 1
f95e9e857dc9b30c8f2e9d5a217feb0c 0 0 504179 0 0
1906296 0 0 0 0 1229638 0 0 0 0 0
3201126 B 3 BS 1 04/06/2018 07/06/2018 31/12/1946 0 2
1 B34.9;R63.0 90.59 - - None None None None A-4-13-I None
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3419348 0 4 0 0 0 AMSIH D378529 71
DR RIZKI; 5.2.2.201806040537 4 186435 1#0##0#0#0.0#2018-06-25
09:42:30#0#09:20:35#09:20:35#12:00:00 1 1b76cc8bf0c308596dc0f87d5dc5a4b6
0 0 183752 0 0 1933900 0 0 0 0
1301696 0 0 0 0 0
3201126 B 1 BS 1 28/05/2018 07/06/2018 04/07/2004 0 1
1 K56.7;K66.0;A41.9 54.11 - - None None None None K-1-40-III
(BERAT) 21013600 0 0 - 0 - 0 - 0 - 0
21013600 35964476 0 11 0 0 0 KINARYA DWI JULIAN
SAPUTRA D377050 13 5076 DR CATUR SUZANTARA 0138R0170518V009720
0001169536487 3;JKN DR RIZKI; 5.2.2.201806040537 4 185070
1#0##0#0#0.0#2018-06-25 09:47:37#0#19:48:51#19:48:51#12:00:00 1
40ea798abe6761f1517abc606cfcebf9 0 15064900 6326944 0 0
12319632 0 0 0 0 2253000 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 07/06/2018 02/05/1960 0 2
1 D64.9;K30 99.04;90.59 - - None None None None D-4-13-I
0 - 0 3584400 5408664 0 3 0 0 0 IPAH
0002091179891 3;JKN DR RIZKI; 5.2.2.201806040537 4 186848
1#0##0#0#0.0#2018-06-25 09:58:07#0#07:54:57#07:54:57#00:00:00 1
cae139236e442cae9edb68b71a2a47b0 0 0 636974 0 0
2876852 0 0 0 0 1894838 0 0 0 0 0
3201126 B 3 BS 1 05/06/2018 07/06/2018 19/04/1958 0 2
1 H40.8;I10;E14.9 90.59;89.52 - - None None None None H-4-
12-I None None None None None None GANGGUAN MATA LAIN-LAIN (RINGAN)
3474500 0 0 - 0 - 0 - 0 - 0
3474500 3798998 0 3 0 0 0 SUGIYEM D376816
60 21962 DR DIAN EKA P, SPM 0138R0170618V001197 0001273517447
3;JKN DR RIZKI; 5.2.2.201806040537 4 187405 1#0##0#0#0.0#2018-
06-25 10:00:07#0#00:00:00#00:00:00#12:00:00 1
699b7ef815308caba7fb62f44e279c66 0 0 365705 0 0
2196760 0 0 0 0 1236533 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 07/06/2018 11/01/1985 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 9845462 0 3 0 0 0 NOPI YANTI D391759
DR RIZKI; 5.2.2.201806040537 4 187558 1#0##0#0#0.0#2018-06-25
10:02:38#0#22:50:18#22:50:18#00:00:00 1 c57bc71d9ffdc9a9b06d79e7cf935b1b
0 0 2134753 0 0 1483713 0 0 0 0
6029996 0 0 197000 0 0
3201126 B 1 BS 1 06/06/2018 07/06/2018 05/01/2010 0 2
(RINGAN) 4126300 0 0 - 0 - 0 - 0 - 0
4126300 9884121 0 2 0 0 0 SYALABIYYAH SALMA
KAMILAH D181140 8 3074 DR BENNY H T, SPOT 0138R0170618V001296
0001623403451 3;JKN DR RIZKI; 5.2.2.201806040537 4 187562
1#0##0#0#0.0#2018-06-25 10:04:56#0#01:27:43#01:27:43#00:00:00 1
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5100000
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10:57:21#0#18:38:53#18:38:53#00:00:00 1 a262906898190c6e0c1c930b4ff8b9ca
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09:17:29#0#16:48:35#16:48:35#12:00:00 2 f94f83dae5e99373b1880cfd2075ffc2
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1#0##0#0#0.0#2018-07-27 09:27:39#0#10:21:15#10:21:15#00:00:00 2
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1#0##0#0#0.0#2018-08-03 09:17:32#0#16:32:22#16:32:22#00:00:00 2
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1#0##0#0#0.0#2018-10-03 15:58:16#0#14:18:25#14:18:25#12:00:00 3
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1804000
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3201126 B 3 BS 1 06/06/2018 08/06/2018 23/06/1995 0 2
- 0 - 0 - 0 - 0 2655900 2336702 0
3 0 0 0 SRI JUMIASIH D333888 22 8384 DR MAYSAM
I., SPS 0138R0170618V001818 0001014209831 3;JKN DR RIZKI;
5.2.2.201806040537 4 188016 1#0##0#0#0.0#2018-06-26
08:49:49#0#00:00:00#00:00:00#00:00:00 1 c042a8bfa93cccdbc2d2ea8ba7664a5a
0 0 292032 0 0 1339802 0 0 0 0 704868
0 0 0 0 0
3201126 B 3 BS 1 07/06/2018 08/06/2018 01/10/1953 0 2
1 I25.0;D64.9;E11.9;I11.0 99.04 - - None None None None I-4-
16-III None None None None None None ATHEROSKLEROSIS (BERAT) 4178900
0 0 - 0 - 0 - 0 - 0 4178900
2822398 0 2 0 0 0 SURYATI D329400 64 23625
DR AZRI NURIZAL SPPD KKV 0138r0170618v001834 0001014230452 3;JKN
DR RIZKI; 5.2.2.201806040537 4 188025 1#0##0#0#0.0#2018-06-26
09:27:37#0#00:23:46#00:23:46#00:00:00 1 77eef96de3510cc33cd9bb137bd180db
0 0 426023 0 0 1659732 0 0 0 0 736643
0 0 0 0 0
3201126 B 3 BS 1 06/06/2018 08/06/2018 01/10/1939 0 1
1 D41.4;N13.3;D29.1 60.29;87.49;89.52;90.59 - - None None None
None V-1-14-II None None None None None None PENGANGKATAN PROSTAT
MELALUI URETRA (SEDANG) 12841200 0 0 - 0 - 0 - 0
- 0 12841200 18755474 0 3 0 0 0 HINDARMAN
D369085 78 28738 DR MOHAMMAD JOHAN SPU 0138R0170618V001309
0001014206319 3;JKN DR RIZKI; 5.2.2.201806040537 4 187567
1#0##0#0#0.0#2018-06-26 09:53:57#0#03:25:44#03:25:44#00:00:00 1
4cad59042f8279db0959eb70ca19ed45 0 3611800 3905360 0 0
6633814 0 0 0 0 1301000 0 0 0 0
3303500
3201126 B 3 BS 1 05/06/2018 08/06/2018 15/05/1976 0 2
1 A01.0;A09.9 90.59;89.52 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 2577425 0 4 0 0 0 MARDIANA
0001014314038 3;JKN DR RIZKI; 5.2.2.201806040537 4 186839
1#0##0#0#0.0#2018-06-26 10:19:59#0#01:50:13#01:50:13#00:00:00 1
f41ed021f8931ddc4e7113527a58f97b 0 0 257183 0 0
1073625 0 0 0 0 1246617 0 0 0 0 0
3201126 B 1 BS 1 06/06/2018 08/06/2018 01/03/1977 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 19459198 0 3 0 0 0 YOSEFINA TEA
0001623495914 3;JKN DR RIZKI; 5.2.2.201806040537 4 188838
1#1#vvip#3#12477698#0.0#2018-06-26 11:13:04#0#19:14:31#19:14:31#00:00:00
1 00053f9e28b34b49546c39b22302f199 0 8271400 6542000 0
0 3285798 0 0 0 0 1291000 0 0 0 0
69000
3201126 B 1 BS 1 06/06/2018 08/06/2018 14/12/1955 0 2
1 T82.4;I12.0;D63.8 38.93;39.50;99.04 - - None None None None
0 - 0 26871300 26001925 0 3 0 0 0 TENDY
LUMBAN TORUAN D299120 62 22820 DEDY PRATAMA,SPBV 0138R0170618V001452
0000060481574 3;JKN DR RIZKI; 5.2.2.201806040537 4 187796
1#0##0#0#0.0#2018-06-26 11:31:00#0#00:00:00#00:00:00#00:00:00 1
402e9e40a24377519c1c78a582637707 0 0 4516995 0 0
11913480 0 0 0 0 9571450 0 0 0 0 0
3201126 B 1 BS 1 07/06/2018 08/06/2018 10/07/1948 0 1
- 0 12472300 10485805 0 2 0 0 0 PAULUS
DIDIDJAJA SETIAWAN D398940 69 25534 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V002054 0001448136224 3;JKN DR RIZKI; 5.2.2.201806040537
4 188191 1#0##0#0#0.0#2018-06-28
12:03:54#0#12:27:01#12:27:01#00:00:00 1 ee09e90c243529099c2a241622ec2384
0 6468200 1268340 0 0 1924820 0 0 0 0
755445 0 0 0 0 69000
3201126 B 2 BS 1 07/06/2018 08/06/2018 08/08/1977 0 1
- 0 10690500 10535117 0 2 0 0 0 NURDIN
0138R0170618V002046 0001238945692 3;JKN DR RIZKI; 5.2.2.201806040537
4 188189 1#0##0#0#0.0#2018-06-28
12:08:40#0#12:05:46#12:05:46#00:00:00 1 f4406f9e18d79d25d19167da95d233ba
0 4929100 2223624 0 0 2548180 0 0 0 0
765213 0 0 69000 0 0
3201126 B 3 BS 1 08/06/2018 08/06/2018 26/09/1976 0 1
1 N18.5;R18 54.91 - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
0001743628138 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188776
1#0##0#0#0.0#2018-07-02 16:56:29#0#00:00:00#00:00:00#00:00:00 1
00bf028f15c17f6586eb183f57dd4029 0 0 571889 0 0 478272
0 0 0 0 382741 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 08/06/2018 11/03/1953 0 2
(SEDANG) 5153300 0 0 - 0 - 0 - 0 - 0
5153300 1726546 0 1 0 0 0 ROSANA d400433
0000511519443 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188801
1#0##0#0#0.0#2018-07-02 16:59:31#0#15:31:46#15:31:46#00:00:00 1
ae7493da8d3c7000e4f2123606843c37 0 0 463796 0 0 860798
0 0 0 0 401952 0 0 0 0 0
3201126 B 3 BS 1 07/06/2018 08/06/2018 29/08/1994 0 1
1 N23;R31 - - - None None None None N-4-13-I None
- 0 - 0 - 0 - 0 3417600 878162 0
2 0 0 0 ANDREI HUTABARAT TN D400404 23 8683 DR
YOHANES DWINANDA R P 0138R0170618V002220 0000235089189 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 188288 1#0##0#0#0.0#2018-07-02
17:00:31#0#22:50:38#22:50:38#00:00:00 1 73e204653518ab28e100c92a7b4374f2
0 0 170880 0 0 360832 0 0 0 0 346450
0 0 0 0 0
3201126 B 1 BS 1 06/06/2018 08/06/2018 01/06/2018 2700 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2549260 0 3 0 0 0 MERRY SUSANTI BY NY
0002355975156 3;JKN ECHI; 5.2.2.201806040537 4 201311
1#0##0#0#0.0#2018-07-27 09:32:20#0#00:00:00#00:00:00#00:00:00 2
9d8c0eac0b6f5c3cf2ee71c1c07f5fce 0 0 460620 0 0 201866
0 0 0 0 1546774 0 0 340000 0 0
3201126 B 1 BS 1 03/06/2018 08/06/2018 22/04/1940 0 2
1 I63.9;G81.9;R13 87.03;90.59;89.52 - - None None None None
0 - 0 9673300 10544946 0 6 0 0 0 RR IDA
NINGSIH D400109 78 28531 DR HARDI PRANATA SPS 0138R0170618V000270
0001434400154 3;JKN DR RIZKI; 5.2.2.201806040537 4 186318
1#0##0#0#0.0#2018-08-03 08:52:04#0#23:09:49#23:09:49#00:00:00 2
6dd559c4d056bb888e2264e68d2c3913 0 0 674855 0 0
5249235 0 0 0 0 4620856 0 0 0 0 0
3201126 B 2 BS 1 06/06/2018 08/06/2018 30/06/1986 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 12440098 0 3 0 0 0 YUNAWATI D398885
TANTIYO S;16137 5.2.2.201806040537 4 187877 1#0##0#0#0.0#2018-
08-04 14:05:29#0#10:52:03#10:52:03#00:00:00 2
ff93fd329d6d5bd0e0ad0dedcde85bc2 0 6167900 2016716 0 0
2202744 0 0 0 0 1291738 0 0 0 0 761000
3201126 B 1 BS 1 05/06/2018 08/06/2018 05/01/1946 0 1
1 I63.9;G81.9;E11.9;E78.5;I10 87.03;87.44 - - None None None
- 0 - 0 9673300 5481182 0 4 0 0 0
SUTIMIN D329241 72 26449 DR MAYSAMIRAWATI SPS
0138R0170618V001278 0000060978104 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 187550 1#0##0#0#0.0#2018-08-04
15:03:31#0#00:00:00#00:00:00#00:00:00 2 2d8b6d345100eca077d739b9ba057819
0 0 1020330 0 0 1297770 0 0 0 0
3163082 0 0 0 0 0
3201126 B 1 BS 1 07/06/2018 08/06/2018 05/09/1992 0 1
0 - 0 - 0 - 0 - 0 3247500 6744811
0 2 0 0 0 RADEN YUDO WICAKSONO PRAKOSO d399958 25
RIZKI; 5.2.2.201806040537 4 188193 1#0##0#0#0.0#2018-09-06
08:33:52#0#12:53:00#12:53:00#00:00:00 2 9383bbf5b454c6c059eea2bf451988b6
0 0 962300 0 0 1241762 0 0 0 0
2791749 0 0 0 0 1749000
3201126 B 1 BS 1 29/05/2018 08/06/2018 20/06/1950 0 2
1 I63.9;G81.9;E87.5;E78.5;S09.9 87.44;87.03;89.52;93.94 - - None
- 0 - 0 - 0 9673300 31106679 0 11 1
5 0 RUKIMAH d399738 67 24815 DR MAYSAMIRAWATI SPS
0138r0170518v009813 0001335858693 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 185105 1#0##0#0#0.0#2018-10-02
14:31:34#0#22:00:43#22:00:43#00:00:00 3 0fe191834ad82de860033a0b9d119934
0 0 1020187 0 0 15131992 0 0 0 0
9931500 0 0 0 0 5023000
3201126 B 2 BS 1 31/05/2018 08/06/2018 17/07/1972 0 1
1 I61.1;I10;R56.8 01.24 - - None None None None G-1-10-II
None None None None None None KRANIOTOMI (SEDANG) 24575000 0
0 - 0 - 0 - 0 - 0 24575000 47585818
0 9 1 6 0 MARODIH D399831 45 16754 DR HARDI
PRANATA SPS 0138R0170518V010318 0002258495548 3;JKN SURYANIH;15136
5.2.2.201806040537 4 185652 1#0##0#0#0.0#2018-10-03
14:25:28#0#02:47:58#02:47:58#00:00:00 2 85dd1e493422924da309d22432ad4c9c
0 10541800 9529740 0 0 18537278 0 0 0 0
3356000 0 0 0 0 5621000
3201126 B 1 BS 1 04/06/2018 08/06/2018 13/02/1947 0 1
1 K40.9;N35.9 53.00 - - None None None None K-1-14-I None
7684500 0 0 - 0 - 0 - 0 - 0
7684500 15392377 0 5 0 0 0 WARNO KRISTIANTO
0001301036591 3;JKN SURYANIH;15136 5.2.2.201806040537 4 186817
1#0##0#0#0.0#2018-10-03 14:34:35#0#00:00:00#00:00:00#00:00:00 2
00b88049750bd8efff593d012864c808 0 8195700 3163755 0 0
2880944 0 0 0 0 1082978 0 0 0 0 69000
3201126 B 1 BS 1 07/06/2018 08/06/2018 19/08/1972 0 2
1 N23;N83.2 - - - None None None None N-4-13-I None
- 0 - 0 - 0 - 0 4784600 3338066 0
2 0 0 0 ASIYAH D400343 45 16728 DR BETTY DWI L,
SPPD 0138R0170618V001972 0001662624944 3;JKN SURYANIH;15136
5.2.2.201806040537 4 188041 1#0##0#0#0.0#2018-10-03
14:37:04#0#00:00:00#00:00:00#00:00:00 2 51cbd556d40d7be4ce0b0af1622d7eda
0 0 483614 0 0 1048074 0 0 0 0
1806378 0 0 0 0 0
3201126 B 3 BS 1 07/06/2018 08/06/2018 26/03/1961 0 2
1 I13.1;T82.4;A49.9 39.42 - - None None None None N-1-12-III
- 0 19332400 20849625 0 2 0 0 0 ERNA
MARDIANA NY D348686 57 20892 SRI KUNMARTINI.DR,SPPD 0138R0170618V002043
0000093184075 3;JKN SURYANIH;15136 5.2.2.201806040537 4 188188
1#0##0#0#0.0#2018-10-03 16:14:10#0#12:00:50#12:00:50#00:00:00 4
1379ced08a043a92b696476263af90f7 0 8197900 5752780 0 0
4397695 0 0 0 0 2432250 0 0 0 0 69000
3201126 B 1 BS 1 06/06/2018 09/06/2018 23/03/1940 0 2
1 I63.9;G81.9 87.03;90.59;89.52;87.44 - - None None None None
0 - 0 9673300 9238935 0 4 0 0 0 AMINAH
NY D315007 78 28564 DR HARDI PRANATA SPS 0138R0170618V001985
0001725666704 3;JKN DR RIZKI; 5.2.2.201806040537 4 188058
1#1#vvip#4#0#0.0#2018-06-25 10:46:10#0#09:17:50#09:17:50#00:00:00 1
d90cd927b245312681e6c5f64fd6f8e5 0 0 1576544 0 0
2792975 0 0 0 0 4869416 0 0 0 0 0
3201126 B 2 BS 1 09/06/2018 09/06/2018 24/04/1985 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 4737009 0 1 0 0 0 ELCY TOGI MARITO
0000207867688 3;JKN DR RIZKI; 5.2.2.201806040537 4 188848
1#0##0#0#0.0#2018-06-25 11:08:50#0#00:00:00#00:00:00#00:00:00 1
567a99400c6461b8a1a82eeaa16ba43e 0 0 853603 0 0 929508
0 0 0 0 2884898 0 0 0 0 69000
3201126 B 2 BS 1 06/06/2018 09/06/2018 29/11/1945 0 1
1 N40;I10;K40.9 60.29;90.59;89.52 - - None None None None
V-1-14-I None None None None None None PENGANGKATAN PROSTAT MELALUI
URETRA (RINGAN) 10605500 0 0 - 0 - 0 - 0 -
0 10605500 14466697 0 4 0 0 0 ANWAR NAWAWI
0002072375065 3;JKN DR RIZKI; 5.2.2.201806040537 4 187726
1#0##0#0#0.0#2018-06-25 11:10:22#0#00:00:00#00:00:00#12:00:00 1
bab23b2cb6489b17831ca2c1ded32c98 0 1660000 3032540 0 0
5301738 0 0 0 0 4472419 0 0 0 0 0
3201126 B 1 BS 1 02/06/2018 09/06/2018 22/04/1983 0 1
5879800 0 0 - 0 - 0 - 0 - 0
5879800 9857867 0 8 0 0 0 EMANUEL D399959
35 12825 DR ARU, SPPD 0138R0170618V000082 0001148245593 3;JKN
DR RIZKI; 5.2.2.201806040537 4 186159 1#0##0#0#0.0#2018-06-25
11:53:30#0#00:00:00#00:00:00#00:00:00 1 42fb6f42d906ece6f8650b2e51d47603
0 0 640980 0 0 2387980 0 0 0 0
6828907 0 0 0 0 0
3201126 B 1 BS 1 06/06/2018 09/06/2018 03/07/2009 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4898335 0 4 0 0 0 AKHIL FEROZ SALIM
0001645279457 3;JKN DR RIZKI; 5.2.2.201806040537 4 188011
1#0##0#0#0.0#2018-06-25 11:55:01#0#17:37:03#17:37:03#12:00:00 1
14f7b6ced387f3f478af19c10199485f 0 0 316331 0 0 771552
0 0 0 0 3470452 0 0 0 0 340000
3201126 B 1 BS 1 03/06/2018 09/06/2018 23/03/1960 0 2
- 0 4903800 9951714 0 7 0 0 0 ISNANIYAH
LUBIS D400096 58 21256 DR ARU, SPPD 0138R0170618V000240
0001813253859 3;JKN DR RIZKI; 5.2.2.201806040537 4 186301
1#0##0#0#0.0#2018-06-25 11:56:59#0#13:42:03#13:42:03#00:00:00 1
16967564de88658a977484c4178dec58 0 0 338858 0 0
3468809 0 0 0 0 6144047 0 0 0 0 0
3201126 B 1 BS 1 04/06/2018 09/06/2018 30/05/1964 0 2
1 E14.9;A09.9 89.52;90.59 - - None None None None E-4-10-I
0 - 0 4903800 8318965 0 6 0 0 0 GLORY
BENDEDE D350717 54 19728 DR. ARU ARIADNO, SPPD 0138R0170618V000663
0002072433407 3;JKN DR RIZKI; 5.2.2.201806040537 4 186979
1#0##0#0#0.0#2018-06-25 12:00:54#0#00:00:00#00:00:00#00:00:00 1
3765b546b0981a7848d04d0e58807d60 0 0 494342 0 0
2568392 0 0 0 0 5256231 0 0 0 0 0
3201126 B 2 BS 1 06/06/2018 09/06/2018 09/09/1969 0 2
(RINGAN) 8447200 0 0 - 0 - 0 - 0 - 0
8447200 12540543 0 4 0 0 0 SITI AMINAH D398383
0001307456471 3;JKN DR RIZKI; 5.2.2.201806040537 4 187896
1#0##0#0#0.0#2018-06-25 13:17:17#0#13:34:19#13:34:19#00:00:00 1
8eeb0d8d462fd0e54aa30bf22601f9ec 0 5741100 2630544 0 0
3127490 0 0 0 0 896409 0 0 0 0 145000
3201126 B 1 BS 1 05/06/2018 09/06/2018 22/12/1949 0 2
1 E10.1;R63.0;I64 99.17;99.21 - - None None None None E-4-
0 - 0 8768000 11291496 0 5 0 0 0
NURWILIS D397980 68 25002 DR ARU, SPPD 0138R0170618V001210
0000039783284 3;JKN DR RIZKI; 5.2.2.201806040537 4 187425
1#1#vvip#5#2523496#0.0#2018-06-25 13:53:51#0#00:00:00#00:00:00#00:00:00
1 bd64152dd70c5d208f88fb0972d0148c 0 0 1587400 0 0
3141900 0 0 0 0 6562196 0 0 0 0 0
3201126 B 1 BS 1 09/06/2018 09/06/2018 11/06/1965 0 2
5879800 0 0 - 0 - 0 - 0 - 0
5879800 3463238 0 1 0 0 0 ELIS LIDIANINGSIH NY
D023181 52 19356 DR SURYA POHAN SPB 0138R0170618V002836
0001866049863 3;JKN DR RIZKI; 5.2.2.201806040537 4 188920
1#1#vvip#1#0#0.0#2018-06-25 13:57:34#0#09:28:03#09:28:03#00:00:00 1
18697ec8e916ccb7c66b9fa561b05f85 0 0 973000 0 0 824671
0 0 0 0 1665567 0 0 0 0 0
3201126 B 2 BS 1 08/06/2018 09/06/2018 26/04/1945 0 2
1 I13.1;J40 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
0 5208600 10020540 0 2 0 0 0 ENAH D329830
0000061009424 3;JKN DR RIZKI; 5.2.2.201806040537 4 188515
1#0##0#0#0.0#2018-06-25 14:42:22#0#11:00:51#11:00:51#00:00:00 1
232a338aff6f30ad4b9cfc10fdf454f5 0 4439100 1094720 0 0
3686171 0 0 0 0 731549 0 0 0 0 69000
3201126 B 1 BS 1 08/06/2018 09/06/2018 16/01/1955 0 2
- 0 12472300 12588559 0 2 0 0 0 WAGINEM CH
0138R0170618V002364 0000061090356 3;JKN DR RIZKI; 5.2.2.201806040537
4 188373 1#0##0#0#0.0#2018-06-25
14:48:00#0#09:19:58#09:19:58#00:00:00 1 bc7059eb739b53c7a2b4d8490ec4c13d
0 6468200 2619183 0 0 2532625 0 0 0 0
899551 0 0 0 0 69000
3201126 B 2 BS 1 06/06/2018 09/06/2018 31/10/1952 0 1
1 D64.9;K92.1;A41.9 99.04;93.57 - - None None None None D-4-
- 0 - 0 6488600 6837439 0 4 0 0 0
NURSAL CHANDRA D373241 65 23959 DR ARU, SPPD
0138R0170618V001303 0001312201438 3;JKN DR RIZKI; 5.2.2.201806040537
4 187564 1#0##0#0#0.0#2018-06-25
14:51:24#0#02:22:27#02:22:27#12:00:00 1 2da17551035bb6a3eeedc0c8df300468
0 0 374830 0 0 3799300 0 0 0 0
2493309 0 0 0 0 170000
3201126 B 3 BS 1 08/06/2018 09/06/2018 04/06/1975 0 2
1 I13.1;J40;D63.8 99.04;39.27 - - None None None None N-1-
- 0 8908800 8758471 0 2 0 0 0 MANAH
0138R0170618V002405 0001480609923 3;JKN DR RIZKI; 5.2.2.201806040537
4 188466 1#0##0#0#0.0#2018-06-25
14:54:59#0#10:28:27#10:28:27#00:00:00 1 1b99949bcea2403c8fa053d25626cba1
0 0 1870848 0 0 2730839 0 0 0 0
4087784 0 0 0 0 69000
3201126 B 2 BS 1 06/06/2018 09/06/2018 02/06/1968 0 2
(SEDANG) 7317500 0 0 - 0 - 0 - 0 - 0
7317500 9148908 0 4 0 0 0 SRI MAWAWANTI
0001128758016 3;JKN DR RIZKI; 5.2.2.201806040537 4 187872
1#0##0#0#0.0#2018-06-26 11:27:26#0#00:00:00#00:00:00#12:00:00 1
d5f5dc3a66d56ef188d76695e698199b 0 0 1499075 0 0
4256306 0 0 0 0 2644527 0 0 0 0 749000
3201126 B 1 BS 1 08/06/2018 09/06/2018 16/09/1947 0 2
- 0 12472300 13162526 0 2 0 0 0 SUPARMAN
0000060729208 3;JKN DR RIZKI; 5.2.2.201806040537 4 188623
1#0##0#0#0.0#2018-06-28 11:38:25#0#13:20:33#13:20:33#00:00:00 1
788248b4391122ca27476c1014c90717 0 0 2647238 0 0
3732188 0 0 0 0 6783100 0 0 0 0 0
3201126 B 1 BS 1 06/06/2018 09/06/2018 22/07/1942 0 1
1 T82.4;I63.9;I12.0 38.95;87.03 - - None None None None N-1-
- 0 - 0 27065300 34401403 0 4 0 0 0
NURHARYONO D393650 75 27713 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V001802 0001257881196 3;JKN DR RIZKI; 5.2.2.201806040537
4 188013 1#0##0#0#0.0#2018-06-28
11:41:48#0#18:10:58#18:10:58#12:00:00 1 eb1bfb0f98bf85672671919d69f17c39
0 7352000 5467191 0 0 17047962 0 0 0 0
2462250 0 0 0 0 2072000
3201126 B 1 BS 1 07/06/2018 09/06/2018 10/08/1937 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 6046846 0 3 0 0 0 FX. DJOKOSOEJONO
0138R0170618V002143 0000044218056 3;JKN DR RIZKI; 5.2.2.201806040537
4 188242 1#0##0#0#0.0#2018-06-28
11:51:06#0#14:52:25#14:52:25#00:00:00 1 ee70ae6c45979bec862ea68ff8560a22
0 0 2594238 0 0 1775250 0 0 0 0
1608358 0 0 0 0 69000
3201126 B 2 BS 1 08/06/2018 09/06/2018 16/04/1965 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3882347 0 2 0 0 0 YAHYA D363282
53 19411 DR SRI KUNMARTINI, SPPD 0138R0170618V002721 0001155907473
3;JKN DR RIZKI; 5.2.2.201806040537 4 188836 1#0##0#0#0.0#2018-
06-28 11:57:48#0#17:23:15#17:23:15#00:00:00 2
6fcf890a859e38b481da591568dc4be3 0 0 446262 0 0
1197350 0 0 0 0 2082485 0 0 0 0 156250
3201126 B 2 BS 1 07/06/2018 09/06/2018 29/04/1999 0 2
1 S09.9;H81.3 - - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 3651800 4316588 0
3 0 0 0 NURUL LUTFIANA D400339 19 6979 DR HARDI
PRANATA SPS 0138R0170618V002016 0002216876128 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 188132 1#0##0#0#0.0#2018-07-02
14:55:37#0#10:37:44#10:37:44#00:00:00 1 ba95c20835c03d9cf27201525bcd89f9
0 0 381662 0 0 2111532 0 0 0 0
1823394 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 09/06/2018 23/09/1957 0 2
1 E11.5;I11.0;K30 - - - None None None None I-4-15-III
LAIN (BERAT) 7317500 0 0 - 0 - 0 - 0 -
0 7317500 844310 0 2 0 0 0 ATIKAH
0002080383996 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188843
1#0##0#0#0.0#2018-07-02 16:48:45#0#00:00:00#00:00:00#12:00:00 1
3c5fe6862da1f974b55188f335472f69 0 0 365875 0 0 134200
0 0 0 0 344235 0 0 0 0 0
3201126 B 1 BS 1 06/06/2018 09/06/2018 22/02/1972 0 2
4 I50.0;I20.9;J18.9 96.71 - - None None None None J-1-20-III
(BERAT) 40790100 0 0 - 0 - 0 - 0 - 0
40790100 14394526 0 4 1 4 24 NURKOMALA SARI
0001725413859 3;JKN ECHI; 5.2.2.201806040537 4 187568
1#0##0#0#0.0#2018-07-27 09:38:40#0#04:33:40#04:33:40#00:00:00 2
950a01870c02155a6f34641ed284b934 0 0 506110 0 0
7224718 0 0 0 0 3747698 0 0 0 0
2916000
3201126 B 3 BS 1 09/06/2018 09/06/2018 13/04/1967 0 1
1 H27.1;H40.9 13.41 - - None None None None H-1-30-I None
None None None None None PROSEDUR LENSA DAN INTRA OKULER (RINGAN)
7454300 0 0 - 0 - 0 - 0 - 0
7454300 7913979 0 1 0 0 0 AEP D387580 51
18685 DR ERRY, SPM 0138R0170618V002902 0000511005284 3;JKN ECHI;
5.2.2.201806040537 4 189084 1#0##0#0#0.0#2018-07-27
09:40:10#0#17:01:14#17:01:14#00:00:00 3 f4e05f43d427c78ea9358ab533634292
0 0 5227980 0 0 442262 0 0 0 0
2243737 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 09/06/2018 10/05/1948 0 1
1 J44.9;K21.9 90.59;87.44 - - None None None None J-4-17-I
None None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (RINGAN)
4426600 0 0 - 0 - 0 - 0 - 0
4426600 5135521 0 5 0 0 0 SAKIM D369625 70
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 187551
1#0##0#0#0.0#2018-08-04 15:04:39#0#00:00:00#00:00:00#00:00:00 2
3ff7d3b4ad6323a7e2e48094891ff44e 0 0 451367 0 0
2302185 0 0 0 0 2381969 0 0 0 0 0
3201126 B 1 BS 1 08/06/2018 09/06/2018 24/08/1948 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 16373397 0 2 0 0 0 ALOYSIUS NUGROHO
0138R0170618V002591 0000060934509 3;JKN SURYANIH;15136
5.2.2.201806040537 4 188756 1#0##0#0#0.0#2018-10-03
15:29:43#0#00:00:00#00:00:00#00:00:00 2 f6e6543d3163d2c1a4bb87b6a4f29e97
0 0 2619183 0 0 6642057 0 0 0 0
7043157 0 0 0 0 69000
3201126 B 3 BS 1 08/06/2018 09/06/2018 31/12/1957 0 2
- 0 8908800 13532108 0 2 0 0 0 AINUN
0001298342362 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188621
1#0##0#0#0.0#2018-10-04 07:42:44#0#13:08:16#13:08:16#00:00:00 3
0cc2462b28e6f7603c4cfa72f71dfd31 0 3438800 1906031 0 0
7176999 0 0 0 0 941278 0 0 0 0 69000
3201126 B 3 BS 1 08/06/2018 10/06/2018 04/04/1984 0 2
6111300 0 0 - 0 - 0 - 0 - 0
6111300 3272198 0 3 0 0 0 ARI YANTIH d380695
3;JKN DR RIZKI; 5.2.2.201806040537 4 188292 1#0##0#0#0.0#2018-
06-26 11:24:56#0#04:34:29#04:34:29#12:00:00 1
0428737abe49d2b0979014d6780575e7 0 0 603017 0 0
1640112 0 0 0 0 1029069 0 0 0 0 0
3201126 B 3 BS 1 07/06/2018 10/06/2018 08/03/1964 0 1
1 E10.6;R10.1 99.17;90.59;89.52 - - None None None None E-4-
0 - 0 3502700 3587151 0 4 0 0 0 NUR
MADSYAH D400365 54 19814 DR ARU, SPPD 0138R0170618V002173
0002425791262 3;JKN DR RIZKI; 5.2.2.201806040537 4 188285
1#0##0#0#0.0#2018-06-26 11:32:19#0#15:59:45#15:59:45#00:00:00 1
15874356ee6ead9a6b3a616a1d7b62bf 0 0 368240 0 0
2169238 0 0 0 0 1049673 0 0 0 0 0
3201126 B 2 BS 1 05/06/2018 10/06/2018 21/10/1998 0 2
0 0 - 0 - 0 - 0 - 0 9917100
15536841 0 6 0 0 0 WULAN QOMARIAH D400195 19
7167 DR ATJANG S, SPOG 0138R0170618V000833 0002354860102 3;JKN DR
RIZKI; 5.2.2.201806040537 4 186838 1#0##0#0#0.0#2018-06-26
11:34:38#0#01:25:19#01:25:19#00:00:00 1 ecb1f0f87fae0bb3b6e963719dd71b16
0 0 2933108 0 0 4718304 0 0 0 0
7667929 0 0 0 0 217500
3201126 B 3 BS 1 07/06/2018 10/06/2018 26/12/2017 0 1
1 A09.9;Q90.9;J18.0 87.44 - - None None None None K-4-17-III
(BERAT) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 3740484 0 4 0 0 0 FARZAN RAYHAAN SHAKEIL
0002294052658 3;JKN DR RIZKI; 5.2.2.201806040537 4 188287
1#0##0#0#0.0#2018-06-26 11:38:44#0#00:00:00#00:00:00#00:00:00 1
f0e53d2012144c4799bcb400a211a5db 0 0 207620 0 0
2040159 0 0 0 0 1322705 0 0 0 0 170000
3201126 B 1 BS 1 05/06/2018 10/06/2018 19/06/1982 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 7930188 0 6 0 0 0 FEBBI AYI D376368
35 13135 DR ARU, SPPD 0138R0170618V000830 0001457355993 3;JKN
DR RIZKI; 5.2.2.201806040537 4 186834 1#0##0#0#0.0#2018-06-26
11:39:31#0#00:37:18#00:37:18#12:00:00 1 a9c47219c9045dabf883e8a186794e9e
0 0 320566 0 0 2378825 0 0 0 0
5230797 0 0 0 0 0
3201126 B 2 BS 1 08/06/2018 10/06/2018 05/10/1990 0 2
- 0 - 0 - 0 - 0 2601900 2095361 0
3 0 0 0 DIAN OKTAVIYANI d384034 27 10108 DR NINING H,
4 188841 1#0##0#0#0.0#2018-06-28
11:31:30#0#19:48:08#19:48:08#00:00:00 1 49783eebb9875d7bf7c54acad1db8d69
0 0 412171 0 0 212610 0 0 0 0
1470580 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 10/06/2018 11/01/1974 0 1
- 0 8908800 15715867 0 3 0 0 0 JAMALUDIN
D398607 44 16219 DR ARU, SPPD 0138R0170618V002855
0001295605877 3;JKN DR RIZKI; 5.2.2.201806040537 4 189056
1#0##0#0#0.0#2018-06-28 12:14:21#0#00:00:00#00:00:00#00:00:00 1
f77136c06c5399bf824609cfe1c1c020 0 0 1906030 0 0
9323195 0 0 0 0 4486642 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 10/06/2018 06/06/1967 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8871344 0 3 0 0 0 HALIMAH
0000510067989 3;JKN DR RIZKI; 5.2.2.201806040537 4 188833
1#0##0#0#0.0#2018-06-28 12:21:16#0#00:00:00#00:00:00#00:00:00 1
d5d7c22ed061e867fd1b3f068147dae4 0 3543300 974100 0 0
3648576 0 0 0 0 636368 0 0 0 0 69000
3201126 B 3 BS 1 09/06/2018 10/06/2018 17/08/1975 0 1
0 - 0 - 0 - 0 - 0 6341300 12025896
0 2 0 0 0 ADNI D399441 42 15637 DR AGOES
5.2.2.201806040537 4 188956 1#0##0#0#0.0#2018-06-29
11:01:09#0#10:02:14#10:02:14#00:00:00 1 b69ee085f8b05282e93a109454b4271b
0 3939000 1268260 0 0 4005895 0 0 0 0
812741 0 0 2000000 0 0
3201126 B 2 BS 1 09/06/2018 10/06/2018 05/05/1948 0 1
1 A09.9;L02.9 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 1505795 0 2 0 0 0 MUHAMAD SJAFRUDIN TN
0000044052412 3;JKN DR RIZKI; 5.2.2.201806040537 4 189519
1#0##0#0#0.0#2018-06-29 14:41:58#0#00:00:00#00:00:00#00:00:00 1
203d05ddaea923fdb192af9940c49c2b 0 0 238535 0 0 132750
0 0 0 0 1134510 0 0 0 0 0
3201126 B 3 BS 1 09/06/2018 10/06/2018 09/06/2018 3865 1
3655700 0 0 - 0 - 0 - 0 - 0
3655700 573828 0 2 0 0 0 BY NY SUPRIHATIN
0002465410274 3;JKN DR RIZKI; 5.2.2.201806040537 4 189506
1#0##0#0#0.0#2018-07-02 14:11:27#0#00:00:00#00:00:00#00:00:00 1
86e3545794513cd9768ae0857c3ab10f 0 0 145000 0 0 134688
0 0 0 0 294140 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 10/06/2018 08/06/2018 2976 1
3655700 0 0 - 0 - 0 - 0 - 0
3655700 720644 0 3 0 0 0 BAYI NY DEVITA
0002456061142 3;JKN DR RIZKI; 5.2.2.201806040537 4 189496
1#0##0#0#0.0#2018-07-02 14:12:59#0#00:00:00#00:00:00#00:00:00 1
ccacb8dc4ed2c25ff223bd42e64939fc 0 0 145000 0 0 88899
0 0 0 0 486745 0 0 0 0 0
3201126 B 3 BS 1 09/06/2018 10/06/2018 31/12/1946 0 2
4 I24.9;I46.9;R57.0 99.60;89.52 - - None None None None I-4-
(BERAT) 7040000 0 0 - 0 - 0 - 0 - 0
7040000 2691299 0 2 0 0 0 AMSIH D378529 71
26093 DR WIDHI DEWANTA K AJI 0138R0170618V002921 0001453649523 3;JKN
DR RIZKI; 5.2.2.201806040537 4 189087 1#0##0#0#0.0#2018-07-02
16:02:45#0#00:00:00#00:00:00#12:00:00 1 d62eae330f5d2b088769074dfea614ad
0 0 520095 0 0 844138 0 0 0 0 483066
0 0 0 0 844000
3201126 B 3 BS 1 09/06/2018 10/06/2018 26/11/1945 0 1
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 2799651 0 2 0 0 0 I.SOEPOMO D400521
72 26493 DR WIDHI DEWANTA K AJI 0138R0170618V002919 0001338480944
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189086
1#0##0#0#0.0#2018-07-02 16:52:06#0#00:00:00#00:00:00#00:00:00 1
7b0d131b9e9dc11bcfde657d8edc7221 0 0 439974 0 0
1887522 0 0 0 0 472155 0 0 0 0 0
3201126 B 3 BS 1 10/06/2018 10/06/2018 03/07/1954 0 1
2 I63.9;G81.9;R47.0 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 1593496 0 1 0 0 0 S. JOHNNY HARTO
MULYONO D359761 63 23353 DR WIDHI DEWANTA K AJI 0138R0170618V002972
0001339919267 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189101
1#0##0#0#0.0#2018-07-02 16:53:42#0#15:58:47#15:58:47#00:00:00 1
afc0a3ec852451dfa2d2ca2300bfb3d9 0 0 345475 0 0 854774
0 0 0 0 393247 0 0 0 0 0
3201126 B 3 BS 1 09/06/2018 10/06/2018 19/01/1987 0 2
0 - 0 - 0 - 0 - 0 1674900 3715374
0 2 0 0 0 SUPRIHATIN D400534 31 11464 DR ERDIYAN,
4 189080 1#0##0#0#0.0#2018-07-04
08:49:28#0#00:00:00#00:00:00#00:00:00 1 2185d77f9495cfc009ddb4da1f6392e3
0 0 334980 0 0 1307732 0 0 0 0
1944662 0 0 128000 0 0
3201126 B 2 BS 1 08/06/2018 10/06/2018 23/05/2018 0 2
1743400 0 0 - 0 - 0 - 0 - 0
1743400 5523582 0 3 0 0 0 BAYI NY FEBERLINA DAELI
0002461537585 3;JKN ECHI; 5.2.2.201806040537 4 188845
1#0##0#0#0.0#2018-07-27 09:41:56#0#00:00:00#00:00:00#00:00:00 2
eb34ff3713cfa924825500d411a9ae03 0 0 209906 0 0
1654820 0 0 0 0 2384856 0 0 0 0
1274000
3201126 B 3 BS 1 09/06/2018 10/06/2018 24/10/1968 0 1
4854000 0 0 - 0 - 0 - 0 - 0
4854000 2187113 0 2 0 0 0 ASNAWALUDIN YUNUS
0001630600817 3;JKN ECHI; 5.2.2.201806040537 4 189091
1#0##0#0#0.0#2018-07-27 09:42:20#0#00:00:00#00:00:00#00:00:00 2
aa7e4bda08d1a66b63787a8dfc4f9251 0 0 252155 0 0
1494502 0 0 0 0 440456 0 0 0 0 0
3201126 B 3 BS 1 16/05/2018 10/06/2018 16/05/2018 1500 1
- 0 - 0 30082000 58717133 0 26 1 6 144
BAYI NY SRI SUPATMI II d398732 0 0 DR AULIA TANGKARI, SPA
0138R0170518V005768 0002459472693 3;JKN ECHI; 5.2.2.201806040537
4 181240 1#0##0#0#0.0#2018-07-27
09:42:54#0#10:24:57#10:24:57#00:00:00 2 85720adfa8e3dd407ca6be6c1d91de59
0 0 3609838 0 0 11403295 0 0 0 0
2726000 22561000 0 0 18417000 0
3201126 B 3 BS 1 07/06/2018 10/06/2018 29/12/1992 0 2
0 - 0 - 0 - 0 - 0 1674900 3929320
0 4 0 0 0 DEVITA D393771 25 9291 DR FX
BHIMANTORO, SPOG 0138R0170618V002033 0001515865217 3;JKN ECHI;
5.2.2.201806040537 4 188176 1#0##0#0#0.0#2018-07-27
09:43:20#0#11:37:01#11:37:01#00:00:00 2 654ee65c85cad02f7c44a4ddf6ab7105
0 0 387980 0 0 919682 0 0 0 0
2493658 0 0 128000 0 0
3201126 B 3 BS 1 09/06/2018 10/06/2018 05/11/1978 0 1
1 I63.9;J22;G81.9 - - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 1520123 0 2 0 0 0 RAHMAT NOVIAN
0001728497215 3;JKN DR RIZKI; 5.2.2.201806040537 4 189089
1#0##0#0#0.0#2018-08-02 16:13:50#0#00:00:00#00:00:00#12:00:00 2
b39f802d2f88451b850be08cefed8898 0 0 433610 0 0 698066
0 0 0 0 388447 0 0 0 0 0
3201126 B 2 BS 1 09/06/2018 10/06/2018 12/01/1975 0 2
1 I13.1;J22;D63.8 99.04;99.21;39.27 - - None None None None
- 0 - 0 10690500 10285497 0 2 0 0 0
SITI NURTIAH NY D400347 43 15854 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V002878 0001167836409 3;JKN DR RIZKI; 5.2.2.201806040537
4 189078 1#0##0#0#0.0#2018-08-02
16:19:45#0#13:39:41#13:39:41#00:00:00 2 46c35b1b3b2b943710a1741d6ead062b
0 4911100 2223624 0 0 2352890 0 0 0 0
728883 0 0 69000 0 0
3201126 B 1 BS 1 07/06/2018 10/06/2018 06/07/1957 0 2
1 S42.20;E14.9 79.31 - - None None None None M-1-80-I
12140800 0 0 - 0 - 0 - 0 - 0
12140800 22883713 0 4 0 0 0 ASNALINA SIALLAGAN
0138r0170618v002225 0000061066427 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 188289 1#0##0#0#0.0#2018-08-04
12:41:58#0#00:17:34#00:17:34#12:00:00 2 b2a06dcd7c646c3df9bb255b8444b9e9
0 0 7406333 0 0 3301180 0 0 0 0
11755300 0 0 0 0 420900
3201126 B 2 BS 1 09/06/2018 10/06/2018 28/08/1950 0 1
- 0 51950600 55913750 0 2 0 0 0 IDRIS
0000197980828 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188902
1#0##0#0#0.0#2018-08-04 14:19:44#0#00:00:00#00:00:00#12:00:00 2
02b599ebdb691bb2e9a62705efe53083 0 9004000 8244960 0 0
29938790 0 0 0 0 1226000 0 0 7500000 0
0
3201126 B 3 BS 1 16/05/2018 10/06/2018 16/05/2018 1584 2
1 P07.1;P07.3;P22.0 87.44 - - None None None None P-8-12-III
PROSEDUR MAYOR (BERAT) 15565600 0 0 - 0 - 0 - 0
- 0 15565600 30977750 0 26 1 6 0 BAYI NY SRI
SUPATMI I D398731 0 0 DR AULIA TANGKARI, SPA 0138R0170518V005760
0002459471916 3;JKN irene; 5.2.2.201806040537 4 181235
1#0##0#0#0.0#2018-09-10 13:50:11#0#10:22:01#10:22:01#00:00:00 5
47a54834974c5e7573ff495e79195fc3 0 0 1063975 0 0
2138775 0 0 0 0 20751000 0 0 0 0
7024000
3201126 B 3 BS 1 31/05/2018 10/06/2018 15/06/2017 0 2
1 A41.9;D64.9;E41 99.06;99.04 - - None None None None A-4-
0 0 - 0 - 0 - 0 - 0 5838600
25925718 0 11 0 0 0 AZIZIAH SALSABILA RAMADHANI
0002435462616 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186133
1#0##0#0#0.0#2018-10-02 08:25:55#0#00:00:00#00:00:00#00:00:00 1
7d1181b2696cbcfcba15ed01ff3b83d9 0 0 578474 0 0
13330244 0 0 0 0 7974000 0 0 0 0
4043000
3201126 B 1 BS 1 09/06/2018 10/06/2018 06/08/1965 0 2
0 - 0 - 0 - 0 - 0 8877800 12837325
0 2 0 0 0 SUHARTINI D400160 52 19300 DR AGOES
KOOSHARTORO SPPD-KKV 0138R0170618V002835 0001438141634 3;JKN
SURYANIH;15136 5.2.2.201806040537 4 188905 1#0##0#0#0.0#2018-
10-03 15:23:03#0#00:00:00#00:00:00#00:00:00 2
be6c25863202f33659664a242ef37f5b 0 4795000 1271460 0 0
3905040 0 0 0 0 865825 0 0 2000000 0
0
3201126 B 3 BS 1 08/06/2018 10/06/2018 09/09/1966 0 2
1 N18.5;J81;D63.8 39.27;99.04 - - None None None None N-1-
- 0 - 0 19332400 9294632 0 3 0 0 0
ROMLAH D400416 51 18900 SRI KUNMARTINI.DR,SPPD
0138R0170618V002460 0001768545347 3;JKN SURYANIH;15136
5.2.2.201806040537 4 188651 1#0##0#0#0.0#2018-10-03
15:25:03#0#13:51:19#13:51:19#00:00:00 2 35ce3147c2b1a98957183ceaab20ba79
0 3611800 1906030 0 0 3043742 0 0 0 0
664060 0 0 0 0 69000
3201126 B 2 BS 1 10/06/2018 11/06/2018 04/03/1951 0 1
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8432315 0 2 0 0 0 SLAMET D396777
0000043291697 3;JKN DR RIZKI; 5.2.2.201806040537 4 189117
1#0##0#0#0.0#2018-06-28 08:33:26#0#21:04:58#21:04:58#00:00:00 2
1fe8c67e3035788a8ab439f9c401d9fb 0 4703600 1104720 0 0
1933890 0 0 0 0 621105 0 0 0 0 69000
3201126 B 2 BS 1 10/06/2018 11/06/2018 15/06/1949 0 2
- 0 10690500 4140626 0 2 0 0 0 KASEM
0001271973699 3;JKN DR RIZKI; 5.2.2.201806040537 4 189098
1#0##0#0#0.0#2018-06-28 08:55:02#0#14:27:11#14:27:11#00:00:00 1
d75791a010a19a72364372db8e519c07 0 0 2276624 0 0
1864002 0 0 0 0 0 0 0 0 0 0
3201126 B 2 BS 1 07/06/2018 11/06/2018 18/09/1993 0 2
(SEDANG) 6486300 0 0 - 0 - 0 - 0 - 0
6486300 11040184 0 5 0 0 0 UMI FAHATI KURNIA
0000034281415 3;JKN DR RIZKI; 5.2.2.201806040537 4 188615
1#0##0#0#0.0#2018-06-28 12:11:43#0#12:01:24#12:01:24#00:00:00 2
2208a255802992559896b1ff83920941 0 5874400 2090753 0 0
1784739 0 0 0 0 836292 0 0 0 0 454000
3201126 B 2 BS 1 09/06/2018 11/06/2018 22/12/1952 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 6708332 0 3 0 0 0 TURSINI NY D068956
DR RIZKI; 5.2.2.201806040537 4 189055 1#0##0#0#0.0#2018-06-28
12:12:53#0#12:16:27#12:16:27#00:00:00 1 b1fb4c7f80f909bce342e1c5746154e5
0 0 833963 0 0 1584506 0 0 0 0
4289863 0 0 0 0 0
3201126 B 2 BS 1 09/06/2018 11/06/2018 16/10/1966 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3387311 0 3 0 0 0 NATALIA ENY SULISTIANTI
0001627397537 3;JKN DR RIZKI; 5.2.2.201806040537 4 189081
1#0##0#0#0.0#2018-06-28 12:22:19#0#00:00:00#00:00:00#00:00:00 1
4507ea29b9a6440afa56865b7ee4b2dc 0 0 729386 0 0 895325
0 0 0 0 1762600 0 0 0 0 0
3201126 B 2 BS 1 09/06/2018 11/06/2018 09/02/1978 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 1848999 0 3 0 0 0 KUNCORO YAKTI
0001643989544 3;JKN DR RIZKI; 5.2.2.201806040537 4 195776
1#0##0#0#0.0#2018-06-29 14:34:10#0#00:00:00#00:00:00#00:00:00 1
05dcef14637b6a74db6ed5bdca2ac5f5 0 0 278711 0 0 413325
0 0 0 0 1156963 0 0 0 0 0
3201126 B 2 BS 1 08/06/2018 11/06/2018 26/10/1981 0 2
- 0 3584400 4908763 0 4 0 0 0 HAWA NAZIYAH
0001620091574 3;JKN DR RIZKI; 5.2.2.201806040537 4 188846
1#0##0#0#0.0#2018-07-02 15:25:16#0#00:00:00#00:00:00#00:00:00 1
10f22b34696046a6479e5b77f352009d 0 0 375596 0 0
2373533 0 0 0 0 2159634 0 0 0 0 0
3201126 B 1 BS 1 10/06/2018 11/06/2018 22/09/1994 0 2
1 K30;A09.9 - - - None None None None K-4-18-I None
2033900 0 0 - 0 - 0 - 0 - 0
2033900 2817937 0 2 0 0 0 PINGKAN WULAN
0001730576788 3;JKN DR RIZKI; 5.2.2.201806040537 4 189093
1#0##0#0#0.0#2018-07-02 15:26:50#0#00:00:00#00:00:00#12:00:00 1
5a1362e1f86c3f4bd2aaa1f2e6c71823 0 0 269459 0 0 776127
0 0 0 0 1772351 0 0 0 0 0
3201126 B 2 BS 1 10/06/2018 11/06/2018 11/12/1948 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
0001222739706 3;JKN DR RIZKI; 5.2.2.201806040537 4 189099
1#0##0#0#0.0#2018-07-02 15:27:52#0#14:40:07#14:40:07#00:00:00 1
e2b5b472109047ce23f021d211e3ca72 0 0 499265 0 0
1709154 0 0 0 0 2500297 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 11/06/2018 30/06/1988 0 2
5405200 0 0 - 0 - 0 - 0 - 0
5405200 9101496 0 4 0 0 0 SYEIRA PUSPA NIDRA
0138R0170618V002764 0000164661772 3;JKN ECHI; 5.2.2.201806040537
4 188839 1#0##0#0#0.0#2018-07-27
09:45:24#0#00:00:00#00:00:00#00:00:00 2 a9ebf652ae30d30bb46dcaae1a9d9d94
0 3621000 1619304 0 0 3080767 0 0 0 0
711425 0 0 69000 0 0
3201126 B 3 BS 1 10/06/2018 11/06/2018 06/05/1965 0 1
1 I64;G81.9;J40 87.03;87.44 - - None None None None G-4-
- 0 - 0 - 0 - 0 4888600 1011551 0
2 0 0 0 NURMANSYAH D392990 53 19393 DR DICKY KARUNDENG
0138R0170618V002979 0001845515632 3;JKN DR RIZKI; 5.2.2.201806040537
4 189103 1#0##0#0#0.0#2018-08-03
08:56:09#0#17:03:06#17:03:06#12:00:00 2 b956cbdecd2dbe5b06db7b827900d73c
0 0 345475 0 0 310900 0 0 0 0 355176
0 0 0 0 0
3201126 B 1 BS 1 06/06/2018 11/06/2018 06/07/1954 0 2
4 E87.2;E14.2;R40.2 90.59;89.52;88.76;96.71;99.04;39.95;38.95 - -
None None None None J-1-20-II None None None None None None
PROSEDUR SISTEM PERNAFASAN NON-KOMPLEKS (SEDANG) 26415700 0 0
- 0 - 0 - 0 - 0 26415700 50085014 0
6 0 0 0 YENNY CITRA DEWI D306193 63 23346 DR. ARU
5.2.2.201806040537 4 187561 1#0##0#0#0.0#2018-09-26
21:19:16#0#01:11:38#01:11:38#00:00:00 4 5e4452252f273f30f2501083ddfb3ea6
0 0 10057482 0 0 29307282 0 0 0 0
7871250 0 0 0 0 2849000
3201126 B 3 BS 1 11/06/2018 11/06/2018 19/12/1973 0 1
0 - 0 - 0 - 0 - 0 4043000 1923482
0 1 0 0 0 WILLEM DEVI GERRITS D400603 44 16245
DR ADITIA NATA KUSUMA 0138R0170618V003138 0001717453967 3;JKN
SURYANIH;15136 5.2.2.201806040537 4 189229 1#0##0#0#0.0#2018-
10-03 15:32:03#0#00:00:00#00:00:00#00:00:00 3
fde63fbaf3e84b5422a41be5cb8be71c 0 0 250735 0 0
1257912 0 0 0 0 414835 0 0 0 0 0
3201126 B 1 BS 1 09/06/2018 11/06/2018 11/04/1965 0 2
1 E87.1;D00.2;A41.8 90.59;89.52 - - None None None None E-4-
(BERAT) 8810600 0 0 - 0 - 0 - 0 - 0
8810600 7957132 0 3 0 0 0 SONDANG PASU APRIANI
0000060739907 3;JKN SURYANIH;15136 5.2.2.201806040537 4 189085
1#1#vip#3#0#0.0#2018-10-03 16:20:11#0#00:00:00#00:00:00#00:00:00 3
c9f56b2fb79380550badc68e1079eb33 0 0 1801250 0 0
2371822 0 0 0 0 3784060 0 0 0 0 0
3201126 B 3 BS 1 06/06/2018 11/06/2018 21/06/1957 0 2
1 I50.0;J90;K30 90.59;89.52;88.76;34.91 - - None None None
(BERAT) 4973600 0 0 - 0 - 0 - 0 - 0
4973600 6884680 0 6 0 0 0 HARMIDAH D400260
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 187860
1#0##0#0#0.0#2018-10-05 10:16:56#0#10:02:00#10:02:00#00:00:00 2
a75751f9750936d2b7803f4f08690700 0 0 1282580 0 0
3522700 0 0 0 0 2079400 0 0 0 0 0
3201126 B 1 BS 1 10/06/2018 11/06/2018 13/09/1968 0 2
1 D05.9;I49.3 85.12 - - None None None None L-1-50-III None
None None None None None PROSEDUR PADA PAYUDARA (BERAT) 21064200
0 0 - 0 - 0 - 0 - 0 21064200
15097930 0 2 0 0 0 DIAH SADIAH D290422 49 18167
TANTIYO S;16137 5.2.2.201806040537 4 189118 1#0##0#0#0.0#2018-
10-05 10:28:35#0#00:00:00#00:00:00#00:00:00 3
bc5f9085d851a122cc14d5c3607258c1 0 6122700 4840950 0 0
2573665 0 0 0 0 1063715 0 0 0 0 496900
3201126 B 1 BS 1 08/06/2018 12/06/2018 01/08/1964 0 1
12140800 0 0 - 0 - 0 - 0 - 0
12140800 20458119 0 5 0 0 0 AGUS K D400419
3;JKN DR RIZKI; 5.2.2.201806040537 4 188508 1#0##0#0#0.0#2018-
06-29 15:18:31#0#10:54:58#10:54:58#00:00:00 1
e6560fb10a244cc1ee39223379a812cc 0 8906600 3573832 0 0
6204787 0 0 0 0 1276000 0 0 496900 0
0
3201126 B 2 BS 1 11/06/2018 12/06/2018 20/01/1991 0 1
1743400 0 0 - 0 - 0 - 0 - 0
1743400 1638070 0 2 0 0 0 MUHAMMAD ROBIYANTO
0002074467958 3;JKN DR RIZKI; 5.2.2.201806040537 4 189125
1#0##0#0#0.0#2018-06-29 15:37:32#0#00:00:00#00:00:00#00:00:00 1
95280174f02e3a706d3e9508b7593518 0 0 209906 0 0 285001
0 0 0 0 1143163 0 0 0 0 0
3201126 B 1 BS 1 08/06/2018 12/06/2018 17/08/1955 0 1
1 I25.0;I11.0;J18.8 88.55 - - None None None None I-1-15-III
0 0 - 0 - 0 - 0 - 0 17095200
20497469 0 5 0 0 0 ENDY SURYADI D282995 62
3;JKN DR RIZKI; 5.2.2.201806040537 4 188844 1#0##0#0#0.0#2018-
07-02 08:41:49#0#00:00:00#00:00:00#00:00:00 1
1e70c2bf5f9c9d9149fbd4156026e850 0 6177000 3472040 0 0
7503429 0 0 0 0 2069000 0 0 1276000 0
0
3201126 B 3 BS 1 11/06/2018 12/06/2018 15/08/1958 0 1
1 I48;I50.0;J06.9 - - - None None None None I-4-19-II
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 1553273 0 2 0 0 0 HARYONO D350955
59 21850 DR MUHAMMAD RIZKI YUWANA 0138r017618v003462
0002089207012 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189706
1#0##0#0#0.0#2018-07-02 14:43:14#0#17:28:40#17:28:40#00:00:00 1
398fed05b6f8506afe8f25b8efcd0a8a 0 0 305565 0 0 857092
0 0 0 0 390616 0 0 0 0 0
3201126 B 3 BS 1 11/06/2018 12/06/2018 25/12/1947 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1923527 0 2 0 0 0 TITIK NURSIATI
0001260578441 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189260
1#0##0#0#0.0#2018-07-02 14:53:29#0#00:00:00#00:00:00#00:00:00 2
0b8ec8b20bff2e119bb8443533ff73e0 0 0 207620 0 0
1038069 0 0 0 0 677838 0 0 0 0 0
3201126 B 2 BS 1 09/06/2018 12/06/2018 25/06/1971 0 2
1 C48.2;R18;J91 88.01 - - None None None None K-4-10-III
None None None None None None TUMOR PENCERNAAN (BERAT) 13320000
0 0 - 0 - 0 - 0 - 0 13320000
5360114 0 4 0 0 0 FININTA SIAGIAN d084666 46
17151 DR HENDRIEK SP B 0138R0170618V002898 0001457727996 3;JKN DR
RIZKI; 5.2.2.201806040537 4 189082 1#0##0#0#0.0#2018-07-02
15:32:08#0#00:00:00#00:00:00#00:00:00 1 4a72f1059fdfa8475aef9326a5bc7389
0 0 947132 0 0 2016320 0 0 0 0
2396662 0 0 0 0 0
3201126 B 3 BS 1 06/06/2018 12/06/2018 10/09/1965 0 1
1 K35.2;A41.9 54.19;89.52;90.59 - - None None None None K-1-
40-III None None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-
LAIN (BERAT) 15009700 0 0 - 0 - 0 - 0 -
0 15009700 13262196 0 7 0 0 0 SUPRIHATIN TN
0001740459431 3;JKN DR RIZKI; 5.2.2.201806040537 4 187901
1#0##0#0#0.0#2018-07-02 15:33:05#0#14:09:25#14:09:25#00:00:00 1
3e1ed5ca79c334c26bb513cbe1ddf664 0 0 4405813 0 0
3782263 0 0 0 0 4936120 0 0 0 0 138000
3201126 B 3 BS 1 07/06/2018 12/06/2018 21/07/1956 0 1
0 0 - 0 - 0 - 0 - 0 3575600
3283955 0 6 0 0 0 MARLIS MALIK D400377 61
3;JKN DR RIZKI; 5.2.2.201806040537 4 188286 1#0##0#0#0.0#2018-
07-02 15:36:20#0#00:00:00#00:00:00#00:00:00 1
c3020fc9aa64bda1458104da66be9478 0 0 374804 0 0
1090313 0 0 0 0 1818838 0 0 0 0 0
3201126 B 2 BS 1 09/06/2018 12/06/2018 29/03/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2922831 0 4 0 0 0 ALNAYRA FAUQISYA
SYABILLA D365065 1 437 DR RIANITA SYAMSU, SPA 0138R0170618V002931
0002237300379 3;JKN DR RIZKI; 5.2.2.201806040537 4 189092
1#0##0#0#0.0#2018-07-02 15:37:12#0#00:00:00#00:00:00#00:00:00 1
cdbbbe01454ac7511450844daf37f574 0 0 238535 0 0 952083
0 0 0 0 1732213 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 12/06/2018 05/08/1970 0 2
1 E11.2;A49.9;D63.8;I11.9 99.04;39.27 - - None None None None
- 0 - 0 12472300 12547997 0 2 0 0 0
WIWIN YULIA D400606 47 17477 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V003205 0000055599884 3;JKN DR RIZKI; 5.2.2.201806040537
4 189378 1#0##0#0#0.0#2018-07-02
15:42:56#0#00:00:00#00:00:00#00:00:00 2 b83e5e3d49462c56d6a870e124c6e097
0 6468200 2619183 0 0 2494717 0 0 0 0
896897 0 0 0 0 69000
3201126 B 2 BS 1 03/06/2018 12/06/2018 23/10/1943 0 2
1 I63.9;I13.0;E14.7;G81.9;S42.30 - - - None None None
- 0 - 0 10406600 26409433 0 10 1 0 0
TUTY SUSANA NY D399701 74 27252 DR. ARU ARIADNO, SPPD
0138R0170618V000264 0000060810401 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 186315 1#0##0#0#0.0#2018-07-02
16:00:36#0#21:48:46#21:48:46#00:00:00 1 3cfa4e51544d84bb2746feeb0be947f9
0 0 1093659 0 0 15016774 0 0 0 0
7106000 0 0 0 0 3193000
3201126 B 3 BS 1 10/06/2018 12/06/2018 21/09/2017 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3108630 0 3 0 0 0 BAYI NY MELINDA
INDRAYANI/FABIAN ALZIO LISADO D381361 0 262 DR OTTY MITHA S, SPA
0138R0170618V003003 0002288414878 3;JKN DR RIZKI; 5.2.2.201806040537
4 189122 1#0##0#0#0.0#2018-07-02
16:07:48#0#23:21:20#23:21:20#12:00:00 1 f4ccbdb2cb9dd078947c56b3a428cfa0
0 0 378188 0 0 1975074 0 0 0 0 755368
0 0 0 0 0
3201126 B 2 BS 1 08/06/2018 12/06/2018 03/10/1984 0 2
(RINGAN) 4203300 0 0 - 0 - 0 - 0 - 0
4203300 6030435 0 5 0 0 0 EVI MAYASARI
0001645507451 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188808
1#0##0#0#0.0#2018-07-02 16:25:01#0#00:00:00#00:00:00#00:00:00 1
dc5d1fad6038541a8c1523f758f50e17 0 0 431297 0 0
2653624 0 0 0 0 2945514 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 12/06/2018 08/10/1976 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4276939 0 2 0 0 0 MUKLIM TN D349314
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189710
1#0##0#0#0.0#2018-07-02 16:27:34#0#19:51:53#19:51:53#00:00:00 1
4cad810d31b48568f7e6c34c40a6a79c 0 0 424889 0 0
1173500 0 0 0 0 2678550 0 0 0 0 0
3201126 B 2 BS 1 11/06/2018 12/06/2018 10/09/1979 0 2
1 G44.2;K29.7 - - - None None None None G-4-23-I None
3180100 0 0 - 0 - 0 - 0 - 0
3180100 3097865 0 2 0 0 0 SUWARNINGSIH
0001175292112 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189126
1#0##0#0#0.0#2018-07-02 16:30:18#0#00:00:00#00:00:00#00:00:00 1
70cde3870fe1e93bb067c4aa60ec84b1 0 0 339209 0 0
1519992 0 0 0 0 1238664 0 0 0 0 0
3201126 B 2 BS 1 07/06/2018 12/06/2018 03/04/1973 0 2
1 E87.6;I50.0;R50.9 - - - None None None None E-4-11-II
None None None None None None HIPOVOLEMIA & GANGGUAN ELEKROLIT (SEDANG)
5405900 0 0 - 0 - 0 - 0 - 0
5405900 7537547 0 6 0 0 0 ROKHAYATUN D400383
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 188561
1#0##0#0#0.0#2018-07-02 16:32:33#0#11:19:34#11:19:34#00:00:00 1
238d79ade80dae93c0d596e613df3c69 0 0 539531 0 0
3656405 0 0 0 0 3341611 0 0 0 0 0
3201126 B 2 BS 1 04/06/2018 12/06/2018 22/12/1970 0 2
1 K35.2;A41.9;J18.0 54.19 - - None None None None K-1-40-III
(BERAT) 18011700 0 0 - 0 - 0 - 0 - 0
18011700 23499710 0 9 0 0 0 SUMIATI D400152
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186815
1#0##0#0#0.0#2018-07-02 16:38:02#0#18:00:56#18:00:56#00:00:00 1
c6db0c6e967de4cf9cb4e76463c5f8ef 0 7608600 5636627 0 0
8853483 0 0 0 0 1256000 0 0 0 0 145000
3201126 B 3 BS 1 11/06/2018 12/06/2018 01/07/1950 0 2
4 E87.1;E87.6;I63.9;G81.9;I46.9 - - - None None None None
ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 - 0 -
0 6293300 4504116 0 2 0 0 0 MIHAR HUTAURUK
0002235386169 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189662
1#0##0#0#0.0#2018-07-02 16:47:16#0#15:26:09#15:26:09#12:00:00 1
abf4652937b9cd8e3af217f69e088ede 0 0 314665 0 0
3605789 0 0 0 0 583662 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 12/06/2018 06/06/2018 2700 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3795157 0 2 0 0 0 YOSEFINA TEA BY NY
0002457098122 3;JKN ECHI; 5.2.2.201806040537 4 189124
1#0##0#0#0.0#2018-07-27 09:47:59#0#00:00:00#00:00:00#00:00:00 2
41a95f9ce268ebcb3532a419b0781df7 0 0 513620 0 0 846256
0 0 0 0 1628281 0 0 0 0 807000
3201126 B 2 BS 1 01/06/2018 12/06/2018 21/12/1954 0 2
1 I50.0;R57.0;J20.9 96.72 - - None None None None J-1-02-III
- 0 79597900 51579436 0 12 1 5 0 HENI ROHAENI
0001290507377 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 186155
1#0##0#0#0.0#2018-08-04 08:37:45#0#00:00:00#00:00:00#00:00:00 3
b616225b511d751889d373e271a6614f 0 0 3649824 0 0
27132612 0 0 0 0 11749000 0 0 0 0
9048000
3201126 B 3 BS 1 11/06/2018 12/06/2018 15/08/1958 0 1
1 I48;I50.0;J06.9 - - - None None None None I-4-19-II
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 1553273 0 2 0 0 0 HARYONO D350955
0002089207012 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189706
1#0##0#0#0.0#2018-08-04 12:56:02#0#17:28:40#17:28:40#00:00:00 2
9668571bf5815a153f57bb8cfc2400f4 0 0 305565 0 0 857092
0 0 0 0 390616 0 0 0 0 0
3201126 B 2 BS 1 11/06/2018 12/06/2018 04/03/1968 0 1
- 0 51950600 62775500 0 2 0 0 0 TUKIJO
0001718632991 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189171
1#0##0#0#0.0#2018-08-04 14:17:08#0#00:00:00#00:00:00#12:00:00 2
25739edcad804e1a3d1c4a76a8223afd 0 8986000 8244960 0 0
36699540 0 0 0 0 1276000 0 0 7569000 0
0
3201126 B 1 BS 1 11/06/2018 12/06/2018 15/11/1964 0 1
1 N20.1;E14.9;I12.9 59.8;56.0 - - None None None None N-1-
(RINGAN) 11257400 0 0 - 0 - 0 - 0 - 0
11257400 18859274 0 2 0 0 0 TUTENG KUSDIA
0001652772543 3;JKN DR RIZKI; 5.2.2.201806040537 4 189250
1#0##0#0#0.0#2018-09-06 15:20:38#0#00:00:00#00:00:00#12:00:00 2
13fcee99df6bcb8e5d2896559afe762d 0 9101600 4433317 0 0
979357 0 0 0 0 1276000 0 0 0 0
3069000
3201126 B 2 BS 1 10/06/2018 12/06/2018 04/01/1968 0 1
1 I50.0;R10.1;I25.0 89.52;87.44 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4290800
3701870 0 3 0 0 0 SUMINTA D366362 50 18420
DR RIZKI; 5.2.2.201806040537 4 189112 1#0##0#0#0.0#2018-09-06
15:24:40#0#20:30:39#20:30:39#00:00:00 2 c17d68a591bfe4fa3845b1e182e1fb57
0 0 439172 0 0 582520 0 0 0 0
2680178 0 0 0 0 0
3201126 B 2 BS 1 10/06/2018 12/06/2018 24/10/1968 0 1
(BERAT) 41224800 0 0 PCI 10725800 - 0 - 0 -
0 51950600 55098360 0 3 0 0 0 ASNAWALUDIN YUNUS
0001630600817 3;JKN irene; 5.2.2.201806040537 4 189106
1#0##0#0#0.0#2018-09-10 13:50:17#0#17:30:12#17:30:12#00:00:00 2
0aa4132ce52a7bdec7f1aa39d14e86a1 0 9401000 8297960 0 0
28554400 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 10/06/2018 12/06/2018 01/03/1950 0 1
1 E11.2;I21.2;B16.9;J81;D63.8 89.52;38.95;99.04 - - None None
- 0 - 0 - 0 19332400 16059429 0 3 0
0 0 SALIM D400572 68 24938 SRI KUNMARTINI.DR,SPPD
0138R0170618V002963 0000384679967 3;JKN SURYANIH;15136
5.2.2.201806040537 4 189094 1#0##0#0#0.0#2018-10-03
15:47:16#0#00:00:00#00:00:00#00:00:00 3 d7b93d2bce027a4817a1ee5fe6bde7de
0 4832800 2320614 0 0 6762398 0 0 0 0
1096617 0 0 0 0 1047000
3201126 B 2 BS 1 12/06/2018 12/06/2018 23/07/1986 0 2
LAIN (RINGAN) 3371200 0 0 - 0 - 0 - 0 -
0 3371200 1255450 0 1 0 0 0 CHOLILAH
0001170134289 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189717
1#0##0#0#0.0#2018-10-05 10:32:22#0#00:00:00#00:00:00#00:00:00 2
d2f322b6eea32677120e07fa66664a2c 0 0 356408 0 0 35910
0 0 0 0 863132 0 0 0 0 0
3201126 B 2 BS 1 12/06/2018 13/06/2018 07/05/1992 0 1
10406400 0 0 - 0 - 0 - 0 - 0
10406400 14846036 0 2 0 0 0 TESAR RAMA CHANDRA
0138R0170618V003667 0001385760126 3;JKN DR RIZKI; 5.2.2.201806040537
4 190030 1#0##0#0#0.0#2018-06-28
09:04:43#0#00:00:00#00:00:00#00:00:00 1 982320dc353eccde3c414b2b3d4f98c6
0 5180500 2913792 0 0 5541508 0 0 0 0
1072236 0 0 138000 0 0
3201126 B 1 BS 1 12/06/2018 13/06/2018 30/05/1964 0 2
1 K30;R10.1 90.59;89.52 - - None None None None K-4-18-I
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 3716384 0 2 0 0 0 MEITY FARIDA
0000005479312 3;JKN DR RIZKI; 5.2.2.201806040537 4 190036
1#0##0#0#0.0#2018-06-28 09:11:06#0#12:33:37#12:33:37#12:00:00 1
8b2acb2f3e1d3ab60b6c73a1e9954ea1 0 0 269459 0 0
1615797 0 0 0 0 1831128 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 13/06/2018 11/06/2018 3151 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2040617 0 3 0 0 0 BAYI NY SEPTIANA PRAKAS
PRATIWI D400607 0 0 DR KHARNINA, SPA 0138R0170618V003967
0002453329743 3;JKN DR RIZKI; 5.2.2.201806040537 4 190383
1#0##0#0#0.0#2018-06-28 09:18:32#0#00:00:00#00:00:00#00:00:00 1
7728f2c053b47f82742773c960103c60 0 0 499620 0 0 156499
0 0 0 0 1384498 0 0 0 0 0
3201126 B 1 BS 1 12/06/2018 13/06/2018 06/11/1958 0 1
- 0 46734600 56087125 0 2 0 0 0 AE PRIYONO
0001729126361 3;JKN DR RIZKI; 5.2.2.201806040537 4 190266
1#0##0#0#0.0#2018-06-28 09:45:43#0#00:00:00#00:00:00#00:00:00 1
b5abe7cf167a091e3299072b1e32aaa0 0 10062000 7201760 0 0
29978365 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 11/06/2018 13/06/2018 02/05/2016 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1721353 0 3 0 0 0 M SAMMI AR RASYID
0002048749637 3;JKN DR RIZKI; 5.2.2.201806040537 4 189703
1#0##0#0#0.0#2018-06-28 10:01:51#0#17:26:19#17:26:19#00:00:00 1
fffa4692cbe49d369bcb31d02f11bc6e 0 0 292031 0 0 588210
0 0 0 0 841112 0 0 0 0 0
3201126 B 3 BS 1 10/06/2018 13/06/2018 27/02/2016 0 1
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2385643 0 4 0 0 0 SAMUEL JOHAN MANALU
0002236378307 3;JKN DR RIZKI; 5.2.2.201806040537 4 189119
1#0##0#0#0.0#2018-06-28 10:02:55#0#22:27:27#22:27:27#12:00:00 1
4debc13cd22f8252b52570f2f91a76ab 0 0 207620 0 0
1206953 0 0 0 0 971070 0 0 0 0 0
3201126 B 3 BS 1 11/06/2018 13/06/2018 21/08/1957 0 1
1 I50.0;J22 93.94;89.52 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 3575600
5327667 0 3 0 0 0 SUKAMTO D385798 60 22209
DR RIZKI; 5.2.2.201806040537 4 189660 1#0##0#0#0.0#2018-06-28
11:28:53#0#15:25:31#15:25:31#12:00:00 2 0562942055e952ec08160d073371fb12
0 0 500624 0 0 3373504 0 0 0 0
1163539 0 0 0 0 290000
3201126 B 1 BS 1 10/06/2018 13/06/2018 21/09/1992 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12956450 0 4 0 0 0 SEPTIANA PRAKAS PRATIWI
0138R0170618V002984 0001797974673 3;JKN DR RIZKI; 5.2.2.201806040537
4 189111 1#0##0#0#0.0#2018-06-29
10:37:59#0#19:56:56#19:56:56#12:00:00 1 56978455ae5c7ae05dbf1129892c9ad3
0 7444400 2373710 0 0 2068722 0 0 0 0
971728 0 0 69000 28890 0
3201126 B 3 BS 1 12/06/2018 13/06/2018 16/07/1975 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 4629372 0 2 0 0 0 MILA BASUKI D270698
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190243
1#0##0#0#0.0#2018-06-30 11:25:32#0#20:13:57#20:13:57#00:00:00 1
d7d37e9f59cc7705302694dd87f86b6b 0 0 424889 0 0
1502877 0 0 0 0 1216500 0 0 0 1485106
0
3201126 B 3 BS 1 09/06/2018 13/06/2018 10/05/1975 0 2
1 E14.5;M71.07;M86.56;R02 84.12 - - None None None None M-1-
02-II None None None None None None AMPUTASI (SEDANG) 15599100 0 0
- 0 - 0 - 0 - 0 15599100 13866650 0
5 0 0 0 LILIS SURYANI D339258 43 15736 DR AGOES
S;16137 5.2.2.201806040537 4 188851 1#0##0#0#0.0#2018-06-30
11:32:17#0#00:00:00#00:00:00#00:00:00 1 584380d4ef4c480827a7cbaa73da4b54
0 0 4701531 0 0 4155164 0 0 0 0
3957800 0 0 0 1052155 0
3201126 B 1 BS 1 07/06/2018 13/06/2018 19/01/2000 0 1
1 D56.1;K12.1;D69.6 99.04 - - None None None DD02 D-4-13-II
None None None None None DD-02-II GANGGUAN SEL DARAH MERAH SELAIN
KRISIS ANEMIA SEL SICKLE (SEDANG) 5918600 0 0 - 0 - 0
- 0 DEFERIPRONE (IP) 5974000 11892600 24028333 0 7
0 0 0 THORIQ KAISAR FADILLAH D052293 18 6714 DR VERA MUNA
MANOE, SPA 0138R0170618V001841 0001258228012 3;JKN DR RIZKI;
5.2.2.201806040537 4 188028 1#0##0#0#0.0#2018-07-02
14:20:23#0#03:35:15#03:35:15#00:00:00 2 e66e1d6cdc3481cbb4e1b161c6a41c41
0 0 429362 0 0 16899971 0 0 0 0
6699000 0 0 0 0 0
3201126 B 2 BS 1 11/06/2018 13/06/2018 01/12/1991 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10966706 0 3 0 0 0 RYANI PUSPA DEWI
0001228560423 3;JKN DR RIZKI; 5.2.2.201806040537 4 189258
1#0##0#0#0.0#2018-07-02 14:25:26#0#00:00:00#00:00:00#00:00:00 1
1e7d72a80d9c0ac357ce52ff98108d57 0 5269900 2569481 0 0
1968877 0 0 0 0 1042448 0 0 116000 0
0
3201126 B 1 BS 1 09/06/2018 13/06/2018 24/12/1971 0 1
- 0 - 0 - 0 - 0 5424200 13902646 0
5 0 0 0 SYARIF HIDAYAT D388254 46 16969 YASMIN
SURYANDARI BACHTIAR. DR. SPB 0138R0170618V002925 0000040614366 3;JKN DR
RIZKI; 5.2.2.201806040537 4 189090 1#0##0#0#0.0#2018-07-02
14:28:34#0#00:00:00#00:00:00#12:00:00 1 181ded16a392efedcc0679e320dafe72
0 7623500 1689018 0 0 3529067 0 0 0 0
985061 0 0 76000 0 0
3201126 B 3 BS 1 12/06/2018 13/06/2018 03/04/1960 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1594473 0 2 0 0 0 RITA ELVINA NY
0001276935344 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189719
1#0##0#0#0.0#2018-07-02 14:57:13#0#03:25:49#03:25:49#00:00:00 1
6f9d98835a93ff085b6838733c7b143c 0 0 183752 0 0 754410
0 0 0 0 656311 0 0 0 0 0
3201126 B 3 BS 1 10/06/2018 13/06/2018 05/07/1942 0 2
0 - 0 - 0 - 0 - 0 3575600 2616668
0 4 0 0 0 MIAH D400589 75 27734 DR AZRI NURIZAL
SPPD KKV 0138R0170618V002983 0002439919102 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 189110 1#0##0#0#0.0#2018-07-02
15:01:11#0#19:54:42#19:54:42#00:00:00 1 48dacdb37d9e15b95b9b9d92bfa621c4
0 0 374804 0 0 1259180 0 0 0 0 982684
0 0 0 0 0
3201126 B 3 BS 1 03/06/2018 13/06/2018 09/09/1960 0 2
1 N13.2;N23;I11.0;I25.1;R57.0 - - - None None None None
N-4-13-III None None None None None None BATU URIN (BERAT) 6512100
0 0 - 0 - 0 - 0 - 0 6512100
16023697 0 11 0 0 0 KARTUTI D400079 57 21086
DR MOHAMMAD JOHAN SPU 0138R0170618V000213 0001865016279 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 186289 1#0##0#0#0.0#2018-
07-02 15:06:48#0#00:00:00#00:00:00#00:00:00 1
85ad7074837963babcefd87f4adbbfca 0 0 500624 0 0
7150894 0 0 0 0 5797279 0 0 0 0
2574900
3201126 B 3 BS 1 11/06/2018 13/06/2018 14/09/1988 0 2
5405200 0 0 - 0 - 0 - 0 - 0
5405200 17489401 0 3 0 0 0 MARIA AGUSTINA KUSUMA
0000511007466 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189127
1#0##0#0#0.0#2018-07-02 15:22:23#0#00:00:00#00:00:00#12:00:00 1
977861767721c68e74574931b594af10 0 3534500 2512184 0 0
9362551 0 0 0 0 1260166 0 0 0 0 820000
3201126 B 1 BS 1 12/06/2018 13/06/2018 27/02/1950 0 1
1 I50.0;H81.1;I25.1 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 5005900
2732942 0 2 0 0 0 MOH TABRANI D399009 68 24942
TANTIYO S;16137 5.2.2.201806040537 4 189716 1#0##0#0#0.0#2018-
07-02 15:55:46#0#02:45:24#02:45:24#00:00:00 1
d6b8c7c9d90361dd27b73320c62aacb0 0 0 503531 0 0 462620
0 0 0 0 1766791 0 0 0 0 0
3201126 B 3 BS 1 09/06/2018 13/06/2018 18/06/1954 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 5472322 0 5 0 0 0 RASUMI
0001318126004 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189079
1#0##0#0#0.0#2018-07-02 15:57:51#0#00:00:00#00:00:00#00:00:00 1
7d6a6bf0077af66288db3060450a0c75 0 0 743950 0 0
3029370 0 0 0 0 1699002 0 0 0 0 0
3201126 B 2 BS 1 11/06/2018 13/06/2018 11/06/2018 2649 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1014894 0 3 0 0 0 RYANI PUSPA DEWI BY NY
D400625 0 0 DR KHARNINA, SPA 0138R0170618V003781
0002465473577 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190235
1#0##0#0#0.0#2018-07-02 16:17:21#0#17:45:00#17:45:00#00:00:00 1
05c421ae2477fce739609f4bb4049e1c 0 0 39000 0 0 88899 0
0 0 0 886995 0 0 0 0 0
3201126 B 3 BS 1 10/06/2018 13/06/2018 03/09/1953 0 2
1 I63.9;G40.9;F29;G81.9 - - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4468392 0 4 0 0 0 ILOH MARYAMAH
D358218 64 23656 DR NURUL KOMARI SPS 0138r0170618v002968
0001771603997 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189100
1#0##0#0#0.0#2018-07-02 16:21:10#0#15:08:35#15:08:35#00:00:00 1
0809cda6690a74182b2b9f602ef92cf0 0 0 674855 0 0
2423212 0 0 0 0 1370325 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 13/06/2018 23/03/1966 0 1
11257400 0 0 - 0 - 0 - 0 - 0
11257400 18625351 0 3 0 0 0 MANAHAN PANGGABEAN
0000060498314 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189396
1#0##0#0#0.0#2018-07-02 16:39:44#0#00:00:00#00:00:00#00:00:00 1
f39900748d06eb07ab6e0ce96b105d29 0 9792600 3152072 0 0
1335679 0 0 0 0 1276000 0 0 0 0
3069000
3201126 B 3 BS 1 12/06/2018 13/06/2018 17/04/1962 0 2
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 2043273 0 2 0 0 0 SUKATMI NY D400690
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190208
1#0##0#0#0.0#2018-07-02 16:40:43#0#15:36:27#15:36:27#00:00:00 1
c542ee6caed4448e58f7e302456c341e 0 0 674855 0 0 682746
0 0 0 0 685672 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 13/06/2018 21/02/1954 0 2
1 I63.9;E11.8;G81.9 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 4303635 0 3 0 0 0 SRI SUPRAPTI
D096535 64 23486 DR HARDI PRANATA SPS 0138r0170618v003358
0001258403016 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189557
1#0##0#0#0.0#2018-07-02 16:42:00#0#14:19:11#14:19:11#00:00:00 1
296262900899c95db4f37aafd99f83da 0 0 923597 0 0 729492
0 0 0 0 2650546 0 0 0 0 0
3201126 B 2 BS 1 12/06/2018 13/06/2018 14/05/1972 0 1
(RINGAN) 5378800 0 0 - 0 - 0 - 0 - 0
5378800 2173702 0 2 0 0 0 M SURYA D400704
3;JKN DR RIZKI; 5.2.2.201806040537 4 190237 1#0##0#0#0.0#2018-
07-04 08:37:31#0#17:48:24#17:48:24#00:00:00 1
03e2b51eaa7789a1956da41403b2d6dc 0 0 537092 0 0 665905
0 0 0 0 970705 0 0 0 0 0
3201126 B 2 BS 1 10/06/2018 13/06/2018 07/07/1983 0 2
0 - 0 - 0 - 0 - 0 4290800 4198996
0 4 0 0 0 RINAH YULIANAH D397435 34 12757 DR
S;16137 5.2.2.201806040537 4 189121 1#0##0#0#0.0#2018-08-04
12:58:43#0#00:00:00#00:00:00#00:00:00 2 772da4f4cf750678444407108681fadf
0 0 426023 0 0 1452272 0 0 0 0
2320701 0 0 0 0 0
3201126 B 2 BS 1 11/06/2018 13/06/2018 28/01/2006 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2825444 0 3 0 0 0 MUHAMMAD IKHSAN MUAFA
0001266482496 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 189707
1#0##0#0#0.0#2018-08-04 13:00:38#0#17:35:36#17:35:36#00:00:00 2
4b7b4649d659661629087dd2ed507498 0 0 154620 0 0
1152482 0 0 0 0 1518342 0 0 0 0 0
3201126 B 3 BS 1 12/06/2018 13/06/2018 01/07/1964 0 1
- 0 36446400 37272840 0 2 0 0 0 MUHAMAD
YASIN D392297 53 19704 DR AZRI NURIZAL SPPD KKV 0138R0170618V003578
0001014237314 3;JKN irene; 5.2.2.201806040537 4 189722
1#0##0#0#0.0#2018-08-09 15:46:18#0#00:00:00#00:00:00#12:00:00 2
d9caa36d16afb75c3aecb8c77c91c65c 0 7996000 5144120 0 0
15406720 0 0 0 0 1226000 0 0 0 0
7500000
3201126 B 2 BS 1 12/06/2018 13/06/2018 06/03/1968 0 1
- 0 41590500 60191783 0 2 0 0 0 MARTONO M
HULALO D400464 50 18360 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170618V003566 0002444222485 3;JKN irene; 5.2.2.201806040537
4 189721 1#0##0#0#0.0#2018-08-09
16:08:07#0#00:00:00#00:00:00#00:00:00 2 c8c51fb3d4f94adb628b9e8a6af69b39
0 8986000 8244960 0 0 34115823 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 2 BS 1 12/06/2018 13/06/2018 02/10/1961 0 2
1 I12.0;E14.9 39.27;39.95 - - None None None None N-1-12-I
- 0 5208600 10889225 0 2 0 0 0 ETTY
PURWANINGSIH D399799 56 20707 DEDY PRATAMA,SPBV 0138R0170618V003509
0000173829947 3;JKN DR RIZKI; 5.2.2.201806040537 4 189720
1#0##0#0#0.0#2018-09-06 13:48:30#0#00:00:00#00:00:00#00:00:00 2
a322ce4f733445a969fb84a663bf3827 0 4911100 2138100 0 0
1826396 0 0 0 0 0 0 0 0 2013629 0
3201126 B 2 BS 1 12/06/2018 13/06/2018 20/05/1961 0 2
1 A01.0;J17.8;E14.9;K30 87.49;90.59;89.52 - - None None None
None A-4-14-III None None None None None None PENYAKIT INFEKSI BAKTERI
DAN PARASIT LAIN-LAIN (BERAT) 3965700 0 0 - 0 - 0 -
0 - 0 3965700 2120917 0 2 0 0 0 SRI
MARYATI D400691 57 20842 SRI KUNMARTINI.DR,SPPD 0138R0170618V003809
0001467506957 3;JKN DR RIZKI; 5.2.2.201806040537 4 190242
1#0##0#0#0.0#2018-09-06 13:53:39#0#19:00:38#19:00:38#00:00:00 3
d11032cbbaaa070e957749bf2c40aeb1 0 0 746333 0 0 407332
0 0 0 0 967252 0 0 0 0 0
3201126 B 2 BS 1 10/06/2018 13/06/2018 12/04/1952 0 1
1 N18.5;T82.4;J40;D63.8;I10;E11.9 99.17;39.27;87.44;99.04 - -
None None None None N-1-12-III None None None None None None
MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (BERAT) 23198900
0 0 - 0 - 0 - 0 - 0 23198900
14302557 0 4 0 0 0 LAMRI BIN UKON ATMADJA D329026
0000042985258 3;JKN DR RIZKI; 5.2.2.201806040537 4 189115
1#0##0#0#0.0#2018-09-06 15:16:52#0#20:54:22#20:54:22#00:00:00 4
19336398d94007e966d9432a1f9e4949 0 0 5036096 0 4703600
3482180 0 0 0 0 1011681 0 0 69000 0 0
3201126 B 2 BS 1 06/06/2018 13/06/2018 24/09/1961 0 1
9351000 0 0 - 0 - 0 - 0 - 0
9351000 18835241 0 8 0 0 0 MARYANTO D400271
3;JKN DR RIZKI; 5.2.2.201806040537 4 187873 1#0##0#0#0.0#2018-
09-06 15:18:38#0#10:32:14#10:32:14#00:00:00 2
03c2f6c60e953dec68191865b8700a75 0 7401100 5276393 0 0
4832748 0 0 0 0 1256000 0 0 0 0 69000
3201126 B 2 BS 1 10/06/2018 13/06/2018 07/07/1960 0 2
- 0 3584400 5585841 0 4 0 0 0 YUSTINA
0001256800713 3;JKN DR RIZKI; 5.2.2.201806040537 4 189113
1#0##0#0#0.0#2018-09-06 16:40:49#0#00:00:00#00:00:00#12:00:00 2
bd728596013fdee0ff8f148db3e9f7bf 0 0 375596 0 0
2778816 0 0 0 0 2431429 0 0 0 0 0
3201126 B 3 BS 1 13/06/2018 13/06/2018 23/03/2018 0 1
1 A41.9;E87.2 96.71 - - None None None None J-1-20-II None
None None None None None PROSEDUR SISTEM PERNAFASAN NON-KOMPLEKS
(SEDANG) 18868400 0 0 - 0 - 0 - 0 - 0
18868400 13895172 0 1 0 0 0 AZKA RAFFASYAH ACHMAD
0002442698201 3;JKN irene; 5.2.2.201806040537 4 190247
1#0##0#0#0.0#2018-09-10 13:51:13#0#02:08:06#02:08:06#00:00:00 2
cda8605d708c984faf66938fab059a84 0 0 943420 0 0
5824722 0 0 0 0 6216030 0 0 0 0 911000
3201126 B 1 BS 1 22/05/2018 13/06/2018 22/05/2018 1558 2
1 P07.1;P71.0 99.05;99.83 - - None None None None P-8-12-III
PROSEDUR MAYOR (BERAT) 21791800 0 0 - 0 - 0 - 0
- 0 21791800 38253185 0 23 1 2 0 BAYI NY
ANNISA UKHTI MUSLIMAH d399237 0 0 DR KHARINA CHATAR SPA
0138R0170518V008018 0002461194246 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 183555 1#0##0#0#0.0#2018-10-02
17:55:33#0#14:04:30#14:04:30#00:00:00 2 559108fbc26c995dd33573f3e37ea7a8
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DR ZULFAN, SPPD 0138R0170618V003195 0000042249745 3;JKN
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10:56:44#0#10:18:18#10:18:18#00:00:00 1 15a27c036659cd2ac83a50818d06593d
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1#0##0#0#0.0#2018-07-02 15:02:24#0#00:00:00#00:00:00#00:00:00 1
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1#0##0#0#0.0#2018-07-02 16:29:15#0#23:00:16#23:00:16#12:00:00 1
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18:32:31#0#00:00:00#00:00:00#00:00:00 1 c044d3acd7043cda22779eb78954ae3d
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10:54:05#0#17:10:09#17:10:09#00:00:00 1 b94bae1e0f243a0888a66fe44b51d081
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0138R0170618V004376 0001014416537 3;JKN DR RIZKI; 5.2.2.201806040537
4 190839 1#0##0#0#0.0#2018-06-28
11:09:40#0#17:31:46#17:31:46#00:00:00 1 b70901d32465f8de8af8c257ed3e8446
0 3525300 4074139 0 0 4233341 0 0 0 0
893045 0 0 0 0 69000
3201126 B 1 BS 1 12/06/2018 16/06/2018 10/01/1970 0 1
1 I11.0;I48;J22 87.44;93.94;89.52 - - None None None None
5802600 0 0 - 0 - 0 - 0 - 0
5802600 4782122 0 5 0 0 0 AMIR MAHMUD MAKKA
0001628178568 3;JKN DR RIZKI; 5.2.2.201806040537 4 190233
1#0##0#0#0.0#2018-06-28 11:18:17#0#00:00:00#00:00:00#00:00:00 1
186579d55871b40bde50158147191dfb 0 0 575233 0 0
2553040 0 0 0 0 1653849 0 0 0 0 0
3201126 B 1 BS 1 14/06/2018 16/06/2018 05/12/2016 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4154556 0 3 0 0 0 ALI HELMY D378964
1 556 KRISTYANINGESTI,DR.SPA 0138R0170618V004146 0002239636781
3;JKN DR RIZKI; 5.2.2.201806040537 4 190642 1#0##0#0#0.0#2018-
07-02 15:05:20#0#00:00:00#00:00:00#12:00:00 1
6957201524d969d1458a2582db6edbed 0 0 316331 0 0
1027432 0 0 0 0 2640793 0 0 0 0 170000
3201126 B 3 BS 1 16/06/2018 16/06/2018 14/07/1939 0 1
4 I67.9;R57.2 99.60 - - None None None None G-4-26-I None
(RINGAN) 3587300 0 0 - 0 - 0 - 0 - 0
3587300 2855900 0 1 0 0 0 ISHAQ HASAN D400899
0000061017456 3;JKN DR RIZKI; 5.2.2.201806040537 4 190869
1#0##0#0#0.0#2018-07-03 08:39:59#0#10:58:47#10:58:47#00:00:00 2
265ca89ee9cf61ce50d287adbdc96b08 0 0 345475 0 0
1276590 0 0 0 0 475835 0 0 758000 0
0
3201126 B 3 BS 1 15/06/2018 16/06/2018 22/02/1944 0 2
2 A09.9;R57.0;R57.1 99.60 - - None None None None K-4-17-III
(BERAT) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 4027096 0 2 0 0 0 MUNARSIH NY D400892
DR RIZKI; 5.2.2.201806040537 4 190859 1#0##0#0#0.0#2018-07-03
09:05:26#0#21:28:57#21:28:57#00:00:00 1 adc212af96150aaf3cfdaa283d0496ef
0 0 199980 0 0 2540661 0 0 0 0 570455
0 0 716000 0 0
3201126 B 3 BS 1 15/06/2018 16/06/2018 09/05/1965 0 1
1 R07.4 89.52 - - None None None None I-4-20-I None None
0 0 - 0 - 0 - 0 - 0 4202600
1216198 0 2 0 0 0 DARYOTO D391777 53 19395
DR LIDYA SANTALIA 0138R0170618V004460 0001634406322 3;JKN DR RIZKI;
5.2.2.201806040537 4 190861 1#0##0#0#0.0#2018-07-03
09:46:19#0#22:51:19#22:51:19#12:00:00 1 d07528fd3b12973af8549f96cd40f8eb
0 0 210130 0 0 201504 0 0 0 0 386564
0 0 418000 0 0
3201126 B 3 BS 1 15/06/2018 16/06/2018 10/05/1948 0 1
0 0 - 0 - 0 - 0 - 0 3688800
2632369 0 2 0 0 0 SAKIM D369625 70 25603 DR
ADRIAN HANDARU 0138R0170618V004448 0000061038426 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 190858 1#0##0#0#0.0#2018-08-04
14:30:10#0#00:00:00#00:00:00#00:00:00 2 51bde0ab511a55cac0ef4e9738ae0e00
0 0 184440 0 0 1252718 0 0 0 0 479211
0 0 716000 0 0
3201126 B 3 BS 1 13/06/2018 16/06/2018 30/12/1999 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1797065 0 4 0 0 0 DELFIN MALVES LOEN
0000510931866 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190638
1#0##0#0#0.0#2018-08-04 14:31:40#0#00:00:00#00:00:00#00:00:00 2
58a7d6378ba08da098158d033131f94e 0 0 257183 0 0 433621
0 0 0 0 1106261 0 0 0 0 0
3201126 B 3 BS 1 15/06/2018 16/06/2018 24/04/2006 0 1
4 A17.0 - - - None None None None G-4-18-I None None
None None None None INFEKSI BAKTERI SISTEM SARAF (RINGAN) 4429400
0 0 - 0 - 0 - 0 - 0 4429400
6544408 0 2 1 2 0 APRIANSYAH AN D400875 12
4435 DR NOVIK BUDIWARDHANA, SPA 0138R0170618V004429 0000511024511
3;JKN irene; 5.2.2.201806040537 4 190852 1#0##0#0#0.0#2018-
08-09 15:48:00#0#00:00:00#00:00:00#00:00:00 2
1155050c04b937ea9a48c5e796c0d251 0 0 276263 0 0
2988006 0 0 0 0 2522139 0 0 758000 0
0
3201126 B 3 BS 1 25/05/2018 16/06/2018 25/05/2018 1896 2
1 P07.3;P07.1;P22.0 96.72 - - None None None None P-8-05-III
DENGAN PROSEDUR MAYOR (BERAT) 40034400 0 0 - 0 - 0 -
0 - 0 40034400 47474292 0 23 1 7 0 DIANA
BY NY D399473 0 0 DR AULIA TANGKARI, SPA 0138R0170518V009382
0002462258305 3;JKN irene; 5.2.2.201806040537 4 184869
1#0##0#0#0.0#2018-08-09 15:48:20#0#10:22:45#10:22:45#00:00:00 2
66d8727de0f49e591a1da1a116cfb5f5 0 0 1982716 0 0
12607576 0 0 0 0 18953000 0 0 0 13931000
0
3201126 B 2 BS 1 15/06/2018 17/06/2018 04/12/1958 0 2
1 E11.9;E16.2;E66.9 - - - None None None None E-4-10-I
0 - 0 4203300 3425509 0 3 0 0 0
CHAIRANNUR NASUTION D315538 59 21743 DR DHARMAWAN, SPPD
0138R0170618V004439 0001458232942 3;JKN DR RIZKI; 5.2.2.201806040537
4 190856 1#0##0#0#0.0#2018-06-28
08:59:30#0#00:00:00#00:00:00#00:00:00 1 c8ed1f60bab5f80a0b9487cc636fce3f
0 0 592710 0 0 1275200 0 0 0 0
1557599 0 0 0 0 0
3201126 B 3 BS 1 15/06/2018 17/06/2018 20/04/1946 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8313804 0 3 0 0 0 WONG JOENG KUAN
0001379938307 3;JKN DR RIZKI; 5.2.2.201806040537 4 190849
1#0##0#0#0.0#2018-06-28 10:10:28#0#10:31:10#10:31:10#00:00:00 1
f65c6344052b8ac5c3e073494f832c46 0 0 1906030 0 0
2107080 0 0 0 0 4231694 0 0 0 0 69000
3201126 B 1 BS 1 12/06/2018 17/06/2018 01/09/1967 0 1
1 I62.0;E11.9;G93.4 87.03;87.44 - - None None None None G-4-
TRAUMATIK (BERAT) 8556600 0 0 - 0 - 0 - 0 -
0 8556600 21559506 0 6 0 0 0 ISTIANTO
D400667 50 18547 DR ARNANDA SPBS 0138R0170618V003583
0000042043781 3;JKN DR RIZKI; 5.2.2.201806040537 4 189724
1#0##0#0#0.0#2018-07-02 14:59:28#0#00:00:00#00:00:00#00:00:00 1
6883fa1f00a64335abb8f9b7ddb0258b 0 0 823094 0 0
11944412 0 0 0 0 6280000 0 2512000 0 0
0
3201126 B 2 BS 1 16/06/2018 17/06/2018 26/01/1986 0 2
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 4841389 0 2 0 0 0 FRIDA AULIANTI
0001740138568 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190874
1#0##0#0#0.0#2018-08-04 14:27:58#0#15:44:52#15:44:52#00:00:00 2
78c1a8411869bcc252b741503604413d 0 0 878996 0 0 651167
0 0 0 0 3276726 0 0 34500 0 0
3201126 B 1 BS 1 13/06/2018 17/06/2018 05/12/2017 0 2
2405100 0 0 - 0 - 0 - 0 - 0
0002317789326 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190641
1#0##0#0#0.0#2018-08-04 14:33:01#0#00:00:00#00:00:00#12:00:00 2
84f9668cd705eca74d11f07faec32a03 0 0 385570 0 0 538745
0 0 0 0 3508222 0 0 340000 0 0
3201126 B 1 BS 1 02/06/2018 17/06/2018 04/02/1940 0 1
1 I95.9;J90;I50.0;A41.9 87.03;88.76;89.52;90.59 - - None None
- 0 - 0 11395800 62128573 0 16 1 8 0
DJOKO WINARDI,H D350675 78 28608 DR CELLY ANANTARIA. SPJP
0138R0170618V000167 0000060578201 3;JKN irene; 5.2.2.201806040537
4 186258 1#1#vvip#16#50732773#0.0#2018-08-11
11:53:15#0#00:00:00#00:00:00#00:00:00 2 d255e466f614a56757ded7c4ec4111d7
0 0 5199000 0 0 27039579 0 0 0 0
18288000 0 0 0 11601994 0
3201126 B 3 BS 1 17/06/2018 17/06/2018 04/02/1951 0 1
2 E16.2;R57.1;C18.9;E87.5 99.60 - - None None None None E-4-
0 - 0 6262900 4092857 0 1 0 0 0
SUTRISNO TN D341056 67 24605 DR MUHAMMAD RIZKI YUWANA
0138R0170618V004576 0000061051252 3;JKN DR RIZKI; 5.2.2.201806040537
4 190891 1#0##0#0#0.0#2018-09-06
15:55:07#0#04:40:10#04:40:10#00:00:00 2 005f0a3b3d384bc39a203510fc23b28b
0 0 406990 0 0 2072110 0 0 0 0 574757
0 0 1039000 0 0
3201126 B 3 BS 1 17/06/2018 17/06/2018 31/12/1957 0 2
- 0 - 0 19332400 6316604 0 1 0 0 0
AINUN D395910 60 22083 DR SRI KUNMARTINI, SPPD 0138R0170618V004566
0001298342362 3;JKN DR RIZKI; 5.2.2.201806040537 4 190888
1#0##0#0#0.0#2018-09-06 15:57:32#0#00:12:25#00:12:25#00:00:00 2
31a29a94bc8c4c085097a248bfab4c09 0 0 4074139 0 0
1490229 0 0 0 0 752236 0 0 0 0 0
3201126 B 3 BS 1 16/06/2018 17/06/2018 03/03/1951 0 2
3 C50.9;R57.2;A41.9 - - - None None None None L-4-11-III
None None None None None None TUMOR PAYUDARA (BERAT) 11526100 0
0 - 0 - 0 - 0 - 0 11526100 2434948
0 2 0 0 0 HADIDJAH D400930 67 24577 DR MUHAMMAD
RIZKI YUWANA 0138R0170618V004554 0001209723895 3;JKN DR RIZKI;
5.2.2.201806040537 4 190882 1#0##0#0#0.0#2018-09-06
15:59:14#0#21:07:54#21:07:54#00:00:00 2 4437f6a6b174d373184b14d023fa67a5
0 0 406990 0 0 1066662 0 0 0 0 466296
0 0 495000 0 0
3201126 B 2 BS 1 14/06/2018 18/06/2018 02/11/1960 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 5733168 0 5 0 0 0 YATI d400846 57
21043 DR DHARMAWAN, SPPD 0138R0170618V004387 0000037041456 3;JKN
DR RIZKI; 5.2.2.201806040537 4 190841 1#0##0#0#0.0#2018-06-28
08:34:44#0#19:16:08#19:16:08#00:00:00 1 18cc87bf5515edc36c249bf91731a453
0 0 278711 0 0 2735890 0 0 0 0
2718567 0 0 0 0 0
3201126 B 2 BS 1 16/06/2018 18/06/2018 10/08/1973 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2592132 0 3 0 0 0 GIYANTO D400916
3;JKN DR RIZKI; 5.2.2.201806040537 4 190877 1#0##0#0#0.0#2018-
06-28 08:37:57#0#17:08:00#17:08:00#00:00:00 1
361c3f14b32f6c1cd0101e651b0401ff 0 0 278711 0 0 602842
0 0 0 0 1710579 0 0 0 0 0
3201126 B 1 BS 1 16/06/2018 18/06/2018 28/09/1981 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12386313 0 3 0 0 0 MAEGA HARTINI
0001791633892 3;JKN DR RIZKI; 5.2.2.201806040537 4 190875
1#0##0#0#0.0#2018-06-28 09:21:47#0#16:17:28#16:17:28#00:00:00 2
866151491c65cbac6e3fed45ab056a60 0 7098900 2489710 0 0
1679383 0 0 0 0 921320 0 0 0 0 197000
3201126 B 1 BS 1 18/06/2018 18/06/2018 31/10/1977 0 2
- 0 - 0 - 0 - 0 3103000 3249637 0
5.2.2.201806040537 4 191213 1#0##0#0#0.0#2018-06-28
09:22:47#0#00:00:00#00:00:00#12:00:00 1 99f3f0e847eb4f8b9a3a1b4b45697cc2
0 0 620600 0 0 1609444 0 0 0 0
1019593 0 0 0 0 0
3201126 B 1 BS 1 11/06/2018 18/06/2018 08/11/1944 0 1
1 I63.9;I11.9;E11.5 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 18970474 0 8 0 0 0 SUDJADI
PURWOSAPUTRO D372988 73 26878 DR NURUL KOMARI SPS
0138R0170618V003193 0000060974921 3;JKN DR RIZKI; 5.2.2.201806040537
4 189337 1#0##0#0#0.0#2018-06-28
09:28:40#0#00:00:00#00:00:00#12:00:00 1 be9bd046d38d9619e88ac1f844d76382
0 10200000 1838398 0 0 5219176 0 0 0 0
1226000 0 0 0 0 486900
3201126 B 1 BS 1 15/06/2018 18/06/2018 11/10/1977 0 1
1 K56.7;K91.4 - - - None None None None K-4-15-II None
None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL (SEDANG)
5711300 0 0 - 0 - 0 - 0 - 0
5711300 7858265 0 4 0 0 0 SUKMO HADI D128658
40 14857 DR DHARMAWAN, SPPD 0138R0170618V004420 0001634026803
3;JKN DR RIZKI; 5.2.2.201806040537 4 190848 1#0##0#0#0.0#2018-
06-28 09:39:47#0#00:00:00#00:00:00#00:00:00 1
1ef2ce5531a6cf66033b2ed40ac54ee7 0 0 620621 0 0
3233552 0 0 0 0 3664092 0 0 0 0 340000
3201126 B 1 BS 1 14/06/2018 18/06/2018 24/08/1970 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 7488376 0 5 0 0 0 ADE DEWI D400838
3;JKN DR RIZKI; 5.2.2.201806040537 4 190837 1#0##0#0#0.0#2018-
06-28 09:42:57#0#00:00:00#00:00:00#00:00:00 2
b4d869f8dfcc23bf2e241bcf36a95370 0 0 316331 0 0
2759562 0 0 0 0 4412483 0 0 0 0 0
3201126 B 3 BS 1 18/06/2018 18/06/2018 14/05/1970 0 2
- 0 - 0 - 0 - 0 2216400 9552571 0
5.2.2.201806040537 4 190998 1#0##0#0#0.0#2018-06-28
10:29:34#0#00:00:00#00:00:00#12:00:00 1 ce6d8a18837cc09a308b62b3909e30b8
0 0 443280 0 0 8195356 0 0 0 0 913935
0 0 0 0 0
3201126 B 3 BS 1 17/06/2018 18/06/2018 31/12/1969 0 1
- 0 8908800 8077475 0 2 0 0 0 MAD
KOMARUDIN PAIMIN D400674 48 17700 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V004602 0001212907601 3;JKN DR RIZKI; 5.2.2.201806040537
4 190896 1#0##0#0#0.0#2018-06-28
10:35:44#0#00:00:00#00:00:00#00:00:00 1 0b3da90800f84a7fc81093d098204ec3
0 3438800 1870848 0 0 2213394 0 0 0 0
554433 0 0 0 0 0
3201126 B 3 BS 1 17/06/2018 18/06/2018 15/10/1981 0 2
1 D64.9;A49.9 99.04 - - None None None None D-4-13-I None
- 0 2987000 2659048 0 2 0 0 0 RISMAWATI. R
0001728092553 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190889
1#0##0#0#0.0#2018-07-02 11:21:27#0#02:58:24#02:58:24#00:00:00 1
0df01cf7dcfdf75f86f28f1e789e307a 0 0 321830 0 0
1611262 0 0 0 0 725956 0 0 0 0 0
3201126 B 3 BS 1 17/06/2018 18/06/2018 27/08/1972 0 1
- 0 8908800 10304691 0 2 0 0 0 SLAMET
HADIANTO D400957 45 16730 SRI KUNMARTINI.DR,SPPD 0138R0170618V004637
0001453962205 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190902
1#0##0#0#0.0#2018-07-02 11:23:53#0#00:00:00#00:00:00#00:00:00 1
f5d2fcf38fe52800c809c79c7e71bf69 0 3062500 1887760 0 0
4535292 0 0 0 0 750139 0 0 0 0 69000
3201126 B 1 BS 1 16/06/2018 18/06/2018 02/08/1957 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3278528 0 3 0 0 0 SUYATMI d240233
0001836076836 3;JKN DR RIZKI; 5.2.2.201806040537 4 190870
1#0##0#0#0.0#2018-07-02 15:01:17#0#00:00:00#00:00:00#00:00:00 1
e164149ef889a851c4f3aacd241034a1 0 0 338858 0 0 356187
0 0 0 0 2583483 0 0 0 0 0
3201126 B 1 BS 1 16/06/2018 18/06/2018 21/03/2017 0 1
1 B34.9;A90 - - - None None None None A-4-13-II None
3734400 0 0 - 0 - 0 - 0 - 0
3734400 3935481 0 3 0 0 0 MUHAMMAD DANESH PRADHIKA
ELHAFIY D400908 1 452 DR AULIA TANGKARI, SPA 0138R0170618V004499
0002233408015 3;JKN DR RIZKI; 5.2.2.201806040537 4 190871
1#0##0#0#0.0#2018-07-03 10:53:26#0#00:00:00#00:00:00#00:00:00 1
621be1a11d19908cebfe9590d4f23d02 0 0 389096 0 0 579924
0 0 0 0 2626461 0 0 0 0 340000
3201126 B 3 BS 1 17/06/2018 18/06/2018 08/06/1976 0 1
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1068134 0 2 0 0 0 RAMDANI D400973
3;JKN DR RIZKI; 5.2.2.201806040537 4 191055 1#0##0#0#0.0#2018-
07-03 15:06:06#0#11:33:25#11:33:25#00:00:00 1
2055153f174cd3b97e81576a4c77cc5c 0 0 122575 0 0 586681
0 0 0 0 358878 0 0 0 0 0
3201126 B 3 BS 1 08/06/2018 18/06/2018 23/06/1959 0 1
1 A41.9;N18.5;J18.9 96.72 - - None None None None J-1-02-III
- 0 66331600 56218536 0 11 1 4 72 SUTARDI
D340291* 58 21535 DR SRI KUNMARTINI, SPPD 0138R0170618V002601
0001089737561 3;JKN DR RIZKI; 5.2.2.201806040537 4 188773
1#0##0#0#0.0#2018-07-04 11:17:32#0#00:00:00#00:00:00#12:00:00 1
b0a97a589453fd1849784f96f1ce96ae 0 0 6887158 0 0
25145378 0 0 0 0 13779000 0 0 0 0
10407000
3201126 B 2 BS 1 08/06/2018 18/06/2018 18/01/2018 0 1
1 G04.2;E87.5 - - - None None None None G-4-18-II None
None None None None None INFEKSI BAKTERI SISTEM SARAF (SEDANG)
7105000 0 0 - 0 - 0 - 0 - 0
7105000 22026962 0 11 0 0 0 MUHAMMAD NUR AZHARI
0002421534993 3;JKN DR RIZKI; 5.2.2.201806040537 4 188842
1#0##0#0#0.0#2018-08-04 11:38:22#0#00:00:00#00:00:00#00:00:00 1
1cd669decb57e1a8d04a0a26bc13f935 1000000 0 481218 0 0
7703744 0 0 0 0 7751000 0 0 0 5091000
0
3201126 B 2 BS 1 17/06/2018 18/06/2018 14/08/1973 0 2
- 0 10690500 10415676 0 2 0 0 0 CUCUM
0001723946938 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190910
1#0##0#0#0.0#2018-08-04 14:24:55#0#00:00:00#00:00:00#00:00:00 2
8e4d905092b45bf06a865aec52e013e3 0 4911100 2276640 0 0
2520537 0 0 0 0 707399 0 0 0 0 0
3201126 B 3 BS 1 11/06/2018 18/06/2018 12/10/1946 0 2
1 J22;I50.0;E14.9 87.44;87.03 - - None None None None J-4-
0 - 0 4508300 14980926 0 8 0 0 0 ONGENG
TJENG D367737 71 26175 DR LIDYA SANTALIA 0138R0170618V003261
0001458680376 3;JKN irene; 5.2.2.201806040537 4 189479
1#1#vvip#8#10472626#0.0#2018-08-09 15:48:41#0#00:00:00#00:00:00#12:00:00
3 82b0a529f91973cd26ee38e46ff27d4f 0 0 1279436 0 0
3517429 0 0 0 0 9178000 0 0 0 1006061
0
3201126 B 2 BS 1 18/06/2018 18/06/2018 05/07/1974 0 2
1 A41.9;N18.5;D63.8;I10;K30 99.04;38.95;99.21 - - None None
- 0 - 0 - 0 10690500 19386245 0 1 0
0 0 KARTINI D062831 43 16054 DR SRI KUMARTINI
0138R0170618V004834 0001258749393 3;JKN irene; 5.2.2.201806040537
4 191088 1#0##0#0#0.0#2018-08-09
16:10:16#0#13:15:04#13:15:04#00:00:00 2 0478ede8ad29e5d04e87086d57c2753f
0 5629100 4878371 0 0 6082524 0 0 0 0
2727250 0 0 0 69000 0
3201126 B 1 BS 1 03/06/2018 18/06/2018 22/09/2014 0 1
1 D64.9;E42;R77.0;Q43.1;R18 99.04;99.09 - - None None None
None D-4-13-III None None None None None None GANGGUAN SEL DARAH MERAH
0 - 0 - 0 7570100 26999996 0 16 0 0
0 CALLISTA BELLVANIA ACHMAD D303757 3 1350 DR AULIA TANGKARI,
5.2.2.201806040537 4 186305 1#0##0#0#0.0#2018-10-02
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3390900
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- 0 - 0 19332400 13638388 0 2 0 0 0
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4 191748 1#0##0#0#0.0#2018-08-09
16:04:09#0#17:44:55#17:44:55#00:00:00 3 cd7b314cf3f21fdf6da2132a8f6f2eab
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16:14:54#0#12:55:10#12:55:10#00:00:00 2 4c4481ee74dc307b6d28e839a263ce6a
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17:49:29#0#00:00:00#00:00:00#00:00:00 2 2f46eec4f5f300a32a3082aeb63e6d83
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1#0##0#0#0.0#2018-10-04 07:50:03#0#00:00:00#00:00:00#00:00:00 3
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3201126 B 3 BS 1 18/06/2018 20/06/2018 18/06/2018 2597 2
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1#0##0#0#0.0#2018-06-30 12:33:15#0#00:00:00#00:00:00#00:00:00 1
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2538800 2903568 0 3 0 0 0 SATRYO GALANG BHUANA
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1#0##0#0#0.0#2018-06-30 13:57:54#0#00:00:00#00:00:00#00:00:00 1
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0
3201126 B 2 BS 1 20/06/2018 20/06/2018 22/04/1967 0 1
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09:00:27#0#00:00:00#00:00:00#00:00:00 1 0492f98052a6d0f7ac549acffc76b59a
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3201126 B 3 BS 1 18/06/2018 20/06/2018 15/02/1980 0 2
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SPPD-KKV 0138R0170618V004875 0000508770415 3;JKN DR RIZKI;
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10:00:43#0#00:00:00#00:00:00#00:00:00 1 36b6dd0eb289a9edea363bc6f77af59f
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3201126 B 3 BS 1 16/06/2018 20/06/2018 07/02/1957 0 2
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- 0 4894400 8697767 0 5 0 0 0 ENDANG
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10:03:05#0#00:00:00#00:00:00#00:00:00 1 26958db6cb4a9b98fc7a8f371c38a949
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4 191282 1#0##0#0#0.0#2018-07-03
10:04:56#0#09:02:42#09:02:42#00:00:00 1 c2a21fefabecb5a268779b3fcc4f9358
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07-03 10:09:19#0#11:10:00#11:10:00#00:00:00 1
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1#0##0#0#0.0#2018-07-03 10:13:59#0#09:10:36#09:10:36#00:00:00 1
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4 191216 1#0##0#0#0.0#2018-07-03
10:20:37#0#00:00:00#00:00:00#00:00:00 1 ad894dec2f9b1e234b30d0e1c6373ca4
0 4615400 1513036 0 0 1413993 0 0 0 0
592720 0 0 0 0 69000
3201126 B 2 BS 1 19/06/2018 20/06/2018 09/05/1942 0 1
- 0 51950600 59503290 0 2 0 0 0 TUKIYAR
0138R0170618V005061 0000060700803 3;JKN DR RIZKI; 5.2.2.201806040537
4 191238 1#0##0#0#0.0#2018-07-03
10:26:58#0#08:29:08#08:29:08#00:00:00 1 491c9a8cbf6d7f082b9f2459063f165b
0 8986000 8244960 0 0 33418330 0 0 0 0
1226000 0 0 0 0 7628000
3201126 B 2 BS 1 17/06/2018 20/06/2018 10/05/1948 0 2
1 I64;R45.3;E14.9 87.44;87.03 - - None None None None G-4-
- 0 - 0 - 0 - 0 4915400 5031900 0
4 0 0 0 ROMLAH .ALI M. D383259 70 25605 DR HARDI
PRANATA SPS 0138R0170618V004669 0002071625591 3;JKN DR RIZKI;
5.2.2.201806040537 4 190911 1#0##0#0#0.0#2018-07-03
10:32:35#0#00:00:00#00:00:00#00:00:00 1 87b6a236ed89696b0d9455c4d3c78622
0 0 594422 0 0 2269788 0 0 0 0
2167690 0 0 0 0 0
3201126 B 2 BS 1 16/06/2018 20/06/2018 13/12/2013 0 1
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(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 4123315 0 5 0 0 0 ZHAFRAN AL MA'SUM
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1#0##0#0#0.0#2018-07-03 10:33:39#0#17:58:01#17:58:01#00:00:00 1
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1#0##0#0#0.0#2018-07-03 10:37:30#0#00:09:55#00:09:55#00:00:00 2
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43144367 0 0 0 0 1226000 0 0 0 0
10174000
3201126 B 1 BS 1 16/06/2018 20/06/2018 06/10/1995 0 2
2925900 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-07-03 10:46:29#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 1 BS 1 13/06/2018 20/06/2018 08/01/1943 0 2
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0 8 0 0 0 NY. Z U L H E N I D400757 75 27550 DR
AGOES KOOSHARTORO SPPD 0138R0170618V004031 0000060775795 3;JKN DR RIZKI;
5.2.2.201806040537 4 190563 1#0##0#0#0.0#2018-07-03
10:49:36#0#00:00:00#00:00:00#00:00:00 1 bc35a6b3547126e29b724bb6fccce0d4
0 0 1063700 0 0 4687208 0 0 0 0
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3201126 B 1 BS 1 16/06/2018 20/06/2018 27/07/1947 0 2
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0 0 - 0 - 0 - 0 - 0 5005900
5669618 0 5 0 0 0 ROCHYATI, NY D302309 70
3;JKN DR RIZKI; 5.2.2.201806040537 4 190883 1#0##0#0#0.0#2018-
07-03 10:52:08#0#22:38:47#22:38:47#12:00:00 1
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1855462 0 0 0 0 3520910 0 0 0 0 0
3201126 B 1 BS 1 19/06/2018 20/06/2018 26/01/1958 0 2
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3349800 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-07-03 10:54:55#0#06:48:18#06:48:18#00:00:00 1
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3201126 B 1 BS 1 17/06/2018 20/06/2018 15/06/2016 0 1
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(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
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4 190918 1#0##0#0#0.0#2018-07-03
10:55:54#0#22:22:18#22:22:18#00:00:00 1 e85e232343222132da9e4a4e59516026
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3201126 B 1 BS 1 16/06/2018 20/06/2018 27/04/2010 0 2
2925900 0 0 - 0 - 0 - 0 - 0
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0001721488274 3;JKN DR RIZKI; 5.2.2.201806040537 4 190867
1#0##0#0#0.0#2018-07-03 11:00:52#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 18/06/2018 20/06/2018 05/06/1969 0 1
1 K56.7;K30 88.76;89.52;90.59 - - None None None None K-4-
15-I None None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190929
1#0##0#0#0.0#2018-08-04 13:19:36#0#04:08:43#04:08:43#00:00:00 2
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3201126 B 3 BS 1 18/06/2018 20/06/2018 11/05/1990 0 2
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TANTIYO S;16137 5.2.2.201806040537 4 190925 1#0##0#0#0.0#2018-
08-04 13:21:21#0#00:10:45#00:10:45#00:00:00 2
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3201126 B 2 BS 1 19/06/2018 20/06/2018 12/01/1964 0 2
- 0 10690500 9559463 0 2 0 0 0 SUNARTI,NY
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1#0##0#0#0.0#2018-08-09 15:22:04#0#00:00:00#00:00:00#00:00:00 3
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3201126 B 2 BS 1 15/06/2018 20/06/2018 17/03/1966 0 1
5039800 0 0 - 0 - 0 - 0 - 0
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3;JKN irene; 5.2.2.201806040537 4 190853 1#0##0#0#0.0#2018-
08-09 16:10:38#0#00:00:00#00:00:00#00:00:00 2
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5159705 0 0 0 0 3668138 0 0 0 0 0
3201126 B 1 BS 1 12/06/2018 20/06/2018 22/07/1942 0 1
1 N18.5;I63.9;D63.8;M51.1 87.03;87.44 - - None None None None
- 0 8508800 16281120 0 9 0 0 0 NURHARYONO
0001257881196 3;JKN irene; 5.2.2.201806040537 4 190244
1#0##0#0#0.0#2018-08-11 11:56:22#0#20:58:27#20:58:27#12:00:00 2
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4452830 0 0 0 0 11243370 0 0 0 0 0
3201126 B 1 BS 1 18/06/2018 20/06/2018 08/10/2013 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2855363 0 3 0 0 0 TREVOR LUCAS TOBING
D263399 4 1714 DR RASTRA, SPA 0138R0170618V004960
0001456316739 3;JKN irene; 5.2.2.201806040537 4 191210
1#0##0#0#0.0#2018-08-11 11:56:50#0#00:00:00#00:00:00#12:00:00 2
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3201126 B 1 BS 1 18/06/2018 20/06/2018 10/08/1934 0 1
5883600 0 0 - 0 - 0 - 0 - 0
5883600 6331814 0 3 0 0 0 SYAWAL HASSAN
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1#0##0#0#0.0#2018-08-11 11:57:59#0#00:00:00#00:00:00#12:00:00 2
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2158083 0 0 0 0 2343000 0 0 0 792131
0
3201126 B 2 BS 1 19/06/2018 20/06/2018 05/05/1958 0 1
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5.2.2.201806040537 4 191317 1#0##0#0#0.0#2018-10-03
14:15:47#0#09:24:38#09:24:38#00:00:00 2 5a8ab93d00931a6c92c15481424ac1af
0 0 1148308 0 0 1328185 0 0 0 0
5670882 0 0 0 0 3069000
3201126 B 3 BS 1 19/06/2018 21/06/2018 01/10/1995 0 2
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191226
1#0##0#0#0.0#2018-06-30 12:35:22#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 16/06/2018 21/06/2018 24/10/1948 0 2
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190866
1#0##0#0#0.0#2018-06-30 13:20:45#0#00:00:00#00:00:00#00:00:00 1
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0
3201126 B 2 BS 1 19/06/2018 21/06/2018 07/11/2010 0 2
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1#0##0#0#0.0#2018-07-02 09:04:53#0#13:27:17#13:27:17#00:00:00 1
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3201126 B 2 BS 1 18/06/2018 21/06/2018 23/03/1962 0 2
5039800 0 0 - 0 - 0 - 0 - 0
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0001459917325 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191015
1#0##0#0#0.0#2018-07-02 09:42:06#0#10:32:16#10:32:16#12:00:00 1
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0
3201126 B 2 BS 1 20/06/2018 21/06/2018 19/07/1984 0 2
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SERVIK (SEDANG) 3046400 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-07-02 13:24:09#0#14:13:53#14:13:53#00:00:00 1
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191045
1#0##0#0#0.0#2018-07-02 13:25:48#0#11:16:42#11:16:42#00:00:00 1
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3201126 B 2 BS 1 18/06/2018 21/06/2018 28/12/1962 0 1
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TANTIYO S;16137 5.2.2.201806040537 4 191031
1#1#vvip#4#6212680#0.0#2018-07-02 13:33:59#0#00:00:00#00:00:00#00:00:00
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3201126 B 2 BS 1 19/06/2018 21/06/2018 23/08/1963 0 2
1 K21.9;K76.0;I10 - - - None None None None K-4-12-II
0 0 - 0 - 0 - 0 - 0 4919200
2756350 0 3 0 0 0 AVECITHA MUTIARA S. D401108
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191746
1#0##0#0#0.0#2018-07-02 13:34:57#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1513822 0 0 0 0 0
3201126 B 1 BS 1 17/06/2018 21/06/2018 03/06/1999 0 1
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2925900 0 0 - 0 - 0 - 0 - 0
2925900 5292504 0 5 0 0 0 BASA AGENG SETRA
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1#0##0#0#0.0#2018-07-02 14:44:32#0#23:43:33#23:43:33#00:00:00 1
41617b4bfb96ea83dcf5786fde2ba2a8 0 0 316331 0 0
1479934 0 0 0 0 3496239 0 0 0 0 0
3201126 B 1 BS 1 19/06/2018 21/06/2018 09/01/2015 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
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d401074 3 1257 DR RASTRA, SPA 0138R0170618V005005
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1#0##0#0#0.0#2018-07-02 14:45:46#0#00:00:00#00:00:00#00:00:00 1
470476eacc6542e4b130c25fc21b9117 0 0 338858 0 0 677391
0 0 0 0 2605967 0 0 0 0 0
3201126 B 1 BS 1 18/06/2018 21/06/2018 24/01/2001 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5218738 0 4 0 0 0 KHOZIMAH AKBARI
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1#0##0#0#0.0#2018-07-02 14:47:46#0#00:00:00#00:00:00#00:00:00 1
b1f01c363c35a6f49ba66fd2fbf0d361 0 0 316331 0 0
1681994 0 0 0 0 2710413 0 0 0 0 510000
3201126 B 1 BS 1 18/06/2018 21/06/2018 19/09/1980 0 2
14456700 0 0 - 0 - 0 - 0 - 0
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13786 DR ARI KUSUMA JANUARTO, DR. SPOG 0138R0170618V004982
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1#0##0#0#0.0#2018-07-02 14:56:08#0#00:00:00#00:00:00#00:00:00 1
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3671111 0 0 0 0 1159108 0 0 0 0 69000
3201126 B 3 BS 1 20/06/2018 21/06/2018 28/08/1970 0 1
1 I13.1;J18.0;D63.8;A41.9 39.27;99.04;99.21 - - None None None
0 - 0 - 0 19332400 10862792 0 2 0 0
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4 192216 1#0##0#0#0.0#2018-07-03
09:43:44#0#00:00:00#00:00:00#00:00:00 2 aec13280116e1d6833c5223712e69e0c
0 3528800 4074139 0 0 2410745 0 0 0 0
780108 0 0 69000 0 0
3201126 B 2 BS 1 17/06/2018 21/06/2018 29/12/1994 0 2
2507900 0 0 - 0 - 0 - 0 - 0
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3;JKN irene; 5.2.2.201806040537 4 191045 1#0##0#0#0.0#2018-
07-03 12:44:30#0#11:16:42#11:16:42#00:00:00 2
2a6244743a3ed404d690218445f4135c 0 0 278711 0 0
1638180 0 0 0 0 2323402 0 0 0 0 0
3201126 B 1 BS 1 20/06/2018 21/06/2018 11/09/1955 0 2
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4 191766 1#0##0#0#0.0#2018-07-03
14:30:55#0#07:28:10#07:28:10#12:00:00 1 c74be36528d7ba7b2ad070a88fcc2d9a
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1276000 0 0 0 0 7569000
3201126 B 1 BS 1 19/06/2018 21/06/2018 14/11/1952 0 1
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0001454260825 3;JKN DR RIZKI; 5.2.2.201806040537 4 191562
1#0##0#0#0.0#2018-07-03 14:42:43#0#12:54:15#12:54:15#00:00:00 1
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3201126 B 1 BS 1 19/06/2018 21/06/2018 01/05/2000 0 1
INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-07-03 14:47:19#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 17/06/2018 21/06/2018 31/07/1955 0 1
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(SEDANG) 12841200 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.2.201806040537 4 190895 1#0##0#0#0.0#2018-
07-03 14:58:58#0#08:24:53#08:24:53#00:00:00 4
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5578089 0 0 0 0 1276000 0 0 0 0
3269000
3201126 B 2 BS 1 20/06/2018 21/06/2018 12/03/1951 0 2
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1#0##0#0#0.0#2018-07-03 15:30:45#0#08:53:52#08:53:52#12:00:00 1
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30690300 0 0 0 0 10262000 0 0 0 0
7569000
3201126 B 1 BS 1 18/06/2018 21/06/2018 26/06/1978 0 2
14456700 0 0 - 0 - 0 - 0 - 0
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14602 DR ANDI DHARMA, SPOG 0138R0170618V004717 0001635696786 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 190928 1#0##0#0#0.0#2018-
07-04 16:04:52#1#03:27:10#03:27:10#00:00:00 3
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3201126 B 3 BS 1 17/06/2018 21/06/2018 01/10/1963 0 1
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- 0 12841200 17506129 0 5 0 0 0 BACHTIAR
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1#0##0#0#0.0#2018-08-03 15:18:00#0#00:00:00#00:00:00#00:00:00 2
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4994077 0 0 0 0 5478800 0 0 0 1214261
0
3201126 B 3 BS 1 21/06/2018 21/06/2018 12/04/1953 0 1
- 0 - 0 - 0 - 0 4043000 893522 0
1 0 0 0 SUPARDI D401295 65 23811 DR DINI DANIATY
0138R0170618V006030 0000041824934 3;JKN DR RIZKI; 5.2.2.201806040537
4 192886 1#0##0#0#0.0#2018-08-04
09:09:21#0#15:29:52#15:29:52#00:00:00 2 7b6477a835f62b8df8cfb8e83591a81c
0 0 360965 0 0 185102 0 0 0 0 347455
0 0 0 0 0
3201126 B 2 BS 1 17/06/2018 21/06/2018 26/05/2017 0 1
1 M00.96;A16.1 - - - None None None None M-4-15-II
None None None None None None ARTRITIS SEPSIS (SEDANG) 5308600
0 0 - 0 - 0 - 0 - 0 5308600
10359479 0 5 0 0 0 ARSENIO SAKHA WAHYUDI D367329
3;JKN DR RIZKI; 5.2.2.201806040537 4 190903
1#1#vip#5#5529675#75.0#2018-08-04 09:27:36#0#00:00:00#00:00:00#12:00:00
3 da3b933976be92f5efe022a3eb5266a4 0 0 891266 0 0
2033490 0 0 0 0 7094723 0 0 0 0 340000
3201126 B 3 BS 1 18/06/2018 21/06/2018 23/12/1951 0 1
1 I63.9;R47.0 - - - None None None None G-4-14-II None
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 3479089 0 4 0 0 0 UUM RUMIDI D401017
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191121
1#0##0#0#0.0#2018-08-04 14:12:49#0#00:00:00#00:00:00#00:00:00 2
734d00eb0416786f6d3be60230915639 0 0 743950 0 0
1429535 0 0 0 0 1052000 0 0 0 253604
0
3201126 B 1 BS 1 17/06/2018 21/06/2018 13/07/1947 0 2
- 0 - 0 - 0 - 0 6844000 4940357 0
5 0 0 0 MUTIARA SILITONGA D032647 70 25907 DR HARDI
PRANATA SPS 0138R0170618V004699 0000060716979 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 190922 1#0##0#0#0.0#2018-08-04
14:23:49#0#23:26:32#23:26:32#00:00:00 2 d96e984ccc8b6e911229d50595d30ebb
0 0 684656 0 0 782500 0 0 0 0
3473201 0 0 0 0 0
3201126 B 3 BS 1 21/06/2018 21/06/2018 17/07/1948 0 1
0 0 - 0 - 0 - 0 - 0 3688800
2143893 0 1 0 0 0 M HUSNI ZEIN D401259 69
25541 DR ADITIA NATA KUSUMA 0138R0170618V005932 0001716191526 3;JKN
irene; 5.2.2.201806040537 4 192716 1#0##0#0#0.0#2018-08-09
15:49:18#0#12:04:57#12:04:57#00:00:00 2 b98cf32c7be2cea90fd0190254a3f593
0 0 113435 0 0 1601203 0 0 0 0 429255
0 0 0 0 0
3201126 B 2 BS 1 19/06/2018 21/06/2018 05/05/1979 0 1
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 6060066 0 3 0 0 0 NINING RUSTINI
0002437157665 3;JKN irene; 5.2.2.201806040537 4 191751
1#0##0#0#0.0#2018-09-10 13:52:27#0#00:00:00#00:00:00#00:00:00 3
6f7226b36fda76b00f6a2b889c567884 0 0 499265 0 0
2231598 0 0 0 0 1307500 0 0 0 2021703
0
3201126 B 1 BS 1 20/06/2018 22/06/2018 09/10/1948 0 1
1 I12.0;A49.9;D63.8;N13.2 38.95;39.95;99.04 - - None None None
0 - 0 - 0 12472300 16442775 0 3 0 0
0 SUWATRIL D305851 69 25456 SRI KUNMARTINI.DR,SPPD
0138R0170618V005319 0000060733888 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 191758 1#0##0#0#0.0#2018-07-02
17:57:34#0#00:00:00#00:00:00#00:00:00 1 46622dda22731939e08befbebd85f8af
0 0 2626604 0 0 3987025 0 0 0 0
7452200 0 0 0 2376946 0
3201126 B 1 BS 1 20/06/2018 22/06/2018 21/10/1944 0 2
1 J18.9;L27.0 - - - None None None None J-4-16-II None
7108500 0 0 - 0 - 0 - 0 - 0
7108500 5338305 0 3 0 0 0 SARIA D314742 73
26905 DR YUNITA ARLINY SPP 0138R0170618V005329 0000060767842 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 191762 1#0##0#0#0.0#2018-
07-02 18:01:09#0#00:00:00#00:00:00#12:00:00 1
451ac576dcf641f997b44e3841aefa26 0 0 614265 0 0
1715805 0 0 0 0 2343000 0 0 0 665235
0
3201126 B 1 BS 1 19/06/2018 22/06/2018 28/12/1954 0 1
1 D64.9;I84.1;I50.0 99.04;88.72 - - None None None None D-4-
0 - 0 5918600 7042999 0 4 0 0 0
SARINGAN SUNARDI D279444 63 23184 DR AZRI NURIZAL SPPD KKV
0138R0170618V005119 0001813696817 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 191547 1#0##0#0#0.0#2018-07-02
18:05:32#0#11:51:50#11:51:50#00:00:00 1 784f494dde0ac542a43cdf4c272c601e
0 0 429362 0 0 2650980 0 0 0 0
3124000 0 0 0 838657 0
3201126 B 1 BS 1 20/06/2018 22/06/2018 21/02/1959 0 2
1 E14.2;A49.9;D63.8 99.04;39.95 - - None None None None N-4-
LAIN (SEDANG) 7385300 0 0 - 0 - 0 - 0 -
0 7385300 6511047 0 3 0 0 0 ROSIYATI
0000044937145 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191867
1#0##0#0#0.0#2018-07-02 18:09:39#0#09:30:35#09:30:35#12:00:00 1
24c107824856deb52a66ad45450c89e2 0 0 573641 0 0
1986200 0 0 0 0 2343000 0 0 0 1608206
0
3201126 B 1 BS 1 20/06/2018 22/06/2018 28/11/1945 0 1
1 I25.1;R10.4 - - - None None None None I-4-16-I None
0 - 0 - 0 - 0 - 0 3036200 3579558
0 3 0 0 0 HOTLAN RITONGA, BCHK D401167 72 26502
TANTIYO S;16137 5.2.2.201806040537 4 192287 1#0##0#0#0.0#2018-
07-02 18:12:37#0#00:00:00#00:00:00#00:00:00 1
3170a79fe3b00f380eef5732cd443780 0 0 236051 0 0 740330
0 0 0 0 2343000 0 0 0 260177 0
3201126 B 3 BS 1 20/06/2018 22/06/2018 08/04/2009 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1629843 0 3 0 0 0 AFFAN AL KHATAB
0001308238839 3;JKN DR RIZKI; 5.2.2.201806040537 4 191765
1#0##0#0#0.0#2018-07-03 09:11:10#0#00:00:00#00:00:00#00:00:00 1
96ba0ff174cb8e9d83a82da528e712b7 0 0 257183 0 0 451035
0 0 0 0 921625 0 0 0 0 0
3201126 B 3 BS 1 17/06/2018 22/06/2018 01/02/1988 0 1
1 K36 47.09;90.59;87.64;89.52 - - None None None None K-1-
13-I None None None None None None PROSEDUR APPENDIK (RINGAN) 3874400
0 0 - 0 - 0 - 0 - 0 3874400
8733870 0 6 0 0 0 SOFIAN SURFIADI D400972 30
11094 YASMIN SURYANDARI BACHTIAR. DR. SPB 0138R0170618V004701
0001014195824 3;JKN DR RIZKI; 5.2.2.201806040537 4 190920
1#0##0#0#0.0#2018-07-03 09:19:49#0#23:23:11#23:23:11#00:00:00 1
9a7605792ba64da0b2b1a7a3e155b5a4 0 3581500 1137832 0 0
3273163 0 0 0 0 672375 0 0 69000 0 0
3201126 B 2 BS 1 17/06/2018 22/06/2018 10/02/1960 0 1
1 I64;E14.9 87.44;87.03 - - None None None None G-4-15-I
- 0 - 0 - 0 - 0 4915400 8679930 0
6 0 0 0 SUYONO D157890 58 21312 DR HARDI PRANATA
4 190892 1#0##0#0#0.0#2018-07-03
09:50:53#0#00:00:00#00:00:00#00:00:00 1 f7a6e54f71ec8e163135e8ca608e3de3
0 0 989594 0 0 3714590 0 0 0 0
3975746 0 0 0 0 0
3201126 B 3 BS 1 21/06/2018 22/06/2018 12/10/1940 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 5495862 0 2 0 0 0 MUNYANIH D398783
3;JKN DR RIZKI; 5.2.2.201806040537 4 192420 1#0##0#0#0.0#2018-
07-03 15:02:33#0#08:10:55#08:10:55#00:00:00 1
19c19a651b48ba157579fd28ae865875 0 3062500 921100 0 0
1007720 0 0 0 0 435542 0 0 0 0 69000
3201126 B 3 BS 1 20/06/2018 22/06/2018 26/09/1976 0 1
1 I13.1;E87.7;A49.9;D63.8 39.95 - - None None None None N-4-
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
S TN D239322 41 15242 SRI KUNMARTINI.DR,SPPD 0138R0170618V005603
0001743628138 3;JKN DR RIZKI; 5.2.2.201806040537 4 193607
1#0##0#0#0.0#2018-07-03 15:22:34#0#00:00:00#00:00:00#00:00:00 1
77867523006ec686867393624454904d 0 0 599993 0 0
2051377 0 0 0 0 3631803 0 0 0 0 451000
3201126 B 3 BS 1 21/06/2018 22/06/2018 01/07/1974 0 2
1 N39.0;N83.0 - - - None None None None N-4-12-I None
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2190549 0 2 0 0 0 IDA FARIDA D401320
3;JKN DR RIZKI; 5.2.2.201806040537 4 192958 1#0##0#0#0.0#2018-
07-03 15:25:15#0#20:33:55#20:33:55#00:00:00 1
9e8415df1fa56c48228e717c2df55575 0 0 321342 0 0 794400
0 0 0 0 1074807 0 0 0 0 0
3201126 B 2 BS 1 20/06/2018 22/06/2018 01/11/1958 0 2
1 I64;H81.3 - - - None None None None G-4-15-I None
- 0 - 0 - 0 4915400 2287211 0 3 0
0 0 MASWANI D401221 59 21781 DR HARDI PRANATA SPS
0138R0170618V005735 0001307081373 3;JKN DR RIZKI; 5.2.2.201806040537
4 192407 1#0##0#0#0.0#2018-07-03
15:48:53#0#00:00:00#00:00:00#00:00:00 1 555264b5f2ddf3066406ca7fb38e3ed8
0 0 216890 0 0 587190 0 0 0 0
1483131 0 0 0 0 0
3201126 B 3 BS 1 16/06/2018 22/06/2018 31/12/1952 0 2
1 G91.9;I64;J40;R40.2 87.03;87.44 - - None None None None
- 0 8922900 11847777 0 7 0 0 0 MUSENAH
0001739674473 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190885
1#0##0#0#0.0#2018-07-04 14:37:08#0#00:00:00#00:00:00#00:00:00 1
08a15c72db8283411a266d44b2f3c0a3 0 0 743950 0 0
7992739 0 0 0 0 2361088 0 0 750000 0
0
3201126 B 3 BS 1 22/06/2018 22/06/2018 31/12/1952 0 1
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 3767770 0 1 0 0 0 WILLEM BASTIAN
D355259 65 23914 DR SUKMARINI 0138R0170618V006324
0000061056595 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193307
1#0##0#0#0.0#2018-07-04 15:24:46#0#11:28:04#11:28:04#00:00:00 1
3dd50bbe52c096361a3c4e17db0b9bc8 0 0 305565 0 0
2192715 0 0 0 0 553490 0 0 0 0 716000
3201126 B 3 BS 1 16/06/2018 22/06/2018 08/08/1954 0 2
1 I11.0;E11.2;I25.0;J22 87.44;89.52 - - None None None None
4144700 0 0 - 0 - 0 - 0 - 0
4144700 5797077 0 7 0 0 0 KASNI KARIM D400922
0001739852403 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190881
1#0##0#0#0.0#2018-08-04 14:25:58#0#19:28:20#19:28:20#00:00:00 2
f8a9bb281c12c732fa08af1c8b70efdb 0 0 431234 0 0
2564195 0 0 0 0 2511648 0 0 290000 0
0
3201126 B 3 BS 1 12/06/2018 22/06/2018 24/04/1972 0 2
1 I21.3;I11.0;J18.9;I25.0 88.55;89.52 - - None None None None
12210800 0 0 - 0 - 0 - 0 - 0
12210800 41930045 0 11 1 10 0 MUHANA D400668
0001740272174 3;JKN irene; 5.2.2.201806040537 4 189764
1#0##0#0#0.0#2018-08-09 15:50:56#0#00:00:00#00:00:00#00:00:00 3
d53f626e24aca2e6bfb0e038d059a39a 0 11086000 2495160 0 0
18542885 0 0 0 0 1226000 0 0 0 0
8580000
3201126 B 3 BS 1 17/06/2018 22/06/2018 16/11/1994 0 2
1 A91;K77.8 - - - None None None None A-4-13-II None
2667400 0 0 - 0 - 0 - 0 - 0
2667400 4851246 0 6 0 0 0 NURSARI PANGARIBUAN
0001423265578 3;JKN irene; 5.2.2.201806040537 4 190915
1#0##0#0#0.0#2018-08-09 16:02:20#0#00:00:00#00:00:00#00:00:00 3
ec41f62171cad23b70ee7080bb162248 0 0 241100 0 0
2775275 0 0 0 0 1834871 0 0 0 0 0
3201126 B 2 BS 1 21/06/2018 22/06/2018 21/06/2018 2700 2
08-I None None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-5
- 0 - 0 - 0 5066300 19723042 0 2 1
2 0 ALEXANDRA MAFAZA PUTRI SIWABESSY d401302 0 0 DR
AULIA TANGKARI, SPA 0138R0170618V006261 0002466066813 3;JKN irvan;
5.2.2.201806040537 4 193104 1#0##0#0#0.0#2018-09-27
10:30:47#0#09:40:25#09:40:25#00:00:00 1 0645faf74a55645a06b311101948c93d
0 0 993802 0 0 10577240 0 0 0 0
3294000 0 0 0 0 4858000
3201126 B 1 BS 1 21/06/2018 22/06/2018 17/08/1937 0 1
1 D12.6;D63.0;K59.1;K80.8 99.04;88.76 - - None None None None
K-4-18-II None None None None None None GANGGUAN SISTEM PENCERNAAN
LAIN-LAIN (SEDANG) 3432200 0 0 - 0 - 0 - 0
- 0 3432200 5176434 0 2 0 0 0 TN ABDUL
BARI D401257 80 29528 DR ZULFAN, SPPD 0138R0170618V005778
0000060952105 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192414
1#0##0#0#0.0#2018-10-02 17:44:27#0#04:01:54#04:01:54#00:00:00 2
9821b8b057b6bda749289dc1e5c6fc50 0 0 942920 0 0
2306869 0 0 0 0 1926645 0 0 0 0 0
3201126 B 3 BS 1 20/06/2018 22/06/2018 01/12/1957 0 1
1 I12.0;T82.4;A49.9;D63.8 39.42;90.59;89.52 - - None None None
0 - 0 - 0 19332400 13251619 0 3 0 0
0 MURTOWO D389563 60 22116 DEDY PRATAMA,SPBV
0138R0170618V005711 0000511824982 3;JKN SURYANIH;15136
5.2.2.201806040537 4 192401 1#0##0#0#0.0#2018-10-03
15:50:22#0#00:00:00#00:00:00#12:00:00 3 2c2222e247941c4c189dbd17bc41c3ce
0 3525300 1906030 0 0 6842861 0 0 0 0
977428 0 0 0 0 0
3201126 B 1 BS 1 22/06/2018 23/06/2018 08/08/1961 0 2
- 0 58821400 31989040 0 2 0 0 0 ATIN
RAHMAWATI D401044 56 20772 DR AGOES KOOSHARTORO SPPD
0138R0170618V006201 0000043441301 3;JKN DR RIZKI; 5.2.2.201806040537
4 192972 1#0##0#0#0.0#2018-07-03
11:21:28#0#07:45:12#07:45:12#00:00:00 2 31cf75db1c453c79797a51a8e0e6d809
0 10062000 9619120 0 0 3462920 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 22/06/2018 23/06/2018 23/02/1963 0 2
- 0 - 0 - 0 - 0 4784600 6046066 0
2 0 0 0 FEBY C.A.ROTINSULU D401365 55 20208 DR
MOHAMMAD JOHAN SPU 0138R0170618V006548 0001468725445 3;JKN DR RIZKI;
5.2.2.201806040537 4 193594 1#0##0#0#0.0#2018-07-03
11:31:48#0#00:00:00#00:00:00#00:00:00 1 76956eba83262acde22debfe58df80c1
0 0 483614 0 0 2362415 0 0 0 0
3200037 0 0 0 0 0
3201126 B 2 BS 1 20/06/2018 23/06/2018 20/06/2018 3255 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2077579 0 4 0 0 0 MAHTIARINI ULFHA BY NY
0002465981234 3;JKN DR RIZKI; 5.2.2.201806040537 4 193397
1#0##0#0#0.0#2018-07-03 13:39:48#0#14:01:06#14:01:06#00:00:00 1
bb29817a8e6028daa1fe69d4c23a720a 0 0 433812 0 0 418251
0 0 0 0 1225516 0 0 0 0 0
3201126 B 2 BS 1 19/06/2018 23/06/2018 09/05/1983 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 14391726 0 5 0 0 0 MAHTIARINI ULFHA
0001426497568 3;JKN DR RIZKI; 5.2.2.201806040537 4 191274
1#0##0#0#0.0#2018-07-03 13:48:52#0#08:57:58#08:57:58#00:00:00 1
11aea51165efce378b063e035bff1400 0 6099900 2689163 0 0
4196148 0 0 0 0 1081515 0 0 0 0 325000
3201126 B 1 BS 1 20/06/2018 23/06/2018 09/08/1986 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12970804 0 4 0 0 0 YUNITA SARI D209019
31 11638 DR BAGUS T, SPOG 0138R0170618V005734 0001370330335 3;JKN
DR RIZKI; 5.2.2.201806040537 4 192406 1#0##0#0#0.0#2018-07-03
14:23:59#0#00:00:00#00:00:00#12:00:00 1 58473268c2a8c57ee5e060ce9a715c4a
0 7426400 2303895 0 0 2068952 0 0 0 0
974557 0 0 0 0 197000
3201126 B 1 BS 1 16/06/2018 23/06/2018 26/04/1952 0 1
1 I25.0;I50.0;E87.6;I49.3;I25.2 89.52;87.44 - - None None None
None I-4-16-III None None None None None None ATHEROSKLEROSIS (BERAT)
5850400 0 0 - 0 - 0 - 0 - 0
5850400 11408784 0 8 0 0 0 FELIX BERTNART B
0001260013511 3;JKN DR RIZKI; 5.2.2.201806040537 4 190887
1#0##0#0#0.0#2018-07-03 14:29:07#0#23:45:52#23:45:52#00:00:00 1
c0a4a5a1669e445cd9db08721fe87292 0 0 823021 0 0
3025394 0 0 0 0 6239369 0 0 0 0
1321000
3201126 B 1 BS 1 20/06/2018 23/06/2018 12/10/1966 0 1
1 D37.5;K92.2;D64.9 99.04;88.76 - - None None None None K-4-
(SEDANG) 3432200 0 0 - 0 - 0 - 0 - 0
3432200 7492215 0 4 0 0 0 RIZAFIANTO D401215
DR RIZKI; 5.2.2.201806040537 4 192405 1#0##0#0#0.0#2018-07-03
14:32:58#0#00:00:00#00:00:00#00:00:00 1 3cbf5d8cf3e0279b3c12c89d326195a8
0 0 1041800 0 0 3155770 0 0 0 0
3294645 0 0 0 0 0
3201126 B 1 BS 1 22/06/2018 23/06/2018 17/05/1958 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4962880 0 2 0 0 0 ROSMIYATI D382439
3;JKN DR RIZKI; 5.2.2.201806040537 4 193537 1#0##0#0#0.0#2018-
07-03 14:34:56#0#00:00:00#00:00:00#12:00:00 1
da37a627542ed31592514c8588df7aec 0 0 520641 0 0
1720190 0 0 0 0 2722049 0 0 0 0 0
3201126 B 1 BS 1 19/06/2018 23/06/2018 21/06/1989 0 2
1 N61;L02.8 86.04 - - None None None None L-4-14-II None
(SEDANG) 6190800 0 0 - 0 - 0 - 0 - 0
6190800 14982192 0 5 0 0 0 YUNI FITRIYANI
0138R0170618V005297 0001313299247 3;JKN DR RIZKI; 5.2.2.201806040537
4 191754 1#0##0#0#0.0#2018-07-03
14:38:29#0#00:00:00#00:00:00#00:00:00 1 97df4977d19a93249c1f1c6a304453b8
0 7278000 1151412 0 0 5011637 0 0 0 0
1056143 0 0 0 0 485000
3201126 B 1 BS 1 22/06/2018 23/06/2018 13/12/1959 0 2
1 N95.0;G81.9;I64;D64.9 99.04;87.03;87.44 - - None None None
None W-4-12-III None None None None None None GANGGUAN MENSTRUASI &
SISTEM REPRODUKSI WANITA LAIN-LAIN (BERAT) 5886200 0 0 - 0
- 0 - 0 - 0 5886200 4992338 0 2 0
0 0 MARIA V DYAH SOENARYO D301040 58 21376 ENDANG TRI
KURNIADEWI DR SPOG 0138R0170618V006242 0001794562659 3;JKN DR RIZKI;
5.2.2.201806040537 4 193046 1#0##0#0#0.0#2018-07-03
14:53:05#0#09:07:24#09:07:24#00:00:00 1 dda0d101772244de04880a0300d4117c
0 0 759344 0 0 1794392 0 0 0 0
2310602 0 0 0 0 128000
3201126 B 3 BS 1 20/06/2018 23/06/2018 01/01/1952 0 2
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2810102 0 4 0 0 0 ENDANG RUSMINI
0001740377316 3;JKN DR RIZKI; 5.2.2.201806040537 4 191756
1#0##0#0#0.0#2018-07-03 15:09:26#0#00:00:00#00:00:00#00:00:00 1
0e41ad272876e8904141c0d8d45cdb60 0 0 430982 0 0
1117282 0 0 0 0 1261838 0 0 0 0 0
3201126 B 3 BS 1 20/06/2018 23/06/2018 24/03/1996 0 1
1 J22;K29.7 90.59;87.44 - - None None None None J-4-21-I
0 - 0 2798500 2077417 0 4 0 0 0 AHMAD
SUHENDI D400940 22 8123 DR ZULFAN, SPPD 0138R0170618V005712
0001771655117 3;JKN DR RIZKI; 5.2.2.201806040537 4 192402
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c12783b643ecc9cc5e9db7ef34d16b83 0 0 257183 0 0 692828
0 0 0 0 1127406 0 0 0 0 0
3201126 B 2 BS 1 19/06/2018 23/06/2018 10/05/1945 0 1
1 J18.0;N39.0;E11.9 87.44 - - None None None None J-4-16-II
(SEDANG) 6093000 0 0 - 0 - 0 - 0 - 0
6093000 4811914 0 5 0 0 0 PARIJO D398115
3;JKN DR RIZKI; 5.2.2.201806040537 4 191750 1#0##0#0#0.0#2018-
07-03 15:26:59#0#00:00:00#00:00:00#00:00:00 1
7f95fb0df5e87a418c94500a44e708c0 0 0 729386 0 0
1424230 0 0 0 0 2658297 0 0 0 0 0
3201126 B 2 BS 1 18/06/2018 23/06/2018 17/07/1964 0 1
1 I21.2;N17.9;I11.9;I24.9 99.10;89.52 - - None None None None
12482300 0 0 - 0 - 0 - 0 - 0
12482300 14350319 0 6 0 0 0 MAHMUD YUNUS ABD QOSIM
0001272013244 3;JKN DR RIZKI; 5.2.2.201806040537 4 191176
1#0##0#0#0.0#2018-07-03 15:42:17#0#00:00:00#00:00:00#00:00:00 1
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4821034 0 0 0 0 5098806 0 0 0 0
3599000
3201126 B 2 BS 1 20/06/2018 23/06/2018 28/06/1940 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9388056 0 4 0 0 0 WASITO BIN KARTONO
0000060642213 3;JKN DR RIZKI; 5.2.2.201806040537 4 192409
1#0##0#0#0.0#2018-07-03 15:43:44#0#20:18:34#20:18:34#00:00:00 1
492b67b2b70e8189db426e2f8ccaf0ee 0 0 1844276 0 0
1251008 0 0 0 0 6223772 0 0 0 0 69000
3201126 B 2 BS 1 21/06/2018 23/06/2018 21/06/2018 3011 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1296167 0 3 0 0 0 LIANITA DIANTARI BY NY
0002466300486 3;JKN DR RIZKI; 5.2.2.201806040537 4 193605
1#0##0#0#0.0#2018-07-03 15:44:19#0#07:29:40#07:29:40#00:00:00 1
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0 0 0 0 656396 0 0 0 0 0
3201126 B 2 BS 1 16/06/2018 23/06/2018 04/04/1964 0 1
1 I25.0;I11.0;E14.9;I48 89.52 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 5014700
7881567 0 8 0 0 0 YULMAN ZUKHRI D400913 54
19796 DR CELLY ANANTARIA. SPJP 0138R0170618V004522 0000042266529
3;JKN DR RIZKI; 5.2.2.201806040537 4 190876 1#0##0#0#0.0#2018-
07-03 15:52:52#0#17:00:38#17:00:38#00:00:00 1
7e06b09aba10664095a43667e12d9ff1 0 0 840940 0 0
1718010 0 0 0 0 4581617 0 0 0 0 741000
3201126 B 2 BS 1 11/06/2018 23/06/2018 10/12/1951 0 2
1 I63.9;G93.4;A41.9;J18.0;E10.7 87.03;99.17 - - None None None
- 0 - 0 10406600 35056849 0 13 0 0 0
NURHAYATI ISHAQ D374940 66 24290 DR ZULFAN, SPPD
0138R0170618V003249 0000060837243 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 189439 1#0##0#0#0.0#2018-07-03
19:05:11#0#11:37:03#11:37:03#12:00:00 1 5b7494490d989e10dada19a803f137c3
0 0 920220 0 0 15727629 0 0 0 0
11103000 0 0 0 0 7306000
3201126 B 2 BS 1 22/06/2018 23/06/2018 16/07/1978 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 1828552 0 2 0 0 0 MARLIANY D401326
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192965
1#0##0#0#0.0#2018-07-03 19:24:39#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1155625 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 23/06/2018 21/07/1956 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
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0001284638927 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192976
1#0##0#0#0.0#2018-07-04 07:56:09#0#08:25:02#08:25:02#00:00:00 2
7b276dd8e4b94516391e3ba6dee46d08 0 0 6870800 0 0
36343950 0 0 0 0 9272000 0 0 0 0
7569000
3201126 B 2 BS 1 22/06/2018 23/06/2018 10/12/1960 0 1
1 C21.8;I10 45.23 - - None None None None K-4-10-I None
0 - 0 - 0 - 0 - 0 5898600 6896557
0 2 0 0 0 IWAN PAPARANG D400170 57 21013 DR.
5.2.2.201806040537 4 193266 1#0##0#0#0.0#2018-08-04
09:07:45#0#11:06:59#11:06:59#00:00:00 3 a2e54c20d3c017dfa4cfc2e6e75569df
0 0 1482340 0 0 1415540 0 0 0 0
2249677 0 0 0 0 1749000
3201126 B 3 BS 1 22/06/2018 23/06/2018 01/04/1963 0 2
1 I12.0;T82.4;D63.8 99.04;39.27;99.21 - - None None None None
- 0 - 0 19332400 16683588 0 2 0 0 0
MASAMAH D391246 55 20171 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V006551 0002336981286 3;JKN DR RIZKI; 5.2.2.201806040537
4 193596 1#0##0#0#0.0#2018-08-04
09:37:47#0#00:00:00#00:00:00#12:00:00 2 e3e7317e5ffb8d81a1f031fdaf91a0c5
0 0 4112804 0 0 8185334 0 0 0 0
4316450 0 0 0 0 69000
3201126 B 3 BS 1 20/06/2018 23/06/2018 30/12/1958 0 1
1 N39.0;A41.9;R33;D29.1;I10 89.52;90.59;99.21;88.76 - - None
None None None N-4-12-III None None None None None None INFEKSI
GINJAL DAN SALURAN URIN (BERAT) 5062600 0 0 - 0 - 0
- 0 - 0 5062600 4109567 0 4 0 0 0
MARWAN D397539 59 21722 DR ZULFAN, SPPD 0138R0170618V005744
0001725302193 3;JKN DR RIZKI; 5.2.2.201806040537 4 192411
1#0##0#0#0.0#2018-08-04 09:47:56#0#00:00:00#00:00:00#00:00:00 2
400c536d811ddbbccad06dde7ab1fb4d 0 0 704501 0 0
2144716 0 0 0 0 1260350 0 0 0 0 0
3201126 B 2 BS 1 21/06/2018 23/06/2018 08/12/1991 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10333037 0 3 0 0 0 LIANITA DIANTARI
0002062494843 3;JKN irene; 5.2.2.201806040537 4 192951
1#0##0#0#0.0#2018-08-09 15:22:28#0#19:14:30#19:14:30#00:00:00 3
3c6dfca598e3a5d0b939b33a7294ef87 0 5269900 2090753 0 0
1983391 0 0 0 0 791993 0 0 0 0 197000
3201126 B 3 BS 1 23/06/2018 23/06/2018 05/07/1974 0 2
4 I61.3;N18.5;G93.6;A41.9 99.60 - - None None None None G-4-
TRAUMATIK (BERAT) 6111900 0 0 - 0 - 0 - 0 -
0 6111900 2810108 0 1 0 0 0 KARTINI
0001258749393 3;JKN irene; 5.2.2.201806040537 4 193604
1#0##0#0#0.0#2018-09-10 13:53:04#0#01:19:34#01:19:34#00:00:00 2
40acae22f8a73eaf8bb2d02c0261b6a0 0 0 305595 0 0
1563674 0 0 0 0 472839 0 0 0 0 468000
3201126 B 3 BS 1 19/06/2018 23/06/2018 30/12/1972 0 2
1 S07.9 - - - None None None None G-4-24-I None None
0 - 0 - 0 - 0 3043100 4216004 0 5
0 0 0 ARIYANTI d401072 45 16607 DR HARDI PRANATA SPS
0138R0170618V005097 0001336902873 3;JKN SURYANIH;15136
5.2.2.201806040537 4 191411 1#0##0#0#0.0#2018-10-03
14:08:16#0#10:36:25#10:36:25#00:00:00 2 fd8c1212b2164412616fb30e3a99a52e
0 0 326879 0 0 2102312 0 0 0 0
1616813 0 0 0 0 170000
3201126 B 1 BS 1 22/06/2018 24/06/2018 15/04/1986 0 1
1 J20.9;K30 87.44 - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 3917900 0 0 - 0 - 0 - 0
- 0 3917900 3750379 0 3 0 0 0 FAHMI FAUZAN
F163984 32 11756 DR YUNITA ARLINY SPP 0138R0170618V006545
0001874015695 3;JKN DR RIZKI; 5.2.2.201806040537 4 193593
1#0##0#0#0.0#2018-07-03 11:25:18#0#18:24:34#18:24:34#12:00:00 1
441dd2eb31a164e8ed20db58db9b4b1c 0 0 333467 0 0
1148060 0 0 0 0 2268852 0 0 0 0 0
3201126 B 3 BS 1 19/06/2018 24/06/2018 19/12/1943 0 2
0 - 0 6909500 7559958 0 6 0 0 0
WURYANINGSIH D401147 74 27211 DR HARDI PRANATA SPS
0138R0170618V005306 0001258234198 3;JKN DR RIZKI; 5.2.2.201806040537
4 191755 1#0##0#0#0.0#2018-07-03
11:52:52#0#00:00:00#00:00:00#00:00:00 1 be80aef26f8cde0e59ff0333ddb5436c
0 0 674855 0 0 4606526 0 0 0 0
1835577 0 443000 0 0 0
3201126 B 3 BS 1 20/06/2018 24/06/2018 01/08/1945 0 2
1 I64;G81.9 87.03;87.44;89.52 - - None None None None G-4-
- 0 - 0 - 0 - 0 4888600 4980563 0
5 0 0 0 HATI HAYATI D401164 72 26621 DR HARDI PRANATA
4 191764 1#0##0#0#0.0#2018-07-03
12:11:55#0#05:22:04#05:22:04#00:00:00 1 b4f5b5bf5a8bf731adba1fa4bc58630c
0 0 743950 0 0 2569782 0 0 0 0
1666831 0 0 0 0 0
3201126 B 3 BS 1 21/06/2018 24/06/2018 15/06/1962 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4580838 0 4 0 0 0 ASIAH D401328
3;JKN DR RIZKI; 5.2.2.201806040537 4 192963 1#0##0#0#0.0#2018-
07-03 13:23:34#0#00:00:00#00:00:00#00:00:00 1
4e65f697826f83e4884604d2e6b9bfe5 0 0 674855 0 0
2791302 0 0 0 0 1114681 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 24/06/2018 31/12/1993 0 1
1 J18.0;B34.9;K36 87.44;88.76 - - None None None None J-4-
(RINGAN) 3613200 0 0 - 0 - 0 - 0 - 0
3613200 3289817 0 3 0 0 0 FIRDAUS RAHMAN
d401353 24 8939 DR HENDRIEK S, SPB 0138r0170618v006377
0001771758448 3;JKN DR RIZKI; 5.2.2.201806040537 4 193377
1#0##0#0#0.0#2018-07-03 13:27:51#0#13:47:08#13:47:08#00:00:00 1
5b929c88b7f79c862f3c2be9f08afd22 0 0 694970 0 0
1564625 0 0 0 0 1030222 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 24/06/2018 26/01/1981 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 8443013 0 3 0 0 0 SITI SURYANIH
0001855722892 3;JKN DR RIZKI; 5.2.2.201806040537 4 193421
1#0##0#0#0.0#2018-07-03 13:29:18#0#14:26:28#14:26:28#00:00:00 1
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2175522 0 0 0 0 603347 0 0 0 0 325000
3201126 B 3 BS 1 22/06/2018 24/06/2018 09/08/1975 0 1
1 I10;G93.4;K30;E78.5;I25.0 89.52;87.03;87.44 - - None None
None None I-4-17-III None None None None None None HIPERTENSI (BERAT)
2663700 0 0 - 0 - 0 - 0 - 0
2663700 2491076 0 3 0 0 0 BUYUNG EDWIN ADRIN
0001728412694 3;JKN DR RIZKI; 5.2.2.201806040537 4 192969
1#0##0#0#0.0#2018-07-03 13:33:59#0#04:28:06#04:28:06#00:00:00 1
d2132c067dba7373f516639e70057a84 0 0 183752 0 0
1329356 0 0 0 0 977968 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 24/06/2018 01/02/1996 0 2
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 4569069 0 2 0 0 0 DINI ANDINI D401448
3;JKN DR RIZKI; 5.2.2.201806040537 4 193685 1#0##0#0#0.0#2018-
07-03 13:36:57#0#11:27:16#11:27:16#00:00:00 1
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1022990 0 0 0 0 2716911 0 0 0 0 69000
3201126 B 2 BS 1 22/06/2018 24/06/2018 20/02/1950 0 1
1 I13.0;I25.0;J22 87.44 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
3289121 0 3 0 0 0 WARJO BIN DARJA D393246 68
3;JKN DR RIZKI; 5.2.2.201806040537 4 193251 1#0##0#0#0.0#2018-
07-03 13:42:45#0#11:00:12#11:00:12#00:00:00 1
cd1a67c32a9392186ba24476faf07707 0 0 504323 0 0 738622
0 0 0 0 1756176 0 0 0 0 290000
3201126 B 2 BS 1 17/06/2018 24/06/2018 03/05/1936 0 1
1 I63.9;I48;E87.6;E87.1 87.03;87.44 - - None None None None
0 - 0 8291400 15760896 0 8 0 0 0 SUJONO
0000060884987 3;JKN DR RIZKI; 5.2.2.201806040537 4 190897
1#0##0#0#0.0#2018-07-03 13:46:13#0#00:00:00#00:00:00#00:00:00 1
c330293f3658df1adeb0112b2c58a075 0 0 674855 0 0
5870054 0 0 0 0 6950987 0 0 0 0
2265000
3201126 B 2 BS 1 22/06/2018 24/06/2018 22/06/2018 3807 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1499552 0 3 0 0 0 BAYI NY. E E N
0002466399115 3;JKN DR RIZKI; 5.2.2.201806040537 4 193589
1#0##0#0#0.0#2018-07-03 13:47:15#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 22/06/2018 24/06/2018 12/12/1988 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10461487 0 3 0 0 0 EEN D397353 29
10784 DR ARIS WAHJU, SPOG 0138R0170618V006346 0002234844797 3;JKN
DR RIZKI; 5.2.2.201806040537 4 193342 1#0##0#0#0.0#2018-07-03
13:51:13#0#12:04:13#12:04:13#00:00:00 1 03e20915e98cfa20528d1ad2488dbabf
0 5269900 2117753 0 0 2141438 0 0 0 0
735396 0 0 0 0 197000
3201126 B 1 BS 1 21/06/2018 24/06/2018 08/08/1932 0 1
1 I64;A49.9 87.03;90.59;89.52 - - None None None None G-4-
- 0 - 0 - 0 - 0 5734600 6957345 0
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13:59:37#0#13:54:19#13:54:19#00:00:00 2 258fd954afe26f116417473175e34ecd
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3605153 0 0 0 0 0
3201126 B 1 BS 1 18/06/2018 24/06/2018 09/07/1954 0 1
1 I64;H81.3;I10;E78.5;E79.0 87.44;87.03 - - None None None
None G-4-15-I None None None None None None KECEDERAAN PEMBULUH
DARAH OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (RINGAN)
5734600 0 0 - 0 - 0 - 0 - 0
5734600 9643314 0 7 0 0 0 HARY PRASETYO
0001788466498 3;JKN DR RIZKI; 5.2.2.201806040537 4 191219
1#0##0#0#0.0#2018-07-03 14:14:09#0#00:00:00#00:00:00#00:00:00 1
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2844613 0 0 0 0 5778371 0 0 0 0 0
3201126 B 1 BS 1 21/06/2018 24/06/2018 30/08/1955 0 1
1 I64;G81.9;J22;G51.9 87.03;87.44 - - None None None None
0 0 - 0 - 0 - 0 - 0 6844000
5929480 0 4 0 0 0 MARUASAS MANGUNSONG D216888
3;JKN DR RIZKI; 5.2.2.201806040537 4 192952 1#0##0#0#0.0#2018-
07-03 14:17:43#0#00:00:00#00:00:00#00:00:00 1
d5b29036ce520e8aecbde7f69ff8b37b 0 0 1020330 0 0
1371240 0 0 0 0 3537910 0 0 0 0 0
3201126 B 1 BS 1 21/06/2018 24/06/2018 30/12/1958 0 2
1 I63.9;H81.3 87.03;87.44 - - None None None None G-4-14-I
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 5124671 0 4 0 0 0 ELISABETH RIANI
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1#0##0#0#0.0#2018-07-03 14:20:04#0#08:25:00#08:25:00#00:00:00 1
7d825b5447e9825b0e7893fce39defc3 0 0 923597 0 0 715815
0 0 0 0 3485259 0 0 0 0 0
3201126 B 1 BS 1 22/06/2018 24/06/2018 21/04/2009 0 2
12140800 0 0 - 0 - 0 - 0 - 0
12140800 19930441 0 3 0 0 0 NAFILAH TUNNAJAH
0001787432016 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193597
1#0##0#0#0.0#2018-07-03 15:24:40#0#00:00:00#00:00:00#00:00:00 1
cba0b3b39a3b2cddc318face6aeb23a5 0 10108800 5573832 0 0
2826809 0 0 0 0 1276000 0 0 0 0 145000
3201126 B 1 BS 1 22/06/2018 24/06/2018 31/05/2016 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3444492 0 3 0 0 0 MOCH SYAFIQ d401343
2 752 DR OTTY MITHA S, SPA 0138r0170618v006287 0002288936542
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193194
1#0##0#0#0.0#2018-07-03 15:27:33#0#10:32:54#10:32:54#00:00:00 1
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0 0 0 0 2594341 0 0 0 0 0
3201126 B 1 BS 1 23/06/2018 24/06/2018 30/11/1984 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6416197 0 2 0 0 0 TIORIA FRANSISCA
0001645861836 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193603
1#0##0#0#0.0#2018-07-03 16:12:11#0#00:55:31#00:55:31#00:00:00 1
1a33d5cec24e530d65c6df600f3e999a 0 0 1007824 0 0
1462122 0 0 0 0 3911751 0 0 0 0 34500
3201126 B 1 BS 1 20/06/2018 24/06/2018 01/04/1956 0 1
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 7523249 0 5 0 0 0 SYAFRIL d401256
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192412
1#0##0#0#0.0#2018-07-03 16:17:42#0#00:00:00#00:00:00#00:00:00 1
64ca36eb5f4951ebf0772e03e451d360 0 0 923597 0 0
2787477 0 0 0 0 3642175 0 0 0 0 170000
3201126 B 2 BS 1 21/06/2018 24/06/2018 14/01/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
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D377205 2 889 DR RASTRA, SPA 0138R0170618V006092
0002073232506 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192960
1#0##0#0#0.0#2018-07-03 19:09:48#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1694115 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 24/06/2018 01/01/1963 0 1
4 G93.4;J80;A41.9 99.60 - - None None None None G-4-21-III
None None None None None None KOMA & STUPOR NON TRAUMA (BERAT)
5520500 0 0 - 0 - 0 - 0 - 0
5520500 9889305 0 2 0 0 0 BONAR HUTAHAYAN
0001739678005 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193718
1#0##0#0#0.0#2018-07-04 09:05:56#0#00:00:00#00:00:00#00:00:00 1
85a69d2d08b1872fb398af4ecfebab6a 0 0 376525 0 0
6790816 0 0 0 0 953964 0 0 0 0
1768000
3201126 B 2 BS 1 21/06/2018 24/06/2018 01/08/1991 0 2
0 0 - 0 - 0 - 0 - 0 5984100
18194231 0 4 0 0 0 NUGRAHANI KHOIRUNISA d398710
0002081606174 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197476
1#0##0#0#0.0#2018-07-04 15:59:53#1#00:00:00#00:00:00#00:00:00 1
89b7171e80dac147f176a927022d0784 0 6706170 7230060 0 0
0 0 0 0 0 0 0 0 0 4258001 0
3201126 B 1 BS 1 21/06/2018 24/06/2018 09/10/1950 0 1
- 0 - 0 - 0 - 0 6844000 8850464 0
4 0 0 0 ENDON D346775 67 24727 DR HARDI PRANATA SPS
0138R0170618V005777 0000039996808 3;JKN DR RIZKI; 5.2.2.201806040537
4 192413 1#0##0#0#0.0#2018-08-03
15:54:57#0#00:00:00#00:00:00#00:00:00 3 a9ebf8eb37f2f6f8aea914f6939a3325
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3729002 0 0 0 0 0
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2061500 7345072 0 7 0 0 0 VIONA PUTRI ARINY
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1#0##0#0#0.0#2018-08-09 16:11:06#0#00:00:00#00:00:00#00:00:00 2
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0
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D391309 1 670 DR RASTRA, SPA 0138R0170618V005445
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1#0##0#0#0.0#2018-08-11 11:58:19#0#09:52:25#09:52:25#12:00:00 2
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1848474 0 0 0 0 3905000 0 0 0 813225
0
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5.2.2.201806040537 4 193925 1#0##0#0#0.0#2018-07-03
11:18:15#0#00:00:00#00:00:00#12:00:00 1 ea39a270111cb89693c447ac100cc11d
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1028769 0 0 0 0 0
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None None None None None None ATHEROSKLEROSIS (RINGAN) 3036200
0 0 - 0 - 0 - 0 - 0 3036200
3;JKN DR RIZKI; 5.2.2.201806040537 4 193731 1#0##0#0#0.0#2018-
07-03 11:36:04#0#00:00:00#00:00:00#00:00:00 1
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6071100 0 0 - 0 - 0 - 0 - 0
6071100 8646451 0 6 0 0 0 MURDJADJI SUPRAPTO
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1#0##0#0#0.0#2018-07-03 11:38:27#0#00:00:00#00:00:00#00:00:00 1
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2807530 0 0 0 0 5277656 0 0 0 0 0
3201126 B 2 BS 1 22/06/2018 25/06/2018 01/12/1953 0 2
1 I20.0;D72.8 - - - None None None None I-4-20-II None
5824800 0 0 - 0 - 0 - 0 - 0
5824800 7072822 0 4 0 0 0 HJ. AISAH D392558
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1#0##0#0#0.0#2018-07-03 11:49:17#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 1 BS 1 22/06/2018 25/06/2018 25/02/2017 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4224920 0 4 0 0 0 GARUDA SATRIAPINANDITO
NUSANTARA D390077 1 482 DR KRISTON SILITONGA, SPA
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5.2.2.201806040537 4 193539 1#0##0#0#0.0#2018-07-03
15:47:04#0#00:00:00#00:00:00#00:00:00 1 32eed52802d2d71c73a3cfe52f89bd69
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3426397 0 0 0 0 0
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2405100 0 0 - 0 - 0 - 0 - 0
2405100 2901568 0 3 0 0 0 FUAD FAYYAZI ANDIRA BOER
0001172367393 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193714
1#0##0#0#0.0#2018-07-03 16:15:14#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 21/06/2018 25/06/2018 01/07/1978 0 2
1 R11 88.76 - - None None None None K-4-17-I None None
1718000 0 0 - 0 - 0 - 0 - 0
1718000 3402390 0 5 0 0 0 SITI ASTUTI D391879
TANTIYO S;16137 5.2.2.201806040537 4 192959 1#0##0#0#0.0#2018-
07-03 16:39:43#0#00:00:00#00:00:00#12:00:00 1
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1700052 0 0 0 0 1518586 0 0 0 0 0
3201126 B 3 BS 1 21/06/2018 25/06/2018 05/05/1981 0 1
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5.2.2.201806040537 4 192961 1#0##0#0#0.0#2018-07-03
16:45:25#0#00:00:00#00:00:00#00:00:00 1 36a1557a4b48890f8d233d4c004fc4e3
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1354363 0 0 0 0 0
3201126 B 3 BS 1 20/06/2018 25/06/2018 02/05/1960 0 2
1 E11.5;L03.1;A41.9 - - - None None None None I-4-15-III
LAIN (BERAT) 7317500 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-07-03 16:47:08#0#00:00:00#00:00:00#00:00:00 1
1e8780f5c60741cca93ceeeb0559f15e 0 0 711575 0 0
3803529 0 0 0 0 1658372 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 25/06/2018 29/08/1964 0 2
- 0 8908800 8835929 0 3 0 0 0 SITI
MARFUATUN D401265 53 19656 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V006762 0002338709376 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 193720 1#0##0#0#0.0#2018-07-03
16:48:21#0#00:00:00#00:00:00#00:00:00 1 99a093551dfbe17b5e16cc097d0dadaa
0 0 1870848 0 0 2716730 0 0 0 0
4179351 0 0 0 0 69000
3201126 B 3 BS 1 23/06/2018 25/06/2018 04/06/1997 0 2
10326200 0 0 - 0 - 0 - 0 - 0
10326200 11150160 0 3 0 0 0 NURLAILA UMIATI NY
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1#0##0#0#0.0#2018-07-03 16:53:43#0#16:44:50#16:44:50#00:00:00 1
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4405810 0 0 0 0 815450 0 0 0 0 69000
3201126 B 3 BS 1 25/06/2018 25/06/2018 18/08/1945 0 1
1 K30;I50.0 - - - None None None None K-4-18-II None
2451500 0 0 - 0 - 0 - 0 - 0
2451500 2282136 0 1 0 0 0 S MIHARDJA D321000
72 26609 DR ADITIA NATA KUSUMA 0138R0170618V007029 0000060968935
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193930
1#0##0#0#0.0#2018-07-03 18:25:49#0#00:00:00#00:00:00#12:00:00 1
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1003437 0 0 0 0 438299 0 0 0 0 418000
3201126 B 2 BS 1 24/06/2018 25/06/2018 11/10/1959 0 2
1 T82.4;N18.5;D63.8;J18.0 39.43;99.04 - - None None None None
- 0 - 0 23198900 10167532 0 2 0 0 0
EKA SETYANINGSIH d384009 58 21441 DR SRI KUN, SPPD
0138R0170618V006830 0001336280185 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 193741 1#0##0#0#0.0#2018-07-03
19:18:19#0#15:03:01#15:03:01#12:00:00 2 c0ee1f551e20f136475bebf8df03c86c
0 4439100 2276624 0 0 2601642 0 0 0 0
781166 0 0 0 0 69000
3201126 B 2 BS 1 22/06/2018 25/06/2018 09/10/1968 0 1
0 - 0 - 0 - 0 - 0 4290800 2925521
0 4 0 0 0 ROLAND ROBERT SOEDIRA D366640 49 18153
TANTIYO S;16137 5.2.2.201806040537 4 192967 1#0##0#0#0.0#2018-
07-03 19:29:11#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 2237389 0 0 0 0 0
3201126 B 3 BS 1 24/06/2018 25/06/2018 26/12/2017 0 1
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 1639623 0 2 0 0 0 FARZAN RAYHAAN SHAKEIL
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1#0##0#0#0.0#2018-07-04 09:08:42#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 659265 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 25/06/2018 03/03/1935 0 2
1 E14.9;K30;J18.0;A41.9;N30.9 - - - None None None None
- 0 - 0 6262900 3793819 0 4 0 0 0
NANI D400634 83 30427 DR SRI KUNMARTINI, SPPD 0138R0170618V006111
0001771598351 3;JKN ECHI; 5.2.2.201806040537 4 192964
1#0##0#0#0.0#2018-07-05 11:19:00#0#00:36:23#00:36:23#00:00:00 1
37bb58beca0a905e5353125cbb1d7722 0 0 630773 0 0
1836852 0 0 0 0 1326194 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 25/06/2018 20/02/1963 0 1
- 0 - 0 - 0 - 0 4888600 2243696 0
4 0 0 0 SANTOSO D401374 55 20211 DR HARDI PRANATA
4 193883 1#0##0#0#0.0#2018-08-03
16:11:39#0#09:56:51#09:56:51#00:00:00 2 20f299aa3e2d0f9513ae867f9e6744fb
0 0 421658 0 0 840254 0 0 0 0 981784
0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 25/06/2018 14/03/1978 0 2
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0 0 0 SURYADI D401514 40 14711 DR MOHAMMAD JOHAN SPU
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4 193722 1#0##0#0#0.0#2018-08-04
10:01:31#0#00:00:00#00:00:00#00:00:00 4 51e8861a61284044f63c24788f1503d7
0 0 423980 0 0 1717727 0 0 0 0 740559
0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 25/06/2018 16/08/1971 0 2
- 0 - 0 - 0 - 0 2216400 3753574 0
5.2.2.201806040537 4 193846 1#0##0#0#0.0#2018-08-04
14:22:06#0#00:00:00#00:00:00#00:00:00 2 5d74e307e35fff575fa465de11e04049
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0 0 0 0 0
3201126 B 3 BS 1 24/06/2018 25/06/2018 07/08/1971 0 1
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1718000 5343064 0 2 0 0 0 IR. MULYADI ARIENSYAH
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1#0##0#0#0.0#2018-08-09 15:51:19#0#06:29:22#06:29:22#00:00:00 4
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3201126 B 1 BS 1 24/06/2018 25/06/2018 13/06/1971 0 1
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GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 3383357 0 2 0 0 0 ARIS MUNENDAR TN
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1#0##0#0#0.0#2018-08-11 11:59:20#0#18:36:16#18:36:16#00:00:00 2
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3201126 B 1 BS 1 21/06/2018 25/06/2018 10/06/1955 0 2
1 E14.2;I48;J18.0;J81;E87.8;E88.0 89.52 - - None None None
None N-4-16-III None None None None None None PENYAKIT GINJAL DAN
SALURAN URIN LAIN-LAIN (BERAT) 10134400 0 0 - 0 - 0
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SRI PONATI, NY D385147 63 23022 SRI KUNMARTINI.DR,SPPD
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4 192953 1#0##0#0#0.0#2018-08-11
12:12:34#0#00:00:00#00:00:00#12:00:00 4 fa2e69fd30087257f3cb7bcd699ad7a8
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3308000 0 0 0 2631984 0
3201126 B 1 BS 1 25/06/2018 25/06/2018 11/09/1958 0 1
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0 1 0 0 0 JAFETH JAMES LAHALLO D400155 59 21837
5.2.2.201806040537 4 193752 1#0##0#0#0.0#2018-09-06
08:32:14#0#00:00:00#00:00:00#00:00:00 2 791865c2c7f3d519e9fb514960808da0
0 0 622492 0 0 1141006 0 0 0 0
2034140 0 0 0 0 1929000
3201126 B 1 BS 1 20/06/2018 25/06/2018 05/03/1967 0 1
4 I64;E87.0 87.03 - - None None None None G-4-15-II None
- 0 - 0 - 0 6844000 24184865 0 6 1
6 0 MUHAMAD SYAH D401210 51 18735 DR HARDI PRANATA SPS
0138R0170618V005743 0001376329972 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 192410 1#0##0#0#0.0#2018-10-02
08:12:43#0#00:00:00#00:00:00#00:00:00 1 116a9d2a726fe11364a200d2574e343a
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5591000 0 0 0 0 0
3201126 B 2 BS 1 20/06/2018 25/06/2018 14/08/1950 0 1
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(RINGAN) 6586700 0 0 - 0 - 0 - 0 - 0
6586700 14642791 0 6 0 0 0 RUNGSIH d401172
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192559
1#0##0#0#0.0#2018-10-04 07:52:43#0#09:45:07#09:45:07#00:00:00 4
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5453261 0 0 0 0 1335840 0 0 0 0 0
3201126 B 1 BS 1 22/06/2018 26/06/2018 04/06/1946 0 1
9856000 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-07-03 15:19:13#0#00:00:00#00:00:00#00:00:00 1
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5543370 0 0 0 0 4758449 0 0 0 0 0
3201126 B 1 BS 1 24/06/2018 26/06/2018 11/06/1968 0 2
0 - 0 - 0 - 0 - 0 3116300 5100304
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5.2.2.201806040537 4 193738 1#0##0#0#0.0#2018-07-03
15:21:53#0#12:46:24#12:46:24#00:00:00 1 ad3575731ce0d21d07016027c708f1dc
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2702665 0 0 0 0 0
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37 13785 DR ARU, SPPD 0138R0170618V007303 0001196971593 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 194276 1#0##0#0#0.0#2018-
07-03 15:28:26#0#23:21:56#23:21:56#00:00:00 1
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3201126 B 1 BS 1 24/06/2018 26/06/2018 10/10/1941 0 1
- 0 12472300 17195878 0 3 0 0 0 DRS H
POERNOMO BUDHI D401526 76 28016 SRI KUNMARTINI.DR,SPPD
0138R0170618V006808 0000078524717 3;JKN TANTIYO S;16137
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15:48:55#0#00:00:00#00:00:00#00:00:00 1 9428902c4bfccdeaec3ebe980ec023ec
0 0 3595000 0 0 7841914 0 0 0 0
5689964 0 0 0 0 69000
3201126 B 1 BS 1 24/06/2018 26/06/2018 30/12/1963 0 1
5879800 0 0 - 0 - 0 - 0 - 0
5879800 5867655 0 3 0 0 0 YURIANTO KRISTIADJI
D345439 54 19900 E. SURYA POHAN 0138R0170618V006806
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1#0##0#0#0.0#2018-07-03 15:50:55#0#00:00:00#00:00:00#00:00:00 1
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2532608 0 0 0 0 2752865 0 0 0 0 0
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TANTIYO S;16137 5.2.2.201806040537 4 194271 1#0##0#0#0.0#2018-
07-03 16:01:26#0#21:15:25#21:15:25#12:00:00 1
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3201126 B 1 BS 1 23/06/2018 26/06/2018 04/04/1967 0 2
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- 0 4903800 5647847 0 4 0 0 0 NY.YOSSY
JOHATHANS D289474 51 18708 DR ARU, SPPD 0138R0170618V006613
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1#0##0#0#0.0#2018-07-03 16:03:45#0#07:46:01#07:46:01#12:00:00 1
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1634020 0 0 0 0 3519485 0 0 0 0 0
3201126 B 1 BS 1 25/06/2018 26/06/2018 30/09/1948 0 2
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D399281 69 25470 DR SIDDHI ANDIKA, SPU 0138r0170618v007258
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1#0##0#0#0.0#2018-07-03 16:08:12#0#17:27:36#17:27:36#00:00:00 1
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1751893 0 0 0 0 971155 0 0 0 0
3034500
3201126 B 1 BS 1 24/06/2018 26/06/2018 06/09/2013 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4026634 0 3 0 0 0 AL FATHIR SUKONO PUTRA
0001766133112 3;JKN DR RIZKI; 5.2.2.201806040537 4 193745
1#0##0#0#0.0#2018-07-03 17:07:32#0#00:00:00#00:00:00#00:00:00 1
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1124750 0 0 0 0 2632425 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 26/06/2018 30/07/2000 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 3565602 0 4 0 0 0 YULIANI D320784
17 6537 DR ARU, SPPD 0138R0170618V007012 0001182440608 3;JKN
DR RIZKI; 5.2.2.201806040537 4 193895 1#0##0#0#0.0#2018-07-03
17:28:56#0#00:00:00#00:00:00#00:00:00 1 7e4e03963422fbe45951afd0559c27c7
0 0 368243 0 0 1972595 0 0 0 0
1224764 0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 26/06/2018 28/06/1962 0 1
1 N20.1;Q62.1;I10;I69.4 58.47;56.31 - - None None None None
- 0 8041000 11909806 0 2 0 0 0 KARTO
D397198 55 20451 DR SIDHI,SPU 0138R0170618V006886
0001610067791 3;JKN DR RIZKI; 5.2.2.201806040537 4 193755
1#0##0#0#0.0#2018-07-03 17:32:25#0#06:55:44#06:55:44#00:00:00 1
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1697200 0 0 0 0 880146 0 0 0 0
3069000
3201126 B 3 BS 1 26/06/2018 26/06/2018 20/05/1990 0 2
1 G70.0;J06.9 - - - None None None None G-4-11-I None
(RINGAN) 4571500 0 0 - 0 - 0 - 0 - 0
4571500 5210873 0 1 0 0 0 CLAUDIA MELANI ROSARI
0001323762366 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194544
1#0##0#0#0.0#2018-07-03 18:35:27#0#11:15:47#11:15:47#00:00:00 1
388014defb84a3c1005249ae5749c56a 0 0 411435 0 0
3230540 0 0 0 0 657898 0 0 0 0 911000
3201126 B 2 BS 1 24/06/2018 26/06/2018 27/07/2012 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2855908 0 3 0 0 0 SYAHIRA D270353
5 2158 DR KHARINA CHATAR SPA 0138R0170618V006822 0001386072516
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193740
1#0##0#0#0.0#2018-07-03 18:58:17#0#00:00:00#00:00:00#00:00:00 1
8b0693c53115c220cbc0fd80656aeecc 0 0 298025 0 0 660048
0 0 0 0 1727835 0 0 0 0 170000
3201126 B 2 BS 1 22/06/2018 26/06/2018 18/12/1999 0 1
1 A91 90.59;89.52 - - None None None None A-4-13-I None
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4481761 0 5 0 0 0 DENY MURFY FATAHILLAH
D401364 18 6761 DR ARU, SPPD 0138R0170618V006483
0001306889774 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193535
1#0##0#0#0.0#2018-07-03 19:06:55#0#00:00:00#00:00:00#00:00:00 1
0a42d42582ed134ed74dba74db6fa343 0 0 278710 0 0
1358852 0 0 0 0 2844199 0 0 0 0 0
3201126 B 2 BS 1 26/06/2018 26/06/2018 11/05/1985 0 2
0 - 0 - 0 - 0 - 0 2009900 4261677
0 1 0 0 0 YULI D401644 33 12099 DR AFRA FONDA SPOG
0138R0170618V007314 0001482115937 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 194283 1#0##0#0#0.0#2018-07-03
19:07:46#0#00:00:00#00:00:00#00:00:00 1 8365be3085b4851ff5acf82d3d22f890
0 2230700 454980 0 0 1106196 0 0 0 0
341801 0 0 0 0 128000
3201126 B 2 BS 1 25/06/2018 26/06/2018 28/12/1938 0 1
(RINGAN) 4203300 0 0 - 0 - 0 - 0 - 0
4203300 2371978 0 2 0 0 0 ABDUL LATIF D401555
TANTIYO S;16137 5.2.2.201806040537 4 193852 1#0##0#0#0.0#2018-
07-03 19:08:49#0#09:47:24#09:47:24#00:00:00 1
5fa72aa98d301a77bc78f8cac139dd0f 0 0 431297 0 0 459505
0 0 0 0 1191176 0 0 0 0 290000
3201126 B 2 BS 1 17/06/2018 26/06/2018 26/04/1976 0 1
1 E14.5;J18.0;E87.6;I50.0 - - - None None None None I-4-
LAIN-LAIN (BERAT) 8781000 0 0 - 0 - 0 - 0 -
0 8781000 16891516 0 10 0 0 0 SUPRIYADI
0002290180105 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 190913
1#0##0#0#0.0#2018-07-03 19:12:05#0#00:00:00#00:00:00#00:00:00 1
4dada967d71746ec40668b7fa6f7290a 0 0 843290 0 0
9399774 0 0 0 0 6325452 0 0 0 0 323000
3201126 B 2 BS 1 24/06/2018 26/06/2018 06/02/1988 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10742423 0 3 0 0 0 FIDRIYANA ELISA
D170028 30 11096 DR ARJU A, SPOG 0138r0170618v006845
0001626892593 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193751
1#0##0#0#0.0#2018-07-03 19:14:01#0#21:08:34#21:08:34#00:00:00 1
7c6f027ec247efb56c2808a95e214cec 0 4854900 2087594 0 0
2646154 0 0 0 0 828775 0 0 0 0 325000
3201126 B 2 BS 1 25/06/2018 26/06/2018 14/05/1969 0 1
1743400 0 0 - 0 - 0 - 0 - 0
1743400 2874529 0 2 0 0 0 HERMAN HIDAYAT
D401554 49 17939 DR ARU, SPPD 0138R0170618V006991
0001963430897 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193832
1#0##0#0#0.0#2018-07-03 19:15:30#0#09:39:32#09:39:32#00:00:00 1
4e372998142259c68feb866558ba13b6 0 0 209906 0 0
1440570 0 0 0 0 1224053 0 0 0 0 0
3201126 B 2 BS 1 25/06/2018 26/06/2018 25/06/2018 3202 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 970298 0 2 0 0 0 BAYI NY FIDRIYANA ELISA
D401572 0 0 DR SRI SAPARNI, SPA 0138R0170618V007508
0002466789265 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194594
1#0##0#0#0.0#2018-07-03 19:22:43#0#00:00:00#00:00:00#00:00:00 1
703627d4e146c8f11998649ad96f7c16 0 0 214472 0 0 86399
0 0 0 0 669427 0 0 0 0 0
3201126 B 3 BS 1 24/06/2018 26/06/2018 29/09/2016 0 2
1 J18.0;A09.9 - - - None None None None J-4-16-I None
3613200 0 0 - 0 - 0 - 0 - 0
0002276507823 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193724
1#0##0#0#0.0#2018-07-04 07:57:20#0#00:20:59#00:20:59#12:00:00 1
57fc2f8b9945470008ccf839dfb430b1 0 0 378188 0 0
2305172 0 0 0 0 1059885 0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 26/06/2018 22/12/1949 0 2
1 E11.9;K30 - - - None None None None E-4-10-I None
- 0 3502700 2176471 0 1 0 0 0 NURWILIS
0000039783284 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194291
1#0##0#0#0.0#2018-07-04 08:35:11#0#05:54:43#05:54:43#00:00:00 1
e7675beb7a936bbf42c76329521236bf 0 0 175135 0 0 802950
0 0 0 0 449386 0 0 0 0 749000
3201126 B 3 BS 1 24/06/2018 26/06/2018 01/02/1949 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 1683034 0 3 0 0 0 SARBINIH TN D171786
TANTIYO S;16137 5.2.2.201806040537 4 193746 1#0##0#0#0.0#2018-
07-04 09:03:04#0#16:19:13#16:19:13#00:00:00 1
5fc265f3227b3a3a5c370f56fad5d6ca 0 0 318941 0 0 438988
0 0 0 0 925105 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 26/06/2018 28/12/1958 0 1
1 A16.2;A49.9;K71.6 - - - None None None None J-4-15-II
(SEDANG) 5180900 0 0 - 0 - 0 - 0 - 0
5180900 7603929 0 5 0 0 0 ABDUR RASYID
0002234277898 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193595
1#0##0#0#0.0#2018-07-04 09:04:16#0#00:00:00#00:00:00#00:00:00 1
269ebc22dc0d425ebced07fda41be171 0 0 519281 0 0
2886695 0 0 0 0 4197953 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 26/06/2018 05/12/1941 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 2515292 0 4 0 0 0 NANI D328633 76
27959 DR ARU, SPPD 0138R0170168V006658 0002094769653 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 193686 1#0##0#0#0.0#2018-
07-04 09:27:19#0#12:57:28#12:57:28#00:00:00 1
5c9ba43e721ad8bf48315186b96dc0e8 0 0 241100 0 0
1031640 0 0 0 0 1242552 0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 26/06/2018 31/10/1932 0 2
1 G31.1;S72.80;G81.9;J81 - - - None None None None G-4-
11-III None None None None None None TUMOR SISTEM SARAF & GANGGUAN
- 0 8922900 5077140 0 1 0 0 0 ELLY
0002422448932 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194490
1#0##0#0#0.0#2018-07-04 15:07:07#0#00:00:00#00:00:00#00:00:00 1
05e818b62ada61d046498ec40030e058 0 0 721855 0 0
2843136 0 0 0 0 626149 0 0 0 0 886000
3201126 B 3 BS 1 26/06/2018 26/06/2018 15/10/1950 0 2
1 I63.9;R33 - - - None None None None G-4-14-I None
(RINGAN) 5013100 0 0 - 0 - 0 - 0 - 0
5013100 4200439 0 1 0 0 0 SALMIATI D398943
67 24726 DR YOHANES DWINANDA R P 0138R0170618V007316 0000060688991
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194284
1#0##0#0#0.0#2018-07-04 15:12:04#0#00:00:00#00:00:00#00:00:00 1
c1afd8922a20a4aedc110eb0b4f01a33 0 0 2506550 0 0 707094
0 0 0 0 568795 0 0 0 0 418000
3201126 B 3 BS 1 19/06/2018 26/06/2018 13/02/2018 0 1
12174500 0 0 - 0 - 0 - 0 - 0
12174500 21647761 0 8 0 0 0 AZRIEL SHARIQ ZHAFRAN
0002315857678 3;JKN DR RIZKI; 5.2.2.201806040537 4 191230
1#0##0#0#0.0#2018-08-03 16:19:06#0#06:50:34#06:50:34#12:00:00 2
7b65af91e0dd9744e86924a9e58905d8 0 6204900 3560256 0 0
9042605 0 0 0 0 1266000 0 0 0 0
1574000
3201126 B 1 BS 1 24/06/2018 26/06/2018 19/05/1973 0 1
1 I25.0;E13.9;I50.0 88.55;36.07 - - YY02 None None None I-1-
(SEDANG) 36008800 0 0 PCI 10725800 - 0 - 0 -
0 46734600 60025805 0 3 0 0 0 SABDA ABADI
0001655863615 3;JKN DR RIZKI; 5.2.2.201806040537 4 193736
1#0##0#0#0.0#2018-08-03 16:22:33#0#00:00:00#00:00:00#00:00:00 2
3c9a96c0dd880b7773e7e745ae050ab4 0 10062000 7254760 0 0
33864045 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 11/06/2018 26/06/2018 11/06/2018 850 1
1 P07.2;P07.0;P22.9 96.72 - - None None None None P-8-02-I
- 0 - 0 84921800 76205162 0 16 1 15 100
BAYI NY MARIA AGUSTINA KUSUMA D400638 0 0 DR AULIA TANGKARI, SPA
0138R0170618V003661 0002465457772 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 190022 1#0##0#0#0.0#2018-08-04
09:04:25#0#00:00:00#00:00:00#00:00:00 2 215d81cbec24a16a37c075ac6c2764ea
0 0 10582398 0 0 23493764 0 0 0 0
17770000 0 0 0 0 24359000
3201126 B 1 BS 1 24/06/2018 26/06/2018 14/07/1971 0 2
1 E14.9;I11.9 - - - None None None None E-4-10-I None
- 0 4903800 2838006 0 3 0 0 0 YULIANTI
D268148 46 17147 DR ARU, SPPD 0138R0170618V006846
0001301056209 3;JKN DR RIZKI; 5.2.2.201806040537 4 193750
1#0##0#0#0.0#2018-08-04 10:00:08#0#00:00:00#00:00:00#12:00:00 3
764edd298ec359df49e734e5f5beafcb 0 0 494342 0 0 570000
0 0 0 0 1773664 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 26/06/2018 05/12/1941 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 2515292 0 4 0 0 0 NANI D328633 76
27959 DR ARU, SPPD 0138R0170618V006658 0002094769653 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 193686 1#0##0#0#0.0#2018-
08-04 13:25:55#0#12:57:28#12:57:28#00:00:00 2
4e42939c8a71ea7c68ff73f9994dcc95 0 0 241100 0 0
1031640 0 0 0 0 1242552 0 0 0 0 0
3201126 B 3 BS 1 17/06/2018 26/06/2018 10/08/1956 0 1
1 I13.2;I49.3;I25.0 38.95;39.95;87.44;87.03 - - None None None
0 - 0 - 0 19332400 42242973 0 10 1 10
0 SUPRIYADI D400116 61 22591 DR AZRI NURIZAL SPPD KKV
0138R0170618V004689 0001734002829 3;JKN irene; 5.2.2.201806040537
4 190916 1#0##0#0#0.0#2018-08-09
15:53:43#0#21:49:01#21:49:01#00:00:00 3 99c95989748b6344652230126e2b17b3
0 0 5659396 0 0 16799427 0 0 0 0
10906150 0 0 8878000 0 0
3201126 B 3 BS 1 26/06/2018 26/06/2018 10/10/1953 0 2
2 I25.0;R00.2;K30 - - - None None None None I-4-16-I
None None None None None None ATHEROSKLEROSIS (RINGAN) 2168700
0 0 - 0 - 0 - 0 - 0 2168700
23635 DR RICO ADITYA 0138R0170618V007571 0001267825792 3;JKN irene;
5.2.2.201806040537 4 194673 1#0##0#0#0.0#2018-08-09
15:54:07#0#00:00:00#00:00:00#00:00:00 2 d1965d292c9eb82710cceb37b78df682
0 0 108435 0 0 1222375 0 0 0 0 462807
0 0 0 0 588000
3201126 B 3 BS 1 25/06/2018 26/06/2018 22/07/1975 0 1
1452800 0 0 - 0 - 0 - 0 - 0
1452800 5240426 0 2 0 0 0 TOMMY KRISTANTO
0001266174314 3;JKN irene; 5.2.2.201806040537 4 194147
1#0##0#0#0.0#2018-08-09 15:54:30#0#14:35:50#14:35:50#00:00:00 2
2641a492d1ff71e492664121d999c761 0 0 522784 0 0 827310
0 0 0 0 2141332 0 0 0 0 1749000
3201126 B 1 BS 1 25/06/2018 26/06/2018 15/05/1966 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 61047200 0 2 0 0 0 MEIRIYADI
0000060524414 3;JKN irene; 5.2.2.201806040537 4 193982
1#0##0#0#0.0#2018-08-11 11:59:45#0#00:00:00#00:00:00#00:00:00 2
74664eb95dfb8e36c865da8d7df68535 0 10080000 9619120 0 0
32503080 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 25/06/2018 26/06/2018 12/02/1963 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 40320535 0 2 0 0 0 ARIF WIDODO
0001337976382 3;JKN irene; 5.2.2.201806040537 4 193760
1#0##0#0#0.0#2018-08-11 12:00:10#0#00:00:00#00:00:00#12:00:00 2
08a06397a7e6080df9843dbd61f5437f 0 10062000 3419040 0 0
17738495 0 0 0 0 1276000 0 0 0 0
7825000
3201126 B 3 BS 1 23/06/2018 26/06/2018 06/02/1962 0 2
4 I21.9;E14.1 99.60 - - None None None None I-4-10-III None
0 - 0 - 0 - 0 - 0 10401900 11265198
0 4 1 2 0 RUSMANIAR D401476 56 20591 DR. ARU
ARIADNO, SPPD 0138R0170618V006761 0002234496576 3;JKN irvan;
5.2.2.201806040537 4 193719 1#0##0#0#0.0#2018-09-27
10:51:03#0#00:00:00#00:00:00#00:00:00 2 f978c902d8236307b70eb762dbc9a20d
0 0 679290 0 0 5815432 0 0 0 0
2948476 0 0 0 0 1822000
3201126 B 1 BS 1 25/06/2018 26/06/2018 24/05/1960 0 2
- 0 12472300 13295127 0 2 0 0 0 MUNIROH
P076688 58 21216 SRI KUNMARTINI.DR,SPPD 0138R0170618V007080
0001383253391 3;JKN SURYANIH;15136 5.2.2.201806040537 4 194047
1#0##0#0#0.0#2018-10-03 14:09:55#0#00:00:00#00:00:00#00:00:00 2
9346a7e5a9be22f4b16fb41177d0ea1b 0 0 2647238 0 0
3719114 0 0 0 0 6859775 0 0 0 0 69000
3201126 B 1 BS 1 23/06/2018 27/06/2018 23/04/1980 0 1
1 E13.9;J18.0;B37.0 - - - None None None None E-4-10-III
0 - 0 8768000 6677410 0 5 0 0 0 RONALD
N D388134 38 13940 DR ARU, SPPD 0138R0170618V006744
0000133709545 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193717
1#0##0#0#0.0#2018-07-03 14:46:03#0#00:00:00#00:00:00#12:00:00 1
c4034c69684dcc53f144e895ad77ddd2 0 0 508265 0 0
2146805 0 0 0 0 4022340 0 0 0 0 0
3201126 B 1 BS 1 19/06/2018 27/06/2018 10/06/1952 0 1
1 E14.2;E87.1;R77.0;R02 88.72 - - None None None None N-4-
LAIN (SEDANG) 7385300 0 0 - 0 - 0 - 0 -
0 7385300 12846557 0 9 0 0 0 ABDUL RODJI
0000059379614 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191695
1#0##0#0#0.0#2018-07-03 14:52:10#0#00:00:00#00:00:00#00:00:00 1
be53715eea826df10bfe30ff35bf0cba 0 0 865383 0 0
2524845 0 0 0 0 8247329 0 0 0 0
1209000
3201126 B 3 BS 1 25/06/2018 27/06/2018 06/12/1973 0 2
(RINGAN) 7039300 0 0 - 0 - 0 - 0 - 0
7039300 10581103 0 3 0 0 0 RIANA TAMBUNAN
0001266689496 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193787
1#0##0#0#0.0#2018-07-03 14:59:21#0#00:00:00#00:00:00#00:00:00 1
ddef59b7fe0b3bc06f1594c20bac4bbd 0 3253500 2034004 0 0
4268412 0 0 0 0 807687 0 0 0 0 217500
3201126 B 1 BS 1 25/06/2018 27/06/2018 20/02/1996 0 2
0 0 - 0 - 0 - 0 - 0 6981500
20870107 0 3 0 0 0 FARHUNISA d383149 22 8161
DR NINING H, SPOG 0138R0170618V007256 0001139041089 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 194262 1#1#vvip#3#13888607#0.0#2018-
07-03 15:11:24#0#17:20:37#17:20:37#00:00:00 1
b4cf4bf5cff0bf63faae1da05eaa80fc 0 7887400 6557176 0 0
4912531 0 0 0 0 1316000 0 0 0 0 197000
3201126 B 1 BS 1 24/06/2018 27/06/2018 20/07/1960 0 2
1 E87.6;I50.0;M06.09;N20.0 - - - None None None None
E-4-11-II None None None None None None HIPOVOLEMIA & GANGGUAN
- 0 6306900 5516006 0 4 0 0 0 TUTI
SUHITAWATI D075030 57 21158 DR AZRI NURIZAL SPPD KKV
0138R0170618V006790 0000039858412 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 193728 1#0##0#0#0.0#2018-07-03
15:14:24#0#00:00:00#00:00:00#00:00:00 1 586b41f72078ed0fad28c6b8f318cf5e
0 0 575234 0 0 1429912 0 0 0 0
3510860 0 0 0 0 0
3201126 B 2 BS 1 26/06/2018 27/06/2018 05/03/1990 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 7827215 0 2 0 0 0 NURHAMIMAH D401684
DR RIZKI; 5.2.2.201806040537 4 194967 1#0##0#0#0.0#2018-07-03
16:55:50#0#19:57:10#19:57:10#00:00:00 1 273f4af7e55f0fe1454cf3ca9cc6f0ea
0 4703600 1563494 0 0 903060 0 0 0 0
588061 0 0 0 0 69000
3201126 B 1 BS 1 25/06/2018 27/06/2018 24/01/2013 0 2
1 A09.9;E87.1;E86 - - - None None None None K-4-17-II
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 2843379 0 3 0 0 0 NARISSARA RIZKANSHA
PRASETIO D375105 5 1978 DR KRISTON SILITONGA, SPA
0138R0170618V007294 0001460969043 3;JKN DR RIZKI; 5.2.2.201806040537
4 194268 1#0##0#0#0.0#2018-07-03
17:05:59#0#20:55:36#20:55:36#00:00:00 1 25166b4234b19b2565cb0fe55ff5af2e
0 0 269099 0 0 364765 0 0 0 0
2209515 0 0 0 0 0
3201126 B 1 BS 1 24/06/2018 27/06/2018 12/06/1950 0 2
1 H81.3;K29.7 - - - None None None None U-4-11-I None
- 0 - 0 - 0 - 0 2124500 4684183 0
4 0 0 0 TUMINI PS D331095 68 24849 DR HARDI PRANATA
4 193743 1#0##0#0#0.0#2018-07-03
17:06:44#0#00:00:00#00:00:00#00:00:00 1 2b4f2959d7b6dc9d6f5bca2735fbdbed
0 0 244205 0 0 983536 0 0 0 0
3456442 0 0 0 0 0
3201126 B 1 BS 1 23/06/2018 27/06/2018 04/05/1999 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5429265 0 5 0 0 0 RATU AYU MAIMUNAH
D014763 19 6990 DR ARU, SPPD 0138R0170618V006728
0002073187473 3;JKN DR RIZKI; 5.2.2.201806040537 4 193716
1#0##0#0#0.0#2018-07-03 17:09:55#0#00:00:00#00:00:00#00:00:00 1
c1cdeea93bcb3bbf877c3bd9476bedd5 0 0 316331 0 0
1172248 0 0 0 0 3940686 0 0 0 0 0
3201126 B 1 BS 1 26/06/2018 27/06/2018 01/03/2012 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 4718895 0 2 0 0 0 AQMARUL IKHSAN
0001274835126 3;JKN DR RIZKI; 5.2.2.201806040537 4 194379
1#0##0#0#0.0#2018-07-03 17:10:52#0#00:00:00#00:00:00#00:00:00 1
4a089991d98bb2cd26fb0bbbd556088a 0 0 376362 0 0
2409820 0 0 0 0 1932713 0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 27/06/2018 13/06/2016 0 1
(RINGAN) 3692900 0 0 - 0 - 0 - 0 - 0
3692900 5876379 0 2 0 0 0 MUHAMMAD GIBRAN ASSIDIQ
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1#0##0#0#0.0#2018-07-03 17:18:27#0#00:00:00#00:00:00#00:00:00 1
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1300431 0 0 0 0 410436 0 0 0 0 69000
3201126 B 3 BS 1 25/06/2018 27/06/2018 02/07/1985 0 2
0 - 0 - 0 - 0 - 0 5331600 9056531
0 3 0 0 0 NUNUNG NURASIAH d398465 32 12046 DR
HENDRIEK S, SPB 0138R0170618V007289 0001259819267 3;JKN DR RIZKI;
5.2.2.201806040537 4 194264 1#0##0#0#0.0#2018-07-03
17:28:20#0#20:27:09#20:27:09#00:00:00 1 f0a05aec24bc37961d64b68f75b3a933
0 3525300 1492848 0 0 3224900 0 0 0 0
668483 0 0 0 0 145000
3201126 B 3 BS 1 26/06/2018 27/06/2018 17/03/1972 0 2
(RINGAN) 15363900 0 0 - 0 - 0 - 0 - 0
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TANTIYO S;16137 5.2.2.201806040537 4 194644 1#0##0#0#0.0#2018-
07-03 18:34:17#0#12:34:43#12:34:43#12:00:00 1
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3201126 B 1 BS 1 24/06/2018 27/06/2018 12/05/1979 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5238741 0 4 0 0 0 RATRI WULANASRI
0001834061185 3;JKN DR RIZKI; 5.2.2.201806040537 4 193749
1#0##0#0#0.0#2018-08-04 08:14:47#0#00:00:00#00:00:00#00:00:00 2
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1622126 0 0 0 0 3147221 0 0 0 0 0
3201126 B 1 BS 1 26/06/2018 27/06/2018 13/12/1959 0 2
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4 194973 1#0##0#0#0.0#2018-08-04
08:27:10#0#21:33:02#21:33:02#00:00:00 2 88dcfd4244b42693c94656fee688829f
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1#0##0#0#0.0#2018-08-04 13:13:08#0#00:03:13#00:03:13#00:00:00 2
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3201126 B 3 BS 1 26/06/2018 27/06/2018 02/05/1958 0 2
- 0 8908800 7745099 0 2 0 0 0 DINA
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1#0##0#0#0.0#2018-08-09 15:54:57#0#17:55:47#17:55:47#00:00:00 2
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SPTHT 0138R0170618V007292 0002311537634 3;JKN irene; 5.2.2.201806040537
4 195029 1#0##0#0#0.0#2018-08-09
15:55:46#0#00:00:00#00:00:00#00:00:00 2 1927d2d0fbf95bc5beb9f4e6d587e486
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3201126 B 1 BS 1 27/06/2018 27/06/2018 19/08/1950 0 1
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7684500 17183416 0 1 0 0 0 LEONARDO SIAGIAN
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1#0##0#0#0.0#2018-08-11 12:00:27#0#22:36:38#22:36:38#00:00:00 2
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4100546 0 0 0 0 10573049 0 0 0 69000 0
3201126 B 1 BS 1 26/06/2018 27/06/2018 14/05/1958 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
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1#0##0#0#0.0#2018-08-11 12:01:05#0#08:01:13#08:01:13#00:00:00 2
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21128165 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 26/06/2018 27/06/2018 24/03/1950 0 1
1 E14.2;A16.1;I11.9;T82.4 39.42 - - None None None None N-1-
- 0 - 0 27065300 17040863 0 2 0 0 0
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12:01:30#0#00:00:00#00:00:00#12:00:00 2 5aeb7a158b902ec551be8ed4fbb2b1c6
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3201126 B 1 BS 1 16/06/2018 27/06/2018 17/02/1955 0 2
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1#0##0#0#0.0#2018-09-27 10:42:43#0#00:00:00#00:00:00#00:00:00 1
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17364470 0 0 0 0 1226000 0 0 0 0
2998000
3201126 B 2 BS 1 22/06/2018 28/06/2018 25/11/1965 0 1
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
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0002080905805 3;JKN DR RIZKI; 5.2.2.201806040537 4 193600
1#0##0#0#0.0#2018-07-03 11:45:39#0#21:59:25#21:59:25#00:00:00 1
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3201126 B 2 BS 1 26/06/2018 28/06/2018 24/02/1967 0 1
1 K30;G20 - - - None None None None K-4-18-II None
2941900 0 0 - 0 - 0 - 0 - 0
2941900 2377006 0 3 0 0 0 HAFID MAULANA
0001722155534 3;JKN DR RIZKI; 5.2.2.201806040537 4 195135
1#0##0#0#0.0#2018-07-03 16:01:21#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 25/06/2018 28/06/2018 27/12/1960 0 2
1 K21.9;N39.0;B17.9 - - - None None None None K-4-12-II
0 0 - 0 - 0 - 0 - 0 4919200
4498904 0 4 0 0 0 NEELCE NATALIE WATTIMENA
D401553 57 20999 DR BETTY 0138R0170618V007072 0001658432463
3;JKN DR RIZKI; 5.2.2.201806040537 4 194043 1#0##0#0#0.0#2018-
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1860558 0 0 0 0 2340321 0 0 0 0 0
3201126 B 2 BS 1 23/06/2018 28/06/2018 12/07/1953 0 2
1 E88.0;D64.9;R63.0 99.04 - - None None None None E-4-12-II
None None None None None None GANGGUAN METABOLIK BAWAAN (SEDANG)
7055400 0 0 - 0 - 0 - 0 - 0
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d401427 64 23722 DR. ARU ARIADNO, SPPD 0138r0170618v006617
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1#0##0#0#0.0#2018-07-03 16:29:06#0#08:34:00#08:34:00#00:00:00 1
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6738914 0 0 0 0 3777105 0 0 0 0 0
3201126 B 1 BS 1 23/06/2018 28/06/2018 20/06/1942 0 1
4136800 0 0 - 0 - 0 - 0 - 0
4136800 11621752 0 6 0 0 0 JAN VICTOR PINONTOAN
D401433 76 27762 DR ARU, SPPD 0138R0170618V007024
0001338464608 3;JKN DR RIZKI; 5.2.2.201806040537 4 193923
1#0##0#0#0.0#2018-07-03 16:38:23#0#00:00:00#00:00:00#00:00:00 2
9016dc43852cd83288a8ad91036b733a 0 0 669698 0 0
6090752 0 0 0 0 4691302 0 0 0 0 170000
3201126 B 2 BS 1 26/06/2018 28/06/2018 08/04/1977 0 2
0 0 - 0 - 0 - 0 - 0 9917100
11110168 0 3 0 0 0 UMI SALAMAH D399085 41 15054
DR RIZKI; 5.2.2.201806040537 4 194292 1#0##0#0#0.0#2018-07-03
16:51:32#0#07:01:49#07:01:49#00:00:00 1 9267f90fca7fd503059f60504e88471c
0 4359000 3366360 0 0 2477975 0 0 0 0
837833 0 0 0 0 69000
3201126 B 2 BS 1 25/06/2018 28/06/2018 13/07/1991 0 1
1 A16.1;J90;R06.0 87.49;90.59;34.91 - - None None None None
J-4-15-I None None None None None None PERADANGAN DAN INFEKSI
PERNAFASAN (RINGAN) 5203800 0 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-07-03 16:54:38#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 26/06/2018 28/06/2018 10/11/1960 0 2
1 I13.1;A49.9;D63.8 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3483084 0 3 0 0 0 NANI MARDIYANTI
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1#0##0#0#0.0#2018-07-03 16:56:52#0#20:29:52#20:29:52#12:00:00 1
ce8b3c7a33327d0bc3c49b7902a36e80 0 0 499265 0 0
1422454 0 0 0 0 1561365 0 0 0 0 0
3201126 B 1 BS 1 27/06/2018 28/06/2018 18/02/1983 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4630958 0 2 0 0 0 ARIF BUDIANSYAH TN
0001472152419 3;JKN DR RIZKI; 5.2.2.201806040537 4 195155
1#0##0#0#0.0#2018-07-03 17:00:12#0#00:00:00#00:00:00#00:00:00 1
d3cef19b1696396995a0f29aef31d954 0 0 573641 0 0
1702482 0 0 0 0 2354835 0 0 0 0 0
3201126 B 1 BS 1 26/06/2018 28/06/2018 23/11/1968 0 2
1 C18.9;D64.9;K92.1;E88.0 99.04 - - None None None None K-4-
0 0 - 0 - 0 - 0 - 0 9888000
12540428 0 3 0 0 0 DWI RACHMA S D010792 49
RIZKI; 5.2.2.201806040537 4 194870 1#0##0#0#0.0#2018-07-03
17:02:58#0#15:48:02#15:48:02#12:00:00 1 1fe03d60674da4d0f7ed74641d3ae467
0 0 1557360 0 0 6311666 0 0 0 0
4671402 0 0 0 0 0
3201126 B 1 BS 1 27/06/2018 28/06/2018 21/12/2007 0 1
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0 4181800 4514977 0 2 0 0 0 IQBAL MARLOPO
0001335363658 3;JKN DR RIZKI; 5.2.2.201806040537 4 194991
1#0##0#0#0.0#2018-07-03 17:08:52#0#00:00:00#00:00:00#12:00:00 1
a31cda0043a6f192d2f081278a4981ff 0 0 376362 0 0
2255243 0 0 0 0 1883372 0 0 0 0 0
3201126 B 3 BS 1 27/06/2018 28/06/2018 01/05/1969 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 2023580 0 2 0 0 0 ERNAWATI D401714
49 17954 DR ARU, SPPD 0138R0170618V007755 0000511519083 3;JKN
DR RIZKI; 5.2.2.201806040537 4 194979 1#0##0#0#0.0#2018-07-03
17:16:31#0#00:00:00#00:00:00#00:00:00 1 bca5f3be1522489eadfb864321bb7ac1
0 0 318941 0 0 1020255 0 0 0 0 684384
0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 28/06/2018 31/12/1949 0 1
1 I50.0;J44.9;I44.0 89.52;90.59;87.44 - - None None None None
4144700 0 0 - 0 - 0 - 0 - 0
4144700 12881752 0 7 0 0 0 SAMIN HS D389095
0001459427095 3;JKN DR RIZKI; 5.2.2.201806040537 4 192970
1#0##0#0#0.0#2018-07-03 17:22:07#0#00:00:00#00:00:00#12:00:00 1
b2945b4023d23774109bb1f336fae268 0 0 4197700 0 0
2252321 0 0 0 0 4539731 0 0 0 0
1892000
3201126 B 3 BS 1 24/06/2018 28/06/2018 23/03/1956 0 1
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0 5 0 0 0 EMELUDIN PAKPHAN D401534 62 22738 DR
ZULFAN, SPPD 0138R0170618V006841 0001272461422 3;JKN DR RIZKI;
5.2.2.201806040537 4 193747 1#0##0#0#0.0#2018-07-03
17:23:24#0#00:00:00#00:00:00#00:00:00 1 c0f33c60698e404a457f7b407a4b16df
0 0 304865 0 0 1259640 0 0 0 0
1451830 0 0 0 0 0
3201126 B 3 BS 1 23/06/2018 28/06/2018 14/03/1981 0 2
1 J01.3;R51 - - - None None None None U-4-13-I None
0 - 0 1980100 3925185 0 6 0 0 0
FERAWATI D401499 37 13615 DR CATUR BANUAJI SPS
0138R0170618V006776 0002102400022 3;JKN DR RIZKI; 5.2.2.201806040537
4 193721 1#0##0#0#0.0#2018-07-03
17:25:02#0#00:00:00#00:00:00#00:00:00 1 b8e3963eb93b376de286f9847dda7a16
0 0 397509 0 0 2016388 0 0 0 0
1511288 0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 28/06/2018 03/11/1971 0 2
- 0 - 0 - 0 - 0 4888600 3097219 0
4 0 0 0 PATIANA D401552 46 17036 DR HARDI PRANATA
4 193891 1#0##0#0#0.0#2018-07-03
17:26:01#0#00:00:00#00:00:00#00:00:00 1 510f1d7b9acfacefa48e4d0358312606
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1280622 0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 28/06/2018 17/03/2010 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 4100902 0 3 0 0 0 ALFATHIRA
0001265724505 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194959
1#0##0#0#0.0#2018-07-03 17:27:03#0#17:14:21#17:14:21#12:00:00 1
0b1400342effc60d8d5d71033184af8f 0 0 268830 0 0
2835289 0 0 0 0 996783 0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 28/06/2018 15/11/2000 0 2
1 K71.6;A16.2;J91 87.44 - - None None None None B-4-13-III
None None None None None None GANGGUAN HATI LAIN-LAIN (BERAT)
6747200 0 0 - 0 - 0 - 0 - 0
6747200 4155236 0 3 0 0 0 FIRDHA AULIA LATIFAH
D401636 17 6432 DR BOBBY DRASTYAWAN SPPA 0138R0170618V007308
0001170701796 3;JKN DR RIZKI; 5.2.2.201806040537 4 194279
1#0##0#0#0.0#2018-07-03 17:27:29#0#00:00:00#00:00:00#00:00:00 1
10546e59789a7bb634657b617a9b2f07 0 0 660248 0 0 785150
0 0 0 0 2709838 0 0 0 0 0
3201126 B 2 BS 1 21/06/2018 28/06/2018 29/10/2017 0 1
1 J22;R50.8 93.94 - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 3358200 0 0 - 0 - 0 - 0
- 0 3358200 8982971 0 8 0 0 0 JAFEER ADHAM
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0002375519387 3;JKN DR RIZKI; 5.2.2.201806040537 4 195006
1#0##0#0#0.0#2018-07-04 08:46:21#0#17:47:26#17:47:26#00:00:00 1
771845c6a70147f4e9eb6534bf79d871 0 0 470356 0 0
4363944 0 0 0 0 4148671 0 0 0 0 0
3201126 B 3 BS 1 28/06/2018 28/06/2018 10/02/1964 0 2
0 - 0 - 0 - 0 - 0 2954900 995063
0 1 0 0 0 KASIYEM D375216 54 19862 DR AHMAD
HIBBAN A WRIYA 0138R0170618V008019 0001266786584 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195023 1#0##0#0#0.0#2018-07-04
15:13:56#0#00:00:00#00:00:00#12:00:00 1 fd68899bd2e7f4ac60806ae577eabea2
0 0 204965 0 0 0 0 0 0 0 372098
0 0 0 0 418000
3201126 B 3 BS 1 26/06/2018 28/06/2018 18/04/1992 0 1
(RINGAN) 7792500 0 0 - 0 - 0 - 0 - 0
7792500 8502327 0 3 0 0 0 PRAYUDA APRIANTO
0001207957386 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194293
1#0##0#0#0.0#2018-07-04 15:19:24#0#00:00:00#00:00:00#00:00:00 1
01f2256e64f3896181e8abcc45b95586 0 3253500 1190832 0 0
3331768 0 0 0 0 657227 0 0 0 0 69000
3201126 B 3 BS 1 19/06/2018 28/06/2018 12/04/1968 0 1
1 E10.7;E87.1;E16.2;N18.4;A41.9;E87.6;J15.9;D63.8 90.59;89.52;86.22 -
- None None None None E-4-10-III None None None None None None
PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK (BERAT) 6262900
0 0 - 0 - 0 - 0 - 0 6262900
17949101 0 10 0 0 0 BUDIMAN D393779 50 18330
TANTIYO S;16137 5.2.2.201806040537 4 191227 1#0##0#0#0.0#2018-
07-04 15:21:43#0#00:00:00#00:00:00#12:00:00 1
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9604604 0 0 0 0 1280240 0 0 0 0 138000
3201126 B 3 BS 1 28/06/2018 28/06/2018 14/01/1984 0 1
1 D33.2;G81.1;Q85.0;Z59.4 - - - None None None None G-4-
LAIN (SEDANG) 4302200 0 0 - 0 - 0 - 0 -
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0001799472262 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195512
1#0##0#0#0.0#2018-07-04 15:33:48#0#00:00:00#00:00:00#00:00:00 1
636d30a40ad5cad79a131941c1f321e2 0 0 215110 0 0 319986
0 0 0 0 416067 0 0 0 0 716000
3201126 B 3 BS 1 28/06/2018 28/06/2018 02/07/1957 0 2
1 N18.5;K21.9;D63.8;I10 99.04;90.59;89.52;39.95 - - None None
0 - 0 - 0 4132100 2653589 0 1 0 0
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0138R0170618V007955 0001293884651 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195018 1#0##0#0#0.0#2018-07-04
15:34:47#0#00:00:00#00:00:00#00:00:00 1 b37d29a7712807d0370f4ff4ebbd43bf
0 0 206605 0 0 739010 0 0 0 0
1289974 0 0 0 0 418000
3201126 B 3 BS 1 25/06/2018 28/06/2018 01/07/1964 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 6329627 0 4 0 0 0 SUNANI D341192
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194003
1#0##0#0#0.0#2018-07-04 15:35:43#0#00:00:00#00:00:00#00:00:00 1
828640762eb3933e1d2a08dacdfcca3b 0 0 424889 0 0
2310150 0 0 0 0 2418588 0 0 0 0
1176000
3201126 B 3 BS 1 23/06/2018 28/06/2018 18/08/1967 0 1
1 I12.0;E87.2 38.95 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 12112273 0 6 0 0 0 MAHDIL
0002067090074 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193712
1#0##0#0#0.0#2018-07-04 15:37:46#0#00:00:00#00:00:00#00:00:00 1
cf45a0ce93df2c4d1136ba9bac93209a 0 3754500 932420 0 0
5331711 0 0 0 0 2024642 0 0 0 0 69000
3201126 B 3 BS 1 27/06/2018 28/06/2018 16/04/1986 0 2
- 0 - 0 - 0 - 0 2168300 1730673 0
2 0 0 0 HENNY APRILIA S NY D316772 32 11760 DR RM
DHENI DANARDHONO SPOG 0138R0170618V007756 0001216211477 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 194980 1#0##0#0#0.0#2018-07-04
15:54:04#0#02:03:03#02:03:03#00:00:00 1 a9d0cdfb0d391ba21ec2639715fc250e
0 0 248147 0 0 602304 0 0 0 0 683222
0 0 0 0 197000
3201126 B 3 BS 1 27/06/2018 28/06/2018 12/10/1940 0 2
1 T82.4;N18.5;I72.9;D63.8 39.42;99.04 - - None None None None
- 0 - 0 8908800 6476792 0 2 0 0 0
MUNYANIH D398783 77 28382 DR DEDY PRATAMA SPBV
0138R0170618V007799 0002020722862 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 194985 1#0##0#0#0.0#2018-07-04
15:56:26#0#08:05:05#08:05:05#00:00:00 1 07a03aa1cfe7f0cb9e20cb82d4cccab1
0 0 974100 0 0 1495177 0 0 0 0
3938515 0 0 0 0 69000
3201126 B 2 BS 1 26/06/2018 28/06/2018 07/01/1976 0 2
6093000 0 0 - 0 - 0 - 0 - 0
6093000 2000000 0 3 0 0 0 WIDYANINGSIH
0001834221521 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194289
1#0##0#0#0.0#2018-07-04 16:05:59#1#05:35:22#05:35:22#00:00:00 1
bd220afe4b4a03653150c7617263b30c 0 0 2000000 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 28/06/2018 31/12/1978 0 2
1 A18.4 83.21;86.22 - - None None None None L-4-14-I None
(RINGAN) 2944000 0 0 - 0 - 0 - 0 - 0
2944000 9118256 0 4 0 0 0 MASLAINI NASUTION
0002296555323 3;JKN DR RIZKI; 5.2.2.201806040537 4 194266
1#0##0#0#0.0#2018-08-04 08:39:32#0#20:41:35#20:41:35#00:00:00 2
b4c91ba26764346bd86cd1da017f3273 0 3235500 879700 0 0
4150535 0 0 0 0 707521 0 0 0 0 145000
3201126 B 3 BS 1 28/06/2018 28/06/2018 30/08/1988 0 2
1 K21.9;I95.9 90.59;89.52 - - None None None None K-4-12-I
0 0 - 0 - 0 - 0 - 0 2954900
1262584 0 1 0 0 0 YENI HANDAYANI D401795 29
10894 DR AHMAD HIBBAN A WRIYA 0138R0170618V007953 0001640363466 3;JKN
DR RIZKI; 5.2.2.201806040537 4 195017 1#0##0#0#0.0#2018-08-04
08:51:13#0#00:00:00#00:00:00#00:00:00 2 68a06f736896ae9c3f09a78f663ccd4b
0 0 204965 0 0 250020 0 0 0 0 389599
0 0 0 0 418000
3201126 B 3 BS 1 28/06/2018 28/06/2018 11/06/1940 0 2
2 I69.4;A49.9;J98.1;Z03.0 87.49;90.59;89.52;87.03 - - None None
None None G-4-26-II None None None None None None GANGGUAN -
PENYAKIT SISTEM SARAF LAIN-LAIN (SEDANG) 4302200 0 0 - 0 -
0 - 0 - 0 4302200 3389257 0 1 0 0
0 SRI SOERYANTI D399079 78 28506 DR AHMAD HIBBAN A WRIYA
0138R0170618V007960 0000060879655 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195020 1#0##0#0#0.0#2018-08-04
14:09:40#0#00:00:00#00:00:00#00:00:00 2 d58fc16a64f7a329adacca6e54f89856
0 0 215110 0 0 2227420 0 0 0 0 528727
0 0 0 0 418000
3201126 B 3 BS 1 18/06/2018 28/06/2018 01/01/1954 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 99959399 0 11 0 0 0 MAMAY D400981
0000395286546 3;JKN irene; 5.2.2.201806040537 4 190927
1#0##0#0#0.0#2018-08-09 15:56:05#0#02:45:44#02:45:44#00:00:00 2
0d7d507de41f43071d8ee77c5b3a770a 0 14813000 6923800 0 0
64083699 0 0 0 0 1607900 0 0 0 0
12531000
3201126 B 3 BS 1 28/06/2018 28/06/2018 28/04/1990 0 2
4336500 0 0 - 0 - 0 - 0 - 0
4336500 6027843 0 1 0 0 0 HEDY TATIPIKALAWAN
0002277805735 3;JKN irene; 5.2.2.201806040537 4 195265
1#0##0#0#0.0#2018-08-09 15:56:25#0#00:00:00#00:00:00#00:00:00 2
7406b2e76287ef63ed406dd754724c2f 0 0 173460 0 0
4104354 0 0 0 0 711029 0 0 0 0
1039000
3201126 B 3 BS 1 27/06/2018 28/06/2018 07/04/1969 0 1
1 T82.4;N18.5;I72.9;D63.8 39.42;39.59;99.04 - - None None None
None I-1-20-II None None None None None None PROSEDUR SISTIM
PEREDARAN DARAH LAIN-LAIN (SEDANG) 19193800 0 0 - 0 - 0
- 0 - 0 19193800 29546159 0 2 0 0 0
EKO PRIAMBODO D401702 49 17978 DR DEDDY SPBTKV
0138R0170618V007820 0001228485802 3;JKN irene; 5.2.2.201806040537
4 194987 1#0##0#0#0.0#2018-08-09
15:56:52#0#00:00:00#00:00:00#00:00:00 2 df2164267d65ca0619667c4f503e01d0
0 3062500 3226419 0 0 19912240 0 0 0 0
1276000 0 0 0 0 2069000
3201126 B 3 BS 1 27/06/2018 28/06/2018 14/10/1969 0 1
- 0 45079800 0 0 2 0 0 0 ANANG RUSDI
0001446446575 3;JKN irene; 5.2.2.201806040537 4 194995
1#0##0#0#0.0#2018-08-09 15:57:24#0#00:00:00#00:00:00#12:00:00 2
2396c621a27e0a709a905b1a93d921e5 0 8014000 0 0 0
12282805 0 0 0 0 1276000 0 0 0 0
7697000
3201126 B 2 BS 1 27/06/2018 28/06/2018 15/06/1947 0 2
1 I08.9;I11.0;I25.0;E13.9 36.07 - - YY02 None None None I-1-
- 0 51950600 61668100 0 2 0 0 0 KOMARIAH
TJIK D347381 71 25945 DR AGOES KOOSHARTORO SPPD 0138R0170618V007787
0001258382518 3;JKN irene; 5.2.2.201806040537 4 194984
1#0##0#0#0.0#2018-08-09 16:11:26#0#07:26:05#07:26:05#00:00:00 2
6852b1de197b07887f7795d77950f035 0 8986000 8244960 0 0
35592140 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 2 BS 1 24/06/2018 28/06/2018 28/04/2014 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3241779 0 5 0 0 0 MIKHAILLA ALLEYSHA VAN
ZUNDERT D273626 4 1518 DR KHARINA CHATAR SPA 0138R0170618V006809
0001515111388 3;JKN irene; 5.2.2.201806040537 4 193735
1#0##0#0#0.0#2018-08-09 16:11:44#0#10:40:38#10:40:38#00:00:00 2
8e4bd053b5f02786b228f74d754476e8 0 0 278711 0 0 704989
0 0 0 0 2020000 0 0 0 238079 0
3201126 B 1 BS 1 25/06/2018 28/06/2018 15/06/1944 0 1
1 N40;N39.0 60.29;90.59;89.52 - - None None None None V-1-
(SEDANG) 17977700 0 0 - 0 - 0 - 0 - 0
17977700 24791404 0 4 0 0 0 HASIM B MARAN
0000060709511 3;JKN irene; 5.2.2.201806040537 4 193757
1#0##0#0#0.0#2018-08-11 12:01:49#0#07:34:06#07:34:06#12:00:00 2
c40f3666c95f2765a598fa05cf68fdcf 0 10501600 3464468 0 0
6255336 0 0 0 0 0 0 0 0 4569993 0
3201126 B 1 BS 1 26/06/2018 28/06/2018 12/02/2016 0 1
(RINGAN) 4126300 0 0 - 0 - 0 - 0 - 0
4126300 11048816 0 3 0 0 0 MUHAMMAD ZACKY AL
GHIFARIE D323626 2 865 DR BENNY H TUMBELAKA 0138R0170618V007576
0002035902712 3;JKN irene; 5.2.2.201806040537 4 194676
1#0##0#0#0.0#2018-08-11 12:03:43#0#00:00:00#00:00:00#00:00:00 2
ac57761d6ab3faf50aeb1c907be267c6 0 6748600 1324364 0 0
2104532 0 0 0 0 798820 0 0 0 0 72500
3201126 B 1 BS 1 27/06/2018 28/06/2018 13/09/1949 0 1
- 0 58821400 62059720 0 2 0 0 0 DIDI
AFFANDI.K D105815 68 25124 DR AZRI NURIZAL SPPD KKV
0138R0170618V007823 0001421639572 3;JKN irene; 5.2.2.201806040537
4 194989 1#0##0#0#0.0#2018-08-11
12:04:10#0#00:00:00#00:00:00#00:00:00 2 f1331eb9870e5e1215ea132bc7d5509f
0 10062000 9619120 0 0 33533600 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 3 BS 1 22/06/2018 28/06/2018 04/11/1956 0 1
(RINGAN) 4482300 0 0 - 0 - 0 - 0 - 0
4482300 16299915 0 7 0 0 0 GUNAWAN D401355
61 22510 DR ARU, SPPD 0138R0170618V006563 0001739830061 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 193598 1#0##0#0#0.0#2018-
10-04 07:54:30#0#00:00:00#00:00:00#00:00:00 3
28da22d4eac7396b621f2a2b7f6e6f6a 0 3772500 1520044 0 0
9596021 0 0 0 0 1342350 0 0 0 0 69000
3201126 B 1 BS 1 27/06/2018 28/06/2018 01/10/1996 0 2
None None None None None PROSEDUR KAKI (RINGAN) 12236300 0 0
- 0 - 0 - 0 - 0 12236300 19883002 0
2 0 0 0 ANNISATUS SHALIHAH D401690 21 7939 DR
MARQUEE KENNY TUMBELAKA SPOT 0138R0170618V007751 0000019523204 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 194977 1#0##0#0#0.0#2018-
10-05 10:09:18#0#00:00:00#00:00:00#00:00:00 2
62d1d40f0b483a52d571f5e73f9eb4cb 0 0 6726527 0 0
1947175 0 0 0 0 11064300 0 0 0 0 145000
3201126 B 2 BS 1 26/06/2018 29/06/2018 23/08/1963 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3872043 0 4 0 0 0 AVECITHA MUTIARA S.
0001268379865 3;JKN DR RIZKI; 5.2.2.201806040537 4 194281
1#0##0#0#0.0#2018-07-03 16:00:04#0#00:00:00#00:00:00#00:00:00 1
1b27fd88414f50b0d3f3954f4ac9b17d 0 0 238535 0 0
1334197 0 0 0 0 2299311 0 0 0 0 0
3201126 B 2 BS 1 25/06/2018 29/06/2018 25/06/2018 2200 2
MAYOR (RINGAN) 6580300 0 0 - 0 - 0 - 0 -
0 6580300 4606699 0 5 1 3 0 NINA KURNIAWATI BY
NY D401643 0 0 DR AD PASARIBU, SPA 0138R0170618V007645
0002467331122 3;JKN DR RIZKI; 5.2.2.201806040537 4 194902
1#0##0#0#0.0#2018-07-03 16:30:09#0#16:00:25#16:00:25#00:00:00 1
d65c8fa59596194c77c63e72a01fae40 0 0 611727 0 0 216599
0 0 0 0 3230373 0 0 0 0 548000
3201126 B 2 BS 1 28/06/2018 29/06/2018 23/07/1938 0 2
1 I11.9;K30;H81.3;R00.1 89.52 - - None None None None I-4-
17-II None None None None None None HIPERTENSI (SEDANG) 2663700 0
0 - 0 - 0 - 0 - 0 2663700 1768464
0 2 0 0 0 MARTHA PARURU d090792 79 29195 DR
5.2.2.201806040537 4 195019 1#0##0#0#0.0#2018-07-03
16:32:02#0#04:41:29#04:41:29#00:00:00 1 b11127892a10117086631430366dccc2
0 0 258920 0 0 357850 0 0 0 0
1151694 0 0 0 0 0
3201126 B 2 BS 1 26/06/2018 29/06/2018 20/05/1950 0 2
1 I63.9;G81.9;R47.1 87.03;87.44 - - None None None None G-4-
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 5475188 0 4 0 0 0 NINING SUKARNI
SUWARSO D383582 68 24874 DR HARDI PRANATA SPS 0138R0170618V007312
0001090286335 3;JKN DR RIZKI; 5.2.2.201806040537 4 194282
1#0##0#0#0.0#2018-07-03 16:33:16#0#01:15:59#01:15:59#12:00:00 1
33138aa4c2a498c34935b6de708d2904 0 0 594422 0 0
2476576 0 0 0 0 2404190 0 0 0 0 0
3201126 B 1 BS 1 27/06/2018 29/06/2018 18/11/1950 0 2
1 E87.1;K30 89.52;90.59 - - None None None None E-4-11-I
4136800 0 0 - 0 - 0 - 0 - 0
4136800 7544288 0 3 0 0 0 NIA KANIA D399133
67 24693 DR M YAMIN, SPPD 0138R0170618V007865 0000057799653 3;JKN
DR RIZKI; 5.2.2.201806040537 4 194997
1#1#vvip#3#3407488#0.0#2018-07-03 16:40:41#0#00:00:00#00:00:00#00:00:00
1 162c9a9c118e50803e877e5a1bb639fc 0 0 704546 0 0
2495190 0 0 0 0 4344552 0 0 0 0 0
3201126 B 1 BS 1 26/06/2018 29/06/2018 21/02/1959 0 2
- 0 - 0 27065300 16402003 0 4 0 0 0
ROSIYATI D384812 59 21675 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V007679 0000044937145 3;JKN DR RIZKI; 5.2.2.201806040537
4 194958 1#0##0#0#0.0#2018-07-03
16:42:24#0#16:57:52#16:57:52#12:00:00 1 7288c0c3115eee184566169c30b2991f
0 0 5683713 0 0 1376512 0 0 0 0
9272778 0 0 0 0 69000
3201126 B 1 BS 1 25/06/2018 29/06/2018 09/12/1953 0 2
1 I10;E14.9;K30;A49.9 - - - None None None None I-4-
0 - 0 - 0 - 0 - 0 2669400 6570974
0 5 0 0 0 NURTIAMAN KUDADIRI D342439 64 23574
5.2.2.201806040537 4 194994 1#0##0#0#0.0#2018-07-03
16:46:01#0#12:05:32#12:05:32#00:00:00 1 f7c85a80126c068fd4cd33686a3ecb0b
0 0 494342 0 0 2496755 0 0 0 0
3579877 0 0 0 0 0
3201126 B 1 BS 1 23/06/2018 29/06/2018 19/11/2017 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 20567547 0 7 0 0 0 ATRIA NADIRA DINATA
0002306259213 3;JKN DR RIZKI; 5.2.2.201806040537 4 193711
1#0##0#0#0.0#2018-07-03 16:46:58#0#00:00:00#00:00:00#00:00:00 1
9f35eb5ba1250e90a682156b14cb27c7 0 9951200 3379850 0 0
5680497 0 0 0 0 1317000 0 0 0 0 239000
3201126 B 2 BS 1 28/06/2018 29/06/2018 02/02/1975 0 2
1 I12.9 39.27;87.49;90.59;89.52 - - None None None None N-1-
- 0 5208600 9094929 0 2 0 0 0 MUJI
0138R0170618V008378 0002283540715 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195410 1#0##0#0#0.0#2018-07-03
17:30:48#0#17:38:01#17:38:01#00:00:00 1 b40f41051813904ecc3feea68893bedf
0 4721600 1094720 0 0 2538614 0 0 0 0
670995 0 0 0 0 69000
3201126 B 1 BS 1 28/06/2018 29/06/2018 19/09/1949 0 1
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
0 12472300 17387548 0 2 0 0 0 SUHAIRI
0138R0170618V008176 0000039905943 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195208 1#0##0#0#0.0#2018-07-03
18:19:19#0#00:00:00#00:00:00#12:00:00 1 3646751c1cbd06a7a85d0acd1fd3a03a
0 5896000 2619183 0 0 7589862 0 0 0 0
1213503 0 0 0 0 69000
3201126 B 1 BS 1 26/06/2018 29/06/2018 17/03/2016 0 1
- 0 - 0 - 0 - 0 3718200 3540448 0
4 0 0 0 ARKANI HAMID HUSEIN D401712 2 831 DR
KRISTON SILITONGA, SPA 0138R0170618V007740 0002047118084 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 194971 1#0##0#0#0.0#2018-07-03
18:20:10#0#20:48:55#20:48:55#00:00:00 1 a5f9649471b01ef73583d6a986cbe000
0 0 387638 0 0 552192 0 0 0 0
2600618 0 0 0 0 0
3201126 B 3 BS 1 27/06/2018 29/06/2018 18/05/2013 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1354958 0 3 0 0 0 KHAIRUNNISA SALSABILAH
D401784 5 1866 DR RASTRA, SPA 0138R0170618V007940
0001811634478 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195012
1#0##0#0#0.0#2018-07-04 14:55:14#0#21:40:02#21:40:02#00:00:00 1
f99d7f363031ff0d438d2ed381740989 0 0 207620 0 0 330196
0 0 0 0 817142 0 0 0 0 0
3201126 B 3 BS 1 22/06/2018 29/06/2018 12/02/1954 0 1
1 I21.3;I11.0;M54.59 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 15199297 0 8 1 4 0 MASLAN D401362
64 23506 DR CATUR BANUAJI SPS 0138R0170618V006482 0001385868418
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193534
1#0##0#0#0.0#2018-07-04 15:08:33#0#00:00:00#00:00:00#00:00:00 1
0c3ff713b90e6e93560e2e10413d8f42 0 0 1197209 0 0
5553741 0 0 0 0 6174347 0 0 0 0
2274000
3201126 B 3 BS 1 22/06/2018 29/06/2018 15/04/2016 0 1
(BERAT) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 7106220 0 8 0 0 0 ARIF HIDAYAT
0002466582423 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193914
1#0##0#0#0.0#2018-07-04 15:26:55#0#10:13:33#10:13:33#00:00:00 1
e9f7865de625aa21cff412061f8b5715 0 0 281492 0 0
3533835 0 0 0 0 3120893 0 0 0 0 170000
3201126 B 3 BS 1 21/06/2018 29/06/2018 18/11/1956 0 1
1 K29.9;A18.3;K59.0;K92.0;R18 - - - None None None None
(SEDANG) 3296400 0 0 - 0 - 0 - 0 - 0
3296400 5358700 0 9 0 0 0 MUHAMMAD YUSUF
0001740129952 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 192955
1#0##0#0#0.0#2018-07-04 15:30:08#0#00:00:00#00:00:00#00:00:00 1
bd42a26a859c029ccb3c891e9c7e8ec0 0 0 402676 0 0
2212455 0 0 0 0 2743569 0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 29/06/2018 01/07/1970 0 2
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 2600123 0 5 0 0 0 MARTINI D358822
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194039
1#0##0#0#0.0#2018-07-04 15:31:03#0#00:00:00#00:00:00#00:00:00 1
dc803d7616aa0cd81172560eaec32fce 0 0 674855 0 0
1348746 0 0 0 0 576522 0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 29/06/2018 01/06/1954 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3656043 0 4 0 0 0 ROHMAH
0000511439534 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194280
1#0##0#0#0.0#2018-07-04 15:32:13#0#00:39:16#00:39:16#00:00:00 1
f3cbb107f6f67234ec302296c424df87 0 0 743950 0 0
1304913 0 0 0 0 1317180 0 0 0 0 290000
3201126 B 3 BS 1 23/06/2018 29/06/2018 17/05/1956 0 1
1 D65;E14.7;A41.9;D63.8 99.21;99.04 - - None None None None
D-4-11-III None None None None None None GANGGUAN PEMBEKUAN DARAH
(BERAT) 10288700 0 0 - 0 - 0 - 0 - 0
10288700 18959021 0 7 0 0 0 SLAMET SISWOYO
D401414 62 22682 DR ARU, SPPD 0138R0170618V006585
0001879449131 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193602
1#0##0#0#0.0#2018-07-04 15:42:40#0#00:00:00#00:00:00#00:00:00 1
4821bded044dce5bac0aee734d916872 0 0 368243 0 0
11400778 0 0 0 0 4287000 0 0 0 0
2903000
3201126 B 3 BS 1 23/06/2018 29/06/2018 02/10/1970 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 5742844 0 7 0 0 0 TONDA SARI d389922
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 193723
1#0##0#0#0.0#2018-07-04 15:46:17#0#00:00:00#00:00:00#12:00:00 2
71cc2d327d9ded61c0b27a7c22e447a0 0 0 420155 0 0
3342989 0 0 0 0 1979700 0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 29/06/2018 20/06/1962 0 2
1 J18.0;I50.0 - - - None None None None J-4-16-II None
5077500 0 0 - 0 - 0 - 0 - 0
5077500 4653493 0 5 0 0 0 ARSIH d370025 56
20459 DR ARU, SPPD 0138R0170618V007212 0002262018701 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 194218 1#0##0#0#0.0#2018-
07-04 15:53:21#0#15:43:27#15:43:27#00:00:00 1
db5d7e97830d5ed0850f0c029cf15a40 0 0 374804 0 0
2343255 0 0 0 0 1645434 0 0 0 0 290000
3201126 B 2 BS 1 24/06/2018 29/06/2018 08/06/1973 0 2
4335900 0 0 - 0 - 0 - 0 - 0
4335900 5611137 0 6 0 0 0 YUSRI YUSA D319431
0001181928407 3;JKN ECHI; 5.2.2.201806040537 4 193739
1#0##0#0#0.0#2018-07-05 11:20:43#0#00:00:00#00:00:00#00:00:00 1
3443730725bf548be8fb49567d596445 0 0 496231 0 0
1563822 0 0 0 0 3423084 0 0 0 0 128000
3201126 B 3 BS 1 26/06/2018 29/06/2018 06/06/1966 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 2714137 0 4 0 0 0 SUSMAWATI d401651
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194970
1#0##0#0#0.0#2018-08-04 14:20:57#0#20:29:58#20:29:58#00:00:00 2
64743f5b5b10a76a44a1d76dd5920003 0 0 183752 0 0
1361325 0 0 0 0 1169060 0 0 0 0 0
3201126 B 3 BS 1 25/06/2018 29/06/2018 05/02/1966 0 2
1 E10.9;A09.9 99.17 - - None None None None E-4-10-I None
- 0 3502700 6735830 0 5 0 0 0 JAMILAH
LINGGA D401533 52 19133 DR. ARU ARIADNO, SPPD 0138R0170618V006851
0001380709743 3;JKN irene; 5.2.2.201806040537 4 193754
1#0##0#0#0.0#2018-08-09 15:57:48#0#00:55:38#00:55:38#00:00:00 2
dee589d4b3523939f8194c61831618aa 0 0 368243 0 0
4279925 0 0 0 0 1781662 0 0 0 0 306000
3201126 B 3 BS 1 27/06/2018 29/06/2018 05/07/1942 0 2
0 - 0 - 0 - 0 - 0 12210800 17341851
0 3 0 0 0 MIAH D400589 75 27751 DR AZRI NURIZAL
SPPD KKV 0138R0170618V007806 0002439919102 3;JKN irene;
5.2.2.201806040537 4 194986 1#0##0#0#0.0#2018-08-09
15:58:12#0#00:00:00#00:00:00#00:00:00 2 d88fffcbb62b95c59abcfae330f9d9fd
0 3994000 715120 0 0 8765217 0 0 0 0
1210514 0 0 0 0 2657000
3201126 B 3 BS 1 25/06/2018 29/06/2018 05/04/2004 0 2
None None None None LUKA BAKAR (RINGAN) 5162500 0 0 -
0 - 0 - 0 - 0 5162500 6577829 0 5
0 0 0 FIRDHA APRILIANA PUTRI D401597 14 5194 DR CATUR
SUZANTARA 0138R0170618V007407 0001848941379 3;JKN irene;
5.2.2.201806040537 4 194336 1#0##0#0#0.0#2018-08-09
15:58:36#0#08:51:21#08:51:21#00:00:00 2 22d6404ec62ff07525b5b3e293ca6d82
0 0 517625 0 0 1583879 0 0 0 0
4476325 0 0 0 0 0
3201126 B 3 BS 1 28/06/2018 29/06/2018 26/01/1981 0 1
1 N18.5;E11.6;D63.8;I10;J90 99.04;87.49;90.59;89.52;38.95 - -
None None None None N-1-12-III None None None None None None
MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT DIALISIS (BERAT) 19332400
0 0 - 0 - 0 - 0 - 0 19332400
7913551 0 2 0 0 0 ANSORRULOH D401816 37 13667
SRI KUNMARTINI.DR,SPPD 0138R0170618V008209 0001483752069 3;JKN irene;
5.2.2.201806040537 4 195263 1#0##0#0#0.0#2018-08-09
15:59:04#0#00:00:00#00:00:00#00:00:00 2 9367ecccbf1bdca0f5b975a7f8c32d0b
0 0 1906030 0 0 2282312 0 0 0 0
3656209 0 0 0 0 69000
3201126 B 2 BS 1 28/06/2018 29/06/2018 20/06/2018 0 1
0 - 0 - 0 - 0 - 0 5045200 2498165
0 2 0 0 0 MAHTIARINI ULFHA BY NY D401193 0 8
DR KHARNINA, SPA 0138R0170618V008325 0002465981234 3;JKN irene;
5.2.2.201806040537 4 195370 1#0##0#0#0.0#2018-08-09
16:12:06#0#15:33:32#15:33:32#00:00:00 2 63371348dc08680c9723f0fdd5441a4f
0 0 454068 0 0 160666 0 0 0 0
1543431 0 0 0 0 340000
3201126 B 2 BS 1 26/06/2018 29/06/2018 26/06/2018 2809 2
0 - 0 5066300 8486371 0 4 0 0 0 BAYI
NY YULI D401647 0 0 DR AULIA TANGKARI, SPA 0138R0170618V007432
0002467113175 3;JKN irene; 5.2.2.201806040537 4 194399
1#0##0#0#0.0#2018-08-09 16:12:29#0#00:00:00#00:00:00#00:00:00 2
5cc1ec3f90bda45f4d093323eb34a0dd 0 0 455967 0 0
3615221 0 0 0 0 3705183 0 0 710000 0
0
3201126 B 2 BS 1 22/06/2018 29/06/2018 20/05/1993 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 7300350 0 8 0 0 0 CHAERUNNISA d326018
25 9164 DR ARU, SPPD 0138R0170618V006542 0002035427995 3;JKN
irene; 5.2.2.201806040537 4 193591 1#0##0#0#0.0#2018-08-09
16:12:49#0#00:00:00#00:00:00#00:00:00 2 1e3ebb8020c927958a39f848edbaaab3
0 0 216890 0 0 2747367 0 0 0 0
4336093 0 0 0 0 0
3201126 B 2 BS 1 28/06/2018 29/06/2018 23/01/1956 0 2
1 E87.7;E11.2;I11.9 38.95 - - None None None None N-1-12-II
- 0 10690500 13084287 0 2 0 0 0 RETNANINGSIH
NY D401841 62 22802 SRI KUNMARTINI.DR,SPPD 0138R0170618V008429
0001284388931 3;JKN irene; 5.2.2.201806040537 4 200381
1#0##0#0#0.0#2018-08-09 16:13:18#0#00:00:00#00:00:00#00:00:00 2
008cfd0a32aaa2f4e0388191d1ee330b 0 0 4074139 0 0
3895067 0 0 0 0 4114100 0 0 0 1000981
0
3201126 B 2 BS 1 23/06/2018 29/06/2018 05/03/1983 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 18281004 0 7 0 0 0 NINA KURNIAWATI
B085265 35 12894 DR ERDIYAN, SPOG 0138R0170618V006699
0001290558396 3;JKN irene; 5.2.2.201806040537 4 193713
1#0##0#0#0.0#2018-08-09 16:13:39#0#00:00:00#00:00:00#00:00:00 2
a1420767c36e4d4d8ab94bf884e4b40a 0 6929900 2329594 0 0
6997556 0 0 0 0 1306954 0 0 0 0 717000
3201126 B 1 BS 1 27/06/2018 29/06/2018 07/09/1944 0 1
- 0 12472300 13312885 0 3 0 0 0 ABDUL RADJAK
0000043320846 3;JKN irene; 5.2.2.201806040537 4 195004
1#0##0#0#0.0#2018-08-11 12:05:13#0#00:00:00#00:00:00#00:00:00 2
aa6f327adade0a0e0a864e1370d95a5c 0 7159200 2647238 0 0
2490511 0 0 0 0 946936 0 0 0 0 69000
3201126 B 2 BS 1 10/06/2018 29/06/2018 06/05/2018 0 2
1 L03.9;A41.9 - - - None None None None L-4-12-III None
None None None None None PERADANGAN KULIT/CELLULITIS (BERAT) 9198300
0 0 - 0 - 0 - 0 - 0 9198300
22368296 0 20 0 0 0 BAYI NY SUGI HARTATI II D400228
0 35 DR KHARINA CHATAR SPA 0138R0170618V002980 0002456890907
3;JKN irvan; 5.2.2.201806040537 4 189108 1#0##0#0#0.0#2018-
09-27 10:18:53#0#18:08:08#18:08:08#00:00:00 1
ac68c3b8a8dbce31291b9b85e4f28bf6 0 0 933847 0 0
4684949 0 0 0 0 16362500 0 0 0 0 387000
3201126 B 2 BS 1 27/06/2018 29/06/2018 13/04/1962 0 2
- 0 - 0 23198900 12326975 0 3 0 0 0
KORIAH D401559 56 20529 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V007930 0002337151509 3;JKN SURYANIH;15136
5.2.2.201806040537 4 195007 1#0##0#0#0.0#2018-10-03
14:13:36#0#00:00:00#00:00:00#00:00:00 3 4c75c25400313c453aa78ac12511bb79
0 0 2245005 0 0 4483932 0 0 0 0
5529038 0 0 0 0 69000
3201126 B 2 BS 1 27/06/2018 30/06/2018 06/07/1992 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 10562533 0 4 0 0 0 DWI KARTIKA SARI
0000061133376 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196126
1#0##0#0#0.0#2018-07-03 17:32:06#0#15:43:12#15:43:12#00:00:00 1
3b580026e3f480e4e1af505dd8c5a5eb 0 5061600 2325900 0 0
2314026 0 0 0 0 792007 0 0 0 0 69000
3201126 B 2 BS 1 28/06/2018 30/06/2018 15/10/1961 0 2
1 E16.1;A49.9 90.59;89.52 - - None None None None E-4-13-I
(RINGAN) 4436500 0 0 - 0 - 0 - 0 - 0
4436500 2855827 0 3 0 0 0 TIOH ROHAETI
0000205500993 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195409
1#0##0#0#0.0#2018-07-03 17:59:19#0#17:37:10#17:37:10#12:00:00 1
38d19099552a21f56d4e5e83e845fb94 0 0 452285 0 0 675712
0 0 0 0 1727830 0 0 0 0 0
3201126 B 1 BS 1 27/06/2018 30/06/2018 17/08/1937 0 1
1 C67.9;R33;N13.0 - - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5374849 0 4 0 0 0 TN ABDUL BARI
0000060952105 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196125
1#0##0#0#0.0#2018-07-03 18:14:32#0#15:22:15#15:22:15#00:00:00 1
9485e4ebe0cab4b5353dfe1dfd61f721 0 0 470546 0 0
1748177 0 0 0 0 3156126 0 0 0 0 0
3201126 B 1 BS 1 27/06/2018 30/06/2018 07/04/2000 0 2
1 A91;J91;R57.9 - - - None None None None A-4-13-III
(BERAT) 4481300 0 0 - 0 - 0 - 0 - 0
4481300 8362076 0 4 1 2 0 CHANDRA AYU AVIANTI
0000038511551 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194978
1#0##0#0#0.0#2018-07-03 18:16:01#0#00:00:00#00:00:00#00:00:00 1
de7e49ca319b5cf81ea954ea02fc9f88 0 0 341081 0 0
2911943 0 0 0 0 3593052 0 0 0 0
1516000
3201126 B 1 BS 1 28/06/2018 30/06/2018 15/02/1979 0 2
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 10711451 0 3 0 0 0 HINDRIARTI D401831
0001295558504 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195418
1#0##0#0#0.0#2018-07-03 18:17:12#0#00:00:00#00:00:00#00:00:00 1
e5ce88a18eb5b658905cb080b5a5e092 0 0 1215340 0 0
2157162 0 0 0 0 7269949 0 0 0 0 69000
3201126 B 1 BS 1 27/06/2018 30/06/2018 08/03/2013 0 2
1 A91;N04.0 - - - None None None None A-4-13-II None
3734400 0 0 - 0 - 0 - 0 - 0
3734400 5178553 0 4 0 0 0 ANINDITA DINARA AULIA
0001812962305 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195003
1#0##0#0#0.0#2018-07-03 18:18:03#0#00:00:00#00:00:00#00:00:00 1
793bfafcdcc7e9d9de73c9fa8b36b123 0 0 389096 0 0
1130673 0 0 0 0 3488784 0 0 0 0 170000
3201126 B 1 BS 1 20/06/2018 30/06/2018 17/07/1952 0 2
1 C95.0;D69.3;K30;I10 90.59;89.52 - - None None None None
C-4-10-II None None None None None None LEUKEMIA AKUT (SEDANG)
10760500 0 0 - 0 - 0 - 0 - 0
10760500 44431047 0 11 0 0 0 RUMINAH D401155
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 191757
1#1#vvip#11#33670547#0.0#2018-07-03 18:22:58#0#00:00:00#00:00:00#00:00:00
1 a09c14c38ef35066fd55e16464a937e6 0 0 2492000 0 0
19623257 0 0 0 0 22315790 0 0 0 0 0
3201126 B 3 BS 1 19/06/2018 30/06/2018 12/07/1977 0 1
1 I21.3;I48;I25.1;R57.0 - - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
10401900 28741800 0 12 0 0 0 YULAN MIRZA D398490
0001647430198 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195837
1#0##0#0#0.0#2018-07-03 18:31:49#0#15:13:23#15:13:23#00:00:00 1
73ea50d77994d4bf86482d01cf8e91df 0 0 989171 0 0
10226129 0 0 0 0 11054500 0 0 0 0
6472000
3201126 B 2 BS 1 26/06/2018 30/06/2018 16/11/1955 0 1
1 D46.9;G82.2;E87.6 87.03;87.44 - - None None None None C-4-
14-II None None None None None None TUMOR MYELOPROLIFERATIF LAIN-LAIN
(SEDANG) 6199300 0 0 - 0 - 0 - 0 - 0
6199300 5976747 0 5 0 0 0 HASBULLAH D399673
62 22868 DR CATUR BANUAJI SPS 0138R0170618V007744 0002376312816
3;JKN DR RIZKI; 5.2.2.201806040537 4 194974 1#0##0#0#0.0#2018-
08-04 08:57:51#0#21:42:36#21:42:36#00:00:00 2
ac032360a6be803e9cc2bbd32c71a546 0 0 910025 0 0
2611720 0 0 0 0 2455002 0 0 0 0 0
3201126 B 3 BS 1 29/06/2018 30/06/2018 11/09/1968 0 1
- 0 8908800 10067104 0 2 0 0 0 D I D I
0138R0170618V008689 0001285776371 3;JKN irene; 5.2.2.201806040537
4 195747 1#0##0#0#0.0#2018-08-09
15:59:29#0#00:00:00#00:00:00#00:00:00 2 d07191320d60cca952fe745bf8662b51
0 3438800 1834760 0 0 3964948 0 0 0 0
759596 0 0 0 0 69000
3201126 B 3 BS 1 29/06/2018 30/06/2018 19/11/1958 0 2
1 N18.5;D63.8;I10 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3391971 0 2 0 0 0 ESDELINA PANJAITAN
0002437624901 3;JKN irene; 5.2.2.201806040537 4 195541
1#0##0#0#0.0#2018-08-09 15:59:56#0#00:00:00#00:00:00#00:00:00 2
956dee0936ff618477a40e8c04560deb 0 0 424889 0 0
2193177 0 0 0 0 773905 0 0 0 0 0
3201126 B 3 BS 1 24/06/2018 30/06/2018 17/09/1953 0 1
0 - 0 - 0 45079800 73899291 0 7 1 1
0 H. MOCH. SAID D311471 64 23656 DR AZRI NURIZAL SPPD KKV
0138R0170618V006976 0001257150633 3;JKN irene; 5.2.2.201806040537
4 193797 1#0##0#0#0.0#2018-08-09
16:00:19#0#00:00:00#00:00:00#00:00:00 3 4ca20934c4edc7baaaa86e50379e767d
0 10823000 9068960 0 0 42111431 0 0 0 0
0 0 0 0 11895900 0
3201126 B 3 BS 1 24/06/2018 30/06/2018 10/10/1968 0 2
1 K65.0;R77.0;R18;J90 - - - None None None None K-4-
16-III None None None None None None INFEKSI-INFEKSI GASTROINTESTINAL
(BERAT) 5159600 0 0 - 0 - 0 - 0 - 0
5159600 6744751 0 7 0 0 0 JUNAH NY D401532
49 18154 DR ARU, SPPD 0138R0170618V006831 0002463371109 3;JKN
irene; 5.2.2.201806040537 4 193742 1#0##0#0#0.0#2018-08-09
16:01:02#0#15:08:29#15:08:29#00:00:00 2 bec103d3850f1db639e1f5e368b69f11
0 0 340783 0 0 4095723 0 0 0 0
2308245 0 0 0 0 0
3201126 B 2 BS 1 29/06/2018 30/06/2018 19/03/1988 0 2
1 I12.0;J18.0 39.27 - - None None None None N-1-12-III None
DIALISIS (BERAT) 23198900 0 0 - 0 - 0 - 0 -
0 23198900 13411007 0 2 0 0 0 MARIA ULFA
0138R0170618V008738 0001971525903 3;JKN irene; 5.2.2.201806040537
4 195785 1#0##0#0#0.0#2018-08-09
16:14:38#0#00:00:00#00:00:00#00:00:00 2 f3e0a4abf0147145a204842fe9258b8d
0 4911100 4692780 0 0 2903771 0 0 0 0
903356 0 0 0 0 0
3201126 B 2 BS 1 24/06/2018 30/06/2018 10/10/1965 0 1
1 A91;R63.0;J18.0 90.59;89.52 - - None None None None A-4-
13-III None None None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN
(BERAT) 3841100 0 0 - 0 - 0 - 0 - 0
3841100 6546783 0 7 0 0 0 TOTO SUPARTO
D401521 52 19250 DR ARU, SPPD 0138R0170618V006812
0001454145265 3;JKN irene; 5.2.2.201806040537 4 193737
1#0##0#0#0.0#2018-08-09 16:14:57#0#00:00:00#00:00:00#00:00:00 3
baabadcffbfc4f6cf46f570e4df77d37 0 0 278711 0 0
2278778 0 0 0 0 3989294 0 0 0 0 0
3201126 B 2 BS 1 29/06/2018 30/06/2018 05/10/1952 0 2
1 I25.1;I11.0;R93.1 88.55 - - None None None None I-1-15-III
0 0 - 0 - 0 - 0 - 0 14653000
14093646 0 2 0 0 0 ASMANI,NY D401844 65 24008
irene; 5.2.2.201806040537 4 196124 1#0##0#0#0.0#2018-08-09
16:15:16#0#15:11:55#15:11:55#00:00:00 2 7be6e3db243607140998af27e70ea852
0 3573000 2930600 0 0 4599140 0 0 0 0
921906 0 0 0 0 2069000
3201126 B 2 BS 1 29/06/2018 30/06/2018 01/01/1951 0 2
- 0 10690500 16136849 0 2 0 0 0 NY.SUDJIATI
0138R0170618V008617 0000042613705 3;JKN irene; 5.2.2.201806040537
4 195616 1#0##0#0#0.0#2018-08-09
16:15:37#0#00:00:00#00:00:00#00:00:00 2 3a5245e7a0b77d10aca3d959aeaa6403
0 4439100 2245005 0 0 8321062 0 0 0 0
1131682 0 0 0 0 0
3201126 B 1 BS 1 29/06/2018 30/06/2018 28/12/1947 0 1
1 I25.1;I11.0 36.07 - - YY02 None None None I-1-40-III None
None YY-02-III None None None PROSEDUR KARDIOVASKULAR PERKUTAN (BERAT)
48095600 0 0 PCI 10725800 - 0 - 0 - 0
58821400 74582377 0 2 0 0 0 OPARIS SIAHAAN,SH
0000038235868 3;JKN irene; 5.2.2.201806040537 4 195748
1#0##0#0#0.0#2018-08-11 12:05:32#0#00:00:00#00:00:00#00:00:00 2
a7ba911d19f997956c86320492986f07 0 10080000 9619120 0 0
45988257 0 0 0 0 1326000 0 0 0 0
7569000
3201126 B 1 BS 1 28/06/2018 30/06/2018 15/05/1941 0 2
1 I63.9;R47.1 87.03;87.44;89.52 - - None None None None G-4-
INFARK (RINGAN) 7018400 0 0 - 0 - 0 - 0 -
0 7018400 3125042 0 3 0 0 0 BUNGA TARCISIA
SIHOMBING D401875 77 28168 DR NURUL KOMARI SPS 0138R0170618V008432
0000022453716 3;JKN irene; 5.2.2.201806040537 4 195420
1#0##0#0#0.0#2018-08-11 12:06:19#0#00:00:00#00:00:00#00:00:00 2
aebd11effe67fe57e50eecf9405c0fc3 0 0 754840 0 0 577760
0 0 0 0 1562000 0 0 0 230442 0
3201126 B 1 BS 1 29/06/2018 30/06/2018 15/10/2008 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5199006 0 2 0 0 0 DAFFA ATHALLAH OCTAVIANO
A213786 9 3544 DR CATUR SUZANTARA 0138R0170618V008891
0001627458524 3;JKN irene; 5.2.2.201806040537 4 195910
1#0##0#0#0.0#2018-08-11 12:07:11#0#17:36:38#17:36:38#12:00:00 2
4e8c6874ec78b9009e865123072169ad 0 0 744204 0 0 917180
0 0 0 0 3052500 0 0 0 485122 0
3201126 B 1 BS 1 28/06/2018 30/06/2018 10/08/1980 0 2
0 - 0 - 0 - 0 - 0 9150100 18502250
irene; 5.2.2.201806040537 4 195142 1#0##0#0#0.0#2018-08-11
12:07:33#0#10:01:09#10:01:09#00:00:00 2 9a733abbc374cecb24c54e2f10f806b5
0 9810600 2653529 0 0 4519621 0 0 0 0
1301000 0 0 0 0 217500
3201126 B 3 BS 1 29/06/2018 30/06/2018 26/08/1969 0 2
2 G81.9;J18.0;R90.0;R40.2;A49.9 - - - None None None None
G-4-26-III None None None None None None GANGGUAN - PENYAKIT SISTEM
SARAF LAIN-LAIN (BERAT) 6240100 0 0 - 0 - 0 - 0
- 0 6240100 3499639 0 2 0 0 0 SULASTI
0001081220523 3;JKN SURYANIH;15136 5.2.2.201806040537 4 195912
1#0##0#0#0.0#2018-10-03 15:53:43#0#19:41:35#19:41:35#00:00:00 3
8a0de631b7852f2a168a297068952ac2 0 0 322857 0 0
2658834 0 0 0 0 517948 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 01/07/2018 23/01/1963 0 2
1 D64.9;D46.9;I11.9;D69.6 99.04 - - None None None None D-4-
0 - 0 4227600 3863221 0 2 0 0 0 SUHAYA
0001263423341 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196103
1#0##0#0#0.0#2018-07-09 09:46:44#0#00:00:00#00:00:00#12:00:00 1
92699a8b64f649bd90a469b33ed521e1 0 0 433484 0 0
2362003 0 0 0 0 1067734 0 0 0 0 0
3201126 B 3 BS 1 01/07/2018 01/07/2018 15/03/1988 0 2
1 A09.9;K30 - - - None None None None K-4-17-I None
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 1357602 0 1 0 0 0 IDA FARIDA D402089
DR RIZKI; 5.2.2.201806040537 4 196157 1#0##0#0#0.0#2018-07-09
11:57:09#0#00:00:00#00:00:00#00:00:00 1 94d99b80bf4406248fe777962214da5a
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3201126 B 1 BS 1 29/06/2018 01/07/2018 29/06/2018 3299 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1753579 0 3 0 0 0 HENDIKA GUSMAWATI BY NY
0002468378935 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195847
1#0##0#0#0.0#2018-07-09 16:22:40#0#15:21:49#15:21:49#00:00:00 1
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3201126 B 3 BS 1 29/06/2018 01/07/2018 01/06/1957 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2936126 0 3 0 0 0 PONIAH
d373295 61 22308 DR ARU, SPPD 0138R0170618V008920
0001014272234 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196127
1#0##0#0#0.0#2018-07-09 16:28:43#0#15:47:45#15:47:45#12:00:00 1
ab26907cfeb5bcb702369230f2297051 0 0 424889 0 0
1590654 0 0 0 0 920583 0 0 0 0 0
3201126 B 3 BS 1 27/06/2018 01/07/2018 04/03/1963 0 1
3613200 0 0 - 0 - 0 - 0 - 0
3613200 6845952 0 5 0 0 0 RACHMAT ISKANDAR
d401722 55 20204 DR BOBBY DRASTYAWAN SPPA 0138R0170618V007759
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1#0##0#0#0.0#2018-07-09 16:34:30#0#00:00:00#00:00:00#00:00:00 1
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1908801 0 0 0 0 4493866 0 0 0 0 0
3201126 B 1 BS 1 25/06/2018 01/07/2018 22/09/2014 0 1
1 E42;R63.8;Q43.1;E87.6;D64.9 99.04 - - None None None None
0 - 0 - 0 6852200 11329752 0 7 0 0
0 CALLISTA BELLVANIA ACHMAD D303757 3 1372 DR AULIA TANGKARI,
5.2.2.201806040537 4 194049 1#0##0#0#0.0#2018-07-09
17:04:35#0#00:00:00#00:00:00#00:00:00 1 344ef5c3b2ca62022c49b7d84ee699c2
0 0 685220 0 0 3894333 0 0 0 0
6240199 0 0 0 0 510000
3201126 B 2 BS 1 27/06/2018 01/07/2018 23/12/1982 0 2
1 J18.0;K30 - - - None None None None J-4-16-I None
4335900 0 0 - 0 - 0 - 0 - 0
4335900 3518906 0 5 0 0 0 SONYA MERRY C
0002104473846 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195002
1#0##0#0#0.0#2018-07-09 17:39:56#0#14:23:53#14:23:53#00:00:00 1
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0 0 0 0 2276209 0 0 0 0 0
3201126 B 1 BS 1 28/06/2018 01/07/2018 29/01/1987 0 2
0 0 - 0 - 0 - 0 - 0 6981500
19058791 0 4 0 0 0 EVA RIZKIANI NY D021090 31
TANTIYO S;16137 5.2.2.201806040537 4 195417
1#1#vip#4#5236125#75.0#2018-07-09 17:42:32#0#22:28:57#22:28:57#00:00:00
1 6180c3bb317ba0bc0241e0ae6a0727df 0 9288600 5062226 0
0 3194965 0 0 0 0 1316000 0 0 0 0
197000
3201126 B 2 BS 1 27/06/2018 01/07/2018 13/05/1966 0 1
1 C22.0;D63.0 99.04 - - None None None None B-4-11-II None
(SEDANG) 8189800 0 0 - 0 - 0 - 0 - 0
8189800 7800754 0 5 0 0 0 ABDUL HARIS D380006
52 19038 DR ARU, SPPD 0138R0170618V007840 0001729967332 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196148 1#0##0#0#0.0#2018-
07-09 17:43:56#0#01:15:37#01:15:37#12:00:00 1
1c682c6515449559ad05e7fd0cd93d50 0 0 790082 0 0
3949342 0 0 0 0 3061330 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 01/07/2018 22/12/1967 0 1
1 N18.5;D63.8;A41.9 99.04;99.21;39.27 - - None None None None
- 0 - 0 19332400 7684644 0 2 0 0 0
WAHYU WINDRADI D399274 50 18453 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170618V008976 0002375862524 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195996 1#0##0#0#0.0#2018-07-09
17:45:21#0#00:00:00#00:00:00#00:00:00 1 7d4a71d8d72d259dad80daa6b6d48194
0 3438800 879420 0 0 2718690 0 0 0 0
578734 0 0 0 0 69000
3201126 B 1 BS 1 29/06/2018 01/07/2018 22/01/2016 0 1
0 - 0 - 0 - 0 - 0 3116300 3424089
0 3 0 0 0 KENZIE AQILA VIRENDRA D321627 2 889
DR KRISTON SILITONGA, SPA 0138R0170618V008445 0001971074687 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 195425 1#0##0#0#0.0#2018-
07-10 07:42:48#0#00:00:00#00:00:00#00:00:00 1
4e6f900f59b2be4281ab09d946a92a73 0 0 333467 0 0 938616
0 0 0 0 1812006 0 0 0 0 340000
3201126 B 3 BS 1 29/06/2018 01/07/2018 12/05/1969 0 2
None None None None ISKEMIK TRANSIENT (RINGAN) 3376700 0 0
- 0 - 0 - 0 - 0 3376700 2452750 0
3 0 0 0 WIJI ASTUTI D401822 49 17945 DR NURUL KOMARI
5.2.2.201806040537 4 195424 1#0##0#0#0.0#2018-07-10
08:36:47#0#00:00:00#00:00:00#00:00:00 1 64af63b10c6ba15c9b116ee610fa2a5e
0 0 303903 0 0 1160285 0 0 0 0 988562
0 0 0 0 0
3201126 B 3 BS 1 26/06/2018 01/07/2018 01/07/1970 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 62843837 0 6 0 0 0 SUFIRMAN
0000512797623 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194313
1#0##0#0#0.0#2018-07-10 08:39:23#0#00:00:00#00:00:00#00:00:00 1
eba8dbc482c5de65e4ae891095ff1a98 0 9212000 6870800 0 0
36953662 0 0 0 0 2085375 0 0 0 0
7722000
3201126 B 3 BS 1 27/06/2018 01/07/2018 23/12/1980 0 2
1 I47.1;E87.6;E87.1 - - - None None None None I-4-19-II
(SEDANG) 6111300 0 0 - 0 - 0 - 0 - 0
6111300 9586476 0 5 0 0 0 ROSMITA d401790
0002338238147 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195014
1#0##0#0#0.0#2018-07-10 08:43:23#0#00:00:00#00:00:00#00:00:00 1
6f1c9e73821b6d932a9b92172986e168 0 0 603017 0 0
4389306 0 0 0 0 2925153 0 0 0 0
1669000
3201126 B 1 BS 1 29/06/2018 01/07/2018 29/08/1987 0 2
0 0 - 0 - 0 - 0 - 0 6981500
23444107 0 3 0 0 0 HENDIKA GUSMAWATI D394645 30
TANTIYO S;16137 5.2.2.201806040537 4 195422
1#1#vvip#3#16462607#0.0#2018-07-10 08:45:02#0#00:00:00#00:00:00#00:00:00
1 05301f30786c4c6ce5cf7c3a00b39964 0 8023000 8709200 0
0 5198907 0 0 0 0 1316000 0 0 0 0
197000
3201126 B 3 BS 1 29/06/2018 01/07/2018 08/12/1966 0 1
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2327888 0 3 0 0 0 DEDDY KUSNADI
0001735605268 3;JKN DR RIZKI; 5.2.2.201806040537 4 196130
1#0##0#0#0.0#2018-07-10 08:56:13#0#16:01:29#16:01:29#00:00:00 1
5dccbad5d7a5fe6c33aa924bd233ad29 0 0 273635 0 0
1086961 0 0 0 0 967292 0 0 0 0 0
3201126 B 1 BS 1 29/06/2018 01/07/2018 01/08/1955 0 1
0 - 0 - 0 - 0 - 0 17095200 14137739
0 3 0 0 0 ALEXANDER FREDERIK PUTONG D356418 62
3;JKN DR RIZKI; 5.2.2.201806040537 4 195427 1#0##0#0#0.0#2018-
07-10 08:57:52#0#00:00:00#00:00:00#00:00:00 1
0d015170ba793e3db6d861499fe0c7c1 0 4795000 1775560 0 0
4447280 0 0 0 0 1050899 0 0 0 0
2069000
3201126 B 1 BS 1 28/06/2018 01/07/2018 29/05/1990 0 2
0 - 0 - 0 - 0 - 0 9150100 18804698
0 4 0 0 0 DEVI ARYANI D399111 28 10257 RACHMAWATI
5.2.2.201806040537 4 195411 1#0##0#0#0.0#2018-07-10
09:33:06#0#20:03:59#20:03:59#00:00:00 1 083b0a9e1a1202da75edcf5260b056ad
0 10138100 2562028 0 0 4586070 0 0 0 0
1301000 0 0 0 0 217500
3201126 B 1 BS 1 29/06/2018 01/07/2018 29/06/2018 2750 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2705879 0 3 0 0 0 EVA RIZKIANI BY NY
0002468572942 3;JKN DR RIZKI; 5.2.2.201806040537 4 196193
1#0##0#0#0.0#2018-07-10 09:35:12#0#10:10:23#10:10:23#00:00:00 1
972305afd1d75d88d9ec6959dda00cea 0 0 243720 0 0 76539
0 0 0 0 2385620 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 01/07/2018 01/12/1957 0 1
- 0 8908800 1964501 0 2 0 0 0 MURTOWO
0000511824982 3;JKN DR RIZKI; 5.2.2.201806040537 4 196152
1#0##0#0#0.0#2018-07-10 09:41:04#0#01:30:25#01:30:25#12:00:00 1
3faf718dfadd973235be198a3122ab72 0 0 404242 0 0 879740
0 0 0 0 680519 0 0 0 0 0
3201126 B 3 BS 1 01/07/2018 01/07/2018 10/11/1952 0 2
4 I64;A41.9;I46.9 96.05 - - None None None None G-4-15-III
- 0 - 0 - 0 - 0 6899800 7549417 0
1 0 0 0 SITI WAKINGAH D402092 65 23974 DR RENDRA
RAMADYA 0138R0170718V000015 0001730049873 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196160 1#0##0#0#0.0#2018-07-14
11:38:46#0#08:58:33#08:58:33#00:00:00 1 692f3c089d9234a50d7b65fe32091a55
0 0 620982 0 0 5411548 0 0 0 0 800887
0 0 0 0 716000
3201126 B 3 BS 1 01/07/2018 01/07/2018 05/05/1960 0 2
1 I95.9;C50.9;R77.0 - - - None None None None I-4-24-I
(RINGAN) 2795900 0 0 - 0 - 0 - 0 - 0
2795900 4174576 0 1 0 0 0 ULAN DARI NY
0001962320602 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196267
1#0##0#0#0.0#2018-07-17 10:08:52#0#11:46:54#11:46:54#00:00:00 1
95ef9a5b0c90eb67061865765b1b9977 0 0 173805 0 0
2381668 0 0 0 0 580103 0 0 0 0
1039000
3201126 B 3 BS 1 30/06/2018 01/07/2018 01/06/1956 0 2
(SEDANG) 6438100 0 0 - 0 - 0 - 0 - 0
6438100 3571570 0 2 0 0 0 ROKAYAH D382073
62 22674 DR. SUKMARINI 0138R0170618V009027 0000511273822 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196142 1#0##0#0#0.0#2018-
07-24 13:35:00#0#00:00:00#00:00:00#12:00:00 1
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2380216 0 0 0 0 522654 0 0 0 0 426000
3201126 B 3 BS 1 30/06/2018 01/07/2018 31/08/1978 0 1
1 I95.9;I21.3;D62;K92.1;K92.0 - - - None None None None
- 0 8139800 5976248 0 2 0 0 0 NIKO HARI
WIBOWO d374482 39 14548 DR. SUKMARINI 0138R0170618V009038
0001775498681 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196146
1#0##0#0#0.0#2018-07-24 15:55:08#0#00:00:00#00:00:00#12:00:00 1
e52880fa554df637bc37f8c140959ab3 1 0 406990 0 0
4173288 0 0 0 0 679969 0 0 0 0 716000
3201126 B 2 BS 1 30/06/2018 01/07/2018 30/06/2018 649 2
None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-1 TANPA
- 0 14743200 4402930 0 2 1 0 0 BY NY
PRASASTI DUTA AGUSTINE D402021 0 0 DR AULIA TANGKARI, SPA
0138R0170618V009041 0002468577442 3;JKN DR RIZKI; 5.2.2.201806040537
4 196188 1#0##0#0#0.0#2018-07-25
15:02:30#0#08:59:35#08:59:35#00:00:00 1 9544a7c44b9312cea1288a17af1259b6
0 0 1326888 0 0 0 0 0 0 0 1876042
0 0 0 0 1200000
3201126 B 3 BS 1 26/06/2018 01/07/2018 01/07/1981 0 2
1 E83.5;C73 - - - None None None None E-4-11-I None
2954900 0 0 - 0 - 0 - 0 - 0
2954900 4805059 0 6 0 0 0 ANI YUNIARNI
0000385185126 3;JKN DR RIZKI; 5.2.2.201806040537 4 196136
1#0##0#0#0.0#2018-07-26 08:33:29#0#16:30:12#16:30:12#00:00:00 1
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3164768 0 0 0 0 1082350 0 0 0 0 239000
3201126 B 1 BS 1 29/06/2018 01/07/2018 23/06/2018 3000 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 4427966 0 3 0 0 0 BAYI NYONYA RIZKA
YUNIARSIH D401479 0 6 DR TRI LESTARI, SPA 0138R0170618V008684
0002467501749 3;JKN DR RIZKI; 5.2.2.201806040537 4 195746
1#0##0#0#0.0#2018-07-26 08:38:41#0#00:00:00#00:00:00#00:00:00 1
2c6179fd14850d980b0732c4d4e49708 0 0 513620 0 0 160666
0 0 0 0 2346680 0 0 0 0 1407000
3201126 B 3 BS 1 30/06/2018 01/07/2018 16/06/1989 0 1
1 A16.0;R50.9 - - - None None None None J-4-15-I None
4336500 0 0 - 0 - 0 - 0 - 0
4336500 1118077 0 2 0 0 0 INDRA PERDANA
D401142 29 10606 DR. SUKMARINI 0138R0170618V009025
0001821779065 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196141
1#0##0#0#0.0#2018-07-28 13:12:16#0#19:06:23#19:06:23#00:00:00 1
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0 0 0 0 362145 0 0 0 0 0
3201126 B 1 BS 1 28/06/2018 01/07/2018 23/03/1949 0 2
None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (BERAT)
21013600 0 0 - 0 - 0 - 0 - 0
21013600 14613399 0 4 0 0 0 NGATIRAH D357098
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196128
1#0##0#0#0.0#2018-09-08 08:47:56#0#15:52:04#15:52:04#00:00:00 3
8c1be267823b29a281dbba34991ea73f 0 7159200 4202716 0 0
2269466 0 0 0 0 982017 0 0 0 0 0
3201126 B 2 BS 1 30/06/2018 01/07/2018 23/08/1985 0 2
0 - 0 - 0 - 0 - 0 2009900 6903188
0 2 0 0 0 PRASASTI DUTA AGUSTINE D391586 32 11999
DR MAMAN H, SPOG 0138R0170618V008939 0000204259825 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 195922 1#0##0#0#0.0#2018-09-08
11:47:38#0#00:00:00#00:00:00#00:00:00 2 9c6e27d189a9c293bacdfd0db38c61f5
2000000 0 528800 0 0 1228919 0 0 0 0
2645700 0 0 0 499769 0
3201126 B 2 BS 1 30/06/2018 01/07/2018 29/12/1949 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 13516039 0 2 0 0 0 ALWI d386293
0001218281455 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196151
1#0##0#0#0.0#2018-09-25 13:05:02#0#01:27:22#01:27:22#12:00:00 2
1404d0037975c0a91853a05f756135de 0 4439100 1044700 0 0
7003012 0 0 0 0 960227 0 0 0 0 69000
3201126 B 2 BS 1 28/06/2018 01/07/2018 16/05/2002 0 2
0 - 0 - 0 - 0 - 0 4649300 9613356
0 4 0 0 0 AMANDA ANJANI D398552 16 5887 DR
5.2.2.201806040537 4 195413 1#0##0#0#0.0#2018-09-26
20:43:06#0#20:06:24#20:06:24#00:00:00 2 8acfbce3f62974d0f9e1d46843d05f42
0 0 1364804 0 0 2388041 0 0 0 0
5791511 0 0 0 0 69000
3201126 B 3 BS 1 27/06/2018 01/07/2018 01/05/2002 0 2
- 0 - 0 - 0 - 0 3874400 9938756 0
5 0 0 0 REGINA ASMELA PUTRI D401718 16 5901 DR
5.2.2.201806040537 4 194975 1#0##0#0#0.0#2018-09-26
20:47:20#0#00:00:00#00:00:00#00:00:00 2 4e29c96e53e6ad58d6e484ee0c25270a
0 0 1315832 0 0 3869925 0 0 0 0
4683999 0 0 0 0 69000
3201126 B 2 BS 1 30/06/2018 01/07/2018 06/11/1960 0 2
1 S93.1;A15.3 79.88 - - None None None None M-1-30-II None
None None None None None PROSEDUR KAKI (SEDANG) 16995200 0 0
- 0 - 0 - 0 - 0 16995200 17414733 0
2 0 0 0 MINTARSIH NY D401981 57 21055 DR BENNY H
T, SPOT 0138R0170618V009043 0001895122045 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196191 1#0##0#0#0.0#2018-10-08
16:42:40#0#09:32:37#09:32:37#00:00:00 2 1fe50703bee0a4bed75b8dede2093ce1
0 0 8550600 0 0 1984351 0 0 0 0
6810782 0 0 0 0 69000
3201126 B 3 BS 1 30/06/2018 01/07/2018 01/09/1995 0 1
3 D69.6;A27.9;B17.8 99.04 - - None None None None D-4-11-II
7264800 0 0 - 0 - 0 - 0 - 0
7264800 3337619 0 2 0 0 0 SAHRUL FAUZI
0000510372358 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195920
1#0##0#0#0.0#2018-10-10 16:27:42#0#00:00:00#00:00:00#00:00:00 2
95440c6b4eb66cdddf2858d99ef966df 0 0 363240 0 0
2467030 0 0 0 0 507349 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 02/07/2018 17/03/1972 0 2
- 0 8908800 9602885 0 3 0 0 0 ERLIYANI
D393077 46 16906 DR ARU, SPPD 0138R0170618V009023
0001264472122 3;JKN DR RIZKI; 5.2.2.201806040537 4 196140
1#0##0#0#0.0#2018-07-09 10:33:49#0#00:00:00#00:00:00#12:00:00 1
13564352848049cd6892c48a98e2fd44 0 3235500 1906030 0 0
3688129 0 0 0 0 704226 0 0 0 0 69000
3201126 B 2 BS 1 01/07/2018 02/07/2018 10/02/1988 0 2
0 - 0 - 0 - 0 - 0 2009900 4657101
0 2 0 0 0 TEGUH RAHAYU D402093 30 11099 DR
ARIS WAHJU, SPOG 0138R0170718V000010 0001428037784 3;JKN DR RIZKI;
5.2.2.201806040537 4 196158 1#0##0#0#0.0#2018-07-09
11:09:46#0#08:29:37#08:29:37#00:00:00 1 dd85847f2114c2f4feae4e0aeaf61004
0 0 454980 0 0 1055751 0 0 0 0
3018370 0 0 0 0 128000
3201126 B 2 BS 1 29/06/2018 02/07/2018 22/10/2007 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3011122 0 4 0 0 0 LUQMAN MAHARDIKA WIRYANA
D281675 10 3903 DR RASTRA, SPA 0138R0170618V008929
0001306893655 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195918
1#0##0#0#0.0#2018-07-09 17:31:22#0#00:00:00#00:00:00#00:00:00 1
c8e39c8dc1401adf3af2d9051ffdb66c 0 0 278711 0 0 654422
0 0 0 0 1737989 0 0 0 0 340000
3201126 B 1 BS 1 30/06/2018 02/07/2018 06/03/1955 0 1
1 I63.9;G81.9;R47.1;E14.9 87.03 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 3484718 0 3 0 0 0 SUPARMAN
0000061087836 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196153
1#0##0#0#0.0#2018-07-09 17:34:19#0#01:32:33#01:32:33#00:00:00 1
83219dbecb540ac39e56cb86f83ccba8 0 0 684656 0 0 203090
0 0 0 0 2596972 0 0 0 0 0
3201126 B 2 BS 1 30/06/2018 02/07/2018 31/12/1943 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2755726 0 3 0 0 0 SOPIAH D402060
74 27210 DR ARU, SPPD 0138R0170618V009019 0001271146094 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196154 1#0##0#0#0.0#2018-
07-09 17:41:18#0#01:34:37#01:34:37#00:00:00 1
53bc989ce38b6e9c0a00cb9b7765ca08 0 0 238535 0 0 795910
0 0 0 0 1721281 0 0 0 0 0
3201126 B 1 BS 1 28/06/2018 02/07/2018 05/08/1974 0 2
1 I87.1;I13.1;D63.8 99.04;88.40;39.90 - - None None None None
I-1-40-II None None None None None None PROSEDUR KARDIOVASKULAR
PERKUTAN (SEDANG) 36008800 0 0 - 0 - 0 - 0 -
0 36008800 38189642 0 5 0 0 0 MARIA ULFA
0000040477184 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195307
1#0##0#0#0.0#2018-07-09 17:59:26#0#14:07:31#14:07:31#00:00:00 1
9838488f7b2e74a0a19fe3fb3115ca38 0 13055200 1707420 0 0
16611772 0 0 0 0 2507250 0 0 0 0
4308000
3201126 B 3 BS 1 29/06/2018 02/07/2018 01/05/1957 0 2
6419700 0 0 - 0 - 0 - 0 - 0
6419700 5739569 0 4 0 0 0 AMINAH D372721
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195426
1#0##0#0#0.0#2018-07-10 07:40:04#0#00:00:00#00:00:00#12:00:00 1
96b0b82ab80a3946c8bd58295a82aa0d 0 0 630773 0 0
2032310 0 0 0 0 3076486 0 0 0 0 0
3201126 B 3 BS 1 29/06/2018 02/07/2018 01/04/1968 0 1
(SEDANG) 6909500 0 0 - 0 - 0 - 0 - 0
6909500 4257327 0 4 0 0 0 MARYADI D401984
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195917
1#0##0#0#0.0#2018-07-10 08:42:00#0#00:00:00#00:00:00#00:00:00 1
3f850a8f516153970fb1d45e4c554647 0 0 504179 0 0
2659631 0 0 0 0 1093517 0 0 0 0 0
3201126 B 1 BS 1 30/06/2018 02/07/2018 12/02/1963 0 2
1 R51 - - - None None None None G-4-23-I None None
0 0 - 0 - 0 - 0 - 0 3710200
3665508 0 3 0 0 0 ERY MUSTIKANINGSIH SE D402083
3;JKN DR RIZKI; 5.2.2.201806040537 4 196147 1#0##0#0#0.0#2018-
07-10 09:36:01#0#00:00:00#00:00:00#00:00:00 1
6389eb3879a232039426cd24b666ba65 0 0 386918 0 0
1450790 0 0 0 0 1827800 0 0 0 0 0
3201126 B 3 BS 1 27/06/2018 02/07/2018 10/03/1982 0 1
1 B34.9;K74.6;D69.6 - - - None None None None A-4-13-II
(SEDANG) 2667400 0 0 - 0 - 0 - 0 - 0
2667400 3366595 0 6 0 0 0 MANSUR D324810
3;JKN DR RIZKI; 5.2.2.201806040537 4 195005 1#0##0#0#0.0#2018-
07-10 09:37:50#0#16:44:05#16:44:05#00:00:00 1
2be446ffa0118fd3115a41f31fa37835 0 0 241100 0 0
1387750 0 0 0 0 1737745 0 0 0 0 0
3201126 B 2 BS 1 27/06/2018 02/07/2018 24/10/1948 0 2
1 I63.9;G81.9;R13 87.03;87.44;96.07 - - None None None None
0 - 0 8291400 6568641 0 6 0 0 0
MA'ANAH D400900 69 25448 DR HARDI PRANATA SPS
0138R0170618V007947 0000061022441 3;JKN DR RIZKI; 5.2.2.201806040537
4 196131 1#0##0#0#0.0#2018-07-10
09:39:24#0#16:05:03#16:05:03#00:00:00 1 5d309fa1e89b3435430cecbedc15ad7c
0 0 654500 0 0 2643417 0 0 0 0
2980724 0 0 0 0 290000
3201126 B 2 BS 1 28/06/2018 02/07/2018 30/09/1962 0 2
- 0 51950600 53331700 0 5 0 0 0 HARIYATI
0000122520418 3;JKN DR RIZKI; 5.2.2.201806040537 4 196134
1#0##0#0#0.0#2018-07-10 15:36:31#0#16:12:35#16:12:35#00:00:00 1
cf81558c73002991315b79cc46207848 0 10591000 8297960 0 0
25597740 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 02/07/2018 02/07/2018 11/04/1968 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 2061978 0 1 0 0 0 MAKMUR SEMBIRING
D226556 50 18344 DR YOHANNES DWINANDA 0138R0170718V000058
0001799451033 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196177
1#0##0#0#0.0#2018-07-16 08:18:23#0#00:45:13#00:45:13#00:00:00 1
701f309adaec53e4f63ff91031226d72 0 0 210130 0 0 693952
0 0 0 0 441896 0 0 0 0 716000
3201126 B 2 BS 1 01/07/2018 02/07/2018 18/04/1935 0 1
1 Z53.0;D29.1;R33 - - - None None None None Z-4-12-I
0 - 0 2252000 2247854 0 2 0 0 0 HERRY
DG SARRO TN D342089 83 30390 R SHIDDHI ANDHIKA DR,SPU
0138R0170718V000040 0000126813431 3;JKN DR RIZKI; 5.2.2.201806040537
4 196169 1#0##0#0#0.0#2018-07-25
15:15:20#0#19:58:17#19:58:17#00:00:00 1 14680179d9b230a2e3f0219f3afc8e32
0 0 564795 0 0 707503 0 0 0 0 975556
0 0 0 0 0
3201126 B 2 BS 1 27/06/2018 02/07/2018 22/06/2011 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 5953858 0 6 0 0 0 FAHREZIADITYA P
D223874 7 2562 DR RASTRA, SPA 0138R0170618V007750
0001181414621 3;JKN DR RIZKI; 5.2.2.201806040537 4 194976
1#0##0#0#0.0#2018-07-25 15:30:25#0#01:00:18#01:00:18#00:00:00 1
75414f7d34f8589ee00f736e16619e7e 0 0 298025 0 0
2210328 0 0 0 0 3445505 0 0 0 0 0
3201126 B 1 BS 1 28/06/2018 02/07/2018 21/10/1952 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 6630886 0 5 0 0 0 YUSRIZAL
d283911 65 23991 DR HARDI PRANATA SPS 0138R0170618V008203
0001453970081 3;JKN DR RIZKI; 5.2.2.201806040537 4 195262
1#0##0#0#0.0#2018-07-26 08:31:38#0#00:00:00#00:00:00#12:00:00 1
92f7498135e8d3681c919cd867348773 0 0 1020330 0 0
1245760 0 0 0 0 4364796 0 0 0 0 0
3201126 B 2 BS 1 29/06/2018 02/07/2018 08/01/1999 0 2
- 0 - 0 - 0 - 0 4649300 11273122 0
4 0 0 0 RIKZA D401913 19 7112 DR HENDRIEK S, SPB
0138R0170618V009042 0001258542988 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196196 1#0##0#0#0.0#2018-09-08
11:00:54#0#10:19:48#10:19:48#00:00:00 2 19ff8b6f8ebe071d75c98c27b7e5df3d
0 5079600 1417804 0 0 4002224 0 0 0 0
773494 0 0 0 0 0
3201126 B 3 BS 1 02/07/2018 02/07/2018 26/12/2017 0 1
- 0 - 0 - 0 - 0 2534700 4071071 0
1 0 0 0 FARZAN RAYHAAN SHAKEIL D400396 0 188 DR
YOHANES DWINANDA R P 0138R0170718V000134 0002294052658 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 196182 1#0##0#0#0.0#2018-09-08
11:05:07#0#07:31:31#07:31:31#00:00:00 2 2b3eff2492c1842eeff5c76b7b262f59
0 0 216515 0 0 2370224 0 0 0 0 573332
0 0 0 0 911000
3201126 B 2 BS 1 29/06/2018 02/07/2018 14/07/2015 0 1
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 3344922 0 4 0 0 0 ALARIC ZAHID MUBARAK
0002284842969 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195566
1#0##0#0#0.0#2018-09-08 11:49:44#0#00:00:00#00:00:00#00:00:00 2
98deb59214703aedbb50481bce6f23fb 0 0 238535 0 0 841560
0 0 0 0 2264827 0 0 0 0 0
3201126 B 3 BS 1 24/06/2018 02/07/2018 09/08/1956 0 2
1 I64;N17.9;E88.9;N29.1 - - - None None None None G-4-
- 0 - 0 - 0 - 0 6899800 22558387 0
9 0 0 0 IDAWATI D393743 61 22599 SRI
KUNMARTINI.DR,SPPD 0138R0170618V006789 0001771769834 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 196135 1#0##0#0#0.0#2018-09-26
08:53:37#0#16:21:14#16:21:14#12:00:00 2 76212f364cd64c6985ec2456c84f8717
0 0 582155 0 0 9683232 0 0 0 0
7253000 0 0 0 0 5040000
3201126 B 2 BS 1 29/06/2018 02/07/2018 05/07/1948 0 2
4 I63.9;I48;E14.7;J18.9;J80 96.71 - - None None None None
- 0 34963000 19749509 0 4 1 2 0 SUPARTINAH
0000060891636 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195421
1#0##0#0#0.0#2018-10-10 16:29:09#0#00:04:56#00:04:56#00:00:00 3
4660958808e8b1bf6c76f527618aeb2a 0 0 1402292 0 0
9363317 0 0 0 0 5069900 0 0 0 0
3914000
3201126 B 1 BS 1 28/06/2018 03/07/2018 17/12/1940 0 1
1 I63.9;G81.9;E75.6;R31 - - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 11187165 0 6 0 0 0 SAPTARDJO
0001461089474 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196149
1#1#vvip#6#1513865#0.0#2018-07-09 09:25:03#0#01:19:47#01:19:47#00:00:00
2 7173c8fc02b74a48cdd15fd82e589600 0 0 1408000 0 0
1956294 0 0 0 0 7822871 0 0 0 0 0
3201126 B 1 BS 1 22/06/2018 03/07/2018 24/10/1974 0 2
1 J65;A15.3 - - - None None None None J-4-19-I None
0 0 - 0 - 0 - 0 - 0 7274100
32405193 0 12 0 0 0 RIMASARI ,SE D053675 43
TANTIYO S;16137 5.2.2.201806040537 4 193588
1#1#vvip#12#25131093#0.0#2018-07-09 09:41:57#0#00:00:00#00:00:00#00:00:00
1 d60e3107314cb3dc71d036c776697f5b 0 0 584221 0 0
15882472 0 0 0 0 15938500 0 0 0 0 0
3201126 B 3 BS 1 28/06/2018 03/07/2018 21/01/1951 0 1
0 - 0 6909500 4703890 0 6 0 0 0 YASIN
0000511390405 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195408
1#0##0#0#0.0#2018-07-09 09:44:13#0#17:09:15#17:09:15#00:00:00 1
1531cd3aab4ee04387d1fb6cae644190 0 0 743950 0 0
2048209 0 0 0 0 1911731 0 0 0 0 0
3201126 B 3 BS 1 27/06/2018 03/07/2018 21/08/1965 0 2
- 0 - 0 - 0 - 0 4178900 4002026 0
7 0 0 0 MARTINI D376222 52 19303 DR AGOES
S;16137 5.2.2.201806040537 4 196129 1#0##0#0#0.0#2018-07-09
09:53:09#0#15:57:51#15:57:51#12:00:00 1 d0e4fc6159030b0ab6152936d3a1f92b
0 0 376101 0 0 1479110 0 0 0 0
2146815 0 0 0 0 0
3201126 B 2 BS 1 29/06/2018 03/07/2018 21/10/1994 0 2
1 A09.9;O34.5 88.78 - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 3962037 0 5 0 0 0 NURAZIZAH D401953
23 8652 DR ARU, SPPD 0138R0170618V008922 0001650678693 3;JKN
DR RIZKI; 5.2.2.201806040537 4 195914 1#0##0#0#0.0#2018-07-09
10:30:03#0#20:24:27#20:24:27#00:00:00 1 a2b78dba0c97a5faa3802cf8854de892
0 0 541535 0 0 817803 0 0 0 0
2602699 0 0 0 0 0
3201126 B 2 BS 1 02/07/2018 03/07/2018 19/02/1993 0 1
0 - 0 5178700 8906055 0 2 0 0 0 ARIE
SETIAWAN D398135 25 9264 DR BENNY H TUMBELAKA 0138R0170718V000426
0001634526088 3;JKN DR RIZKI; 5.2.2.201806040537 4 196323
1#0##0#0#0.0#2018-07-09 11:04:23#0#15:16:15#15:16:15#00:00:00 3
0b895703d1fd93df4726aab699b9b65e 0 5560500 2075036 0 0
577380 0 0 0 0 658639 0 0 0 0 34500
3201126 B 2 BS 1 30/06/2018 03/07/2018 25/06/2016 0 1
- 0 - 0 - 0 - 0 3187000 4589043 0
4 0 0 0 ERLAND JUNILIO D401734 2 735 DR KRISTON
SILITONGA, SPA 0138R0170618V008983 0002060604303 3;JKN DR RIZKI;
5.2.2.201806040537 4 196024 1#0##0#0#0.0#2018-07-09
11:06:49#0#00:00:00#00:00:00#00:00:00 2 d72587f133b2077ce065f6d835d3168d
0 0 339830 0 0 1032995 0 0 0 0
2346218 0 0 0 0 870000
3201126 B 1 BS 1 27/06/2018 03/07/2018 27/09/1980 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 8180459 0 7 0 0 0 EKA AMIYATI D401598
37 13787 DR ARU, SPPD 0138R0170618V007885 0001196971593 3;JKN
DR RIZKI; 5.2.2.201806040537 4 196132 1#0##0#0#0.0#2018-07-09
11:08:44#0#16:06:43#16:06:43#00:00:00 1 ae5e04b2d7ed2821a989c381fb9f9cfe
0 0 236051 0 0 1916238 0 0 0 0
6028170 0 0 0 0 0
3201126 B 1 BS 1 01/07/2018 03/07/2018 06/07/1955 0 2
1 I12.0;D63.8;J81;N39.0 99.04;38.95 - - None None None None
- 0 - 0 27065300 21413017 0 3 0 0 0
NENENG KURNIATI D402110 62 23006 SRI KUNMARTINI.DR,SPPD
0138R0170718V000026 0000060996767 3;JKN DR RIZKI; 5.2.2.201806040537
4 196163 1#0##0#0#0.0#2018-07-09
11:32:48#0#15:33:11#15:33:11#00:00:00 1 7379f708aae44bd5983b56b09df70c07
0 0 2647238 0 0 9362529 0 0 0 0
9334250 0 0 0 0 69000
3201126 B 3 BS 1 02/07/2018 03/07/2018 26/07/1984 0 1
2954900 0 0 - 0 - 0 - 0 - 0
2954900 3657830 0 2 1 1 0 NURHALI D402136
3;JKN DR RIZKI; 5.2.2.201806040537 4 196184 1#0##0#0#0.0#2018-
07-09 11:34:17#0#08:22:42#08:22:42#00:00:00 1
56b0aa6fe8f8e189c3dde2a59f662385 0 0 318941 0 0 840592
0 0 0 0 1562297 0 0 0 0 936000
3201126 B 3 BS 1 01/07/2018 03/07/2018 30/10/1996 0 1
8672000 0 0 - 0 - 0 - 0 - 0
8672000 12214173 0 3 0 0 0 OSFALDO MARTEEN
CHRISAPUTRA TN D305242 21 7914 DR BENNY H TUMBELAKA
0138R0170718V000048 0001267010471 3;JKN DR RIZKI; 5.2.2.201806040537
4 196173 1#0##0#0#0.0#2018-07-09
11:39:40#0#22:00:26#22:00:26#00:00:00 1 75adcb7024b9d141bc727768f1191b59
0 5740500 3567880 0 0 1885735 0 0 0 0
875058 0 0 0 0 145000
3201126 B 2 BS 1 30/06/2018 03/07/2018 04/01/1969 0 1
0 0 - 0 - 0 - 0 - 0 5043100
5093411 0 4 0 0 0 MUHAMMAD IRFAN D401991 49
18074 DR CELLY ANANTARIA. SPJP 0138R0170618V008961 0001131393442
3;JKN DR RIZKI; 5.2.2.201806040537 4 195924 1#0##0#0#0.0#2018-
07-09 11:41:34#0#07:59:14#07:59:14#00:00:00 1
9a92820098230c34fdce818960b46715 0 0 813320 0 0
1882877 0 0 0 0 2397214 0 0 0 0 0
3201126 B 3 BS 1 01/07/2018 03/07/2018 12/07/1978 0 1
1 N13.3;N23 - - - None None None None N-4-13-I None
- 0 - 0 - 0 - 0 3417600 3063258 0
3 0 0 0 AHMAD RONNIH TN D402102 39 14599 DR MOHAMMAD
JOHAN SPU 0138R0170718V000033 0001310733224 3;JKN DR RIZKI;
5.2.2.201806040537 4 196166 1#0##0#0#0.0#2018-07-09
11:42:41#0#16:37:10#16:37:10#00:00:00 1 6542aae31683be3c52151aee5aea9b8c
0 0 423980 0 0 1623878 0 0 0 0
1015400 0 0 0 0 0
3201126 B 2 BS 1 29/06/2018 03/07/2018 24/09/1989 0 1
1 B17.9;R11 - - - None None None None B-4-13-I None
0 0 - 0 - 0 - 0 - 0 5045200
4430673 0 5 0 0 0 EKO SUHADI D401912 28 10505
5.2.2.201806040537 4 196825 1#0##0#0#0.0#2018-07-09
11:43:22#0#19:57:10#19:57:10#00:00:00 1 fac0019aaa2b6249a39ef3edec1fc11b
0 0 507068 0 0 1082748 0 0 0 0
2840857 0 0 0 0 0
3201126 B 1 BS 1 30/06/2018 03/07/2018 11/04/1957 0 2
1 A41.9;I50.0;N17.9 88.76 - - None None None None A-4-10-III
0 - 0 - 0 - 0 - 0 8174100 5630051
0 4 0 0 0 TARYUNI D300278 61 22360 DR ARU, SPPD
0138R0170618V009022 0001850149078 3;JKN DR RIZKI; 5.2.2.201806040537
4 196139 1#0##0#0#0.0#2018-07-09
11:45:37#0#00:00:00#00:00:00#00:00:00 1 2810973f4c9865c99fcb4c82f123b6a2
0 0 452995 0 0 2004235 0 0 0 0
3172821 0 0 0 0 0
3201126 B 3 BS 1 01/07/2018 03/07/2018 05/02/1961 0 1
1 N39.0;D29.1 - - - None None None None N-4-12-I None
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2268758 0 3 0 0 0 ALI BIN DON DURO
0002298992894 3;JKN DR RIZKI; 5.2.2.201806040537 4 196827
1#0##0#0#0.0#2018-07-09 11:48:07#0#20:00:24#20:00:24#00:00:00 1
aa3cbb3bbaf9217b39f265c500f9350d 0 0 268343 0 0
1036992 0 0 0 0 963423 0 0 0 0 0
3201126 B 1 BS 1 29/06/2018 03/07/2018 18/12/1946 0 1
5058500 0 0 - 0 - 0 - 0 - 0
5058500 6402232 0 5 0 0 0 SADIKUN D336800
71 26126 DR ARU, SPPD 0138R0170618V008893 0000060721749 3;JKN
DR RIZKI; 5.2.2.201806040537 4 196133 1#0##0#0#0.0#2018-07-09
11:49:45#0#16:11:09#16:11:09#00:00:00 1 2e88d95dddc0df6707b9424bd2e9744d
0 0 547342 0 0 1850552 0 0 0 0
4004338 0 0 0 0 0
3201126 B 1 BS 1 02/07/2018 03/07/2018 08/06/1960 0 2
- 0 58821400 64522475 0 2 0 0 0 SUPIYETI, NY
0000061119753 3;JKN DR RIZKI; 5.2.2.201806040537 4 196197
1#0##0#0#0.0#2018-07-10 15:30:11#0#10:26:41#10:26:41#12:00:00 1
cbb6b570050df24671518516510ea2c3 0 10753000 9619120 0 0
35305355 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 01/07/2018 03/07/2018 13/12/1962 0 1
8672000 0 0 - 0 - 0 - 0 - 0
8672000 12209192 0 3 0 0 0 PARDOMUAN SIMATUPANG TN
0001881643285 3;JKN DR RIZKI; 5.2.2.201806040537 4 196172
1#0##0#0#0.0#2018-07-10 15:40:04#0#21:50:02#21:50:02#00:00:00 1
5297e40f5a4799f759a8e3384a80ab5f 0 5740500 3567880 0 0
1881080 0 0 0 0 874732 0 0 145000 0
0
3201126 B 3 BS 1 02/07/2018 03/07/2018 12/05/1954 0 2
- 0 45079800 55967390 0 2 0 0 0 NURAIDA
0002222571341 3;JKN DR RIZKI; 5.2.2.201806040537 4 196194
1#0##0#0#0.0#2018-07-11 09:09:15#0#10:11:16#10:11:16#12:00:00 1
1e0f891e6f09f28f22e0c3b8dd6dfb93 0 7996000 6870800 0 0
32255590 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 1 BS 1 01/07/2018 03/07/2018 16/08/2017 0 1
1 J21.9;J45.9;J06.9 87.44 - - None None None None J-4-18-I
3116300 0 0 - 0 - 0 - 0 - 0
3116300 3024851 0 3 0 0 0 MUZAFFAR ALHAQ
0002142282971 3;JKN DR RIZKI; 5.2.2.201806040537 4 196175
1#0##0#0#0.0#2018-07-24 10:53:43#1#23:14:11#23:14:11#00:00:00 1
454a668fc0ff81c60cf1703f7e0c83fc 0 0 278640 0 0
1321904 0 0 0 0 1424307 0 0 0 0 0
3201126 B 1 BS 1 03/07/2018 03/07/2018 20/06/1938 0 1
- 0 58821400 73860790 0 1 0 0 0 MURDJADJI
SUPRAPTO D317779 80 29233 DR EKA GINANJAR SPPD 0138R0170718V000823
0000060716564 3;JKN DR RIZKI; 5.2.2.201806040537 4 196631
1#0##0#0#0.0#2018-07-24 14:20:31#0#12:46:04#12:46:04#00:00:00 1
79c4b0a72b577a881e87df443f38ffba 0 0 9772620 0 0
43013170 0 0 0 0 12024000 0 0 0 0
9051000
3201126 B 3 BS 1 02/07/2018 03/07/2018 11/05/1970 0 1
1 I84.2;K51.2 45.23 - - None None None None K-4-18-II None
2451500 0 0 - 0 - 0 - 0 - 0
2451500 6168443 0 2 0 0 0 MIZWAR D398467
48 17584 DR ARU, SPPD 0138R0170718V000564 0001290957579 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196344 1#0##0#0#0.0#2018-
09-24 12:34:51#0#18:20:34#18:20:34#00:00:00 2
fec9a5e6dc5cbe2e4def66f60f1a2f85 0 0 1168324 0 0
1439576 0 0 0 0 3484543 0 0 76000 0 0
3201126 B 2 BS 1 28/06/2018 03/07/2018 02/10/1961 0 2
1 I13.1;T82.4;E87.6;D63.8 39.42;38.53 - - None None None None
- 0 - 0 23198900 25136984 0 6 0 0 0
ETTY PURWANINGSIH D399799 56 20723 DEDY PRATAMA,SPBV
0138R0170618V008233 0000173829947 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195266 1#0##0#0#0.0#2018-09-25
11:45:07#0#00:00:00#00:00:00#00:00:00 2 6d672fccb6e96dc25a7e62de9e62bbb7
0 6571100 4871769 0 0 11192865 0 0 0 0
2432250 0 0 0 0 69000
3201126 B 1 BS 1 02/07/2018 03/07/2018 12/01/1957 0 2
1 T82.4;I12.0;D63.8 99.04;38.95 - - None None None None N-1-
- 0 12472300 17909145 0 2 0 0 0 ANAH
0138R0170718V000324 0001257026297 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196280 1#0##0#0#0.0#2018-09-25
13:05:52#0#12:49:17#12:49:17#00:00:00 2 966bbfa746edb7d53dc4c4c043ae5cb3
0 0 2619183 0 0 7871836 0 0 0 0
7383626 0 0 0 0 34500
3201126 B 1 BS 1 25/06/2018 03/07/2018 29/01/1956 0 1
4 I11.0;I25.0;R57.0;E87.6;I34.0 89.52 - - None None None None
6963100 0 0 - 0 - 0 - 0 - 0
6963100 16788865 0 9 1 6 0 KARYANTO D344004
62 22793 DR SUPONO 0138R0170618V007299 0000041115633 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 194274 1#0##0#0#0.0#2018-
10-10 16:31:10#0#22:04:35#22:04:35#00:00:00 4
7ca22432eeea834aa2813e0c3c47ac68 0 0 785580 0 0
4508948 0 0 0 0 7850337 0 0 0 0
3644000
3201126 B 2 BS 1 28/06/2018 03/07/2018 01/03/2011 0 1
1 A91;R57.1 87.44 - - None None None None A-4-13-III None
3841100 0 0 - 0 - 0 - 0 - 0
3841100 12549556 0 6 1 3 0 ULINNAS NUR SOLIHIN
0002468139761 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195456
1#0##0#0#0.0#2018-10-10 16:32:06#0#00:00:00#00:00:00#00:00:00 4
4960d35c85bd0f5af551cf915dd1553a 0 0 398699 0 0
4312858 0 0 0 0 5463999 0 0 0 0
2374000
3201126 B 1 BS 1 01/07/2018 04/07/2018 11/03/1993 0 2
12-II None None None None None None PERSALINAN VAGINAL DENGAN PROSEDUR SELAIN
0 - 0 - 0 4219100 8493734 0 4 0 0
0 BINTANG PISCESKA ARYANDINI D296608 25 9243 DR ERDIYAN, SPOG
0138R0170718V000049 0002096665727 3;JKN DR RIZKI; 5.2.2.201806040537
4 196174 1#0##0#0#0.0#2018-07-10
16:24:12#0#22:56:54#22:56:54#12:00:00 1 e099d1fe3446589fa6f7bc38c8fd08f0
0 0 608080 0 0 1986789 0 0 0 0
5228865 0 0 670000 0 0
3201126 B 3 BS 1 02/07/2018 04/07/2018 16/06/1960 0 2
0 0 - 0 - 0 - 0 - 0 8264200
10547190 0 3 0 0 0 NURHAYATI NY D401691 58
21200 DR ERDIYAN, SPOG 0138R0170718V000292 0000511941216 3;JKN DR
RIZKI; 5.2.2.201806040537 4 196242 1#0##0#0#0.0#2018-07-10
16:28:21#0#11:24:29#11:24:29#00:00:00 1 980229982dbb623eed180ba388ced494
0 3615000 2727186 0 0 3259001 0 0 0 0
835003 0 0 0 0 111000
3201126 B 1 BS 1 26/06/2018 04/07/2018 17/08/1955 0 1
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 12244152 0 9 0 0 0 ENDY SURYADI
0001721943101 3;JKN DR RIZKI; 5.2.2.201806040537 4 194972
1#0##0#0#0.0#2018-07-10 16:35:32#0#20:49:33#20:49:33#00:00:00 1
cb00e7060fec662ff9d5c08c126d140d 0 6248000 564777 0 0
3193300 0 0 0 0 1532075 0 0 706000 0
0
3201126 B 1 BS 1 02/07/2018 04/07/2018 18/02/1965 0 1
- 0 12472300 13041467 0 3 0 0 0 FABIAN HELMI
0138R0170718V000594 0001299435862 3;JKN DR RIZKI; 5.2.2.201806040537
4 196345 1#0##0#0#0.0#2018-07-10
16:37:40#0#00:00:00#00:00:00#00:00:00 1 b5094d40b43c0325a432133a2122e728
0 6813700 1243123 0 0 3986464 0 0 0 0
922180 0 0 76000 0 0
3201126 B 1 BS 1 01/07/2018 04/07/2018 28/06/1941 0 2
1 I50.0;I48;I25.0 89.52 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 5802600
5835376 0 4 0 0 0 ENDAH MURDAYA, NY D392747 77
3;JKN DR RIZKI; 5.2.2.201806040537 4 196164 1#0##0#0#0.0#2018-
07-10 16:43:22#0#15:51:23#15:51:23#12:00:00 1
3501bf1deec3739be4bd9d95fdd96cd3 0 0 823022 0 0
1480600 0 0 0 0 3531754 0 0 0 0 0
3201126 B 2 BS 1 01/07/2018 04/07/2018 17/04/1987 0 2
1 B90.9;M79.1 - - - None None None None J-4-19-I None
0 0 - 0 - 0 - 0 - 0 6234900
4282649 0 4 0 0 0 YANTI MULYAWATI D402125 31
DR RIZKI; 5.2.2.201806040537 4 196171 1#0##0#0#0.0#2018-07-11
08:20:13#0#21:18:28#21:18:28#00:00:00 2 0ab06240f0d411dabbc44de9c8d83323
0 0 614141 0 0 1549835 0 0 0 0
2118673 0 0 0 0 0
3201126 B 1 BS 1 02/07/2018 04/07/2018 21/11/2017 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3204292 0 3 0 0 0 NALENDRA ARKAAN SUWARSO
0002459167391 3;JKN DR RIZKI; 5.2.2.201806040537 4 196178
1#0##0#0#0.0#2018-07-11 08:25:18#0#01:59:06#01:59:06#00:00:00 1
e4d1a6d83b4a51bc83f4aa22dedb638a 0 0 316331 0 0 874334
0 0 0 0 1843627 0 0 170000 0 0
3201126 B 3 BS 1 03/07/2018 04/07/2018 30/07/1971 0 1
1 K74.6;I85.0;D64.9;B16.2 99.04 - - None None None None B-4-
6747200 0 0 - 0 - 0 - 0 - 0
6747200 4671292 0 2 0 0 0 EDI WAHYUDIN
0001257549636 3;JKN DR RIZKI; 5.2.2.201806040537 4 196359
1#0##0#0#0.0#2018-07-11 08:31:30#0#04:54:56#04:54:56#00:00:00 1
5d97e1b1654f0ccb1c44074bcab67985 0 0 660248 0 0
3153445 0 0 0 0 857599 0 0 0 0 0
3201126 B 1 BS 1 02/07/2018 04/07/2018 22/11/2016 0 2
0 0 - 0 - 0 - 0 - 0 3349800
3526493 0 3 0 0 0 ADIBAH KAMILAH ALHAKIM D393235
1 587 DR RASTRA, SPA 0138R0170718V000202 0002204312027 3;JKN
DR RIZKI; 5.2.2.201806040537 4 196189 1#0##0#0#0.0#2018-07-11
08:34:05#0#00:00:00#00:00:00#12:00:00 1 dc5137cf8b40a557bafd3427ffa1fcc6
0 0 338858 0 0 587930 0 0 0 0
2599705 0 0 0 0 0
3201126 B 1 BS 1 03/07/2018 04/07/2018 03/01/1960 0 2
- 0 58821400 58247210 0 2 0 0 0 IR ROSAIDAR
ARIF D390734 58 21366 DR AZRI NURIZAL SPPD KKV 0138R0170718V000775
0001880736851 3;JKN DR RIZKI; 5.2.2.201806040537 4 196566
1#0##0#0#0.0#2018-07-11 08:41:41#0#11:11:24#11:11:24#12:00:00 2
70ea319fe70c787c00859d4500b31b28 0 10062000 9619120 0 0
29721090 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 2 BS 1 02/07/2018 04/07/2018 21/11/1962 0 2
- 0 51950600 57399510 0 3 0 0 0 TATI
SUMIYATY D308209 55 20312 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170718V000601 0002090857432 3;JKN DR RIZKI; 5.2.2.201806040537
4 196350 1#0##0#0#0.0#2018-07-11
08:45:24#0#21:46:34#21:46:34#00:00:00 2 6e51cdf76c708837d6183084abfb222e
0 9479000 8297960 0 0 30777550 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 02/07/2018 04/07/2018 09/09/1961 0 2
1 I67.4;I10;K29.7;E14.9 89.52 - - None None None None G-4-
21-I None None None None None None KOMA & STUPOR NON TRAUMA (RINGAN)
3769000 0 0 - 0 - 0 - 0 - 0
3769000 3970214 0 3 0 0 0 HERLIEN WIDAYATI
D295668 56 20750 DR ARU, SPPD 0138R0170718V000599
0000037967106 3;JKN DR RIZKI; 5.2.2.201806040537 4 197536
1#0##0#0#0.0#2018-07-11 08:52:09#0#17:38:12#17:38:12#00:00:00 1
25730a1261cd999cefb46b23e27e97bf 0 0 1015568 0 0
1106912 0 0 0 0 1847734 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 04/07/2018 17/07/1956 0 2
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2706061 0 5 0 0 0 T RAMAULY PANJAITAN NY
D402070 61 22628 DR ARU, SPPD 0138R0170618V009047
0001336232597 3;JKN DR RIZKI; 5.2.2.201806040537 4 196327
1#0##0#0#0.0#2018-07-11 08:58:15#0#15:27:53#15:27:53#00:00:00 1
e6e5e79dd4940bfd88f300bf2c927804 0 0 268343 0 0
1182686 0 0 0 0 1255032 0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 04/07/2018 21/08/1968 0 1
0 - 0 - 0 - 0 - 0 4144700 2525353
0 2 0 0 0 SUEDY SUKIA D365591 49 18213 SRI
5.2.2.201806040537 4 196814 1#0##0#0#0.0#2018-07-11
09:12:31#0#00:00:00#00:00:00#00:00:00 1 350c3166aadd43db84f7e09065bc7627
0 0 424889 0 0 1383254 0 0 0 0 717210
0 0 0 0 0
3201126 B 1 BS 1 28/06/2018 04/07/2018 22/04/1966 0 1
14562700 0 0 - 0 - 0 - 0 - 0
14562700 29882182 0 7 1 6 0 JOHN TUA TN D148895
3;JKN DR RIZKI; 5.2.2.201806040537 4 195016 1#0##0#0#0.0#2018-
07-11 09:34:34#0#02:31:01#02:31:01#00:00:00 1
225f5f09830275f9ab785d789462d199 0 0 1093191 0 0
15211966 0 0 0 0 10025025 0 0 3552000 0
0
3201126 B 3 BS 1 30/06/2018 04/07/2018 15/06/1977 0 2
1 I12.0;J81;J18.0;E87.8;D63.8;I24.9 39.42;39.95;89.52 - - None
0 - 0 - 0 - 0 19332400 26304373 0 5
1 3 0 MASIAH D400461 41 14990 DR AZRI NURIZAL SPPD KKV
0138R0170618V008969 0001739778478 3;JKN DR RIZKI; 5.2.2.201806040537
4 195939 1#0##0#0#0.0#2018-07-11
09:43:14#0#08:44:46#08:44:46#00:00:00 1 bda98858539a2ae2a49ff3c335f50749
0 5699500 4267463 0 0 10324260 0 0 0 0
3049150 0 0 0 0 2964000
3201126 B 3 BS 1 04/07/2018 04/07/2018 21/04/1978 0 1
1 N18.5;J81;A41.9 - - - None None None None N-4-10-III
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 5346334 0 1 0 0 0 MUHAMAD SOLEH TN
0001455588617 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196838
1#0##0#0#0.0#2018-07-12 16:05:55#0#00:30:53#00:30:53#00:00:00 1
6d3f096fde3f70a7db4f8bd8c2f47ae1 0 0 599993 0 0
2246206 0 0 0 0 1315000 0 0 0 1185135
0
3201126 B 3 BS 1 02/07/2018 04/07/2018 06/05/1986 0 2
1 N18.5;D63.8;A41.9 38.95;99.21;99.04 - - None None None None
- 0 - 0 19332400 18219678 0 3 0 0 0
0138R0170718V000501 0002196827987 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196340 1#0##0#0#0.0#2018-07-16
09:56:54#0#17:09:33#17:09:33#12:00:00 1 e8ea1cbeb9ca8a82ea4386f84eee5361
0 0 4112804 0 0 9244432 0 0 0 0
4503442 0 0 0 0 359000
3201126 B 2 BS 1 02/07/2018 04/07/2018 25/12/2012 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2818215 0 3 0 0 0 ARGANDRA TRIPUTRA AFKAR
VILANNADI D402134 5 2015 DR OTTY MITHA S, SPA 0138R0170718V000067
0001624814425 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196180
1#0##0#0#0.0#2018-07-16 15:52:42#0#03:34:44#03:34:44#00:00:00 1
d807289aaebe1bac2bba3bb2a92f1b60 0 0 298025 0 0 794821
0 0 0 0 1725369 0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 04/07/2018 18/04/1949 0 1
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 54907720 0 2 0 0 0 H.BUCHORI
0001739971956 3;JKN DR RIZKI; 5.2.2.201806040537 4 196737
1#0##0#0#0.0#2018-07-18 15:29:18#0#00:00:00#00:00:00#12:00:00 1
e6b44f741fa5765b346e74231731ce35 0 7996000 6870800 0 0
31195920 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 2 BS 1 02/07/2018 04/07/2018 09/04/1978 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3051708 0 3 0 0 0 YANAH SURYANAH NY
0002084416593 3;JKN DR RIZKI; 5.2.2.201806040537 4 196279
1#0##0#0#0.0#2018-07-24 11:25:45#1#12:44:29#12:44:29#00:00:00 3
f7186d4bd3248083214f32bc7027f04e 0 0 251100 0 0
1072394 0 0 0 0 1600214 0 0 0 128000
0
3201126 B 2 BS 1 02/07/2018 04/07/2018 02/07/2018 2827 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1612245 0 3 0 0 0 BAYI NY ARIS RATNA
SAFITRI D402203 0 0 DR KRISTON SILITONGA, SPA
0138R0170718V001325 0002450907213 3;JKN DR RIZKI; 5.2.2.201806040537
4 197067 1#0##0#0#0.0#2018-07-25
14:39:35#0#10:44:21#10:44:21#00:00:00 1 4330cbc62ff76ce01e25050d0a27d170
0 0 214472 0 0 471699 0 0 0 0 926074
0 0 0 0 0
3201126 B 2 BS 1 29/06/2018 04/07/2018 18/01/2018 0 1
- 0 - 0 9841500 7796207 0 6 0 0 0
MUHAMMAD NUR AZHARI D400465 0 162 DR NOVIK BUDIWARDHANA, SPA
0138R0170618V008438 0002421534993 3;JKN DR RIZKI; 5.2.2.201806040537
4 195423 1#0##0#0#0.0#2018-07-25
14:41:34#0#00:00:00#00:00:00#00:00:00 1 fd21709ab1559835d0862401c8b9c84b
0 0 683567 0 0 4363608 0 0 0 0
2069032 0 0 0 0 680000
3201126 B 2 BS 1 02/07/2018 04/07/2018 05/05/1979 0 1
1 I13.0;D63.8;K30 99.04 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4973600
4928754 0 3 0 0 0 NINING RUSTINI D398049 39
14303 DR SRI KUNMARTINI, SPPD 0138R0170718V000592 0002437157665 3;JKN
DR RIZKI; 5.2.2.201806040537 4 196346 1#0##0#0#0.0#2018-07-25
15:09:39#0#20:24:36#20:24:36#00:00:00 1 e7f16bd6eb88a3add711f30a73e047d8
0 0 709388 0 0 2563424 0 0 0 0
1655942 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 04/07/2018 30/01/2001 0 2
1 J36 - - - None None None None U-4-13-I None None
0 - 0 1980100 3161010 0 5 0 0 0
MALINDA REVY MAHAPUTRI D402069 17 6360 DR RISMAN S, SPTHT
0138R0170618V009034 0001739763303 3;JKN DR RIZKI; 5.2.2.201806040537
4 196144 1#0##0#0#0.0#2018-07-26
09:13:20#0#00:00:00#00:00:00#00:00:00 1 a449aa7156a98f36f6575cc04c9aec57
0 0 263096 0 0 1613119 0 0 0 0
1284795 0 0 0 0 0
3201126 B 1 BS 1 28/06/2018 04/07/2018 22/04/1966 0 1
14562700 0 0 - 0 - 0 - 0 - 0
14562700 29882182 0 7 1 6 0 JOHN TUA TN D148895
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195016
1#0##0#0#0.0#2018-09-08 08:45:36#0#02:31:01#02:31:01#00:00:00 2
c964083d003bf175c60673a826e80f36 0 0 1093191 0 0
15211966 0 0 0 0 10025025 0 0 3552000 0
0
3201126 B 3 BS 1 04/07/2018 04/07/2018 17/07/1952 0 2
4 I67.9;C91.1 - - - None None None None G-4-26-II None
(SEDANG) 4302200 0 0 - 0 - 0 - 0 - 0
4302200 3262712 0 1 0 0 0 RUMINAH D401155
65 24093 DR ADITIA NATA KUSUMA 0138R0170718V001316 0000078936467
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197056
1#0##0#0#0.0#2018-09-08 10:42:13#0#10:33:52#10:33:52#00:00:00 3
501c95c6f29dfdecc06593df059d75e1 0 0 215110 0 0
2545154 0 0 0 0 502448 0 0 0 0 0
3201126 B 2 BS 1 02/07/2018 04/07/2018 06/08/1980 0 2
1 O99.0;O82.9;O14.1;Z37.0;Z73.0;O42.0 74.0;99.04;66.32 - - None
None None None O-6-10-II None None None None None None OPERASI
PEMBEDAHAN CAESAR (SEDANG) 6486300 0 0 - 0 - 0 -
0 - 0 6486300 16460648 0 3 0 0 0 ARIS
RATNA SAFITRI NY D402156 37 13844 DR FERRI SABARUDDIN SPOG
0138R0170718V000336 0002446462754 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196281 1#0##0#0#0.0#2018-09-08
11:41:52#0#12:49:52#12:49:52#00:00:00 2 fce6dc2bd811f0442d0c3b15cb91de4a
0 6857900 2299479 0 0 5652269 0 0 0 0
1326000 0 0 0 0 325000
3201126 B 2 BS 1 03/07/2018 04/07/2018 17/11/1994 0 2
1 O05.4;O99.0;O75.1 69.02;99.04 - - None None None None W-1-
SERVIK (SEDANG) 3046400 0 0 - 0 - 0 - 0 -
0 3046400 7483079 0 2 0 0 0 NIA LESTARI
0001740385866 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197542
1#0##0#0#0.0#2018-09-08 11:44:21#0#18:53:11#18:53:11#00:00:00 2
5982b5b3119b7523294c3a9dfc3fab63 0 0 905992 0 0
3036040 0 0 0 0 3472047 0 0 0 0 69000
3201126 B 2 BS 1 03/07/2018 04/07/2018 16/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 2783600
6533996 0 2 0 0 0 SURYATI BR GINTING D048548
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196558
1#0##0#0#0.0#2018-09-24 12:37:15#0#10:58:14#10:58:14#00:00:00 2
12fd28eaf99eae053d4c6f54baeadef9 0 0 832408 0 0 994630
0 0 0 0 2957958 0 0 0 0 1749000
3201126 B 3 BS 1 03/07/2018 04/07/2018 03/07/1955 0 1
- 0 - 0 19332400 14459703 0 2 0 0 0
SANWANIH D398117 63 23011 SRI KUNMARTINI.DR,SPPD
0138R0170718V000966 0001210525896 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196783 1#0##0#0#0.0#2018-09-25
13:06:42#0#00:00:00#00:00:00#00:00:00 2 00e0f3b27d49cf9014b104c1abd867c8
0 0 1906030 0 0 8400211 0 0 0 0
4084462 0 0 0 0 69000
3201126 B 1 BS 1 03/07/2018 04/07/2018 28/02/1967 0 1
- 0 - 0 27065300 18735788 0 2 0 0 0
ARIEF RACHMAN HAKIM D093472 51 18753 SRI KUNMARTINI.DR,SPPD
0138R0170718V001007 0001404442833 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196816 1#0##0#0#0.0#2018-09-25
13:07:32#0#00:00:00#00:00:00#00:00:00 2 9f0485e139c27e8dcf99cab7dbdc052a
0 5896000 2557460 0 0 8937328 0 0 0 0
1276000 0 0 0 0 69000
3201126 B 3 BS 1 02/07/2018 04/07/2018 06/01/1969 0 2
4 I61.2;S09.8;S06.5;S02.0 01.24;96.71 - - None None None None
G-1-10-II None None None None None None KRANIOTOMI (SEDANG)
20479100 0 0 - 0 - 0 - 0 - 0
20479100 37244974 0 3 1 3 24 ROSLIANA D402167
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196328
1#0##0#0#0.0#2018-10-03 09:18:55#0#15:51:30#15:51:30#00:00:00 3
740a4d02679ce888c1d88fd980632418 0 0 10328756 0 0
13398018 0 0 0 0 9489200 0 0 0 0
4029000
3201126 B 2 BS 1 28/06/2018 04/07/2018 17/10/2008 0 2
1 D69.3;R57.1 - - - None None None None D-4-11-III None
None None None None None GANGGUAN PEMBEKUAN DARAH (BERAT) 12346500
0 0 - 0 - 0 - 0 - 0 12346500
18303502 0 7 1 3 0 SEKAR NUR CARISSA D300827 9
3541 DR NOVIK BUDIWARDHANA, SPA 0138R0170618V008421 0001290270262
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195415
1#0##0#0#0.0#2018-10-10 16:33:23#0#20:30:25#20:30:25#00:00:00 3
d65d6fbfc5e1dd087419048dcfc34db2 0 0 1164188 0 0
8562889 0 0 0 0 5896425 0 0 0 0
2680000
3201126 B 1 BS 1 05/07/2018 05/07/2018 01/01/1962 0 2
- 0 12472300 13740547 0 1 0 0 0 TASLIMAH
0001229013551 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197968
1#0##0#0#0.0#2018-07-11 14:29:41#0#14:39:41#14:39:41#00:00:00 1
4cc82e9f22168fda5f526bd5444673a4 0 0 2494460 0 0
3523170 0 0 0 0 6468200 0 0 0 1254717
0
3201126 B 3 BS 1 04/07/2018 05/07/2018 01/06/1946 0 2
- 0 45079800 67623168 0 2 0 0 0 NAMI
0002099426747 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197231
1#0##0#0#0.0#2018-07-11 14:33:20#0#12:34:02#12:34:02#12:00:00 1
b79cfb141ed94d1cfc6c5f409424c9d0 10000000 0 6870800 0 0
33911368 0 0 0 0 7996000 0 0 0 8845000
0
3201126 B 2 BS 1 30/06/2018 05/07/2018 06/05/1944 0 1
1 E87.6;K59.1;I50.0;R77.0 - - - None None None None E-4-
5405900 0 0 - 0 - 0 - 0 - 0
5405900 11629959 0 6 0 0 0 ALI BIN KILAN
D402057 74 27083 DR ARU, SPPD 0138R0170618V009016
0001336230483 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196137
1#0##0#0#0.0#2018-07-14 09:02:08#0#16:47:52#16:47:52#00:00:00 1
f4ed655897f2c0da4ce50eaebc5d6002 0 0 593590 0 0
7219531 0 0 0 0 3816838 0 0 0 0 0
3201126 B 1 BS 1 01/07/2018 05/07/2018 05/01/1963 0 2
- 0 - 0 - 0 - 0 2669400 6903042 0
5 0 0 0 APRIANINGSIH D402096 55 20266 DR ARU, SPPD
0138R0170718V000021 0000041707394 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 197537 1#0##0#0#0.0#2018-07-14
09:07:38#0#17:44:25#17:44:25#00:00:00 1 d8e7e5395790fe9af56a90531737032e
0 0 269459 0 0 2250982 0 0 0 0
4382601 0 0 0 0 0
3201126 B 1 BS 1 01/07/2018 05/07/2018 02/11/2015 0 1
1 A49.9;A09.9;B37.9 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0 - 0
- 0 3855500 5594958 0 5 0 0 0 MARSELINUS
AGNELO MARSAHALA HALOHO D314482 2 972 DR KRISTON SILITONGA, SPA
0138R0170718V000035 0002242317903 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196167 1#0##0#0#0.0#2018-07-14
10:09:46#0#17:26:31#17:26:31#12:00:00 1 4d20249438a8ab86afccdcf130242e58
0 0 269459 0 0 1033974 0 0 0 0
3951525 0 0 0 0 340000
3201126 B 2 BS 1 03/07/2018 05/07/2018 03/07/2018 2368 2
(RINGAN) 6580300 0 0 - 0 - 0 - 0 - 0
6580300 1009236 0 3 0 0 0 BAYI NY RIZKI MARDIANTI
d402322 0 0 DR. TRI LESTARI 0138R0170718V001915
0002456062648 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197812
1#0##0#0#0.0#2018-07-14 11:40:01#0#00:00:00#00:00:00#00:00:00 1
83f05e1698757d58eea21cc956e22ed2 0 0 282712 0 0 156499
0 0 0 0 570025 0 0 0 0 0
3201126 B 1 BS 1 02/07/2018 05/07/2018 03/10/1975 0 1
5883600 0 0 - 0 - 0 - 0 - 0
5883600 7037508 0 4 0 0 0 DONALD OSCAR KARUNDENG
0000060484645 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196341
1#1#vip#1#4412700#75.0#2018-07-16 08:20:23#0#00:00:00#00:00:00#12:00:00
1 7c6ae43a611076bdb6624bdeeffa2a59 0 0 473430 0 0
2252680 0 0 0 0 4311398 0 0 0 0 0
3201126 B 1 BS 1 02/07/2018 05/07/2018 04/12/1992 0 2
0 0 - 0 - 0 - 0 - 0 6981500
14579466 0 4 0 0 0 ANNISA FADILLAH D259368 25
9341 DR ARJU A, SPOG 0138R0170718V000492 0001626892165 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196336 1#0##0#0#0.0#2018-
07-16 08:21:45#0#00:00:00#00:00:00#12:00:00 1
4c4ed5a8ee3087e711a2222ddbd1c582 0 7789900 2419895 0 0
2845874 0 0 0 0 1069797 0 0 0 0 454000
3201126 B 3 BS 1 29/06/2018 05/07/2018 15/01/1960 0 2
0 - 0 - 0 - 0 - 0 4144700 8710427
0 7 1 2 0 MARWATI D401941 58 21350 DR BAMBANG
5.2.2.201806040537 4 195869 1#0##0#0#0.0#2018-07-16
08:25:31#0#15:44:46#15:44:46#00:00:00 1 bc8c9a96017232c0160d5c3b6e17e5b2
0 0 489860 0 0 3368726 0 0 0 0
2867841 0 0 0 0 1984000
3201126 B 2 BS 1 04/07/2018 05/07/2018 04/07/2018 3652 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 935556 0 2 0 0 0 BAYI NY NUR AVNI
MAULIDAYANTI D402350 0 0 DR TRI LESTARI, SPA
0138R0170718V002060 0002470245399 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198022 1#0##0#0#0.0#2018-07-16
08:29:05#0#15:35:03#15:35:03#00:00:00 2 4c75cad7b1e5cc4ebbeb160af2582374
0 0 194972 0 0 175379 0 0 0 0 565205
0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 05/07/2018 14/02/1988 0 1
1 B19.9;R17 - - - None None None None B-4-13-II None
0 0 - 0 - 0 - 0 - 0 4897800
2421884 0 3 0 0 0 RYALDI EBRI D402282 30 11097
DR BETTY DWI L, SPPD 0138R0170718V001045 0001794731128 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196818 1#0##0#0#0.0#2018-
07-16 09:39:35#0#17:19:27#17:19:27#00:00:00 1
873cabba38a5fc4196bccf4755950456 0 0 431387 0 0
1017056 0 0 0 0 973441 0 0 0 0 0
3201126 B 2 BS 1 03/07/2018 05/07/2018 05/07/1960 0 2
- 0 3584400 3862530 0 3 0 0 0 SURYANIH
D397847 57 21182 DR ARU, SPPD 0138R0170718V001055
0001266397323 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196819
1#0##0#0#0.0#2018-07-16 09:51:25#0#00:00:00#00:00:00#00:00:00 1
737fce83ace269636bb17877c742debf 0 0 322596 0 0
1618245 0 0 0 0 1793689 0 0 0 0 128000
3201126 B 1 BS 1 30/06/2018 05/07/2018 09/04/1976 0 1
6795600 0 0 - 0 - 0 - 0 - 0
6795600 9147452 0 6 0 0 0 RIKI APRIANSYAH
0001603710911 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195921
1#0##0#0#0.0#2018-07-16 14:25:33#0#00:00:00#00:00:00#00:00:00 1
2f966ce3c2a9c7d9381c6664123fec4b 0 0 664604 0 0
2713417 0 0 0 0 5310431 0 459000 0 0
0
3201126 B 2 BS 1 03/07/2018 05/07/2018 03/07/2018 2710 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1790400 0 3 0 0 0 BAYI NY. LAYLA ROCHMANIA
0002470068549 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197833
1#1#vip#3#731200#0.0#2018-07-16 14:27:46#0#00:00:00#00:00:00#00:00:00 1
7d806158515a57382b5d1e53523fbc89 0 0 194972 0 0 201699
0 0 0 0 1393729 0 0 0 0 0
3201126 B 1 BS 1 02/07/2018 05/07/2018 31/10/1977 0 2
- 0 - 0 - 0 - 0 3103000 3479845 0
5.2.2.201806040537 4 196321 1#0##0#0#0.0#2018-07-16
16:04:40#0#15:13:44#15:13:44#12:00:00 1 dfe4697fc134b44cbee6145ffb9afd86
0 0 1002360 0 0 1442832 0 0 0 0
1034653 0 0 0 0 0
3201126 B 3 BS 1 01/07/2018 05/07/2018 25/12/1951 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3798088 0 5 0 0 0 KAMARIA TANJUNG NY
0002232413289 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196168
1#0##0#0#0.0#2018-07-16 16:10:09#0#19:45:44#19:45:44#00:00:00 1
399f7de8650d98dc721ace83058e8721 0 0 674855 0 0
1620260 0 0 0 0 1502973 0 0 0 0 0
3201126 B 2 BS 1 02/07/2018 05/07/2018 27/01/1990 0 2
0 0 - 0 - 0 - 0 - 0 5984100
11228931 0 4 0 0 0 RIZKI MARDIANTI D402195 28
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196337
1#0##0#0#0.0#2018-07-16 16:13:03#0#00:00:00#00:00:00#00:00:00 1
2e763ebcbc3cbed898b467a03c45eed2 0 5684900 2090753 0 0
2405675 0 0 0 0 850603 0 0 0 0 197000
3201126 B 2 BS 1 02/07/2018 05/07/2018 16/04/1969 0 1
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 4037096 0 4 0 0 0 CARIDIN TN D402126
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196176
1#0##0#0#0.0#2018-07-16 16:14:14#0#00:31:14#00:31:14#00:00:00 1
7240603ab9500eed554789e979c8c2d2 0 0 504286 0 0
1222701 0 0 0 0 2310109 0 0 0 0 0
3201126 B 3 BS 1 28/06/2018 05/07/2018 21/04/1946 0 2
1 K21.9;N17.9;K92.1;D64.9 99.04 - - None None None None K-4-
12-III None None None None None None GANGGUAN ESOFAGUS (BERAT)
6781600 0 0 - 0 - 0 - 0 - 0
6781600 9600483 0 8 0 0 0 YATTY MUGIATY
D320236 72 26366 DR ARU, SPPD 0138R0170618V008273
0001280852559 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195325
1#0##0#0#0.0#2018-07-16 16:33:40#0#14:17:17#14:17:17#00:00:00 1
a518ae2245a519bc8324e41a99dd5816 0 0 433484 0 0
6408930 0 0 0 0 2758069 0 0 0 0 0
3201126 B 1 BS 1 03/07/2018 05/07/2018 17/07/1954 0 2
1 N39.0;I10;A01.0 - - - None None None None N-4-12-III
7087700 0 0 - 0 - 0 - 0 - 0
7087700 4115584 0 3 0 0 0 SYIFA D370400 63
TANTIYO S;16137 5.2.2.201806040537 4 196352 1#0##0#0#0.0#2018-
07-17 09:35:10#0#00:03:51#00:03:51#12:00:00 1
e7143cfe264de0988acb72976e3322fe 0 0 354482 0 0
1122858 0 0 0 0 2638244 0 0 0 0 0
3201126 B 2 BS 1 03/07/2018 05/07/2018 22/03/1991 0 2
0 0 - 0 - 0 - 0 - 0 5984100
21441612 0 3 0 0 0 LAYLA ROCHMANIA D397949 27
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196353
1#1#vvip#3#15457512#0.0#2018-07-17 09:41:39#0#00:51:20#00:51:20#00:00:00
1 83309c12e613ec7a61194ab8116b4f25 0 8023000 8778198 0
0 2515414 0 0 0 0 1326000 0 0 0 0
799000
3201126 B 1 BS 1 29/06/2018 05/07/2018 19/06/1959 0 1
1 M51.1;E14.9;E78.5 - - - None None None None M-4-17-I
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 9195605 0 7 0 0 0 SURATKO D360894
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195685
1#0##0#0#0.0#2018-07-17 09:47:51#0#00:00:00#00:00:00#00:00:00 2
830072be6022b0edbeffd7388f49f53d 0 0 570661 0 0
2530362 0 0 0 0 6094582 0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 05/07/2018 01/08/1950 0 1
1 I48;I11.0;I25.0 - - - None None None None I-4-19-III
(BERAT) 7295800 0 0 - 0 - 0 - 0 - 0
7295800 2443651 0 3 0 0 0 MUTAR d384015 67
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196356
1#0##0#0#0.0#2018-07-17 09:51:57#0#00:00:00#00:00:00#12:00:00 1
842e97ef7513c616efdc602519c5bb19 0 0 709622 0 0 759164
0 0 0 0 974865 0 0 0 0 0
3201126 B 2 BS 1 02/07/2018 05/07/2018 02/03/2007 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2750050 0 4 0 0 0 DZAHFA ALI MUFTI N
0001171017077 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196348
1#0##0#0#0.0#2018-07-17 09:55:03#0#00:00:00#00:00:00#00:00:00 1
df7dc43579e193829fe6dc8867774a62 0 0 207620 0 0 524020
0 0 0 0 2018410 0 0 0 0 0
3201126 B 3 BS 1 29/06/2018 05/07/2018 26/02/1973 0 2
0 0 - 0 - 0 - 0 - 0 10401900
15868228 0 7 1 0 0 HASUNAH D401922 45 16559
DR ARU 0138R0170618V008842 0000512467751 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 195909 1#0##0#0#0.0#2018-07-17
10:04:34#0#16:54:17#16:54:17#00:00:00 1 7106d13e1255b5d7358c6e3e19a43e45
0 0 989170 0 0 7259950 0 0 0 0
5345108 0 0 0 0 2274000
3201126 B 2 BS 1 04/07/2018 05/07/2018 12/11/1968 0 2
- 0 51950600 57215085 0 2 0 0 0 SUMINI
0001283774264 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197299
1#0##0#0#0.0#2018-07-17 13:36:07#0#14:27:36#14:27:36#12:00:00 1
ab9e35fad128df62d6c0e4d96f7b27b5 0 9004000 8244960 0 0
31121125 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 04/07/2018 05/07/2018 16/10/1989 0 1
1 I12.0;J81;T82.4;D63.8 38.95;99.04;87.44;89.52 - - None None
- 0 - 0 - 0 19332400 13230597 0 2 0
0 0 OKDIANTO D402342 28 10488 SRI KUNMARTINI.DR,SPPD
0138R0170718V001584 0000524121974 3;JKN DR RIZKI; 5.2.2.201806040537
4 198086 1#0##0#0#0.0#2018-07-18
09:48:40#0#00:00:00#00:00:00#00:00:00 1 03685831b1ddd81e39423a9ffb76be4f
0 3062500 1906030 0 0 7251514 0 0 0 0
941553 0 0 0 0 69000
3201126 B 3 BS 1 04/07/2018 05/07/2018 25/06/1957 0 1
1 A15.3 - - - None None None None J-4-15-I None None
4336500 0 0 - 0 - 0 - 0 - 0
4336500 8402850 0 2 0 0 0 JHONY DAYOH TN
0000512091909 3;JKN DR RIZKI; 5.2.2.201806040537 4 197547
1#0##0#0#0.0#2018-07-18 10:06:15#0#22:28:33#22:28:33#00:00:00 1
68fa9650ef875d2f51ef204c2a7302cd 0 0 466281 0 0
3863850 0 0 0 0 3356719 0 0 0 0 716000
3201126 B 2 BS 1 04/07/2018 05/07/2018 24/01/1971 0 1
- 0 10690500 15203435 0 2 0 0 0 SATIRI EKA
PUTRA D402384 47 17328 SRI KUNMARTINI.DR,SPPD 0138R0170718V001702
0001637142614 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197544
1#0##0#0#0.0#2018-07-18 11:24:55#0#00:00:00#00:00:00#00:00:00 1
db83ac3a94fc953e60a115063b5f91ea 0 8324600 2276624 0 0
3462594 0 0 0 0 1070617 0 0 0 0 69000
3201126 B 2 BS 1 03/07/2018 05/07/2018 22/06/1995 0 2
0 0 - 0 - 0 - 0 - 0 5984100
12544506 0 3 0 0 0 BELLA SYAFIRA D402242 23
8412 DR BAGUS T, SPOG 0138R0170718V000625 0002046365212 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196361 1#0##0#0#0.0#2018-
07-18 12:43:30#0#00:00:00#00:00:00#00:00:00 1
c37ab22cb01808139298dc2643011082 0 5269900 2144753 0 0
3529184 0 0 0 0 1196669 0 0 0 0 404000
3201126 B 2 BS 1 02/07/2018 05/07/2018 09/08/1974 0 1
1 D41.0;N23 - - - None None None None N-4-16-I None
(RINGAN) 4435100 0 0 - 0 - 0 - 0 - 0
4435100 5407094 0 4 0 0 0 ALEXANDER MAYULU TN
0001620766078 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196278
1#0##0#0#0.0#2018-07-18 13:21:12#0#12:32:41#12:32:41#00:00:00 1
303f21114fc72b9e939c645158b7f028 0 0 505159 0 0
2502200 0 0 0 0 2399735 0 0 0 0 0
3201126 B 1 BS 1 03/07/2018 05/07/2018 03/07/2018 3062 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2174260 0 3 0 0 0 ANNISA FADILLAH BY NY
0002470015991 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197866
1#0##0#0#0.0#2018-07-18 13:32:44#0#11:46:04#11:46:04#00:00:00 1
265aa44835f1babdae3202a539215274 0 0 316720 0 0 396699
0 0 0 0 1460841 0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 05/07/2018 25/04/1961 0 2
- 0 45079800 65041085 0 3 0 0 0 SAPUROH
0001454773803 3;JKN DR RIZKI; 5.2.2.201806040537 4 196355
1#0##0#0#0.0#2018-07-18 15:30:48#0#01:59:34#01:59:34#00:00:00 1
6e852d7a01dc4cdb3440d051c5ac6bb4 0 8169000 6923800 0 0
39714285 0 0 0 0 1286000 0 0 0 0
8948000
3201126 B 3 BS 1 05/07/2018 05/07/2018 03/08/1946 0 2
None None None None SEPTIKEMIA (RINGAN) 2534700 0 0 -
0 - 0 - 0 - 0 2534700 1508669 0 1
0 0 0 MASITOH HJ NY D402440 71 26269 DR YOHANNES
DWINANDA 0138R0170718V001834 0000060960508 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 197654 1#0##0#0#0.0#2018-07-20
18:02:08#0#00:00:00#00:00:00#00:00:00 1 130e582cc47ebec5c557823a00492e69
0 0 126735 0 0 994236 0 0 0 0 387698
0 0 0 0 0
3201126 B 2 BS 1 03/07/2018 05/07/2018 19/10/1988 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 10587039 0 3 0 0 0 NUR AVNI MAULIDAYANTI
0001652898431 3;JKN DR RIZKI; 5.2.2.201806040537 4 196826
1#0##0#0#0.0#2018-07-25 14:42:51#0#00:00:00#00:00:00#00:00:00 1
392dd278159fa0eeb6dadc1f14a9b9f7 0 5062400 2215753 0 0
2165276 0 0 0 0 818610 0 0 0 0 325000
3201126 B 3 BS 1 04/07/2018 05/07/2018 18/12/1946 0 1
0 - 0 - 0 - 0 - 0 4144700 1924994
0 2 0 0 0 SADIKUN D336800 71 26131 DR YOHANNES
DWINANDA 0138r0170718v001720 0000060721749 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 197556 1#0##0#0#0.0#2018-09-08
09:15:31#0#01:15:54#01:15:54#00:00:00 2 8cd2a9cc6bd06f0c1498667d04f75ac9
0 0 473023 0 0 1037037 0 0 0 0 414934
0 0 0 0 0
3201126 B 2 BS 1 03/07/2018 05/07/2018 30/08/1956 0 1
0 - 0 - 0 - 0 - 0 4649300 10965386
0 3 0 0 0 MANUTURI SIBUEA D397118 61 22587 DR
5.2.2.201806040537 4 196632 1#0##0#0#0.0#2018-09-08
11:34:35#0#13:14:46#13:14:46#00:00:00 2 91d27f7687e80dc876da4b76dada2ec3
0 5326100 2618280 0 0 2158644 0 0 0 0
793362 0 0 0 0 69000
3201126 B 2 BS 1 02/07/2018 05/07/2018 04/05/1942 0 1
1 D29.1;N13.3;I10 60.29 - - None None None None V-1-14-II
(SEDANG) 15409500 0 0 - 0 - 0 - 0 - 0
15409500 24862380 0 4 0 0 0 SYAMSUDIN SUKADI
0001426623142 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196181
1#0##0#0#0.0#2018-09-08 11:46:04#0#06:14:59#06:14:59#00:00:00 2
7937b19749c0a8d54eb6a570c9af6d22 0 9036500 2814350 0 0
4921530 0 0 0 0 4821000 0 0 0 0
3269000
3201126 B 2 BS 1 03/07/2018 05/07/2018 22/04/1967 0 1
1 E14.2;T82.4 39.42 - - None None None None N-1-12-III None
DIALISIS (BERAT) 23198900 0 0 - 0 - 0 - 0 -
0 23198900 10667535 0 3 0 0 0 TAUFIK QURRAKHMAN
TN D316253 51 18700 DEDY PRATAMA,SPBV 0138R0170718V001000
0001900946597 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196809
1#0##0#0#0.0#2018-09-25 12:54:19#0#00:00:00#00:00:00#00:00:00 2
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9855000 16315946 0 4 0 0 0 EMANUEL D399959
0001148245593 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196276
1#0##0#0#0.0#2018-09-26 19:20:16#0#12:01:40#12:01:40#00:00:00 3
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3201126 B 2 BS 1 03/07/2018 05/07/2018 08/04/1982 0 2
1 S22.40;S27.1;S01.1 86.22;08.89;87.03 - - None None None
None J-4-13-II None None None None None None TRAUMA DADA (SEDANG)
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6895100 12465323 0 3 0 0 0 RATNA D402278 36
TANTIYO S;16137 5.2.2.201806040537 4 196820 1#0##0#0#0.0#2018-
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3201126 B 3 BS 1 01/07/2018 05/07/2018 28/01/1986 0 1
1 S09.7;I61.9;R11;R55 - - - None None None None G-4-
24-I None None None None None None TRAUMA KEPALA (RINGAN) 3043100 0
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DR HARDI PRANATA SPS 0138R0170718V000216 0002041836884 3;JKN
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3201126 B 2 BS 1 05/07/2018 06/07/2018 25/06/2014 0 2
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0
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14:00:30#0#00:00:00#00:00:00#00:00:00 1 5031c487c691b3370e773c88682968bb
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TANTIYO S;16137 5.2.2.201806040537 4 196832 1#0##0#0#0.0#2018-
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197784
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3201126 B 1 BS 1 04/07/2018 06/07/2018 04/07/2018 2750 1
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1#1#vip#3#0#0.0#2018-07-17 11:25:59#0#00:00:00#00:00:00#00:00:00 1
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0001809320231 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196358
1#0##0#0#0.0#2018-07-18 11:29:32#0#03:55:33#03:55:33#00:00:00 1
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1471327 0 0 0 0 3497213 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 06/07/2018 31/12/1955 0 2
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0 7 1 3 0 MARWATI D402081 62 22827 DR AGOES
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11:37:07#0#00:00:00#00:00:00#00:00:00 1 c06fccf2cbe1981db429a5c3ad88f9a7
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4215060 0 0 0 0 2529000
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TANTIYO S;16137 5.2.2.201806040537 4 198382
1#1#vvip#4#19857129#0.0#2018-07-18 11:38:50#0#13:26:09#13:26:09#00:00:00
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3201126 B 2 BS 1 26/06/2018 06/07/2018 13/03/1982 0 1
1 K80.0;E11.9;B16.9 90.59;89.52 - - None None None None B-4-
14-II None None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN
(SEDANG) 5879600 0 0 - 0 - 0 - 0 - 0
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0001627424278 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 194288
1#0##0#0#0.0#2018-07-18 11:40:16#0#03:13:38#03:13:38#00:00:00 1
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2271210 0 0 0 0 6175522 0 0 0 0 0
3201126 B 2 BS 1 04/07/2018 06/07/2018 25/06/1966 0 1
- 0 10690500 12590549 0 3 0 0 0 DARMINTO
0002046355749 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197535
1#0##0#0#0.0#2018-07-18 11:41:26#0#00:00:00#00:00:00#00:00:00 1
3977c0ec516711450f3c41157c2f101d 0 0 2276624 0 0
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3201126 B 3 BS 1 02/07/2018 06/07/2018 05/03/1955 0 1
1 N40;I69.4;R33;I11.9 60.29 - - None None None None V-1-
(RINGAN) 8837900 0 0 - 0 - 0 - 0 - 0
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63 23130 DR SIDHI,SPU 0138R0170718V000316 0001256557329 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196277 1#0##0#0#0.0#2018-
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9612590 0 0 0 0 1376000 0 0 0 0
3338000
3201126 B 2 BS 1 05/07/2018 06/07/2018 13/11/2012 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4642844 0 2 0 0 0 HAYDAR HUSAIN SAMSUDIN
0002093882668 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197783
1#0##0#0#0.0#2018-07-18 13:10:34#0#10:35:38#10:35:38#00:00:00 1
ddb3face74a7ab5ece8423f3c80cc6d4 0 2864000 493024 0 0
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3201126 B 1 BS 1 02/07/2018 06/07/2018 25/12/1954 0 2
1 K80.8;R11 - - - None None None None B-4-14-I None
5879800 0 0 - 0 - 0 - 0 - 0
5879800 8763410 0 5 0 0 0 SADINI NY D402118
63 23200 DR ARU, SPPD 0138R0170718V000176 0000042206095 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196183 1#0##0#0#0.0#2018-
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1828035 0 0 0 0 5956307 0 0 0 0 0
3201126 B 1 BS 1 03/07/2018 06/07/2018 03/07/2018 316333
1 1 P03.4 - - - None None None None P-8-17-I None
(RINGAN) 5118000 0 0 - 0 - 0 - 0 - 0
5118000 3965312 0 4 0 0 0 BAYI NY. SANTI
WIDIASARI, SE D402253 0 0 DR SUPROHAITA SPA(K)
0138R0170718V001287 0002469567418 3;JKN TANTIYO S;16137
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13:15:24#0#09:35:36#09:35:36#00:00:00 1 5c2683510bc38c39a20575365a15a94f
0 0 310000 0 0 170299 0 0 0 0
3485013 0 0 0 0 0
3201126 B 1 BS 1 04/07/2018 06/07/2018 21/07/1987 0 2
7087700 0 0 - 0 - 0 - 0 - 0
7087700 4106807 0 3 0 0 0 STELLA GRACIA HANASA
0001259166262 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196914
1#0##0#0#0.0#2018-07-18 13:17:41#0#08:34:04#08:34:04#00:00:00 1
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1069142 0 0 0 0 2637670 0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 06/07/2018 05/06/1970 0 2
1 K74.6;B17.9;R77.0;E13.9 - - - None None None None B-4-
4204300 0 0 - 0 - 0 - 0 - 0
4204300 3054012 0 4 0 0 0 MASKUNA D393070
3;JKN DR RIZKI; 5.2.2.201806040537 4 196829 1#0##0#0#0.0#2018-
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1231330 0 0 0 0 1191295 0 0 0 0 0
3201126 B 3 BS 1 06/07/2018 06/07/2018 03/06/1994 0 2
1 F06.9 87.03 - - None None None None F-4-15-I None None
None None None None FOBIA, ANXIETAS DAN NEUROSIS LAIN-LAIN (RINGAN)
2786300 0 0 - 0 - 0 - 0 - 0
2786300 694157 0 1 0 0 0 DIAN YUNIASIH NN
0001854557706 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198102
1#0##0#0#0.0#2018-07-20 18:03:44#0#06:46:24#06:46:24#00:00:00 1
3145ab781c8ce6cd00a9b8cde61ed36a 0 0 132795 0 0 226950
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3201126 B 3 BS 1 02/07/2018 06/07/2018 10/05/1975 0 2
7219300 0 0 - 0 - 0 - 0 - 0
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0001305707128 3;JKN DR RIZKI; 5.2.2.201806040537 4 196347
1#0##0#0#0.0#2018-07-25 14:36:29#0#00:00:00#00:00:00#00:00:00 1
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4086000
3201126 B 3 BS 1 04/07/2018 06/07/2018 20/04/1999 0 1
None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
0 - 0 2952500 6789934 0 3 0 0 0 JAKA
BAGUS BUDIMAN D401669 19 7015 DR HENDRIEK SP B 0138R0170718V001710
0001014494668 3;JKN DR RIZKI; 5.2.2.201806040537 4 197545
1#0##0#0#0.0#2018-07-25 16:27:32#0#00:00:00#00:00:00#00:00:00 1
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2344033 0 0 0 0 3619201 0 0 0 0 0
3201126 B 2 BS 1 30/06/2018 06/07/2018 22/10/1959 0 1
1 M54.47;A15.6;J44.9 87.44;87.24;93.94 - - None None None
None M-4-17-II None None None None None None MASALAH BAGIAN
PUNGGUNG/PINGGANG BELAKANG (SEDANG) 6189400 0 0 - 0 - 0
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HERMAN D235517 58 21436 DR HARDI PRANATA SPS
0138R0170618V009030 0001459582727 3;JKN DR RIZKI; 5.2.2.201806040537
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09:08:47#0#20:23:44#20:23:44#12:00:00 1 e9479daf9cf1a08e5f6456b4ac28e4cb
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3627345 0 0 0 0 0
3201126 B 1 BS 1 04/07/2018 06/07/2018 19/05/1988 0 2
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S;16137 5.2.2.201806040537 4 196839 1#1#vvip#3#14828412#0.0#2018-
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3201126 B 1 BS 1 05/07/2018 06/07/2018 13/10/1957 0 1
1 T82.4;I12.0;A41.9 38.95;99.21 - - None None None None N-1-
- 0 - 0 27065300 20475052 0 2 0 0 0
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0138R0170718V001870 0000059549321 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 197733 1#0##0#0#0.0#2018-09-25
13:09:55#0#09:38:37#09:38:37#00:00:00 2 ce3382ff6eda5a10fac7cab3ca0d2214
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7225000 0 0 0 0 69000
3201126 B 3 BS 1 05/07/2018 06/07/2018 03/11/1973 0 2
4 I25.0;I61.9;I60.9 87.03;96.71 - - None None None None J-1-
KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0 -
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0001855781357 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198090
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7585707 0 0 0 0 2068000 0 0 0 2519727
0
3201126 B 1 BS 1 01/07/2018 06/07/2018 14/07/1960 0 1
1 I61.9;I10;E14.9;G81.9 87.44;87.03 - - None None None None
0 - 0 7214600 20656842 0 6 0 0 0 HADI
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0000060499416 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196165
1#0##0#0#0.0#2018-10-10 16:34:33#0#16:05:12#16:05:12#00:00:00 3
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9420748 0 0 0 0 5817000 0 0 0 0
4596000
3201126 B 2 BS 1 06/07/2018 07/07/2018 11/09/1957 0 1
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DJOHAN D402544 60 22213 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V002390 0001257129055 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198303 1#0##0#0#0.0#2018-07-11
12:57:55#0#00:00:00#00:00:00#00:00:00 1 4aba828e1dab7c3613f0d551184e2f3d
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4911100 0 0 0 966682 0
3201126 B 2 BS 1 03/07/2018 07/07/2018 12/03/1960 0 1
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5.2.2.201806040537 4 196840 1#0##0#0#0.0#2018-07-11
13:03:20#0#04:17:12#04:17:12#00:00:00 1 ab43d7d2bea7f4b0b26fe4f3e1394b5f
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2583500 0 0 0 1039298 0
3201126 B 1 BS 1 05/07/2018 07/07/2018 16/07/1950 0 1
1 E14.9;R63.0;A01.0;I25.1 - - - None None None None E-4-
0 - 0 8768000 4258128 0 3 0 0 0 FAUZAN
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1#0##0#0#0.0#2018-07-11 13:05:37#0#01:11:40#01:11:40#00:00:00 1
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0
3201126 B 2 BS 1 03/07/2018 07/07/2018 05/04/1931 0 2
1 A49.9;I11.9 - - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196836
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3201126 B 3 BS 1 04/07/2018 07/07/2018 10/11/1941 0 2
1 S72.9;I10;D62 77.25;78.05;99.04;79.35 - - None None None
None M-1-20-II None None None None None None PROSEDUR PAHA DAN SENDI
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13:13:39#0#00:00:00#00:00:00#00:00:00 1 28c615eabfb2ceed3883b9b676cbb193
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5913500 0 0 0 1370000 0
3201126 B 3 BS 1 03/07/2018 07/07/2018 30/07/2017 0 2
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 1754607 0 5 0 0 0 KHILDA ZAHIRA AN.
D374308 0 338 DR RASTRA, SPA 0138r0170718v001130
0002271188305 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196835
1#0##0#0#0.0#2018-07-11 13:24:26#0#22:59:54#22:59:54#12:00:00 1
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3201126 B 3 BS 1 05/07/2018 07/07/2018 22/11/2015 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1340537 0 3 0 0 0 AZKA FANINDA
D402434 2 956 DR RASTRA, SPA 0138R0170718V001726
0002063191792 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197559
1#0##0#0#0.0#2018-07-11 14:04:57#0#00:00:00#00:00:00#00:00:00 1
e43e83b2482006241d8a846cac36276e 0 0 207620 0 0 230218
0 0 0 0 789000 0 0 0 113699 0
3201126 B 2 BS 1 03/07/2018 07/07/2018 25/03/1941 0 2
1 E87.6;F02.8;I69.4;J18.0;D64.9 99.04 - - None None None None
ELEKROLIT (BERAT) 7552000 0 0 - 0 - 0 - 0 -
0 7552000 13720516 0 5 0 0 0 SEMIYEM
0001903951899 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196834
1#1#vvip#5#6168516#0.0#2018-07-11 14:13:49#0#21:26:37#21:26:37#12:00:00
2 7f660587911c6183f0038ba6d3e9c609 0 0 1506760 0 0
5502652 0 0 0 0 5787500 0 0 0 923604
0
3201126 B 2 BS 1 02/07/2018 07/07/2018 18/12/2006 0 1
1 Q54.9;N36.0 58.49 - - None None None None N-1-40-I None
9649200 0 0 - 0 - 0 - 0 - 0
9649200 13884780 0 6 0 0 0 WILDAN AKRAM RIZKI
ROSLANT D252386 11 4214 DR CATUR S, SPB 0138R0170718V000246
0001469188258 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196195
1#0##0#0#0.0#2018-07-11 14:22:16#0#10:18:16#10:18:16#00:00:00 1
29a07d4e2e8a604f5cd815ea263428c8 0 0 2701776 0 0
4409354 0 0 0 0 5644300 0 0 0 1129350
0
3201126 B 1 BS 1 06/07/2018 07/07/2018 04/07/1942 0 1
0 0 - 0 - 0 - 0 - 0 17095200
14601439 0 2 0 0 0 TAPSIR D308731 76 27761
DR AGOES KOOSHARTORO SPPD 0138R0170718V002301 0000039928689 3;JKN
DR RIZKI; 5.2.2.201806040537 4 198103 1#0##0#0#0.0#2018-07-18
09:23:53#0#08:11:44#08:11:44#00:00:00 1 2c83d9320421c4e5ce0688f0e55eb339
0 4707000 3419040 0 0 3375165 0 0 0 0
1031234 0 0 0 0 2069000
3201126 B 2 BS 1 06/07/2018 07/07/2018 08/06/2015 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4872693 0 2 0 0 0 MUHAMAD ILHAM FATHUL
AZZAM D401887 3 1124 DR CATUR SUZANTARA 0138R0170718V002577
0001968811097 3;JKN DR RIZKI; 5.2.2.201806040537 4 198664
1#0##0#0#0.0#2018-07-18 09:32:29#0#00:00:00#00:00:00#00:00:00 1
c8ca2dd8a137567bc5147de7326dfc29 0 0 556024 0 0
1210895 0 0 0 0 3033274 0 0 0 0 72500
3201126 B 1 BS 1 06/07/2018 07/07/2018 24/07/1938 0 2
17095200 0 0 - 0 - 0 - 0 - 0
17095200 15949324 0 2 0 0 0 HJ. RUSMALA D101514
0001261760962 3;JKN DR RIZKI; 5.2.2.201806040537 4 198114
1#0##0#0#0.0#2018-07-18 10:43:43#0#08:31:14#08:31:14#00:00:00 1
3179ac8921e1392b92a74ede861500c7 0 4777000 3419040 0 0
4564870 0 0 0 0 0 0 0 1119414 0
2069000
3201126 B 3 BS 1 01/07/2018 07/07/2018 15/01/1967 0 2
1 I20.9;D64.9;R11;M54.59 99.04 - - None None None None I-4-
4854000 0 0 - 0 - 0 - 0 - 0
4854000 7890364 0 7 0 0 0 ASMAWIYAH D368283
51 18795 DR ARU, SPPD 0138R0170718V000006 0001740420865 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196156 1#0##0#0#0.0#2018-
07-18 11:04:26#0#02:23:12#02:23:12#00:00:00 1
2bb5dcc362ca64a0f6c5b1379defd10c 0 0 289752 0 0
5217420 0 0 0 0 2383192 0 0 0 0 0
3201126 B 3 BS 1 04/07/2018 07/07/2018 01/03/1964 0 1
0 0 - 0 - 0 - 0 - 0 6341300
13617851 0 4 0 0 0 HASAN D401954 54 19848 DR
RIZKI; 5.2.2.201806040537 4 197112 1#0##0#0#0.0#2018-07-18
14:05:26#0#11:18:55#11:18:55#00:00:00 1 c67e4a7f8dbe7d5d6bd2b269ee79b444
0 3417000 3838760 0 0 3326204 0 0 0 0
966887 0 0 0 0 2069000
3201126 B 3 BS 1 04/07/2018 07/07/2018 31/01/1954 0 2
- 0 - 0 - 0 - 0 1517500 3917429 0
4 0 0 0 SUMIATI D402339 64 23530 DR MAYSAM I., SPS
0138R0170718V001362 0001299297521 3;JKN DR RIZKI; 5.2.2.201806040537
4 197172 1#0##0#0#0.0#2018-07-18
14:25:09#0#11:43:19#11:43:19#00:00:00 1 b31d3b9338be2c7c8633f479ca3b6f91
0 0 358559 0 0 2224590 0 0 0 0
1334280 0 0 0 0 0
3201126 B 2 BS 1 05/07/2018 07/07/2018 04/10/1993 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 9821816 0 3 0 0 0 OCTI DWI SURYANI
D402504 24 9040 DR RM DHENI DANARDHONO SPOG 0138R0170718V002131
0002071829799 3;JKN DR RIZKI; 5.2.2.201806040537 4 198080
1#0##0#0#0.0#2018-07-18 14:31:19#0#17:13:42#17:13:42#00:00:00 1
bb6653389647c37ceefbddea6f31fdb1 0 5269900 2134753 0 0
1466614 0 0 0 0 753549 0 0 0 0 197000
3201126 B 1 BS 1 06/07/2018 07/07/2018 31/12/1968 0 1
1 N18.5;E87.7;J18.0;D63.8 99.04 - - None None None None N-4-
GINJAL (BERAT) 8508800 0 0 - 0 - 0 - 0 -
0 8508800 4976417 0 2 0 0 0 INDRAWAN RUSMAN
0001621275952 3;JKN DR RIZKI; 5.2.2.201806040537 4 198670
1#0##0#0#0.0#2018-07-18 14:33:58#0#00:00:00#00:00:00#00:00:00 1
00c1795c74fc245c240402eaffa3fd3e 0 0 818792 0 0
1434690 0 0 0 0 2722935 0 0 0 0 0
3201126 B 3 BS 1 02/07/2018 07/07/2018 01/12/1944 0 2
1 I13.2;I48;B34.9 89.52;87.44 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
10492603 0 6 1 4 0 ASMANI D376629 73 26876
DR RIZKI; 5.2.2.201806040537 4 196179 1#0##0#0#0.0#2018-07-18
14:59:14#0#02:06:09#02:06:09#12:00:00 1 a04d495549764433b9486a236945342c
0 0 374804 0 0 4053867 0 0 0 0
4436932 0 0 0 0 1627000
3201126 B 1 BS 1 06/07/2018 07/07/2018 05/04/1942 0 1
1 I25.1;I05.9;I50.0;I48;N18.9 88.55;36.07 - - YY02 None None
0 - 0 - 0 46734600 64692662 0 2 0 0
0 HASSAN M. NOOR D385796 76 27851 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170718V002336 0001261658733 3;JKN DR RIZKI; 5.2.2.201806040537
4 198159 1#0##0#0#0.0#2018-07-18
15:11:07#0#08:58:29#08:58:29#12:00:00 1 51cadfcbe1accc9778051ed9c2dce87d
0 10062000 9619120 0 0 36166542 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 04/07/2018 07/07/2018 18/03/1955 0 2
0 - 0 - 0 - 0 - 0 17095200 18391028
0 4 0 0 0 SUGIYANI, NY D329424 63 23119 DR
RIZKI; 5.2.2.201806040537 4 197223 1#0##0#0#0.0#2018-07-18
15:27:52#0#12:20:04#12:20:04#00:00:00 1 0b56aef04a86f963c29b78aadc4575ff
0 6159000 5649460 0 0 3237568 0 0 0 0
1276000 0 0 0 0 2069000
3201126 B 2 BS 1 06/07/2018 07/07/2018 03/04/1957 0 2
1 I12.0;J20.9 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
0 5208600 11484538 0 2 0 0 0 IKA SUMARTIKA
0000069321611 3;JKN DR RIZKI; 5.2.2.201806040537 4 198673
1#0##0#0#0.0#2018-07-18 15:38:04#0#00:00:00#00:00:00#00:00:00 1
f91b69201edd6066fa739a274e0eef87 0 4911100 2276624 0 0
3400489 0 0 0 0 827325 0 0 0 0 69000
3201126 B 1 BS 1 06/07/2018 07/07/2018 19/09/1958 0 1
1 K20;K29.5;K31.7 45.16 - - None None None None K-4-12-I
0 0 - 0 - 0 - 0 - 0 4136800
6291059 0 2 0 0 0 TATYANI LEWA D119638 59
DR RIZKI; 5.2.2.201806040537 4 198665 1#0##0#0#0.0#2018-07-18
15:50:47#0#00:00:00#00:00:00#00:00:00 1 6eb9b1311519d27f0176fc43fd0a2870
0 0 1274304 0 0 851190 0 0 0 0
2416565 0 0 0 0 1749000
3201126 B 3 BS 1 06/07/2018 07/07/2018 28/06/1993 0 2
1 I10;R11 - - - None None None None I-4-17-I None
- 0 - 0 - 0 - 0 1906700 1997019 0
2 0 0 0 MURNI ASIH D402523 25 9139 DR ARU, SPPD
0138R0170718V002198 0002057325704 3;JKN DR RIZKI; 5.2.2.201806040537
4 198098 1#0##0#0#0.0#2018-07-18
15:52:05#0#00:00:00#00:00:00#00:00:00 1 3d0d2916ac06ca47654454f6a8cba9bc
0 0 224603 0 0 1089770 0 0 0 0 682646
0 0 0 0 0
3201126 B 1 BS 1 06/07/2018 07/07/2018 29/06/2018 0 1
0 - 0 - 0 - 0 - 0 5886000 2960868
0 2 0 0 0 HENDIKA GUSMAWATI BY NY D401924 0 7
RIZKI; 5.2.2.201806040537 4 198659 1#0##0#0#0.0#2018-07-24
14:02:20#0#17:22:00#17:22:00#00:00:00 1 62fb4ffa22cb1e0284a033b9a10c01c6
0 0 1177200 0 0 163466 0 0 0 0
1280202 0 0 0 0 340000
3201126 B 1 BS 1 06/07/2018 07/07/2018 30/08/2017 0 1
2033900 0 0 - 0 - 0 - 0 - 0
2033900 2829545 0 2 0 0 0 MUHAMMAD ARBANI AZIZ
D394453 0 310 DR RASTRA, SPA 0138R0170718V002200
0002262776365 3;JKN DR RIZKI; 5.2.2.201806040537 4 198099
1#0##0#0#0.0#2018-07-24 14:29:57#0#00:00:00#00:00:00#12:00:00 1
4308871f832cf1938e0faf1a57ce50ab 0 0 438550 0 0 617885
0 0 0 0 1773110 0 0 0 0 0
3201126 B 1 BS 1 06/07/2018 07/07/2018 31/12/2015 0 1
1 Z53.0;N48.1;J02.9 - - - None None None None Z-4-12-I
0 - 0 2627300 1904327 0 2 0 0 0
MUHAMMAD FADLI PRAYOGA D335099 2 918 DR CATUR SUZANTARA
0138R0170718V002579 0001903343951 3;JKN DR RIZKI; 5.2.2.201806040537
4 198669 1#0##0#0#0.0#2018-07-25
16:03:46#0#00:00:00#00:00:00#00:00:00 1 e702f44a77f7f1571c82a57b191fe613
0 0 184887 0 0 352358 0 0 0 0
1367082 0 0 0 0 0
3201126 B 3 BS 1 02/07/2018 07/07/2018 27/12/1967 0 2
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 14904088 0 6 1 5 0 MULYATI
0001322482408 3;JKN DR RIZKI; 5.2.2.201806040537 4 196298
1#0##0#0#0.0#2018-07-26 09:33:16#0#13:59:40#13:59:40#12:00:00 1
aa770d250d192a479bc31d6a1b724b47 0 0 424889 0 0
5181790 0 0 0 0 6438409 0 0 0 0
2859000
3201126 B 2 BS 1 02/07/2018 07/07/2018 17/12/2015 0 2
- 0 3584400 6211916 0 6 0 0 0 ADEEVA
0138R0170718V000552 0001898497269 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196343 1#0##0#0#0.0#2018-09-08
08:49:19#0#18:11:19#18:11:19#00:00:00 2 a5fc18bf0795ff1de772205523ca0da3
0 0 268829 0 0 2688200 0 0 0 0
2822500 0 0 0 432387 0
3201126 B 3 BS 1 03/07/2018 07/07/2018 02/05/1960 0 2
1 D21.4;E87.1;R18;I50.0;R57.1;D63.0 99.04;88.76 - - None None
None None M-4-21-III None None None None None None GANGGUAN SISTEM
MUSKULOSKELETAL & JA(RINGAN) PENGHUBUNG LAIN-LAIN (BERAT) 8279000 0 0
- 0 - 0 - 0 - 0 8279000 13755303 0
5 0 0 0 IPAH D400197 58 21246 DR ARU, SPPD
0138R0170718V000623 0002091179891 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 196360 1#0##0#0#0.0#2018-09-08
09:06:19#0#05:06:16#05:06:16#00:00:00 2 c5b6c16c435809772b347ccddc560fcc
0 0 682330 0 0 6827093 0 0 0 0
2893000 0 0 0 3352880 0
3201126 B 2 BS 1 05/07/2018 07/07/2018 05/07/2018 2680 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 1202649 0 3 0 0 0 OCTI DWI SURYANI BY NY
0002470481662 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198319
1#0##0#0#0.0#2018-09-08 09:17:54#0#11:22:51#11:22:51#00:00:00 2
1f4ea8e7da353cc954e7c153d2709803 0 0 214472 0 0 88899
0 0 0 0 899278 0 0 0 0 0
3201126 B 1 BS 1 05/07/2018 08/07/2018 07/12/2003 0 1
(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 4318569 0 4 0 0 0 DESKA ARYO BIMO
0002097706127 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198019
1#0##0#0#0.0#2018-07-11 08:17:41#0#00:00:00#00:00:00#00:00:00 1
021dbd7c83943c212194001aa550d1cf 0 0 319571 0 0 566475
0 0 0 0 3124000 0 0 0 308523 0
3201126 B 3 BS 1 04/07/2018 08/07/2018 30/12/1954 0 1
None None None None None PENYAKIT PARU OBSTRUKTIF KRONIS (BERAT)
5797000 0 0 - 0 - 0 - 0 - 0
5797000 3403915 0 5 0 0 0 BUYUNG HERMAN TN
0000512650833 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196841
1#0##0#0#0.0#2018-07-11 12:44:22#0#07:31:38#07:31:38#00:00:00 1
343b20f8fe1e1839e48d9868f9161c48 0 0 574730 0 0
1265499 0 0 0 0 1315000 0 0 0 248686
0
3201126 B 2 BS 1 03/07/2018 08/07/2018 27/07/1943 0 1
0 0 - 0 - 0 - 0 - 0 8663100
10996714 0 6 0 0 0 DJUMIRAN D357840 74 27370
EKA GINANJAR 0138R0170718V001116 0000060772228 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 196824 1#0##0#0#0.0#2018-07-11
12:49:09#0#00:00:00#00:00:00#00:00:00 1 43d4db3a64d026e15ab9106596d19c63
0 0 918679 0 0 3031124 0 0 0 0
3949500 0 0 2352000 745411 0
3201126 B 1 BS 1 06/07/2018 08/07/2018 18/05/2018 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5761384 0 3 0 0 0 KENZO MUSYAFFA HABIBI
0002460400536 3;JKN DR RIZKI; 5.2.2.201806040537 4 198668
1#0##0#0#0.0#2018-07-18 09:50:11#0#20:30:23#20:30:23#00:00:00 1
80099b4936d06fc236dbef8aa4ae543f 0 3743500 575204 0 0
844767 0 0 0 0 452913 0 0 0 0 145000
3201126 B 3 BS 1 06/07/2018 08/07/2018 04/03/2017 0 1
(SEDANG) 2753900 0 0 - 0 - 0 - 0 - 0
2753900 1579734 0 3 0 0 0 JAZIMA RASYA MUFLIH
0002419035309 3;JKN DR RIZKI; 5.2.2.201806040537 4 198671
1#0##0#0#0.0#2018-07-18 09:53:09#0#00:00:00#00:00:00#00:00:00 1
8d3c85e2a89532ed725dcef3e20d2dfc 0 0 292031 0 0 632356
0 0 0 0 655347 0 0 0 0 0
3201126 B 1 BS 1 07/07/2018 08/07/2018 01/11/2006 0 1
1 S52.41;L91.0 78.63;86.84 - - None None None None M-1-
0 - 0 6041900 16654961 0 2 0 0 0
MUHAMMAD IHSAN FIRDAUS D365389 11 4266 DR BENNY H T, SPOT
0138R0170718V002661 0001848198227 3;JKN DR RIZKI; 5.2.2.201806040537
4 198843 1#0##0#0#0.0#2018-07-18
12:32:59#0#13:12:43#13:12:43#00:00:00 1 20675b2f221dcc3363db7b3017b5e185
0 9763300 2963112 0 0 2592972 0 0 0 0
1190577 0 0 0 0 145000
3201126 B 3 BS 1 07/07/2018 08/07/2018 13/01/1994 0 2
8672000 0 0 - 0 - 0 - 0 - 0
8672000 12510082 0 2 0 0 0 ISMU ISNAENI
0002006704798 3;JKN DR RIZKI; 5.2.2.201806040537 4 198845
1#0##0#0#0.0#2018-07-18 12:34:56#0#13:19:33#13:19:33#00:00:00 1
613112f4ac30c6f8423120ee90cabd74 0 0 4162560 0 0
1654105 0 0 0 0 6548417 0 0 0 0 145000
3201126 B 1 BS 1 06/07/2018 08/07/2018 30/03/1982 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 14622952 0 3 0 0 0 EVI NURAHMAH
0001900805826 3;JKN DR RIZKI; 5.2.2.201806040537 4 198097
1#0##0#0#0.0#2018-07-18 14:42:38#0#00:21:55#00:21:55#00:00:00 1
61715bfdfe11e9f3b2054091297e7f17 0 7098900 3306939 0 0
2809471 0 0 0 0 1082642 0 0 0 0 325000
3201126 B 3 BS 1 08/07/2018 08/07/2018 07/08/1995 0 2
- 0 - 0 - 0 - 0 2168300 918752 0
1 0 0 0 NABILA MAULIDINI D393093 22 8371 DR RM DHENI
DANARDHONO SPOG 0138R0170718V002727 0001328129256 3;JKN DR RIZKI;
5.2.2.201806040537 4 198899 1#0##0#0#0.0#2018-07-18
14:48:51#0#01:19:41#01:19:41#00:00:00 1 223587849d18106c573224f3d905681c
0 0 195147 0 0 177500 0 0 0 0 349105
0 0 0 0 197000
3201126 B 1 BS 1 03/07/2018 08/07/2018 05/09/1957 0 1
1 J44.9;B90.9 93.94;87.44 - - None None None None J-4-17-I
5164300 0 0 - 0 - 0 - 0 - 0
5164300 9065184 0 6 0 0 0 E D BENYAMIN WAGEY TN
0001258209088 3;JKN DR RIZKI; 5.2.2.201806040537 4 196354
1#0##0#0#0.0#2018-07-18 15:26:38#0#00:00:00#00:00:00#00:00:00 1
18413217b9c6d9dcdc0750f789a9db5a 0 0 390787 0 0
3369348 0 0 0 0 5305049 0 0 0 0 0
3201126 B 1 BS 1 07/07/2018 08/07/2018 16/06/1980 0 2
1 S42.20;M62.41;L91.0 78.62;86.84;93.14 - - None None None
None M-1-40-I None None None None None None EKSISI LOKAL DAN
PENGANGKATAN ALAT FIKSASI INTERNAL (RINGAN) 6041900 0 0 - 0
- 0 - 0 - 0 6041900 16956938 0 2 0
0 0 EMAWATI HIDAYAT D370779 38 13900 DR BENNY H T, SPOT
0138R0170718V002645 0001078542055 3;JKN DR RIZKI; 5.2.2.201806040537
4 198746 1#0##0#0#0.0#2018-07-18
15:45:48#0#09:50:59#09:50:59#00:00:00 1 22cd630544f2410e45062c3631c8a038
0 9763300 3500200 0 0 2413106 0 0 0 0
1135332 0 0 0 0 145000
3201126 B 2 BS 1 07/07/2018 08/07/2018 27/07/1948 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 10369885 0 2 0 0 0 SULASTRI
D402656 69 25547 EKA GINANJAR 0138R0170718V002688
0001256056659 3;JKN DR RIZKI; 5.2.2.201806040537 4 198877
1#0##0#0#0.0#2018-07-18 15:47:50#0#00:00:00#00:00:00#00:00:00 1
5620729c01444a8d34b4eb9e59687e60 0 0 2276624 0 0
2358757 0 0 0 0 5665504 0 0 0 0 69000
3201126 B 1 BS 1 05/07/2018 08/07/2018 13/09/2015 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2858107 0 4 0 0 0 MUHAMMAD ABDURRAHMAN
ABQARY D330721 2 1026 DR HUDA, SPA 0138R0170718V001962
0002300054422 3;JKN DR RIZKI; 5.2.2.201806040537 4 197909
1#0##0#0#0.0#2018-07-24 11:35:13#1#12:34:32#12:34:32#12:00:00 1
5ba46a448fcb7ecdabf484a098b9cfb0 0 0 303750 0 0
1074408 0 0 0 0 1139949 0 0 0 340000
0
3201126 B 1 BS 1 07/07/2018 08/07/2018 13/06/1979 0 1
0 0 - 0 - 0 - 0 - 0 4666300
4494884 0 2 1 1 0 PUGUH HARYONO D402438 39
RIZKI; 5.2.2.201806040537 4 198897 1#0##0#0#0.0#2018-07-24
13:43:03#0#00:00:00#00:00:00#00:00:00 1 448be9925404ebddead02347bfb7a6f8
0 0 582182 0 0 2777144 0 0 0 0
1135558 0 0 0 0 0
3201126 B 1 BS 1 05/07/2018 08/07/2018 04/09/2013 0 1
- 0 - 0 - 0 - 0 3718200 4318151 0
4 0 0 0 SAHAT RAJO SAMUEL DOLOKSARIBU D384782 4 1765
5.2.2.201806040537 4 198078 1#0##0#0#0.0#2018-07-24
14:31:08#0#00:00:00#00:00:00#12:00:00 1 e4b8d02a5740845be1882ebb67f79114
0 0 499184 0 0 731971 0 0 0 0
3086996 0 0 0 0 0
3201126 B 2 BS 1 06/07/2018 08/07/2018 25/06/2016 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2615946 0 3 0 0 0 QUEENSHA RAMADHANNIS
HUMAIRA D402536 2 741 DR RIANITA SYAMSU, SPA 0138R0170718V002385
0002068116704 3;JKN DR RIZKI; 5.2.2.201806040537 4 198287
1#0##0#0#0.0#2018-07-24 14:32:20#0#10:46:41#10:46:41#00:00:00 1
0598080985093dc8ac44d3afaba5d939 0 0 298025 0 0 605784
0 0 0 0 1712137 0 0 0 0 0
3201126 B 1 BS 1 06/07/2018 08/07/2018 25/01/2002 0 2
0 0 - 0 - 0 - 0 - 0 2775400
5764729 0 3 0 0 0 GITA AULIA GUNAWAN D399946
16 6006 DR RM DHENI DANARDHONO SPOG 0138R0170718V002570
0001962551823 3;JKN DR RIZKI; 5.2.2.201806040537 4 198662
1#0##0#0#0.0#2018-07-25 15:47:14#0#18:59:24#18:59:24#00:00:00 1
6223fc9cbace90543303117afbdaa166 0 0 637980 0 0 724917
0 0 0 0 4273832 0 0 0 0 128000
3201126 B 3 BS 1 05/07/2018 08/07/2018 13/09/2017 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2902752 0 4 0 0 0 ADITYA PRATAMA JULIANTO
D390741 0 295 DR RASTRA, SPA 0138R0170718V002074
0002313256656 3;JKN DR RIZKI; 5.2.2.201806040537 4 198029
1#0##0#0#0.0#2018-07-25 15:48:28#0#00:00:00#00:00:00#12:00:00 1
4d440b87f1a51a5793807c8ad948180c 0 0 221965 0 0 902887
0 0 0 0 1267900 0 0 0 0 510000
3201126 B 2 BS 1 07/07/2018 08/07/2018 01/12/1993 0 2
0 0 - 0 - 0 - 0 - 0 2379000
4881754 0 2 0 0 0 WIWIN YUNIANAH D402674 24
DR RIZKI; 5.2.2.201806040537 4 198873 1#0##0#0#0.0#2018-07-25
15:50:57#0#00:00:00#00:00:00#00:00:00 2 ca8a64a35572eb3a51f2ed023ea37299
0 0 454980 0 0 1307707 0 0 0 0
2991067 0 0 0 0 128000
3201126 B 1 BS 1 05/07/2018 08/07/2018 24/01/1980 0 2
1 O00.9;E87.6 66.69 - - None None None None W-1-20-II None
None None None None None PROSEDUR PADA RAHIM & ADNEKSA (SEDANG)
14456700 0 0 - 0 - 0 - 0 - 0
14456700 19051084 0 4 0 0 0 LINDA HAYANI
0001971283421 3;JKN DR RIZKI; 5.2.2.201806040537 4 197560
1#0##0#0#0.0#2018-07-25 15:54:59#0#07:40:36#07:40:36#00:00:00 1
3a2f1fc000e324a52028c262adaea968 0 0 4828038 0 0
4935046 0 0 0 0 9091000 0 0 0 0 197000
3201126 B 2 BS 1 06/07/2018 08/07/2018 27/01/1992 0 2
- 0 - 0 - 0 - 0 2601900 3264086 0
3 0 0 0 ARINA QONITA D051562 26 9657 DR RM DHENI
DANARDHONO SPOG 0138R0170718V002554 0002312770015 3;JKN DR RIZKI;
5.2.2.201806040537 4 198657 1#0##0#0#0.0#2018-07-25
16:02:10#0#16:41:16#16:41:16#00:00:00 1 ff53838de17dec7501859d647353c266
0 0 287171 0 0 1076377 0 0 0 0
1772538 0 0 0 0 128000
3201126 B 3 BS 1 05/07/2018 08/07/2018 01/02/1997 0 2
- 0 - 0 - 0 - 0 3874400 9564846 0
4 0 0 0 ELYSA PEBRIANI D402497 21 7824 DR HENDRIEK
5.2.2.201806040537 4 198088 1#0##0#0#0.0#2018-09-08
11:36:01#0#00:00:00#00:00:00#00:00:00 2 4be5d5406093403eda34addb46a81676
0 0 2350900 0 0 2884708 0 0 0 0
3408500 0 0 0 920738 0
3201126 B 3 BS 1 06/07/2018 08/07/2018 24/03/2007 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1742139 0 3 0 0 0 INTAN KAREFESINA
0002212105724 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198592
1#0##0#0#0.0#2018-09-24 12:40:35#0#00:00:00#00:00:00#12:00:00 2
152ec63059c76e6a8b27693722575657 0 0 261764 0 0 551403
0 0 0 0 789000 0 0 0 139972 0
3201126 B 3 BS 1 07/07/2018 08/07/2018 15/06/1977 0 2
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 12331943 0 2 0 0 0 MASIAH
0001739778478 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198883
1#0##0#0#0.0#2018-09-25 13:00:24#0#17:05:15#17:05:15#00:00:00 2
095d6e8b56771bf94949fb2cec0bb0d8 0 0 1781760 0 0
6535920 0 0 0 0 3945263 0 0 0 0 69000
3201126 B 2 BS 1 07/07/2018 08/07/2018 26/10/1955 0 1
4 I20.0;R57.0 - - - None None None None I-4-20-III None
8448000 0 0 - 0 - 0 - 0 - 0
8448000 5305296 0 2 0 0 0 HASANUDDIN D402676
62 22900 EKA GINANJAR 0138R0170718V002715 0001769598516 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 198892 1#0##0#0#0.0#2018-
09-26 18:43:56#0#00:00:00#00:00:00#00:00:00 1
f7de47022127592a9d9797068ce473ed 0 0 506879 0 347075
2931342 0 0 0 0 1366000 0 0 0 154000
0
3201126 B 3 BS 1 06/07/2018 08/07/2018 12/04/1958 0 2
1 I13.2;E11.9;E83.5 99.17 - - None None None None I-4-12-II
0 0 - 0 - 0 - 0 - 0 4144700
2489508 0 3 0 0 0 TURYATI D374697 60 22000
TANTIYO S;16137 5.2.2.201806040537 4 198111 1#0##0#0#0.0#2018-
09-26 20:55:46#0#08:29:42#08:29:42#12:00:00 2
66d9e3d5d0d71572a94581133b0edd9b 0 0 424889 0 0
1086754 0 0 0 0 789000 0 0 0 188865
0
3201126 B 2 BS 1 06/07/2018 08/07/2018 15/08/1967 0 1
1 I13.1;E87.7;J18.0 - - - None None None None N-4-10-III
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 4265469 0 3 0 0 0 KUSROTO
0001869464845 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198660
1#0##0#0#0.0#2018-09-28 15:54:14#0#00:00:00#00:00:00#00:00:00 2
ed880e1bacad7a7ab6b2163148dca033 0 0 499265 0 0
1344280 0 0 0 0 2421924 0 0 0 0 0
3201126 B 3 BS 1 08/07/2018 09/07/2018 18/05/1961 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7327654 0 2 0 0 0 JHON RIZAL D348325
0001281285685 3;JKN DR RIZKI; 5.2.2.201806040537 4 198911
1#0##0#0#0.0#2018-07-18 09:14:03#0#00:00:00#00:00:00#00:00:00 2
d40830cfe922efca450694d2387e962f 0 3438800 921100 0 0
2343375 0 0 0 0 555379 0 0 0 0 69000
3201126 B 1 BS 1 09/07/2018 09/07/2018 02/03/1970 0 2
- 0 - 0 - 0 - 0 3103000 5313702 0
1 0 0 0 WIWIK TRI WAHYUNI D402152 48 17661 DR.
RAHMAWATI SP.B ONK 0138R0170718V003062 0001630438593 3;JKN DR RIZKI;
5.2.2.201806040537 4 199114 1#0##0#0#0.0#2018-07-18
09:45:08#0#00:00:00#00:00:00#00:00:00 1 7776702bc46c1afd0a1153191099e3a7
0 0 620600 0 0 3538477 0 0 0 0
1154625 0 0 0 0 0
3201126 B 3 BS 1 08/07/2018 09/07/2018 05/02/1948 0 2
1 J80;E87.2;J44.1;N18.9 96.05 - - None None None None J-4-
0 - 0 4508300 5001551 0 2 0 0 0 MIEKE
FEMMY MASENGI D382666 70 25721 DR ADITIA NATA KUSUMA
0138R0170718V002791 0001718071244 3;JKN DR RIZKI; 5.2.2.201806040537
4 198929 1#0##0#0#0.0#2018-07-18
10:22:22#0#00:00:00#00:00:00#12:00:00 1 b6f15871f7a1629b4ac75d48b02b8dfe
0 0 405747 0 0 3979600 0 0 0 0 616204
0 0 0 0 0
3201126 B 3 BS 1 09/07/2018 09/07/2018 14/05/1970 0 2
- 0 - 0 - 0 - 0 2216400 5599021 0
5.2.2.201806040537 4 199157 1#0##0#0#0.0#2018-07-18
10:46:22#0#00:00:00#00:00:00#12:00:00 1 95f5d611815ef1c8391c5106d374328b
0 0 443280 0 0 4500450 0 0 0 0 655291
0 0 0 0 0
3201126 B 1 BS 1 07/07/2018 09/07/2018 07/07/2018 33133 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1788204 0 3 0 0 0 RATNA MARLINA S BY NY
0002462831695 3;JKN DR RIZKI; 5.2.2.201806040537 4 199209
1#0##0#0#0.0#2018-07-18 11:07:17#0#14:38:33#14:38:33#00:00:00 1
627be068698e29331f92a19247ccd9d5 0 0 243720 0 0 88899
0 0 0 0 1455585 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 09/07/2018 31/10/1977 0 2
- 0 - 0 - 0 - 0 3103000 3100566 0
5.2.2.201806040537 4 199161 1#0##0#0#0.0#2018-07-18
11:08:28#0#00:00:00#00:00:00#12:00:00 1 7cc6c5d82c011bd9b622ffa4d47ea1f3
0 0 620600 0 0 1470125 0 0 0 0
1009841 0 0 0 0 0
3201126 B 2 BS 1 08/07/2018 09/07/2018 13/04/1962 0 2
- 0 10690500 11927198 0 2 0 0 0 KORIAH
0138r0170718v002751 0002337151509 3;JKN DR RIZKI; 5.2.2.201806040537
4 198908 1#0##0#0#0.0#2018-07-18
12:56:04#0#13:24:08#13:24:08#00:00:00 1 d27be3ca7374cf5decf0162c909fc08a
0 4911100 2223624 0 0 3867190 0 0 0 0
856284 0 0 0 0 69000
3201126 B 1 BS 1 05/07/2018 09/07/2018 15/10/2012 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5670568 0 5 0 0 0 CHESTER CLEVERLY
YEHEZKIEL ATIM D251683 5 2089 DR KRISTON SILITONGA, SPA
0138R0170718V001729 0001480435964 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199431 1#0##0#0#0.0#2018-07-18
13:23:39#0#00:00:00#00:00:00#00:00:00 1 3c93fefd5ec8e1802fe55266e1a146d9
0 0 338858 0 0 1029738 0 0 0 0
4301972 0 0 0 0 0
3201126 B 1 BS 1 05/07/2018 09/07/2018 19/07/1940 0 2
1 S06.5;G81.9;I10 87.03 - - None None None None G-4-24-II
0 - 0 - 0 - 0 - 0 5322700 8179609
0 5 0 0 0 LIEN LAGARDE d308504 77 28475 DR
NURUL KOMARI SPS 0138R0170718V002171 0001436422645 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199068 1#0##0#0#0.0#2018-07-18
13:35:07#0#00:00:00#00:00:00#00:00:00 1 bc855754fc3abdb0d3942784f6125373
0 0 532043 0 0 2993451 0 0 0 0
4484115 0 0 0 0 170000
3201126 B 3 BS 1 07/07/2018 09/07/2018 01/02/1999 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2341258 0 3 0 0 0 TENIA D402620 19
RIZKI; 5.2.2.201806040537 4 198678 1#0##0#0#0.0#2018-07-18
13:36:39#0#00:00:00#00:00:00#00:00:00 1 2f9df690384bd1a83fac5b70bd2a68e5
0 0 183752 0 0 1189340 0 0 0 0 968166
0 0 0 0 0
3201126 B 3 BS 1 08/07/2018 09/07/2018 17/09/1961 0 2
- 0 8908800 14408874 0 2 0 0 0 DJUHROTUN
0138R0170718V002754 0001228740412 3;JKN DR RIZKI; 5.2.2.201806040537
4 198910 1#0##0#0#0.0#2018-07-18
13:39:55#0#14:03:09#14:03:09#00:00:00 1 0e685a923de3eae1f384ad34b733a130
0 0 1853030 0 0 8387707 0 0 0 0
4099137 0 0 0 0 69000
3201126 B 2 BS 1 06/07/2018 09/07/2018 12/10/2017 0 1
1 K52.2;A49.9;J06.9 - - - None None None None K-4-17-I
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 4580316 0 4 0 0 0 LEVI SAHRUM D402566
0 267 DR RIANITA SYAMSU, SPA 0138R0170718V002493 0002436255415
3;JKN DR RIZKI; 5.2.2.201806040537 4 198434 1#0##0#0#0.0#2018-
07-18 14:08:00#0#00:00:00#00:00:00#00:00:00 1
d75cd7ac81677d95ee6b6dc67d5cb910 0 0 298025 0 0
1596644 0 0 0 0 2345647 0 0 0 0 340000
3201126 B 1 BS 1 06/07/2018 09/07/2018 30/07/1976 0 2
5879800 0 0 - 0 - 0 - 0 - 0
5879800 5896870 0 4 0 0 0 NIA ISTIANI D245137
3;JKN DR RIZKI; 5.2.2.201806040537 4 198666 1#0##0#0#0.0#2018-
07-18 14:09:22#0#00:00:00#00:00:00#00:00:00 1
c74e1ed016260f20f44ca0acfd4dcdfe 0 0 485918 0 0
2220675 0 0 0 0 3190277 0 0 0 0 0
3201126 B 3 BS 1 03/07/2018 09/07/2018 01/08/1953 0 2
1 I63.9;G81.9;I10;E14.9 87.44;87.03;89.52 - - None None None
- 0 - 0 6909500 4233657 0 7 0 0 0
ATIKAH D402290 64 23712 DR MAYSAMIRAWATI SPS
0138R0170718V001111 0000511622638 3;JKN DR RIZKI; 5.2.2.201806040537
4 196823 1#0##0#0#0.0#2018-07-18
14:12:08#0#00:00:00#00:00:00#00:00:00 1 d77fcedf0c86eff3e5e9f5b39d614802
0 0 743950 0 0 1432239 0 0 0 0
2057468 0 0 0 0 0
3201126 B 3 BS 1 06/07/2018 09/07/2018 18/06/1966 0 2
1 R57.2;A41.9;R11 - - - None None None None I-4-14-III
None None None None None None CARDIAC ARREST, TIDAK DIKETAHUI (BERAT)
6043900 0 0 - 0 - 0 - 0 - 0
6043900 4977013 0 4 0 0 0 ROHAYATI D393089
52 19011 DR ARU, SPPD 0138R0170718V002552 0002297585384 3;JKN
DR RIZKI; 5.2.2.201806040537 4 198618 1#0##0#0#0.0#2018-07-18
14:13:26#0#00:00:00#00:00:00#12:00:00 1 36ff77106a72a399e8c878f2354c48d2
0 0 596951 0 0 1738463 0 0 0 0
2641599 0 0 0 0 0
3201126 B 2 BS 1 05/07/2018 09/07/2018 20/12/1945 0 1
1 K81.1;J18.0;R11 88.76;87.44 - - None None None None B-4-
(BERAT) 7875800 0 0 - 0 - 0 - 0 - 0
7875800 6284588 0 5 0 0 0 UDING D402467 72
RIZKI; 5.2.2.201806040537 4 198083 1#0##0#0#0.0#2018-07-18
14:15:44#0#00:00:00#00:00:00#00:00:00 1 b15b0103e4528399ff742c4c15872513
0 0 761822 0 0 2560625 0 0 0 0
2962141 0 0 0 0 0
3201126 B 1 BS 1 07/07/2018 09/07/2018 16/08/2017 0 1
(RINGAN) 5170000 0 0 - 0 - 0 - 0 - 0
5170000 6914529 0 3 0 0 0 SHAQUILLE ARSENIO
SAMODRA D384315 0 325 DR OTTY MITHA S, SPA 0138R0170718V002703
0002305264667 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198885
1#0##0#0#0.0#2018-07-18 14:17:42#0#00:00:00#00:00:00#12:00:00 1
e82f34e2d1a9ba3cbc585fb9366c6b84 0 3398000 734204 0 0
2108973 0 0 0 0 528352 0 0 0 0 145000
3201126 B 1 BS 1 08/07/2018 09/07/2018 08/06/1992 0 1
12140800 0 0 - 0 - 0 - 0 - 0
12140800 18104318 0 2 0 0 0 ZULHA MALIK BASKORO TN
0001139923258 3;JKN DR RIZKI; 5.2.2.201806040537 4 198922
1#0##0#0#0.0#2018-07-18 14:17:50#0#20:21:37#20:21:37#00:00:00 1
f951fba92eec966e4ac93029546764a5 0 9417800 5073832 0 0
2182291 0 0 0 0 1285395 0 0 0 0 145000
3201126 B 2 BS 1 06/07/2018 09/07/2018 11/09/1996 0 1
1 R11 88.76 - - None None None None K-4-17-I None None
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3126347 0 4 0 0 0 ADITHIA SEPTIAN BUDI
D402619 21 7968 DR ARU, SPPD 0138R0170718V002593
0001212446351 3;JKN DR RIZKI; 5.2.2.201806040537 4 198675
1#0##0#0#0.0#2018-07-18 14:20:33#0#00:00:00#00:00:00#00:00:00 1
2ec9265bede0a9af2ccf13d84e0c04b3 0 0 209906 0 0
1170914 0 0 0 0 1745527 0 0 0 0 0
3201126 B 3 BS 1 04/07/2018 09/07/2018 22/06/1964 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 4222736 0 6 0 0 0 GADRY ABDUL QADIR
0002340716398 3;JKN DR RIZKI; 5.2.2.201806040537 4 197471
1#0##0#0#0.0#2018-07-18 14:22:48#0#00:00:00#00:00:00#00:00:00 1
407b92b686d3218010a2547eb71773c8 0 0 241100 0 0
2101382 0 0 0 0 1880254 0 0 0 0 0
3201126 B 2 BS 1 06/07/2018 09/07/2018 23/12/1950 0 1
- 0 - 0 - 0 - 0 4290800 3133905 0
4 0 0 0 DIDIN SYAFRUDIN D321637 67 24667 DR AGOES
5.2.2.201806040537 4 198489 1#0##0#0#0.0#2018-07-18
14:36:32#0#14:46:55#14:46:55#00:00:00 2 b89e35ff732b82f15269fa5a480b148b
0 0 439172 0 0 443711 0 0 0 0
2251022 0 0 0 0 0
3201126 B 2 BS 1 07/07/2018 09/07/2018 24/09/1989 0 1
0 - 0 - 0 - 0 - 0 5045200 3164630
0 3 0 0 0 EKO SUHADI D401912 28 10513 DR ARU, SPPD
0138R0170718V002603 0001096089006 3;JKN DR RIZKI; 5.2.2.201806040537
4 198681 1#0##0#0#0.0#2018-07-18
14:37:41#0#00:00:00#00:00:00#00:00:00 1 f40838776ffb6ffd625f82415fad1219
0 0 443231 0 0 973367 0 0 0 0
1748032 0 0 0 0 0
3201126 B 3 BS 1 07/07/2018 09/07/2018 13/02/1966 0 1
1 E10.2;A49.9;D63.8;I10 38.95;99.17;99.21;99.04 - - None None
- 0 - 0 - 0 8908800 20408685 0 3 0
0 0 JARI SUHUDI D402679 52 19137 SRI KUNMARTINI.DR,SPPD
0138R0170718V002690 0001212951093 3;JKN DR RIZKI; 5.2.2.201806040537
4 198879 1#0##0#0#0.0#2018-07-18
15:32:40#0#00:00:00#00:00:00#00:00:00 1 b228a3bc97403f007c91154fefc4fde4
0 0 4074139 0 0 9384346 0 0 0 0
6881200 0 0 0 0 69000
3201126 B 1 BS 1 07/07/2018 09/07/2018 03/04/1996 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 12865605 0 3 0 0 0 RATNA MARLINA S
D402624 22 8130 DR FAHMIALDI, SPOG 0138R0170718V002596
0002097712866 3;JKN DR RIZKI; 5.2.2.201806040537 4 198679
1#0##0#0#0.0#2018-07-18 15:34:02#0#00:00:00#00:00:00#00:00:00 1
cb596a2dabf70d6babb3448b331e3272 0 7116900 2480710 0 0
2103320 0 0 0 0 967675 0 0 0 0 197000
3201126 B 2 BS 1 07/07/2018 09/07/2018 11/04/1983 0 1
None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN PENGHUBUNG
LAIN-LAIN (RINGAN) 9584600 0 0 - 0 - 0 - 0
- 0 9584600 16630927 0 3 0 0 0 ADE SANDRA
0001151702829 3;JKN DR RIZKI; 5.2.2.201806040537 4 198697
1#0##0#0#0.0#2018-07-18 15:39:14#0#08:59:32#08:59:32#00:00:00 1
3344a86b7b96c8b9e0353fe3b26cc3a1 0 7972500 4600608 0 0
2723814 0 0 0 0 1189005 0 0 0 0 145000
3201126 B 3 BS 1 09/07/2018 09/07/2018 12/06/1969 0 1
1 E16.2;J81 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 6262900 0 0 - 0 - 0 - 0 -
0 6262900 1808946 0 1 0 0 0 WINANDO
0001315834492 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198939
1#0##0#0#0.0#2018-07-18 16:21:14#0#00:00:00#00:00:00#00:00:00 1
0da72071acfee35f14b3380721a22587 0 0 352000 0 0 333604
0 0 0 0 407342 0 0 0 0 716000
3201126 B 3 BS 1 06/07/2018 09/07/2018 02/10/1975 0 1
1 A86;G40.9 - - - None None None None G-4-19-II None
- 0 - 0 6246400 3149682 0 4 0 0 0
EDI ANSHORI D402437 42 15618 DR MAYSAMIRAWATI SPS
0138R0170718V002594 0001739641195 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198676 1#0##0#0#0.0#2018-07-24
16:05:24#0#00:00:00#00:00:00#00:00:00 1 eeee259ccd5e48e46184c2ec40af4cdf
0 0 615176 0 0 1513452 0 0 0 0
1021054 0 0 0 0 0
3201126 B 1 BS 1 05/07/2018 09/07/2018 18/08/1957 0 2
1 N17.9;R11;B02.9 - - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 9115921 0 5 0 0 0 ASNETTI
0000017862737 3;JKN ECHI; 5.2.2.201806040537 4 198094
1#1#vvip#5#3331021#0.0#2018-07-27 12:56:34#0#23:22:14#23:22:14#00:00:00
2 db1b003829082ed6ffbe806d60f03ab5 0 0 964121 0 0
2429431 0 0 0 0 5722369 0 0 0 0 0
3201126 B 3 BS 1 30/06/2018 09/07/2018 04/01/1937 0 2
0 0 - 0 - 0 - 0 - 0 4144700
9703004 0 10 0 0 0 ROHINI D398803 81 29762
ECHI; 5.2.2.201806040537 4 196123 1#0##0#0#0.0#2018-07-27
13:03:37#0#00:00:00#00:00:00#00:00:00 3 9b05901b15a543d1fc3bb88718412542
0 0 619396 0 0 3814832 0 0 0 0
4510776 0 0 0 0 758000
3201126 B 3 BS 1 08/07/2018 09/07/2018 09/03/1965 0 2
4 E14.1;I49.3;E87.6 96.05;96.71 - - None None None None J-1-
KOMPLEKS (BERAT) 29135800 0 0 - 0 - 0 - 0 -
0 29135800 12755153 0 2 0 0 0 OMMIE D068574
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198931
1#0##0#0#0.0#2018-09-26 18:36:07#0#23:48:40#23:48:40#00:00:00 1
a9ccfd5269843225ac9b7a4492562a08 0 0 2775722 0 860449
7057982 0 0 0 0 1034000 0 0 0 1027000
0
3201126 B 1 BS 1 01/07/2018 09/07/2018 22/04/1963 0 2
1 B17.9;E87.6;R09.1;D37.6 88.01;87.44 - - None None None None
(SEDANG) 6857000 0 0 - 0 - 0 - 0 - 0
6857000 17338163 0 9 0 0 0 ERNAWITA D266611
55 20159 DR SUKAMTO SPPD 0138R0170718V000004 0000039393641 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196155 1#0##0#0#0.0#2018-
09-27 11:46:28#0#00:00:00#00:00:00#00:00:00 2
d969bf098f782aee1a5bd9c49a179248 0 0 912932 0 0
7775959 0 0 0 0 8189272 0 0 0 0 460000
3201126 B 3 BS 1 04/07/2018 09/07/2018 05/03/1960 0 2
1 N18.5;J80;D63.8;I64 99.04;96.71;87.03 - - None None None
None J-1-20-III None None None None None None PROSEDUR SISTEM
- 0 - 0 29135800 23698534 0 6 1 2 0
SAFIAH D398345 58 21305 DR. ARU ARIADNO, SPPD
0138R0170718V001519 0001458793225 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 197418 1#0##0#0#0.0#2018-09-28
15:50:49#0#00:00:00#00:00:00#00:00:00 2 45cf8aba3b72375ac38af52d53a0b7bb
0 0 631389 0 0 14671145 0 0 0 0
4346000 0 0 0 0 4050000
3201126 B 2 BS 1 03/07/2018 09/07/2018 16/03/2000 0 2
1 S02.10;S02.70 87.44 - - None None None None G-4-24-I
0 - 0 - 0 - 0 - 0 3651800 11232454
0 7 0 0 0 HILDA SINTANIA D402238 18 6683 DR
S;16137 5.2.2.201806040537 4 196726 1#0##0#0#0.0#2018-10-08
20:07:30#0#00:00:00#00:00:00#00:00:00 2 2f837b7e583b05376bb8f21037eee729
0 0 487662 0 0 6158959 0 0 0 0
4295833 0 0 0 0 290000
3201126 B 2 BS 1 09/07/2018 10/07/2018 20/04/1952 0 2
1 E11.2;E87.7;D63.8;I10 38.95;99.04 - - None None None None
- 0 - 0 10690500 18449841 0 2 0 0 0
NY.SAIRAH D392205 66 24186 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V003229 0001458222265 3;JKN DR RIZKI; 5.2.2.201806040537
4 199241 1#0##0#0#0.0#2018-07-18
09:01:46#0#15:22:37#15:22:37#12:00:00 1 3d8f3530fc903e669f4c8029fbf12446
0 0 4871769 0 0 7793972 0 0 0 0
5715100 0 0 0 0 69000
3201126 B 1 BS 1 27/06/2018 10/07/2018 02/05/1935 0 1
1 I62.0;G81.9;R40.2;I10;J18.9;K25.9 87.44;87.03 - - None None
None None G-4-13-III None None None None None None PERDARAHAN INTRA
KRANIAL BUKAN TRAUMATIK (BERAT) 8556600 0 0 - 0 - 0
- 0 - 0 8556600 35733808 0 14 1 6 0
JOSADAK ALIAMBAR D387286 83 30372 DR NURUL KOMARI SPS
0138R0170618V007870 0000060799869 3;JKN DR RIZKI; 5.2.2.201806040537
4 194999 1#0##0#0#0.0#2018-07-18
09:05:34#0#13:21:37#13:21:37#12:00:00 1 de04d5834b4e66bf624064b109f6c196
0 0 725309 0 0 17169499 0 0 0 0
12712000 0 0 0 0 5127000
3201126 B 1 BS 1 07/07/2018 10/07/2018 23/03/1960 0 2
1 E11.2;N20.0 89.52 - - None None None None N-4-16-II None
(SEDANG) 7385300 0 0 - 0 - 0 - 0 - 0
7385300 4881881 0 4 0 0 0 ISNANIYAH LUBIS
0001813253859 3;JKN DR RIZKI; 5.2.2.201806040537 4 198798
1#0##0#0#0.0#2018-07-18 09:08:25#0#11:20:51#11:20:51#00:00:00 1
ad5f158aadfe626644697ad836f7e090 0 0 669690 0 0 742816
0 0 0 0 3469375 0 0 0 0 0
3201126 B 1 BS 1 07/07/2018 10/07/2018 29/04/2010 0 1
1 A49.9;K29.7;E73.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 4583581 0 4 0 0 0 FAUZAN IFFAT
SULAIMAN D197426 8 2991 DR RIANITA SYAMSU, SPA 0138R0170718V002692
0002327963578 3;JKN DR RIZKI; 5.2.2.201806040537 4 198880
1#0##0#0#0.0#2018-07-18 09:09:57#0#00:00:00#00:00:00#00:00:00 1
1433f0c48ccccf186fcb038c76011223 0 0 338858 0 0 794863
0 0 0 0 3449860 0 0 0 0 0
3201126 B 1 BS 1 07/07/2018 10/07/2018 08/06/1987 0 2
0 0 - 0 - 0 - 0 - 0 2453800
4484707 0 4 0 0 0 RICHA MEGAWANTI P003277 31
RIZKI; 5.2.2.201806040537 4 198881 1#0##0#0#0.0#2018-07-18
09:30:28#0#00:00:00#00:00:00#00:00:00 1 573ea87519a0fde7f04ba97a6e2e2fd8
0 0 478015 0 0 908800 0 0 0 0
3097892 0 0 0 0 0
3201126 B 3 BS 1 05/07/2018 10/07/2018 02/03/2017 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2874477 0 6 0 0 0 WILSA ELINVANIA ENONI
LAIA D402511 1 490 DR RASTRA, SPA 0138R0170718V002179
0002213902607 3;JKN DR RIZKI; 5.2.2.201806040537 4 198087
1#0##0#0#0.0#2018-07-18 09:40:56#0#00:00:00#00:00:00#00:00:00 1
97662ba1030f3ca8202c9f21918ef274 0 0 207620 0 0 961307
0 0 0 0 1705550 0 0 0 0 0
3201126 B 3 BS 1 09/07/2018 10/07/2018 20/05/1991 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 1982252 0 2 0 0 0 RIYANTO D402791
27 9912 DR ARU, SPPD 0138R0170718V002931 0002317988158 3;JKN
DR RIZKI; 5.2.2.201806040537 4 198955 1#0##0#0#0.0#2018-07-18
09:52:09#0#00:00:00#00:00:00#00:00:00 1 c7bdfa94302fd4fbb91fc5b81c625dc3
0 0 241100 0 0 1059472 0 0 0 0 681680
0 0 0 0 0
3201126 B 3 BS 1 04/07/2018 10/07/2018 04/04/1940 0 2
1 I64;J18.0;G81.9;I10 87.44;87.03 - - None None None None
OTAK NON SPESIFIK & PENYUMBATAN PRE-CEREBRAL TANPA INFARK (BERAT) 6899800
0 0 - 0 - 0 - 0 - 0 6899800
7975710 0 7 0 0 0 NIJAH D402355 78 28580 DR
5.2.2.201806040537 4 198085 1#0##0#0#0.0#2018-07-18
10:29:08#0#00:00:00#00:00:00#00:00:00 1 3a54a7424ca77a80483269e5a2a988b0
0 0 1006942 0 0 4579993 0 0 0 0
2388775 0 0 0 0 0
3201126 B 2 BS 1 09/07/2018 10/07/2018 07/06/1940 0 1
- 0 10690500 14858864 0 2 0 0 0 ADAM
0138R0170718V003303 0000059079126 3;JKN DR RIZKI; 5.2.2.201806040537
4 199290 1#0##0#0#0.0#2018-07-18
10:36:07#0#18:40:09#18:40:09#00:00:00 1 e4bf04187c521ae81f0f455fe611b8b4
0 4231600 2245005 0 0 7265184 0 0 0 0
1048075 0 0 0 0 69000
3201126 B 2 BS 1 06/07/2018 10/07/2018 25/03/1986 0 2
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 4573090 0 5 0 0 0 GRESIA NATASYA K NY
0002135847958 3;JKN DR RIZKI; 5.2.2.201806040537 4 198095
1#0##0#0#0.0#2018-07-18 11:12:51#0#00:19:48#00:19:48#00:00:00 2
f8a74907d4e2fd0fc2d72c7fb55195cf 0 0 339209 0 0
1383707 0 0 0 0 2850174 0 0 0 0 0
3201126 B 3 BS 1 06/07/2018 10/07/2018 01/12/1970 0 2
1 I63.9;I10;G81.9;E78.5 87.03;87.44 - - None None None None
0 - 0 6909500 5391082 0 5 0 0 0
DAMERIA LASE D402508 47 17384 DR MAYSAMIRAWATI SPS
0138R0170718V002203 0000269820538 3;JKN DR RIZKI; 5.2.2.201806040537
4 198101 1#0##0#0#0.0#2018-07-18
13:05:31#0#00:00:00#00:00:00#00:00:00 1 a93a709204d7e80470c2e5e54b71639b
0 0 674855 0 0 1802539 0 0 0 0
2913688 0 0 0 0 0
3201126 B 3 BS 1 08/07/2018 10/07/2018 28/10/1984 0 2
0 0 - 0 - 0 - 0 - 0 4986800
8952797 0 3 0 0 0 NURYANTI MELANI D402778 33
12306 DR MUTIA P, SPOG 0138R0170718V002775 0002451411764 3;JKN DR
RIZKI; 5.2.2.201806040537 4 198921 1#0##0#0#0.0#2018-07-18
13:09:05#0#20:04:56#20:04:56#00:00:00 1 0041aa52b240aa996a375802d164eb71
0 0 1815644 0 0 2780456 0 0 0 0
4159697 0 0 0 0 197000
3201126 B 2 BS 1 08/07/2018 10/07/2018 15/11/2017 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 1830582 0 3 0 0 0 ARSAKHA VIRENDRA
SYAHPUTRA D402782 0 235 DR KRISTON SILITONGA, SPA
0138R0170718V002784 0002434786953 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198927 1#0##0#0#0.0#2018-07-18
13:25:41#0#22:23:00#22:23:00#00:00:00 1 b65987ca309c4482b58efd9425f059bb
0 0 238535 0 0 436289 0 0 0 0
1155758 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 10/07/2018 02/04/1967 0 2
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4361952 0 2 0 0 0 MARIA CHRISTINA ATJE NY
0001320360423 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199302
1#0##0#0#0.0#2018-07-18 13:27:37#0#00:00:00#00:00:00#00:00:00 1
06e654d80d1b5b3415ec3ea5058ec317 0 0 573641 0 0
1104200 0 0 0 0 2684111 0 0 0 0 0
3201126 B 2 BS 1 07/07/2018 10/07/2018 06/02/1984 0 1
0 0 - 0 - 0 - 0 - 0 5043100
5143716 0 4 0 0 0 SYAHRIMAR ISMAIL D331498 34
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198888
1#0##0#0#0.0#2018-07-18 14:10:59#0#00:00:00#00:00:00#12:00:00 1
e6a22720c75c8b24c718e71fbebf2632 0 0 506879 0 0
2461832 0 0 0 0 2175005 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 10/07/2018 15/01/1950 0 2
1 E10.1;I11.0;A49.9 - - - None None None None E-4-10-III
0 - 0 6262900 2190770 0 1 0 0 0 A
NAHIDOH D400593 68 25013 DR DINI DANIATY 0138R0170718V003634
0000060742798 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199648
1#0##0#0#0.0#2018-07-18 14:54:24#0#00:00:00#00:00:00#00:00:00 1
b12e477d723e4c89f0d2b4d5e9241fdc 0 0 313145 0 0
1445304 0 0 0 0 432321 0 0 0 0 0
3201126 B 3 BS 1 04/07/2018 10/07/2018 16/10/2002 0 1
1 A16.1;K67.3;E44.1;D64.9 99.04 - - None None None None J-4-
(BERAT) 6970400 0 0 - 0 - 0 - 0 - 0
6970400 15142322 0 7 0 0 0 ADI NURRUDIN AN
D398995 15 5740 DR RASTRA, SPA 0138R0170718V001399
0001739955161 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197238
1#0##0#0#0.0#2018-09-08 09:12:18#0#12:44:21#12:44:21#00:00:00 2
42298652b5a72a37b748ddb026584186 0 0 1126446 0 0
7371257 0 0 0 0 6644619 0 0 0 0 0
3201126 B 3 BS 1 08/07/2018 10/07/2018 05/04/1948 0 1
4 I61.9;I61.5;I11.0;G81.9;R40.2;K25.9 96.71;87.03 - - None None
- 0 - 0 29135800 24810569 0 3 0 0 0
M RISNAN RAMELAN SE d402753 70 25661 DR NURUL KOMARI SPS
0138R0170718V002749 0001658163789 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198916 1#0##0#0#0.0#2018-09-08
09:20:14#0#15:58:11#15:58:11#00:00:00 2 eedeb1cc60b1e290e0eb01320221c869
0 0 5048312 0 0 11256257 0 0 0 0
4328000 0 0 0 0 4178000
3201126 B 3 BS 1 10/07/2018 10/07/2018 17/08/1976 0 2
1 A41.9;K74.6;D64.9 99.04 - - None None None None A-4-10-II
0 - 0 - 0 - 0 - 0 4330300 11076210
0 1 0 0 0 RONAH MARLENAH D402914 41 15302 DR
BETTY DWI L, SPPD 0138R0170718V003455 0001740057333 3;JKN DR RIZKI;
5.2.2.201806040537 4 199432 1#0##0#0#0.0#2018-09-12
12:26:56#0#00:00:00#00:00:00#00:00:00 3 b5bdd926aa73187b749c7cd03c023cbe
0 0 321905 0 0 6311693 0 0 0 0
3531612 0 0 0 0 911000
3201126 B 3 BS 1 09/07/2018 10/07/2018 12/04/1958 0 2
1 I12.0;T82.4 38.95;99.17 - - None None None None N-1-12-III
- 0 19332400 13278473 0 2 0 0 0 TURYATI
0001435178845 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199293
1#0##0#0#0.0#2018-09-25 13:11:42#0#19:40:13#19:40:13#12:00:00 2
dd3ebcc5ec9807d809ae066a4903c9e3 0 0 1906030 0 0
7382758 0 0 0 0 3920685 0 0 0 0 69000
3201126 B 3 BS 1 10/07/2018 10/07/2018 16/02/1981 0 2
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 1878754 0 1 0 0 0 DEWI SITI ROBIAH
0001743673274 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199350
1#0##0#0#0.0#2018-09-26 21:03:24#0#08:20:50#08:20:50#00:00:00 2
9965f46dc71f641fb142c6b32d1b4277 0 0 321495 0 0 539350
0 0 0 0 429909 0 0 0 0 588000
3201126 B 3 BS 1 10/07/2018 10/07/2018 11/12/2017 0 2
4 E87.2;A09.9;R57.9 - - - None None None None E-4-11-II
4504900 0 0 - 0 - 0 - 0 - 0
4504900 1560028 0 1 0 0 0 HIFZA ZURA INSIYAH
0002319139631 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199337
1#0##0#0#0.0#2018-09-27 11:49:06#0#00:00:00#00:00:00#00:00:00 3
59356c14c22f60b6f639f1eb238ebe12 0 0 314665 0 0 854305
0 0 0 0 391058 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 11/07/2018 29/09/1969 0 2
1 N18.5;K52.9;K21.9 - - - None None None None N-4-10-I
GINJAL (RINGAN) 4639400 0 0 - 0 - 0 - 0 -
0 4639400 3368610 0 3 0 0 0 YAYAH RODIYAH,S.PD
0001273353625 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199307
1#0##0#0#0.0#2018-07-18 13:30:57#0#00:00:00#00:00:00#00:00:00 1
d502a78d48ee8b4e28a708acb5eb1df0 0 0 269459 0 0 191400
0 0 0 0 2617751 0 0 0 0 290000
3201126 B 1 BS 1 09/07/2018 11/07/2018 09/07/2014 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4687645 0 3 0 0 0 KENZIE RASYID IHSAN
D282190 4 1461 DR RASTRA, SPA 0138R0170718V003279
0002045439009 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199282
1#1#vvip#3#1761745#0.0#2018-07-18 13:36:54#0#16:56:11#16:56:11#00:00:00
1 3a08182a50681a1cce43e1e4d3617d04 0 0 513829 0 0
597648 0 0 0 0 3576168 0 0 0 0 0
3201126 B 1 BS 1 06/07/2018 11/07/2018 17/12/1939 0 2
1 G40.9;E87.1;G81.9 - - - None None None None G-4-22-II
None None None None None None SERANGAN KEJANG (SEDANG) 4750700
0 0 - 0 - 0 - 0 - 0 4750700
7558553 0 6 0 0 0 NURHAYATUN D338046 78 28691
DR MAYSAMIRAWATI SPS 0138R0170718V002589 0000060807655 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 198674 1#0##0#0#0.0#2018-
07-18 13:39:06#0#00:00:00#00:00:00#00:00:00 1
cdd6321800be2195525a1c4056f14765 0 0 480563 0 0
2652505 0 0 0 0 4425485 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 11/07/2018 27/10/1952 0 2
1 K21.0;F41.9;I10;E87.1 - - - None None None None K-4-
0 0 - 0 - 0 - 0 - 0 5739000
4398610 0 3 0 0 0 RUKI TAURGUN BR HUTABARAT
0000060965998 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199018
1#0##0#0#0.0#2018-07-18 13:56:43#0#09:22:35#09:22:35#00:00:00 1
9e12b99ca353ba844ef46c87bae52816 0 0 569510 0 0
1172340 0 0 0 0 2656760 0 0 0 0 0
3201126 B 1 BS 1 10/07/2018 11/07/2018 15/11/2003 0 1
10235200 0 0 - 0 - 0 - 0 - 0
10235200 9650962 0 2 0 0 0 M AJMAL FAADHIL YULIANTO
d375728 14 5351 DR MOHAMMAD AULIA HERDIYANA,SPOT
0138R0170718V003532 0001831460916 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199550 1#0##0#0#0.0#2018-07-18
14:24:42#0#11:13:18#11:13:18#12:00:00 1 fc7102a99240a91001ec6f1579a40431
0 5901200 1155364 0 0 1717027 0 0 0 0
732371 0 0 0 0 145000
3201126 B 1 BS 1 06/07/2018 11/07/2018 05/04/1953 0 2
0 - 0 - 0 - 0 - 0 14562700 15167516
0 6 0 0 0 TUTI MURDIYATMI D402532 65 23833 DR
TANTIYO S;16137 5.2.2.201806040537 4 198108 1#0##0#0#0.0#2018-
07-18 14:32:43#0#08:27:55#08:27:55#00:00:00 1
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4767606 0 0 0 0 6072267 0 0 0 0
2964000
3201126 B 3 BS 1 05/07/2018 11/07/2018 31/12/1958 0 2
1 I63.9;E14.9;G81.9 87.03 - - None None None None G-4-14-II
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4848680 0 7 0 0 0 SITI NASEHA
0001447969926 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198082
1#0##0#0#0.0#2018-07-18 14:36:53#0#17:44:40#17:44:40#00:00:00 1
4b67d556c2964ca51197f9845e8e98b0 0 0 743950 0 0
2007027 0 0 0 0 2097703 0 0 0 0 0
3201126 B 2 BS 1 09/07/2018 11/07/2018 16/07/2006 0 2
LAIN (RINGAN) 3371200 0 0 - 0 - 0 - 0 -
0 3371200 4873299 0 3 0 0 0 SYABILA CAHYA
RAHAPUTRI D112572 11 4376 DR CATUR SUZANTARA 0138R0170718V002891
0001821895301 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198940
1#0##0#0#0.0#2018-07-18 14:38:28#0#00:00:00#00:00:00#00:00:00 1
37a50078456b28e6e48f9b9a85930404 0 0 409408 0 0
2354077 0 0 0 0 2109814 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 11/07/2018 02/08/1987 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3748479 0 3 0 0 0 ARIEF MUBARAK
0002339357365 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198936
1#0##0#0#0.0#2018-07-18 14:39:55#0#06:09:42#06:09:42#00:00:00 1
9aee4917c7e48c6a1a7ce56940d3b8e8 0 0 338858 0 0 795393
0 0 0 0 2614228 0 0 0 0 0
3201126 B 3 BS 1 09/07/2018 11/07/2018 10/06/1967 0 2
- 0 8908800 14495463 0 3 0 0 0 NURWITA
0138R0170718V003301 0001212590226 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199288 1#0##0#0#0.0#2018-07-18
14:40:51#0#18:20:42#18:20:42#12:00:00 1 2c5d3a417b81a47c6716f14bbd372260
0 0 1844760 0 0 8187402 0 0 0 0
4173301 0 0 0 0 290000
3201126 B 2 BS 1 09/07/2018 11/07/2018 02/02/1941 0 1
1 Q64.3;D29.1;N21.0 57.92;56.0 - - None None None None N-1-
(SEDANG) 13103400 0 0 - 0 - 0 - 0 - 0
13103400 15232371 0 3 0 0 0 KUSNEN KUSNADI
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1#0##0#0#0.0#2018-07-18 14:43:14#0#00:00:00#00:00:00#00:00:00 1
78535dec33917afce490e8da42ed5855 0 7446500 1772484 0 0
1871877 0 0 0 0 1072510 0 0 0 0
3069000
3201126 B 2 BS 1 10/07/2018 11/07/2018 02/05/1964 0 2
1 T82.4;I12.0;D63.8;J91 38.95;99.04 - - None None None None
- 0 - 0 23198900 14882549 0 2 0 0 0
SUKEN RINI , S.PD ,MM D183622 54 19792 DR IRFIANSYAH LESMANA DR
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14:44:47#0#00:00:00#00:00:00#12:00:00 1 9ae37e61be060235052b2d9c12ae5481
0 0 2223624 0 0 7135700 0 0 0 0
5488725 0 0 0 0 34500
3201126 B 2 BS 1 03/07/2018 11/07/2018 13/05/1966 0 1
1 C22.9;J90 88.01 - - None None None None B-4-11-III None
(BERAT) 9921900 0 0 - 0 - 0 - 0 - 0
9921900 10336029 0 9 0 0 0 ABDUL HARIS D380006
52 19044 DR ARU, SPPD 0138R0170718V001120 0001729967332 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 196828 1#0##0#0#0.0#2018-
07-18 14:49:13#0#00:00:00#00:00:00#12:00:00 1
1f2ead8176012dd02552a2f987c7f045 0 0 1045190 0 0
4251150 0 0 0 0 5039689 0 0 0 0 0
3201126 B 2 BS 1 04/07/2018 11/07/2018 24/10/1948 0 2
1 I69.4;D50.0;A49.9;I13.0;K92.2 99.04 - - None None None None
G-4-26-III None None None None None None GANGGUAN - PENYAKIT SISTEM
SARAF LAIN-LAIN (BERAT) 7488200 0 0 - 0 - 0 - 0
- 0 7488200 12583520 0 8 0 0 0 MA'ANAH
0000061022441 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197550
1#0##0#0#0.0#2018-07-18 14:51:19#0#23:48:22#23:48:22#00:00:00 1
2900323f0fa675fb2676b9f0acd0ec4d 0 0 726938 0 0
6230361 0 0 0 0 4110221 0 0 0 0
1516000
3201126 B 1 BS 1 05/07/2018 11/07/2018 03/01/1950 0 1
1 I63.8;D29.1;G81.9;K40.4 - - - None None None None G-4-
- 0 12141100 10411110 0 7 0 0 0 REGINALD E
JONATHANS D292794 68 25020 DR HARDI PRANATA SPS 0138r0170718v002189
0001268729919 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198092
1#0##0#0#0.0#2018-07-18 14:53:09#0#23:02:28#23:02:28#12:00:00 1
13d2c3f628e151f8401235ecdd0718ca 0 0 1388521 0 0
4120488 0 0 0 0 4612101 0 0 0 0 290000
3201126 B 2 BS 1 07/07/2018 11/07/2018 17/05/1999 0 2
1 K59.0;N39.0 - - - None None None None K-4-18-II None
2941900 0 0 - 0 - 0 - 0 - 0
2941900 4355168 0 5 0 0 0 PUTRI MONICA
0001286482893 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199095
1#0##0#0#0.0#2018-07-18 15:00:42#0#00:00:00#00:00:00#00:00:00 1
20c02605c9250e285783cb0cc9fe2265 0 0 311408 0 0
1694842 0 0 0 0 2348918 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 11/07/2018 16/11/1967 0 2
1 I12.0;E10.2 39.27;99.17 - - None None None None N-1-12-II
- 0 8908800 8311427 0 2 0 0 0 NUNUNG
0001233732723 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199836
1#0##0#0#0.0#2018-07-18 15:02:43#0#20:25:09#20:25:09#00:00:00 1
d1a445cf379772595cefecda0d195b19 0 0 1906030 0 0
2364359 0 0 0 0 3972038 0 0 0 0 69000
3201126 B 3 BS 1 08/07/2018 11/07/2018 01/09/1997 0 2
1 G40.9;N39.0 89.14 - - None None None None G-4-22-II None
None None None None None SERANGAN KEJANG (SEDANG) 3393400 0
0 - 0 - 0 - 0 - 0 3393400 4076953
0 4 0 0 0 ROSALINAH D402784 20 7615 DR MAYSAM
I., SPS 0138R0170718V002786 0000510921933 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198928 1#0##0#0#0.0#2018-07-20
18:12:38#0#00:00:00#00:00:00#00:00:00 1 91d537eb60777816eff28c50473914a9
0 0 292031 0 0 2003205 0 0 0 0
1081717 0 0 0 0 700000
3201126 B 1 BS 1 10/07/2018 11/07/2018 25/12/1949 0 2
1 I12.0;R00.0;E10.2 38.95;99.17 - - None None None None N-1-
- 0 12472300 17090270 0 2 0 0 0 SUMIAH
0001456293429 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199312
1#0##0#0#0.0#2018-07-20 18:14:49#0#00:00:00#00:00:00#00:00:00 1
2f5255c2bdd5e183f31a7f855f1da587 0 0 2647238 0 0
7402977 0 0 0 0 7040055 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 11/07/2018 11/09/1965 0 2
LAIN-LAIN (SEDANG) 3857000 0 0 - 0 - 0 - 0
- 0 3857000 2924436 0 2 0 0 0 NENA TARINA
D402938 52 19295 DR FAHMIALDI, SPOG 0138R0170718V003599
0001430453766 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199618
1#0##0#0#0.0#2018-07-20 18:15:56#0#00:00:00#00:00:00#00:00:00 1
8e2bb36131193301642cbc8971a580fc 0 0 252846 0 0
1928272 0 0 0 0 743318 0 0 0 0 0
3201126 B 1 BS 1 10/07/2018 11/07/2018 08/09/1956 0 1
1 I12.0;D63.8;E87.7 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 2646402 0 2 0 0 0 MUSLIH
0001457564534 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199843
1#0##0#0#0.0#2018-07-20 18:38:36#0#00:00:00#00:00:00#00:00:00 1
e8de8921723ccbc7efd9a2d7812d69bc 0 0 573641 0 0
1092632 0 0 0 0 980129 0 0 0 0 0
3201126 B 2 BS 1 09/07/2018 11/07/2018 03/07/2018 3500 2
4386800 0 0 - 0 - 0 - 0 - 0
4386800 4091656 0 3 0 0 0 BAYI NY RIZKI MARDIANTI
d402322 0 6 DR TRI LESTARI, SPA 0138R0170718V003314
0002456062648 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199294
1#0##0#0#0.0#2018-07-20 18:39:22#0#19:51:04#19:51:04#00:00:00 2
f9bb41bd86623e833f73295eec2ad8fd 0 0 447812 0 0 160666
0 0 0 0 2031178 0 0 0 0 1452000
3201126 B 1 BS 1 04/07/2018 11/07/2018 15/06/1969 0 1
1 K74.6;R18 - - - None None None None B-4-13-II None
0 0 - 0 - 0 - 0 - 0 6857000
14642893 0 8 0 0 0 PARUDI D397320 49 17916
TANTIYO S;16137 5.2.2.201806040537 4 197546 1#0##0#0#0.0#2018-
07-20 18:43:09#0#00:00:00#00:00:00#00:00:00 1
abec2326d4b2698be0b758de257aa479 0 0 807270 0 0
7094677 0 0 0 0 6450946 0 0 0 0 290000
3201126 B 1 BS 1 10/07/2018 11/07/2018 15/01/1940 0 1
1 I20.0;I48;I10;I11.0 88.55;36.07 - - YY02 None None None
- 0 58821400 59852230 0 2 0 0 0 SUHUPI
0001831283627 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199653
1#0##0#0#0.0#2018-07-20 19:25:14#0#00:00:00#00:00:00#12:00:00 1
7127b5ef16bf9b143147a18c4bd991ac 0 10062000 9619120 0 0
31326110 0 0 0 0 1276000 0 0 0 0
7569000
3201126 B 3 BS 1 07/07/2018 11/07/2018 21/01/1965 0 1
1 G51.0;E75.6;E79.9 - - - None None None None G-4-17-II
(SEDANG) 5897300 0 0 - 0 - 0 - 0 - 0
5897300 4356463 0 5 0 0 0 SAHRIAL D402718
TANTIYO S;16137 5.2.2.201806040537 4 198894 1#0##0#0#0.0#2018-
07-20 19:31:56#0#00:00:00#00:00:00#00:00:00 1
8904f3122cb726a027cea810a94b1091 0 0 510784 0 0
2482677 0 0 0 0 1363002 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 11/07/2018 02/02/1951 0 2
1 A15.3;E11.6;R63.0 - - - None None None None J-4-15-II
(SEDANG) 5180900 0 0 - 0 - 0 - 0 - 0
5180900 2438478 0 2 0 0 0 JASMI D397410 67
24630 DR ARU, SPPD 0138R0170718V003343 0001454167923 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199313 1#0##0#0#0.0#2018-
07-20 19:33:30#0#00:00:00#00:00:00#00:00:00 1
def82586f49217f597fc6549b102d13e 0 0 519281 0 0 917670
0 0 0 0 711527 0 0 0 0 290000
3201126 B 1 BS 1 09/07/2018 11/07/2018 12/09/1991 0 1
None None None None None TANDA, GEJALA & PERADANGAN MUSKULOSKELETAL
(RINGAN) 4105100 0 0 - 0 - 0 - 0 - 0
4105100 3749890 0 3 0 0 0 EFA FATONI D298018
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199306
1#0##0#0#0.0#2018-07-20 19:51:12#0#00:00:00#00:00:00#12:00:00 1
358fb6c310a58365b970d410ba024a28 0 0 528459 0 0 952611
0 0 0 0 2268820 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 11/07/2018 12/07/1977 0 1
12210800 0 0 - 0 - 0 - 0 - 0
12210800 11804116 0 2 0 0 0 YULAN MIRZA D398490
0001647430198 3;JKN DR RIZKI; 5.2.2.201806040537 4 199456
1#0##0#0#0.0#2018-07-23 09:54:22#0#00:00:00#00:00:00#00:00:00 1
60f0389a6da0a8eeb9136c7ba5130ad8 0 2421000 2442160 0 0
4023724 0 0 0 0 848232 0 0 0 0
2069000
3201126 B 3 BS 1 08/07/2018 11/07/2018 24/01/1973 0 1
1 A16.1;R65.9;K73.9 - - - None None None None J-4-15-I
(RINGAN) 4336500 0 0 - 0 - 0 - 0 - 0
4336500 5623103 0 4 0 0 0 RINALDI D399378
45 16601 DR SUKAMTO SPPD 0138R0170718V002731 0002326411552 3;JKN
DR RIZKI; 5.2.2.201806040537 4 198902 1#0##0#0#0.0#2018-07-23
12:48:43#0#02:32:29#02:32:29#00:00:00 1 afbe41b8cf2f7d42b117d0bb17a64e06
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3609867 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 11/07/2018 28/10/1950 0 1
1 I25.0;I50.0;K30 89.52 - - None None None None I-4-16-II
None None None None None None ATHEROSKLEROSIS (SEDANG) 3482400
0 0 - 0 - 0 - 0 - 0 3482400
1429606 0 2 0 0 0 TAKIM H, DRS DE402963 67
24727 DR RENDRA RAMADYA 0138R0170718V003786 0000060952836 3;JKN DR
RIZKI; 5.2.2.201806040537 4 199835 1#0##0#0#0.0#2018-07-23
13:01:36#0#19:22:41#19:22:41#00:00:00 1 55d84342aaea06ca2fdaedf29324452f
0 0 178780 0 0 134300 0 0 0 0 400526
0 0 0 0 716000
3201126 B 3 BS 1 06/07/2018 11/07/2018 31/10/1953 0 1
1 J18.0;A41.9;E11.2;K59.0;I10 90.59;89.52 - - None None None
- 0 6419700 15623222 0 6 0 0 0 RIDWAN
0001260649282 3;JKN DR RIZKI; 5.2.2.201806040537 4 198221
1#1#vvip#6#9203522#0.0#2018-07-24 13:21:11#0#09:23:36#09:23:36#00:00:00
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5804040 0 0 0 0 8698080 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 11/07/2018 12/07/1991 0 2
0 - 0 - 0 - 0 - 0 2899500 2531679
0 2 0 0 0 EKAWATI D402921 26 9860 DR ERDIYAN,
4 199340 1#0##0#0#0.0#2018-07-24
13:28:46#0#00:00:00#00:00:00#00:00:00 1 29e661e4b05dd7effa0d7623c0225343
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3201126 B 1 BS 1 10/07/2018 11/07/2018 27/06/1989 0 2
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2 0 0 0 KHUZAIMAH D355274 29 10605 DR ERDIYAN, SPOG
0138R0170718V003355 0001646091279 3;JKN DR RIZKI; 5.2.2.201806040537
4 199325 1#0##0#0#0.0#2018-07-24
13:32:08#0#04:55:46#04:55:46#00:00:00 2 1a1f152332f9f4608f7b5f775516f742
0 0 451204 0 0 835642 0 0 0 0
1789239 0 0 0 0 0
3201126 B 2 BS 1 08/07/2018 11/07/2018 16/03/1944 0 1
1 K21.9;E11.5;I11.9 - - - None None None None K-4-12-II
0 0 - 0 - 0 - 0 - 0 4919200
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RIZKI; 5.2.2.201806040537 4 198925 1#0##0#0#0.0#2018-07-24
16:20:58#0#21:40:14#21:40:14#00:00:00 1 ec6a41fd1d2060255055641fe76f0780
0 0 537092 0 0 1155762 0 0 0 0
1842270 0 0 0 0 0
3201126 B 2 BS 1 10/07/2018 11/07/2018 05/07/1960 0 2
2061500 0 0 - 0 - 0 - 0 - 0
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58 21189 DR ARU, SPPD 0138R0170718V003549 0001266397323 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199601 1#0##0#0#0.0#2018-
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1422588 0 0 0 0 2232058 0 0 0 0
1749000
3201126 B 3 BS 1 10/07/2018 11/07/2018 21/08/1988 0 1
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29 10915 DR ARU, SPPD 0138R0170718V003564 0000320809342 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199613 1#0##0#0#0.0#2018-
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3201126 B 3 BS 1 10/07/2018 11/07/2018 15/06/1957 0 1
2319600 0 0 - 0 - 0 - 0 - 0
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61 22305 DR ARU 0138R0170718V003572 0001457386435 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199615 1#0##0#0#0.0#2018-
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233d7000448f5ba63fa3862db85b984b 0 0 702488 0 0 840296
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3201126 B 2 BS 1 10/07/2018 11/07/2018 07/05/2000 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-09-25 13:12:37#0#18:36:29#18:36:29#12:00:00 2
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0 0 0 0 5053724 0 0 0 0 34500
3201126 B 3 BS 1 11/07/2018 11/07/2018 17/03/1951 0 1
4 I25.0;I50.0;J22;I46.9 99.60 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4178900
2493140 0 1 0 0 0 EKA UTOYO D390851 67 24588
DR DICKI PRATAMA 0138R0170718V003902 0001809227406 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 199853 1#0##0#0#0.0#2018-09-26
08:48:32#0#08:00:25#08:00:25#12:00:00 2 6c310e01aa9fbf4c802af80689bcbae5
0 0 461465 0 0 1058572 0 0 0 0 683103
0 0 0 0 290000
3201126 B 3 BS 1 08/07/2018 11/07/2018 06/04/1968 0 2
1 J46 - - - None None None None J-4-18-I None None
0 - 0 - 0 - 0 - 0 2225900 4631550
0 4 0 0 0 SITI DJULAEHA D324080 50 18355 DR
MOHAMAD NIZAM ERHAMZA SPP 0138R0170718V002729 0000511565747 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 198900 1#0##0#0#0.0#2018-
09-26 18:53:05#0#00:00:00#00:00:00#00:00:00 1
c4e4f531ddbc0dcc3c30e2acabcf1485 0 0 253331 0 0
2997220 0 0 0 0 1380999 0 0 0 0 0
3201126 B 3 BS 1 11/07/2018 12/07/2018 06/09/1948 0 2
1 E14.1;J81 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 6262900 0 0 - 0 - 0 - 0 -
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0000060627227 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200503
1#0##0#0#0.0#2018-07-18 16:09:45#0#18:20:08#18:20:08#00:00:00 1
26f029ff774391a3ed3da3e48820fda9 0 0 313145 0 0
2942250 0 0 0 0 3304098 0 0 0 0
1039000
3201126 B 3 BS 1 12/07/2018 12/07/2018 01/06/1946 0 2
4 J96.0;R06.0;E05.2 99.60 - - None None None None J-4-11-II
None None None None None None KEGAGALAN PERNAFASAN (SEDANG) 3713600
0 0 - 0 - 0 - 0 - 0 3713600
3990213 0 1 0 0 0 SUTIKEM D397437 72 26339
DR NIKEN PRABHA DUHITA 0138R0170718V004377 0001905811637 3;JKN DR
RIZKI; 5.2.2.201806040537 4 200520 1#0##0#0#0.0#2018-07-18
16:21:18#0#07:03:49#07:03:49#00:00:00 1 252c106bc54555ba8c4b8f587d6a31ea
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3201126 B 1 BS 1 08/07/2018 12/07/2018 31/01/1937 0 2
1 I63.9;E14.0;G81.9 - - - None None None None G-4-14-III
INFARK (BERAT) 12141100 0 0 - 0 - 0 - 0 -
0 12141100 7149881 0 5 0 0 0 MULJASRI
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1#0##0#0#0.0#2018-07-20 17:54:51#0#00:00:00#00:00:00#00:00:00 1
e041b9037406f5acd4c2d697b1b0dd6e 0 0 1267110 0 0
1484022 0 0 0 0 4398749 0 0 0 0 0
3201126 B 3 BS 1 07/07/2018 12/07/2018 01/09/1993 0 2
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 3026850 0 6 0 0 0 AGRY KUNANG SARI
0000510368984 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198887
1#0##0#0#0.0#2018-07-20 17:55:51#0#00:00:00#00:00:00#12:00:00 1
175d030d89d40ffb4e91694da2a8b631 0 0 257183 0 0
1054149 0 0 0 0 1715518 0 0 0 0 0
3201126 B 2 BS 1 08/07/2018 12/07/2018 05/09/1945 0 1
- 0 - 0 - 0 - 0 4851600 8597579 0
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ANANTARIA. SPJP 0138R0170718V002766 0000060707226 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198917 1#0##0#0#0.0#2018-07-20
17:57:21#0#00:00:00#00:00:00#00:00:00 1 162d8fbb6df784f792ec8ef40872dbf2
0 0 489644 0 0 3462477 0 0 0 0
3469458 0 0 0 0 1176000
3201126 B 1 BS 1 30/06/2018 12/07/2018 18/03/1967 0 2
1 I63.9;I13.0;G81.9;N18.5;J18.0 - - - None None None None
0 - 0 12141100 43009947 0 13 1 1 0 SITI
NURAINI d390277 51 18732 DR MAYSAM I., SPS 0138R0170618V008934
0000061127302 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 195919
1#0##0#0#0.0#2018-07-20 18:08:07#0#00:00:00#00:00:00#12:00:00 1
a721c8c1b1f798242fa45f8712a0337d 0 0 1267110 0 0
17270837 0 0 0 0 15573000 0 0 0 0
8899000
3201126 B 3 BS 1 10/07/2018 12/07/2018 25/05/1993 0 2
0 - 0 - 0 - 0 - 0 1674900 3576187
0 3 0 0 0 MEGA TRESNAWATI D402917 25 9177 DR
5.2.2.201806040537 4 199323 1#0##0#0#0.0#2018-07-20
18:11:07#0#04:25:25#04:25:25#00:00:00 1 be2dcc7ff429385d1ef39717ff64c4ef
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1 D45;K30;R16.1 88.76;90.59;89.52 - - None None None None
C-4-11-I None None None None None None LIMFOMA & LEUKEMIA NON AKUT
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1 N40 60.29;87.49;89.52;90.59 - - None None None None V-1-
(RINGAN) 12373100 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-07-20 19:26:33#0#06:28:56#06:28:56#00:00:00 1
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3269000
3201126 B 3 BS 1 09/07/2018 12/07/2018 11/01/1953 0 2
1 I63.9;I15.9;E78.5;E14.8 87.03 - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 2980363 0 4 0 0 0 ZAINIDAR
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1#0##0#0#0.0#2018-07-20 19:28:40#0#20:13:26#20:13:26#00:00:00 1
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3201126 B 2 BS 1 09/07/2018 12/07/2018 10/06/1976 0 2
1743400 0 0 - 0 - 0 - 0 - 0
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D402787 42 15369 DR ARU, SPPD 0138R0170718V002800
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1934065 0 0 0 0 2339298 0 0 0 0 0
3201126 B 2 BS 1 06/07/2018 12/07/2018 19/12/1946 0 1
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0 24212000 24857545 0 7 1 6 0 DJAMAK SARI
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6520145 0 0 0 0 1276000 0 0 0 0
4078000
3201126 B 2 BS 1 05/07/2018 12/07/2018 18/04/1935 0 1
1 D29.1;R33 60.29 - - None None None None V-1-14-I None
None None None None None PENGANGKATAN PROSTAT MELALUI URETRA (RINGAN)
10605500 0 0 - 0 - 0 - 0 - 0
10605500 24386989 0 8 0 0 0 HERRY DG SARRO TN
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1#0##0#0#0.0#2018-07-20 19:44:37#0#00:00:00#00:00:00#00:00:00 1
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7333105 0 0 0 0 10677500 0 0 0 0
3269000
3201126 B 2 BS 1 09/07/2018 12/07/2018 09/07/2018 4224 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 3420759 0 4 0 0 0 BAYI NY. DINA ALDILA
d402888 0 0 DR BENNY S, SPA 0138R0170718V003758
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1#0##0#0#0.0#2018-07-20 19:45:26#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 09/07/2018 12/07/2018 15/12/1986 0 2
0 0 - 0 - 0 - 0 - 0 5984100
22534326 0 4 0 0 0 DINA ALDILA D386196 31 11529
S;16137 5.2.2.201806040537 4 199164 1#1#vvip#4#16550226#0.0#2018-
07-20 19:46:52#0#13:24:45#13:24:45#00:00:00 1
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2841126 0 0 0 0 1336000 0 0 0 0 197000
3201126 B 2 BS 1 10/07/2018 12/07/2018 18/12/2017 0 2
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9350901 0 3 0 0 0 RIZKA ADELIA
0002466304233 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199451
1#0##0#0#0.0#2018-07-20 19:48:44#0#00:00:00#00:00:00#00:00:00 1
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1990588 0 0 0 0 712741 0 0 0 0 145000
3201126 B 3 BS 1 08/07/2018 12/07/2018 17/06/1949 0 1
0 0 - 0 - 0 - 0 - 0 1752700
3302166 0 5 0 0 0 ABDUL SALIM D402761 69 25223
DR ARU, SPPD 0138R0170718V002753 0001971628907 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 198914 1#0##0#0#0.0#2018-07-20
20:03:22#0#14:39:02#14:39:02#00:00:00 1 9d7d64251d14a4b9ff7f8ea62928f7ec
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1557030 0 0 0 0 0
3201126 B 2 BS 1 10/07/2018 12/07/2018 17/07/1972 0 1
1 Q75.9 02.06 - - None None None None G-1-10-I None None
None None None None KRANIOTOMI (RINGAN) 20872300 0 0 -
0 - 0 - 0 - 0 20872300 23509064 0 3
0 0 0 MARODIH D399831 45 16794 DR ARNANDA SPBS
0138R0170718V003399 0002258495548 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199329 1#0##0#0#0.0#2018-07-20
20:10:42#0#00:00:00#00:00:00#00:00:00 1 408e3ef96c02c2f51823baabc95591ee
0 5326100 6887859 0 0 9776605 0 0 0 0
1301000 0 0 0 0 217500
3201126 B 3 BS 1 11/07/2018 12/07/2018 16/09/1980 0 1
- 0 8908800 10359208 0 2 0 0 0 YAYAN
WARDIYANA D403037 37 13812 DR SRI KUNMARTINI, SPPD 0138R0170718V004304
0002446150408 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200504
1#0##0#0#0.0#2018-07-23 07:44:06#0#19:01:51#19:01:51#00:00:00 1
0da936d036a9710b5aea357e30295a1f 0 0 1906030 0 0
4688973 0 0 0 0 3729705 0 0 0 0 34500
3201126 B 1 BS 1 10/07/2018 12/07/2018 18/09/1948 0 2
1 E87.6;D69.6;I69.4;N39.0 - - - None None None None E-4-
6306900 0 0 - 0 - 0 - 0 - 0
6306900 5711477 0 3 0 0 0 YAP HOEI NIO,NY
0000060981917 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199423
1#0##0#0#0.0#2018-07-23 07:45:07#0#00:00:00#00:00:00#00:00:00 1
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1888208 0 0 0 0 2742648 0 0 0 0 460000
3201126 B 3 BS 1 10/07/2018 12/07/2018 29/10/1992 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 4414739 0 3 0 0 0 REZA ANDENI P
D395244 25 9385 DR ARU, SPPD 0138R0170718V003775
0002444706112 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199818
1#0##0#0#0.0#2018-07-23 07:46:04#0#18:37:30#18:37:30#00:00:00 1
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2163160 0 0 0 0 1826690 0 0 0 0 0
3201126 B 1 BS 1 05/07/2018 12/07/2018 03/10/1944 0 2
1 I63.8;A41.9;J18.0;E87.6;G81.9 - - - None None None None
0 - 0 12141100 14185862 0 8 0 0 0
ROEKIJAH,HJ D333169 73 26938 DR NURUL KOMARI SPS
0138R0170718V001958 0000060854578 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 197893 1#0##0#0#0.0#2018-07-23
07:47:17#0#12:14:46#12:14:46#00:00:00 1 8dc1bfac7b4c022e94cb8364557385d9
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7202047 0 0 0 0 290000
3201126 B 1 BS 1 11/07/2018 12/07/2018 06/06/1953 0 1
(SEDANG) 26871300 0 0 - 0 - 0 - 0 - 0
26871300 35797120 0 2 0 0 0 SUWARNO D400989
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1#0##0#0#0.0#2018-07-23 07:52:54#0#00:00:00#00:00:00#00:00:00 1
cb23e8cb99dcf66804f3086dff78a577 0 5896000 5374260 0 0
23216360 0 0 0 0 1276000 0 0 0 0 34500
3201126 B 3 BS 1 11/07/2018 12/07/2018 21/08/1965 0 2
- 0 - 0 - 0 - 0 4178900 5556060 0
2 0 0 0 MARTINI D376222 52 19317 DR AGOES
S;16137 5.2.2.201806040537 4 200004 1#0##0#0#0.0#2018-07-23
07:58:32#0#00:00:00#00:00:00#12:00:00 1 c8445278288996754b4a07524d1900ce
0 0 376101 0 0 4239698 0 0 0 0 940261
0 0 0 0 0
3201126 B 1 BS 1 10/07/2018 12/07/2018 17/02/1988 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 16194833 0 3 0 0 0 FERA MAKAMINAN
D394043 30 11101 DR ARJU A, SPOG 0138R0170718V003345
0001584959758 3;JKN DR RIZKI; 5.2.2.201806040537 4 199316
1#0##0#0#0.0#2018-07-23 09:47:28#0#00:00:00#00:00:00#00:00:00 1
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3305211 0 0 0 0 1110475 0 0 0 0
1312000
3201126 B 1 BS 1 10/07/2018 12/07/2018 15/08/2015 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5037220 0 3 0 0 0 AKMAL SHARKAN HENDRAWAN
D356190 2 1060 DR CATUR S, SPB 0138R0170718V003806
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1#0##0#0#0.0#2018-07-23 11:43:50#0#00:00:00#00:00:00#00:00:00 1
88a719ae0763ac0183b46d9ac67a66be 0 2707000 691204 0 0
1088478 0 0 0 0 405538 0 0 0 0 145000
3201126 B 1 BS 1 09/07/2018 12/07/2018 21/02/1959 0 2
1 E11.2;J91;D63.8;E87.8 99.04;39.42 - - None None None None
- 0 - 0 27065300 24593976 0 4 0 0 0
ROSIYATI D384812 59 21688 DR IRFIANSYAH LESMANA DR SPBTKV
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4 199300 1#0##0#0#0.0#2018-07-23
12:51:42#0#00:00:00#00:00:00#12:00:00 1 12c5082dca475b4da593057761e65249
0 10138100 7857806 0 0 4443695 0 0 0 0
2085375 0 0 0 0 69000
3201126 B 1 BS 1 10/07/2018 12/07/2018 10/07/2018 2780 2
5118000 0 0 - 0 - 0 - 0 - 0
5118000 1828436 0 3 0 0 0 BAYI NY FERA MAKAMINAN
0002472376803 3;JKN DR RIZKI; 5.2.2.201806040537 4 200913
1#0##0#0#0.0#2018-07-23 12:52:40#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1458217 0 0 0 0 0
3201126 B 1 BS 1 11/07/2018 12/07/2018 27/08/1958 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4369790 0 2 0 0 0 SUTARNO TN D362350
59 21868 SRI KUNMARTINI.DR,SPPD 0138r0170718v004239 0000043741427
3;JKN DR RIZKI; 5.2.2.201806040537 4 200502 1#0##0#0#0.0#2018-
07-23 12:55:19#0#17:18:46#17:18:46#00:00:00 1
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1165900 0 0 0 0 2683249 0 0 0 0 0
3201126 B 3 BS 1 12/07/2018 12/07/2018 27/09/1964 0 1
1 E11.2;A16.1;D63.8 99.04 - - None None None None N-4-16-II
LAIN (SEDANG) 5275200 0 0 - 0 - 0 - 0 -
0 5275200 3127690 0 1 0 0 0 ABDUL KHOLIK
SUWARTO D403056 53 19646 DR MUHAMMAD RIZKI YUWANA
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4 200516 1#0##0#0#0.0#2018-07-24
15:11:20#0#05:16:49#05:16:49#00:00:00 1 907def5a9b848a916439ac6eae0f60e4
0 0 474768 0 0 1443307 0 0 0 0 493615
0 0 0 0 716000
3201126 B 3 BS 1 12/07/2018 12/07/2018 28/03/1950 0 2
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4185840 0 1 0 0 0 RISIYANI
0001462656341 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200680
1#0##0#0#0.0#2018-08-29 20:14:23#0#00:00:00#00:00:00#12:00:00 1
36b3937fcaedcf2e7dd1d060ba3cb2ca 0 0 345475 0 0
2561525 0 0 0 0 562840 0 0 0 0 716000
3201126 B 1 BS 1 10/07/2018 12/07/2018 10/05/1962 0 1
5022200 0 0 - 0 - 0 - 0 - 0
5022200 8541265 0 3 0 0 0 DEDY MAIZAL D359575
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199319
1#0##0#0#0.0#2018-09-26 18:57:46#0#02:00:53#02:00:53#00:00:00 1
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3287495 0 0 0 0 3825000 0 0 0 584774
0
3201126 B 1 BS 1 07/07/2018 12/07/2018 17/08/1933 0 2
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(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 30509586 0 6 0 0 0 DJANIDAH DJALAL,HJ
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1#0##0#0#0.0#2018-09-27 10:15:30#0#19:03:18#19:03:18#00:00:00 1
9578927beb560c647f6bcc4ea6a151cb 0 24020800 1559072 0 0
3619214 0 0 0 0 1276000 0 0 0 0 34500
3201126 B 3 BS 1 08/07/2018 12/07/2018 30/12/1958 0 1
1 N40;D64.8;I10;R33 60.29;99.04;90.59;89.52 - - None None None
- 0 12841200 19415059 0 5 0 0 0 MARWAN
D397539 59 21740 R SIDHI SPU 0138R0170718V002739 0001725302193
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198906
1#0##0#0#0.0#2018-09-28 15:49:33#0#05:45:18#05:45:18#00:00:00 3
46b2e6a51b93915870b07a9b30d16f00 0 5565300 3648536 0 0
5631223 0 0 0 0 1301000 0 0 0 0
3269000
3201126 B 3 BS 1 07/07/2018 12/07/2018 13/10/1963 0 2
4 I61.9;I13.2;J80;A41.9;J18.9 87.03;96.72 - - None None None
None J-1-02-III None None None None None None VENTILASI MEKANIKAL LONG
TERM TANPA TRAKEOSTOMI (BERAT) 66331600 0 0 - 0 - 0
- 0 - 0 66331600 28807924 0 6 0 0 0
SITI CHASIDAH D368675 54 19991 DR MAYSAM I., SPS
0138R0170718V002680 0000511209819 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198875 1#0##0#0#0.0#2018-10-10
16:36:11#0#14:18:31#14:18:31#00:00:00 3 b7d0cb285f2a71692aaf3e493e2182d7
0 0 725308 0 0 14804616 0 0 0 0
7016000 0 0 0 0 6262000
3201126 B 1 BS 1 11/07/2018 13/07/2018 29/04/2010 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3491635 0 3 0 0 0 FAUZAN IFFAT SULAIMAN
0002327963578 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200248
1#0##0#0#0.0#2018-07-18 15:41:12#0#13:21:11#13:21:11#00:00:00 1
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0 0 0 0 2597425 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 13/07/2018 30/05/2011 0 1
- 0 - 0 - 0 - 0 3718200 5561538 0
5 0 0 0 GYAN ALBARRA NAZIEF D328832 7 2597 DR
5.2.2.201806040537 4 199250 1#0##0#0#0.0#2018-07-18
15:42:15#0#15:34:52#15:34:52#00:00:00 1 25ad0c4e87a01a6f9d1d958ec22c249b
0 0 387638 0 0 879061 0 0 0 0
4294839 0 0 0 0 0
3201126 B 3 BS 1 12/07/2018 13/07/2018 28/05/2008 0 2
40-II None None None None None None EKSISI LOKAL DAN PENGANGKATAN ALAT
0 - 0 7653600 9545938 0 2 0 0 0 MEIKA
AULIA ANGGARA D386876 10 3697 DR MARQUEE KENNY TUMBELAKA SPOT
0138r0170718v004342 0001281175402 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 200517 1#0##0#0#0.0#2018-07-18
16:08:07#0#06:06:04#06:06:04#00:00:00 1 1c3abc7a6296757c0e1c9c275446cc87
0 0 1708368 0 0 1338069 0 0 0 0
6354501 0 0 0 0 145000
3201126 B 3 BS 1 11/07/2018 13/07/2018 10/06/1957 0 1
- 0 45079800 57242835 0 3 0 0 0 ENDANG
SUHERMAN d402295 61 22311 DR AZRI NURIZAL SPPD KKV
0138r0170718v004311 0001739816111 3;JKN DR RIZKI; 5.2.2.201806040537
4 200506 1#0##0#0#0.0#2018-07-19
08:58:47#0#20:28:37#20:28:37#00:00:00 1 e54de648a0c0552e895f8c7c93374b89
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9376500 0 0 0 0 7697000
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201166
1#0##0#0#0.0#2018-07-20 17:29:50#0#18:15:24#18:15:24#12:00:00 1
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2063945 0 0 0 0 4859472 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 13/07/2018 04/09/1953 0 2
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 14818112 0 2 0 0 0 STEFANA SUMIYATI RY
0138R0170718V004551 0000166017453 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 200910 1#0##0#0#0.0#2018-07-20
17:48:20#0#00:00:00#00:00:00#00:00:00 1 89f466a1ba0ae007c82dab7c9f279284
0 0 1278340 0 0 6579363 0 0 0 0
6891409 0 0 0 0 69000
3201126 B 1 BS 1 12/07/2018 13/07/2018 08/10/1976 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 5942163 0 2 0 0 0 MUKLIM TN D349314
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201171
1#0##0#0#0.0#2018-07-20 19:57:49#0#20:39:12#20:39:12#00:00:00 1
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1770032 0 0 0 0 3598490 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 13/07/2018 16/09/1947 0 2
(RINGAN) 4639400 0 0 - 0 - 0 - 0 - 0
4639400 3267717 0 2 0 0 0 SUPARMAN D331604
70 25867 DR ARU, SPPD 0138R0170718V004722 0000060729208 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 201590 1#0##0#0#0.0#2018-
07-20 19:59:51#0#17:07:53#17:07:53#00:00:00 1
13240d22a541e427228ed0292cf4a3ee 0 0 573641 0 0
1237800 0 0 0 0 1456276 0 0 0 0 0
3201126 B 3 BS 1 12/07/2018 13/07/2018 08/08/1961 0 2
- 0 8908800 14027729 0 2 0 0 0 WATINI
0000371121243 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200515
1#0##0#0#0.0#2018-07-20 20:02:29#0#02:04:04#02:04:04#00:00:00 1
4ed8b8d56cb1ca0e458a85bfefa5c17d 0 0 1906030 0 0
7996497 0 0 0 0 4056202 0 0 0 0 69000
3201126 B 3 BS 1 11/07/2018 13/07/2018 11/07/2018 2172 1
(RINGAN) 5483600 0 0 - 0 - 0 - 0 - 0
5483600 875520 0 3 0 0 0 BAYI NY. TAHWILAH
0002459978919 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200742
1#0##0#0#0.0#2018-07-20 20:08:23#0#00:00:00#00:00:00#00:00:00 1
2112ead44f1f00fcb40e8a1a7b766bb7 0 0 258344 0 0 100299
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3201126 B 2 BS 1 11/07/2018 13/07/2018 24/11/1985 0 2
0 0 - 0 - 0 - 0 - 0 3955700
5969804 0 3 0 0 0 KOMARIAH d103283 32 11917
TANTIYO S;16137 5.2.2.201806040537 4 200513 1#0##0#0#0.0#2018-
07-20 20:13:50#0#00:38:17#00:38:17#00:00:00 1
4a3d95730f426e212a90ec94584f6935 0 0 1160596 0 0 871160
0 0 0 0 2189048 0 0 0 0 1749000
3201126 B 1 BS 1 10/07/2018 13/07/2018 25/08/2016 0 1
1 G41.9;J06.9 - - - None None None None G-4-22-I None
0 - 0 - 0 - 0 - 0 3718200 6795260
0 4 0 0 0 ASYTAR SALIM GHALI ASYA D342594 1 684
DR NOVIK BUDIWARDHANA, SPA 0138R0170718V003676 0002077408214 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199674 1#0##0#0#0.0#2018-
07-20 20:15:42#0#00:00:00#00:00:00#00:00:00 1
978034380fa0b91673c5f45c8b3ec0b3 0 0 387638 0 0
1839072 0 0 0 0 4100550 0 0 0 0 468000
3201126 B 2 BS 1 10/07/2018 13/07/2018 12/05/1964 0 2
1 E13.9;N39.0 - - - None None None None E-4-10-II None
- 0 5873300 3387898 0 4 0 0 0 SINAH
0000165551826 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199314
1#0##0#0#0.0#2018-07-20 20:17:23#0#00:00:00#00:00:00#00:00:00 2
f6625cb0808fb4f680803fd45886daa6 0 0 311408 0 0 808852
0 0 0 0 2267638 0 0 0 0 0
3201126 B 2 BS 1 10/07/2018 13/07/2018 28/10/1981 0 2
0 0 - 0 - 0 - 0 - 0 5984100
12577269 0 4 0 0 0 MARIA PUSPASARI NY D115950
0001153890977 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199840
1#0##0#0#0.0#2018-07-20 20:19:17#0#21:32:30#21:32:30#00:00:00 1
419bf2c6e5deef3771cf9f4adba1c953 0 6114400 2268117 0 0
3063940 0 0 0 0 933812 0 0 0 0 197000
3201126 B 1 BS 1 07/07/2018 13/07/2018 06/06/1960 0 2
1 I63.9;I49.3;G81.9;E75.6;I10;E14.9 - - - None None None
- 0 - 0 12141100 12786884 0 7 0 0 0
AGNES DELILA GRACE GULTOM D372541 58 21215 DR NURUL KOMARI SPS
0138R0170718V002606 0001472452468 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198682 1#0##0#0#0.0#2018-07-23
07:40:38#0#00:00:00#00:00:00#12:00:00 1 bd7e5244d15241b5d50e3b64510bca0e
0 0 1267110 0 0 5190249 0 0 0 0
6329525 0 0 0 0 0
3201126 B 2 BS 1 10/07/2018 13/07/2018 27/12/1949 0 2
1 J18.9;J94.9;B90.9 - - - None None None None J-4-16-I
(RINGAN) 4335900 0 0 - 0 - 0 - 0 - 0
4335900 4084231 0 4 0 0 0 MUSRINGAH D158498
0001337121461 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199608
1#0##0#0#0.0#2018-07-23 07:43:02#0#00:00:00#00:00:00#00:00:00 1
c6bdb8d839014035c264aa1c4798fc0a 0 0 355238 0 0
1415800 0 0 0 0 2313193 0 0 0 0 0
3201126 B 1 BS 1 08/07/2018 13/07/2018 18/06/1955 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 7338904 0 6 0 0 0 MUHAMAD NASECH TN
0000036625443 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198923
1#0##0#0#0.0#2018-07-23 07:48:12#0#20:28:08#20:28:08#00:00:00 1
aedf75424120729c41ef32c789340982 0 0 1020330 0 0
1907459 0 0 0 0 4411115 0 0 0 0 0
3201126 B 3 BS 1 11/07/2018 13/07/2018 28/06/1984 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 9041162 0 3 0 0 0 TAHWILAH D403014
0002324053708 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199849
1#0##0#0#0.0#2018-07-23 07:49:57#0#00:00:00#00:00:00#00:00:00 1
5d87c4f7923ef30b9aff305bf9a4b81f 0 3534500 1851644 0 0
2105540 0 0 0 0 957478 0 0 0 0 592000
3201126 B 3 BS 1 10/07/2018 13/07/2018 15/06/1960 0 1
1 K21.9;A01.0;F41.9;D29.1;B90.9;N28.1 - - - None None None
(BERAT) 6781600 0 0 - 0 - 0 - 0 - 0
6781600 3362740 0 4 0 0 0 JAINO D402973 58
21209 DR BETTY 0138R0170718V003795 0001739677072 3;JKN DR RIZKI;
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11:11:05#0#00:00:00#00:00:00#00:00:00 1 39569ca3b844f03fc5937e11a3362280
0 0 663344 0 0 1664404 0 0 0 0
1034992 0 0 0 0 0
3201126 B 1 BS 1 11/07/2018 13/07/2018 09/07/1965 0 2
1 H81.1;E78.5;K30 - - - None None None None U-4-11-I
0 - 0 - 0 - 0 - 0 2124500 3845854
0 3 0 0 0 DRA. ROSLINAH D290846 53 19360 DR
CATUR BANUAJI SPS 0138R0170718V003815 0000037481319 3;JKN DR RIZKI;
5.2.2.201806040537 4 199848 1#0##0#0#0.0#2018-07-23
11:40:53#0#00:00:00#00:00:00#00:00:00 1 fc2ef04de00248daf6185cfc95cd1a3a
0 0 244205 0 0 981051 0 0 0 0
2620598 0 0 0 0 0
3201126 B 2 BS 1 12/07/2018 13/07/2018 12/05/1991 0 2
- 0 - 0 - 0 - 0 2601900 2756980 0
2 0 0 0 WIJI ASTUTI RAHARJO D392973 27 9923 DR ARI
KUSUMA JANUARTO, DR. SPOG 0138R0170718V004723 0001467493615 3;JKN DR
RIZKI; 5.2.2.201806040537 4 201175 1#0##0#0#0.0#2018-07-23
11:53:49#0#21:09:31#21:09:31#12:00:00 1 e6dbf40be4df988786fa765d9ee67480
0 0 537171 0 0 995946 0 0 0 0
1026863 0 0 0 0 197000
3201126 B 3 BS 1 12/07/2018 13/07/2018 06/04/1980 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 8111669 0 2 0 0 0 HARJANTO TN D400099
3;JKN DR RIZKI; 5.2.2.201806040537 4 201163 1#0##0#0#0.0#2018-
07-23 11:55:07#0#00:00:00#00:00:00#00:00:00 1
222790c71d1af5b3a0cac498363e0f10 0 3438800 1853030 0 0
2144169 0 0 0 0 606670 0 0 0 0 69000
3201126 B 2 BS 1 12/07/2018 13/07/2018 23/03/1955 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 4391036 0 2 0 0 0 ASTUTI D365706
63 23122 DR ARU, SPPD 0138R0170718V004542 0001843511747 3;JKN
DR RIZKI; 5.2.2.201806040537 4 201591 1#0##0#0#0.0#2018-07-23
12:17:23#0#17:10:29#17:10:29#00:00:00 1 50de2744a48b530f66be078eedeb641c
0 0 499265 0 0 1759132 0 0 0 0
2132639 0 0 0 0 0
3201126 B 1 BS 1 11/07/2018 13/07/2018 27/12/1955 0 2
1 A01.0;I11.9;J81;M54.59 - - - None None None None A-4-
0 - 0 4626600 6864953 0 3 0 0 0 ENDAH
SRI SUBEKTI HJ. d112309 62 22842 DR BETTY DWI L, SPPD
0138R0170718V004146 0000060653968 3;JKN DR RIZKI; 5.2.2.201806040537
4 200401 1#0##0#0#0.0#2018-07-23
12:18:35#0#15:22:35#15:22:35#00:00:00 1 c07b304b0f80017d89d48aada539733b
0 0 410320 0 0 2154524 0 0 0 0
4300109 0 0 0 0 0
3201126 B 2 BS 1 11/07/2018 13/07/2018 17/07/1964 0 1
- 0 10690500 14069877 0 3 0 0 0 MAHMUD YUNUS
ABD QOSIM D401037 53 19717 SRI KUNMARTINI.DR,SPPD 0138R0170718V004327
0001272013244 3;JKN DR RIZKI; 5.2.2.201806040537 4 200511
1#0##0#0#0.0#2018-07-23 12:26:02#0#23:42:38#23:42:38#00:00:00 1
86cdb7d1d673cb5b2040139f6bf07dd3 0 4439100 2297100 0 0
5146468 0 0 0 0 2152709 0 0 0 0 34500
3201126 B 2 BS 1 07/07/2018 13/07/2018 08/02/1942 0 1
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 8223515 0 7 0 0 0 SYAMSUDIN TN
0001294920753 3;JKN DR RIZKI; 5.2.2.201806040537 4 201605
1#0##0#0#0.0#2018-07-23 12:44:00#0#20:07:50#20:07:50#00:00:00 1
7334d27189bbc2975d373c0e4d0cebd9 0 0 882140 0 0
3242388 0 0 0 0 4098987 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 13/07/2018 22/04/1941 0 1
1 I63.9;G81.9;J18.9 87.03;87.44 - - None None None None G-4-
- 0 12141100 7354608 0 5 0 0 0 RAMELAN
0000060612669 3;JKN DR RIZKI; 5.2.2.201806040537 4 199305
1#0##0#0#0.0#2018-07-23 12:46:06#0#00:00:00#00:00:00#12:00:00 1
900be4b8937fb487be871a10faeae09c 0 0 1174935 0 0
2113030 0 0 0 0 4066643 0 0 0 0 0
3201126 B 2 BS 1 09/07/2018 13/07/2018 10/04/2009 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 4552204 0 5 0 0 0 NADA APRILIA PUTRI
0001171798716 3;JKN DR RIZKI; 5.2.2.201806040537 4 199162
1#0##0#0#0.0#2018-07-23 12:54:11#0#00:00:00#00:00:00#00:00:00 1
7103941a6691b3ca9e9b1907625341b9 0 0 278711 0 0
1424685 0 0 0 0 2848808 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 13/07/2018 01/05/1972 0 2
1 J02.9;A91;B19.9 - - - None None None None U-4-13-III
ISPA DAN LARINGOTRAKEITIS (BERAT) 2792100 0 0 - 0 - 0
- 0 - 0 2792100 2307031 0 4 0 0 0
NURHASIAH JAMIL D402915 46 16871 DR BETTY DWI L, SPPD
0138R0170718V003353 0001014450557 3;JKN DR RIZKI; 5.2.2.201806040537
4 199321 1#0##0#0#0.0#2018-07-23
12:57:26#0#00:00:00#00:00:00#00:00:00 1 0e27566c90720fdd8d3983b0c0aa0da4
0 0 304289 0 0 773815 0 0 0 0
1228927 0 0 0 0 0
3201126 B 3 BS 1 12/07/2018 13/07/2018 01/06/1952 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3714563 0 2 0 0 0 SATAR TN D350156
66 24147 DR ARU, SPPD 0138R0170718V004561 0000511411612 3;JKN
DR RIZKI; 5.2.2.201806040537 4 201594 1#0##0#0#0.0#2018-07-23
13:00:06#0#17:22:20#17:22:20#00:00:00 1 c07e192d1c021f8fb0aefe7069737a83
0 0 424889 0 0 1685290 0 0 0 0
1604384 0 0 0 0 0
3201126 B 1 BS 1 10/07/2018 13/07/2018 16/12/1980 0 2
- 0 10523000 18423170 0 4 0 0 0 DINDA
RAHMADEWI d093000 37 13720 RACHMAWATI DR,SPB(K)ONK 0138R0170718V003797
0000199764516 3;JKN DR RIZKI; 5.2.2.201806040537 4 199839
1#0##0#0#0.0#2018-07-23 13:00:51#0#21:17:06#21:17:06#00:00:00 1
bd29c30a9bc96863467f59a2b3dde996 0 9792600 2946440 0 0
4093130 0 0 0 0 1301000 0 0 0 0 290000
3201126 B 1 BS 1 09/07/2018 13/07/2018 07/03/2011 0 1
10909500 0 0 - 0 - 0 - 0 - 0
10909500 23451927 0 5 0 0 0 M RADITYA MALIK FADILLAH
D402716 7 2681 DR H. H PUAR, SPB 0138R0170718V003325
0001226465932 3;JKN DR RIZKI; 5.2.2.201806040537 4 199304
1#1#vip#5#8182125#75.0#2018-07-24 11:13:30#1#21:30:09#21:30:09#00:00:00
1 7df806f555c4640689a70a1a4da24898 0 8136693 9979281 0
0 3883953 0 0 0 0 1307000 0 0 0 145000
0
3201126 B 2 BS 1 09/07/2018 13/07/2018 25/06/2018 0 1
1 P71.1;P90 - - - None None None None E-4-10-III None
METABOLIK (BERAT) 7515400 0 0 - 0 - 0 - 0 -
0 7515400 16531959 0 5 1 5 0 MUHAMMAD FAIZ
0002467218519 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199299
1#0##0#0#0.0#2018-09-08 09:22:47#0#21:09:38#21:09:38#00:00:00 2
196440806ca1313f9062ce719a1bae02 0 0 616661 0 0
6433268 0 0 0 0 6167030 0 0 0 0
3315000
3201126 B 1 BS 1 08/07/2018 13/07/2018 18/10/1958 0 1
1 E14.9;J91;I50.0;N18.5 34.91 - - None None None None E-4-
0 - 0 8768000 13460359 0 6 0 0 0 BASUKI
D402748 59 21813 DR ARU, SPPD 0138R0170718V002757
0000040481897 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201596
1#0##0#0#0.0#2018-09-08 11:17:18#0#17:31:16#17:31:16#00:00:00 2
24fcc834cc14be85dd139f6b232df1da 0 0 1465096 0 0
5772679 0 0 0 0 5592584 0 0 0 0 630000
3201126 B 2 BS 1 04/07/2018 13/07/2018 20/06/1977 0 2
1 O00.9;O85;O06.1;O99.0 99.04;69.49;68.39;69.01 - - None None
None None W-1-20-III None None None None None None PROSEDUR PADA
RAHIM & ADNEKSA (BERAT) 14364900 0 0 - 0 - 0 - 0
- 0 14364900 33396305 0 10 0 0 0 TRI WAHYUNI
0001810228746 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 196917
1#0##0#0#0.0#2018-09-08 11:22:58#0#08:35:12#08:35:12#00:00:00 2
5552634e5e4a890de3de28a600616c04 0 9819500 6000920 0 0
15905885 0 0 0 0 1387000 0 0 0 0 283000
3201126 B 3 BS 1 12/07/2018 13/07/2018 17/09/1961 0 2
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 9512801 0 2 0 0 0 DJUHROTUN
0001228740412 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201177
1#0##0#0#0.0#2018-09-25 13:13:37#0#23:12:30#23:12:30#00:00:00 2
6d42547b53013e6679203b4bf1e41db7 0 0 4074139 0 0
1781829 0 0 0 0 3587833 0 0 0 0 69000
3201126 B 3 BS 1 10/07/2018 13/07/2018 03/08/1991 0 1
1 S42.00;D50.0 99.04;78.51 - - None None None None J-1-
30-II None None None None None None PROSEDUR SISTEM PERNAFASAN KOMPLEKS
(SEDANG) 13243500 0 0 - 0 - 0 - 0 - 0
13243500 18485451 0 4 0 0 0 ANDRI SETIYAWAN TN
0002058777595 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199775
1#0##0#0#0.0#2018-10-08 20:08:46#0#16:22:44#16:22:44#00:00:00 2
71d1a92244a0e4e0474bb5a48c79fe93 0 6000000 6674750 0 0
4364701 0 0 0 0 1301000 0 0 0 0 145000
3201126 B 2 BS 1 12/07/2018 14/07/2018 19/08/1943 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9759985 0 3 0 0 0 FRANSISCUS XAVERIUS
PRIYANTO D281711 74 27356 DR HENDRIEK S, SPB 0138R0170718V004826
0001260035594 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201190
1#0##0#0#0.0#2018-07-18 16:01:02#0#08:15:01#08:15:01#00:00:00 1
c551f8a2e5ea69e3fc40daddc9a06715 0 4854100 1963143 0 0
2159238 0 0 0 0 714504 0 0 0 0 69000
3201126 B 3 BS 1 11/07/2018 14/07/2018 01/12/1954 0 2
1 J18.0;K76.0 - - - None None None None J-4-16-II None
5077500 0 0 - 0 - 0 - 0 - 0
5077500 3953264 0 4 0 0 0 RINAH D402999 63
TANTIYO S;16137 5.2.2.201806040537 4 201724 1#0##0#0#0.0#2018-
07-18 16:12:30#0#00:00:00#00:00:00#00:00:00 1
96ca61431d6079980ecdabfe433f6473 0 0 227720 0 0
2037019 0 0 0 0 1688525 0 0 0 0 0
3201126 B 3 BS 1 13/07/2018 14/07/2018 12/02/1954 0 1
7040000 0 0 - 0 - 0 - 0 - 0
7040000 10468987 0 2 0 0 0 MASLAN D401362
0001385868418 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201411
1#0##0#0#0.0#2018-07-18 16:15:43#0#00:00:00#00:00:00#00:00:00 1
5cd6a8499166a0a885863bfdd4d062d3 0 2421000 1408000 0 0
3860100 0 0 0 0 710887 0 0 0 0
2069000
3201126 B 1 BS 1 13/07/2018 14/07/2018 09/04/2001 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2428246 0 2 0 0 0 SONIA AULIA D023406
17 6304 DR KRISTON SILITONGA, SPA 0138R0170718V004728
0002273793129 3;JKN DR RIZKI; 5.2.2.201806040537 4 201178
1#0##0#0#0.0#2018-07-19 10:50:09#0#00:00:00#00:00:00#00:00:00 1
2863a5abf576e7fb1f282a865def9a1b 0 0 316331 0 0 365058
0 0 0 0 1746857 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 14/07/2018 31/03/1954 0 1
0 - 0 - 0 - 0 - 0 5005900 5305058
0 3 0 0 0 PRAYITNO RAMONA D021524 64 23479 DR.
ARU ARIADNO, SPPD 0138r0170718v004678 0001460946802 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201734 1#0##0#0#0.0#2018-07-20
16:49:46#0#22:25:16#22:25:16#00:00:00 1 74bc0d231faad3da77b4a52715d04740
0 0 556531 0 0 2032467 0 0 0 0
2716060 0 0 0 0 0
3201126 B 3 BS 1 13/07/2018 14/07/2018 19/08/1981 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2817998 0 2 0 0 0 IIN SUPRIATIN
D385388 36 13477 DR ARU, SPPD 0138R0170718V005115
0002282454371 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201601
1#0##0#0#0.0#2018-07-20 17:24:52#0#19:19:02#19:19:02#12:00:00 2
06c51766a280515232844ea1ac31b3dd 0 0 424889 0 0
1743254 0 0 0 0 649855 0 0 0 0 0
3201126 B 2 BS 1 12/07/2018 14/07/2018 12/07/2018 2948 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 984549 0 3 0 0 0 BAYI NY RINI DWI
PRIMASARI D403188 0 0 DR A.D. PASARIBU SP.A 0138R0170718V004904
0002472720614 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201354
1#0##0#0#0.0#2018-07-20 20:01:23#0#00:00:00#00:00:00#00:00:00 1
d421702648b9317f96a858709df37163 0 0 145000 0 0 79039
0 0 0 0 760510 0 0 0 0 0
3201126 B 2 BS 1 11/07/2018 14/07/2018 10/10/1955 0 2
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 10033878 0 4 0 0 0 NASIAH
D403016 62 22920 DR NURUL 0138R0170718V003968 0000170140814
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200035
1#1#kelas_1#4#1381900#0.0#2018-07-20 20:04:50#0#00:00:00#00:00:00#00:00:00
1 173d21fa4edcbfd4852fb6ccddb433a7 0 0 1408000 0 0
2261456 0 0 0 0 6364422 0 0 0 0 0
3201126 B 2 BS 1 09/07/2018 14/07/2018 30/11/1964 0 1
1 I63.8;E10.4;G81.9 87.03;90.59;89.52;99.17 - - None None None
- 0 - 0 8291400 7231963 0 6 0 0 0
ALI ARMAN S. D402792 53 19579 DR NURUL KOMARI SPS
0138R0170718V003092 0002305695442 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199159 1#0##0#0#0.0#2018-07-20
20:06:33#0#00:00:00#00:00:00#00:00:00 1 e8e75b46c78e19fca88b67f3b1b46a5d
0 0 882140 0 0 2820704 0 0 0 0
3529119 0 0 0 0 0
3201126 B 3 BS 1 11/07/2018 14/07/2018 27/08/1957 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2770218 0 4 0 0 0 MARLIN SISWATI NY
0001743648118 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200507
1#0##0#0#0.0#2018-07-20 20:07:32#0#20:38:38#20:38:38#00:00:00 1
4d5dbe1d2df209451a01bc9bf20719cd 0 0 424889 0 0
1172600 0 0 0 0 1172729 0 0 0 0 0
3201126 B 2 BS 1 11/07/2018 14/07/2018 08/02/1982 0 2
0 0 - 0 - 0 - 0 - 0 9917100
13181496 0 4 0 0 0 FANI INDRIANTI d381930 36
13302 DR ATJANG S, SPOG 0138R0170718V004310 0001202061835 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 201188 1#0##0#0#0.0#2018-
07-20 20:12:24#0#07:54:58#07:54:58#12:00:00 1
c447f4bcdc30916b7f720022d77533ac 0 5503000 3669327 0 0
2814328 0 0 0 0 963341 0 0 0 0 231500
3201126 B 3 BS 1 13/07/2018 14/07/2018 18/11/1974 0 2
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 7886322 0 2 0 0 0 NINING SURYANI
d403273 43 15943 DR. ARU ARIADNO, SPPD 0138r0170718v005104
0002302622357 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201717
1#0##0#0#0.0#2018-07-20 20:23:03#0#16:57:23#16:57:23#00:00:00 1
13a05779b17394710ca213453395b2f2 0 3062500 974100 0 0
3177827 0 0 0 0 602895 0 0 0 0 69000
3201126 B 2 BS 1 10/07/2018 14/07/2018 10/11/1954 0 1
1 D29.1;D62 60.29;99.04 - - None None None None V-1-14-II
(SEDANG) 15409500 0 0 - 0 - 0 - 0 - 0
15409500 22452778 0 5 0 0 0 SJAHRUDIN d392304
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201716
1#0##0#0#0.0#2018-07-20 20:26:51#0#14:20:22#14:20:22#12:00:00 2
ebfb3cb8ace3b416e402e9f28b62aefb 0 8276500 3075595 0 0
6530683 0 0 0 0 1301000 0 0 0 0
3269000
3201126 B 3 BS 1 10/07/2018 14/07/2018 15/12/1956 0 1
1 N40;I25.1;I11.0 60.29;90.59;89.52 - - None None None None
V-1-14-III None None None None None None PENGANGKATAN PROSTAT MELALUI
URETRA (BERAT) 16034600 0 0 - 0 - 0 - 0 -
0 16034600 22305350 0 5 0 0 0 HAMZAH SIMIN
0001772148969 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199328
1#0##0#0#0.0#2018-07-20 20:30:35#0#06:38:50#06:38:50#12:00:00 1
025afe5b21fb7ad33cfb16d2c6eba5d5 0 5565300 4810726 0 0
7359324 0 0 0 0 1301000 0 0 0 0
3269000
3201126 B 2 BS 1 12/07/2018 14/07/2018 04/04/1965 0 1
1 K74.6;I98.3;K92.1;D62 45.16;99.04 - - None None None None
(SEDANG) 5877400 0 0 - 0 - 0 - 0 - 0
5877400 13299428 0 3 0 0 0 SARYADI D386719
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200514
1#0##0#0#0.0#2018-07-20 20:42:52#0#00:45:52#00:45:52#00:00:00 1
ebce01cbd9eed0f20d93703eee3edc10 0 0 1751767 0 0
4869068 0 0 0 0 3249593 0 0 0 0
3429000
3201126 B 3 BS 1 09/07/2018 14/07/2018 28/03/2018 0 1
1 Z93.3;A04.9 - - - None None None None Z-4-12-II None
0 - 0 3938000 5154600 0 6 0 0 0 BAYI
NY DEWI KOMALA SARI D394770 0 103 DR AULIA TANGKARI, SPA
0138r0170718v003284 0002438966193 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 199284 1#0##0#0#0.0#2018-07-20
20:48:05#0#17:29:17#17:29:17#12:00:00 1 fc4da50d42a902f4aae316ef3b43835a
0 0 274965 0 0 2684918 0 0 0 0
1854717 0 0 0 0 340000
3201126 B 2 BS 1 12/07/2018 14/07/2018 14/02/1991 0 2
0 - 0 - 0 - 0 - 0 2009900 5718321
0 3 0 0 0 RINI DWI PRIMASARI D214735 27 10010
DR FX BHIMANTORO, SPOG 0138R0170718V004548 0001734174145 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 200909 1#0##0#0#0.0#2018-
07-20 20:48:53#0#12:44:29#12:44:29#00:00:00 1
3db7c52f7e8c8433be728bbae4ce79e9 0 0 588980 0 0
1391545 0 0 0 0 3609796 0 0 0 0 128000
3201126 B 2 BS 1 07/07/2018 14/07/2018 13/07/2007 0 2
1 D65;K92.1;A41.9;R77.0;D64.9 99.06;99.07;99.04 - - None None
None None D-4-11-III None None None None None None GANGGUAN PEMBEKUAN
DARAH (BERAT) 12346500 0 0 - 0 - 0 - 0 -
0 12346500 24146773 0 8 1 0 0 BUNGA RIZKI ILVIA
R059047 10 4012 DR NOVIK BUDIWARDHANA, SPA 0138R0170718V002718
0001169393848 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198893
1#0##0#0#0.0#2018-07-20 20:51:11#0#00:00:00#00:00:00#00:00:00 1
0979e370ae6dce1dfaade926c9750d23 0 0 423718 0 0
14113055 0 0 0 0 6877000 0 0 0 0
2733000
3201126 B 1 BS 1 11/07/2018 14/07/2018 19/12/1948 0 1
0 - 0 - 0 - 0 - 0 5802600 6275522
0 4 0 0 0 KUS HARYONO SUDIBYO D078374 69 25406
S;16137 5.2.2.201806040537 4 201711 1#0##0#0#0.0#2018-07-20
20:52:26#0#14:05:08#14:05:08#00:00:00 1 61878f3b4368bc5a0855377403b10ec8
0 0 426022 0 0 2941952 0 0 0 0
2779548 0 0 0 0 128000
3201126 B 1 BS 1 10/07/2018 14/07/2018 21/07/1952 0 1
1 J45.9;J18.9 89.52;90.59 - - None None None None J-4-18-III
None None None None None None ASTHMA & BRONKIOLITIS (BERAT) 4376300
0 0 - 0 - 0 - 0 - 0 4376300
6662160 0 5 0 0 0 EDY PRAMONO TN D402923 65
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199797
1#0##0#0#0.0#2018-09-08 09:24:18#0#17:43:21#17:43:21#00:00:00 2
6752da5b6c0c95e4cc71d070bb0ee81d 0 0 333467 0 0
2307351 0 0 0 0 4021342 0 0 0 0 0
3201126 B 3 BS 1 13/07/2018 14/07/2018 13/05/1964 0 2
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 13130471 0 2 0 0 0 ANI ROHANI
0138R0170718V004903 0001290203414 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201348 1#0##0#0#0.0#2018-09-25
13:14:17#0#10:54:40#10:54:40#00:00:00 2 83a27bdea00a2a88d66a48ba2f75cea9
0 3062500 1870848 0 0 7243120 0 0 0 0
885003 0 0 0 0 69000
3201126 B 3 BS 1 13/07/2018 14/07/2018 22/09/2017 0 1
1 E87.6;Q43.1 - - - None None None None E-4-11-II None
4504900 0 0 - 0 - 0 - 0 - 0
4504900 5979843 0 2 0 0 0 RAYYAN D403249
0 294 DR NOVIK BUDIWARDHANA, SPA 0138R0170718V005096
0002290550848 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201578
1#0##0#0#0.0#2018-09-26 09:11:22#0#16:29:58#16:29:58#00:00:00 1
c57708f6f64e5ccfe5f83cb905cde87b 0 0 273635 0 417205
2759003 0 0 0 0 1619000 0 0 0 911000
0
3201126 B 1 BS 1 14/07/2018 15/07/2018 08/09/1942 0 1
- 0 58821400 44217440 0 2 0 0 0 H ROBANI
0001338490765 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201634
1#0##0#0#0.0#2018-07-18 15:47:26#0#00:00:00#00:00:00#12:00:00 1
6efc3a7790bf596f6bb3e7643c110533 0 10062000 9619120 0 0
15810320 0 0 0 0 1226000 0 0 0 0
7500000
3201126 B 3 BS 1 14/07/2018 15/07/2018 31/07/1960 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 6953973 0 2 0 0 0 IWAN GUNAWAN
0138R0170718V005194 0001480183299 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201690 1#0##0#0#0.0#2018-07-18
16:14:47#0#00:00:00#00:00:00#00:00:00 2 46ca5c2ff7e7f8d0518c69cadf5b3f2f
0 3438800 921100 0 0 1994140 0 0 0 0
530933 0 0 0 0 69000
3201126 B 2 BS 1 14/07/2018 15/07/2018 07/12/1991 0 1
1 I12.0;J81 39.27 - - None None None None N-1-12-III None
DIALISIS (BERAT) 23198900 0 0 - 0 - 0 - 0 -
0 23198900 12256247 0 2 0 0 0 DENI RUSTANDI TN
0000042732639 3;JKN DR RIZKI; 5.2.2.201806040537 4 201721
1#0##0#0#0.0#2018-07-19 11:22:22#0#19:17:24#19:17:24#00:00:00 1
6f4d956e8651a04f7ffa8aa04536833d 0 4703600 4878371 0 0
1727465 0 0 0 0 877811 0 0 0 0 69000
3201126 B 2 BS 1 13/07/2018 15/07/2018 29/12/1939 0 2
1 E13.9;J45.9;R63.0 - - - None None None None E-4-10-I
0 - 0 4203300 3289507 0 3 0 0 0
ROGAYAH BT WIRATMI D068565 78 28686 DR BETTY
0138R0170718V004985 0000039243317 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201454 1#0##0#0#0.0#2018-07-20
08:10:38#0#00:00:00#00:00:00#00:00:00 1 760dedb53cdad3cc6c345c74716165b5
0 0 293399 0 0 1239907 0 0 0 0
1756201 0 0 0 0 0
3201126 B 3 BS 1 13/07/2018 15/07/2018 28/03/2017 0 2
- 0 - 0 - 0 - 0 2655900 2163111 0
3 0 0 0 KHANZA ANASYA JEHAN D403223 1 472 DR
5.2.2.201806040537 4 201187 1#0##0#0#0.0#2018-07-20
08:13:22#0#07:32:09#07:32:09#00:00:00 1 a56807ac9e43355783e4f7797fead3dd
0 0 292031 0 0 744568 0 0 0 0 956512
0 0 0 0 170000
3201126 B 3 BS 1 10/07/2018 15/07/2018 05/04/1947 0 1
1 I50.0;K59.0;M11.8 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 3575600
5275314 0 6 0 0 0 SUHANDA D402962 71 26029
S;16137 5.2.2.201806040537 4 199841 1#0##0#0#0.0#2018-07-20
08:18:34#0#00:00:00#00:00:00#00:00:00 1 c3a7355cf46633dc176926cf3b5405be
0 0 248183 0 0 3341017 0 0 0 0
1686114 0 0 0 0 0
3201126 B 2 BS 1 13/07/2018 15/07/2018 01/12/2006 0 1
1 E87.8;R62.9;N25.8;A49.9 - - - None None None None E-4-
5405900 0 0 - 0 - 0 - 0 - 0
5405900 5556035 0 3 0 0 0 SELVIANY DEA POPUTRA
Q063018 11 4242 DR NOVIK BUDIWARDHANA, SPA 0138R0170718V004737
0001258032554 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201183
1#0##0#0#0.0#2018-07-20 16:41:03#0#00:00:00#00:00:00#00:00:00 1
758d4ab4b04999ac9055d9315d0061e0 0 0 539531 0 0
2413025 0 0 0 0 2433479 0 0 0 0 170000
3201126 B 2 BS 1 11/07/2018 15/07/2018 09/09/2012 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 3778997 0 5 0 0 0 SEPTIAN YUDIANTO
D370374 5 2131 DR RASTRA, SPA 0138R0170718V004315
0002265072568 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200508
1#0##0#0#0.0#2018-07-20 16:54:54#0#21:05:06#21:05:06#00:00:00 1
bd143d8d1736c8cd2582d26972fdc8e2 0 0 209906 0 0 978367
0 0 0 0 2590724 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 15/07/2018 30/09/1963 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4357727 0 4 0 0 0 NANA MARDIANA
0000037707772 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200512
1#0##0#0#0.0#2018-07-20 16:58:01#0#00:00:00#00:00:00#00:00:00 1
288d2ca70cac0d0d6339c3084278b5b7 0 0 269459 0 0 632725
0 0 0 0 3455543 0 0 0 0 0
3201126 B 2 BS 1 12/07/2018 15/07/2018 04/06/1968 0 2
0 - 0 - 0 - 0 1821000 3252200 0 4
0 0 0 LENNI ROSSELANI BR D190374 50 18300 DR CATUR
BANUAJI SPS 0138R0170718V004716 0001191493427 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201169 1#0##0#0#0.0#2018-07-20
17:00:48#0#19:46:02#19:46:02#00:00:00 1 943c37254f22bcd055ddd1b2e90d1a3a
0 0 216890 0 0 984049 0 0 0 0
2051261 0 0 0 0 0
3201126 B 2 BS 1 13/07/2018 15/07/2018 08/12/2005 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2507903 0 3 0 0 0 ARTIKA WIDIYANTI
0002303144368 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201527
1#0##0#0#0.0#2018-07-20 17:02:10#0#15:53:03#15:53:03#00:00:00 1
7b467b0cb3a22fce7d2017a1d352caa4 0 0 278707 0 0 348128
0 0 0 0 1711068 0 0 0 0 170000
3201126 B 2 BS 1 14/07/2018 15/07/2018 21/02/2011 0 2
10406400 0 0 - 0 - 0 - 0 - 0
10406400 11585261 0 2 0 0 0 KANAYA ZIVIA AL QALAMI
0001639684012 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201618
1#0##0#0#0.0#2018-07-20 17:05:18#0#00:00:00#00:00:00#00:00:00 1
53c265a37b52a35899db891aa7c60627 0 0 2913792 0 0
2562055 0 0 0 0 5964414 0 0 0 0 145000
3201126 B 2 BS 1 13/07/2018 15/07/2018 24/04/1940 0 2
1 A01.0;M54.47;I10 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 2649398 0 3 0 0 0 KANTI
D368804 78 28569 DR BETTY DWI L, SPPD 0138r0170718v005053
0000060999603 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201490
1#0##0#0#0.0#2018-07-20 17:06:15#0#15:04:59#15:04:59#00:00:00 1
2d5781392af244dc6779683ffa812fb2 0 0 257183 0 0 677890
0 0 0 0 1714325 0 0 0 0 0
3201126 B 3 BS 1 12/07/2018 15/07/2018 22/03/1995 0 2
- 0 - 0 - 0 - 0 2168300 2668660 0
4 0 0 0 DINDA VIRO NULAILA D279763 23 8513 DR
5.2.2.201806040537 4 201058 1#0##0#0#0.0#2018-07-20
17:07:26#0#14:57:17#14:57:17#00:00:00 1 0a1d26519f8365903c0da1e95682bb73
0 0 373147 0 0 1024928 0 0 0 0
1270585 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 15/07/2018 12/07/2018 3599 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3442081 0 4 0 0 0 BAYI NY IVANA ELABAESA
SUMBAYAK D403182 0 0 DR RASTRA, SPA 0138R0170718V004960
0002472779114 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201451
1#1#vip#4#0#0.0#2018-07-20 17:08:32#0#00:00:00#00:00:00#00:00:00 1
b7126df50761ea1f0dd93d7954834424 0 0 243720 0 0 79578
0 0 0 0 3118783 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 15/07/2018 14/03/1991 0 2
0 0 - 0 - 0 - 0 - 0 6981500
23044916 0 4 0 0 0 IVANA ELABAESA SUMBAYAK D042972
27 9982 DR FX BHIMANTORO, SPOG 0138R0170718V004596 0000040447034
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200962
1#1#vvip#4#16063416#0.0#2018-07-20 17:10:01#0#00:00:00#00:00:00#00:00:00
1 6c573eaa5e69208304ca9bc7d4165800 0 9198000 8962200 0
0 3208716 0 0 0 0 1351000 0 0 0 0
325000
3201126 B 3 BS 1 12/07/2018 15/07/2018 15/01/1956 0 1
None None None None None ISKEMIK TRANSIENT (RINGAN) 3376700 0
0 - 0 - 0 - 0 - 0 3376700 2107988
0 4 0 0 0 SAAMAN TN D403195 62 22824 DR CATUR
BANUAJI SPS 0138R0170718V004721 0001739963068 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201173 1#0##0#0#0.0#2018-07-20
17:12:21#0#20:54:08#20:54:08#00:00:00 1 638047e41b8f6d1bcd2d1c0ded142c87
0 0 357703 0 0 611297 0 0 0 0
1138988 0 0 0 0 0
3201126 B 3 BS 1 12/07/2018 15/07/2018 12/05/1945 0 2
1 E13.4;K30 - - - None None None None G-4-17-I None
4497600 0 0 - 0 - 0 - 0 - 0
4497600 3249668 0 4 0 0 0 ROSADA D403118
73 26724 DR ARU, SPPD 0138R0170718V004600 0002047561356 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 200966 1#0##0#0#0.0#2018-
07-20 17:14:59#0#00:00:00#00:00:00#00:00:00 1
3466c0bd02cb52410a97be465accc033 0 0 368243 0 0
1590830 0 0 0 0 1290595 0 0 0 0 0
3201126 B 3 BS 1 13/07/2018 15/07/2018 28/08/1950 0 1
1 I21.9;I11.0;I10 88.56;36.07 - - YY02 None None None I-1-
- 0 45079800 48618345 0 3 0 0 0 SALIM
0000511822811 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201610
1#0##0#0#0.0#2018-07-20 17:20:45#0#20:30:50#20:30:50#00:00:00 1
2feca2aa85d454625daea2b12a331109 0 8082500 2442160 0 0
29239685 0 0 0 0 1226000 0 0 0 0
7628000
3201126 B 3 BS 1 11/07/2018 15/07/2018 06/05/1986 0 2
1 I72.1;N18.5;D63.8;A41.9;M32.9 99.04;38.43 - - None None None
None I-1-20-III None None None None None None PROSEDUR SISTIM
- 0 - 0 20176600 27725721 0 5 0 0 0
0138R0170718V004229 0002196827987 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 200501 1#0##0#0#0.0#2018-07-20
17:26:22#0#17:05:47#17:05:47#12:00:00 1 dd8088345b3a4f86513c7e8d355f6e5f
0 6965300 5989861 0 0 11697160 0 0 0 0
1662900 0 0 0 0 1410500
3201126 B 3 BS 1 11/07/2018 15/07/2018 01/03/1992 0 1
0 - 0 - 0 - 0 - 0 4042800 5276880
0 5 0 0 0 NASRULLOH D403083 26 9628 SRI
S;16137 5.2.2.201806040537 4 200969 1#0##0#0#0.0#2018-07-20
17:46:22#0#00:00:00#00:00:00#00:00:00 2 cf388b83beeebaf3c8ef0386a8d69a38
0 0 241100 0 0 1296564 0 0 0 0
3399216 0 0 0 0 340000
3201126 B 2 BS 1 13/07/2018 15/07/2018 05/10/2010 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 2543379 0 3 0 0 0 KHOIRUL AZAM BAHA K AN
D403213 7 2838 DR RASTRA, SPA 0138R0170718V004730
0001633300108 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201181
1#0##0#0#0.0#2018-07-20 17:47:16#0#01:20:29#01:20:29#00:00:00 1
0441d3ab16dcc1f3d72f64ea1e7d1c36 0 0 278711 0 0 557279
0 0 0 0 1707389 0 0 0 0 0
3201126 B 3 BS 1 10/07/2018 15/07/2018 03/03/1953 0 1
0 - 0 - 0 - 0 - 0 10401900 11979539
0 6 1 2 0 ABDUL KODIR D402866 65 23870 DR BAMBANG
5.2.2.201806040537 4 199333 1#0##0#0#0.0#2018-07-20
17:51:44#0#00:00:00#00:00:00#00:00:00 2 3d481e6c243dc34d6900d8cf4d8b3af5
0 0 989167 0 0 4909664 0 0 0 0
4564708 0 0 0 0 1516000
3201126 B 1 BS 1 12/07/2018 15/07/2018 02/07/1949 0 2
1 K74.6;K80.4;N13.2 - - - None None None None B-4-13-II
6857000 0 0 - 0 - 0 - 0 - 0
6857000 7520058 0 4 0 0 0 SUHARTINI NY
0000041061712 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201589
1#0##0#0#0.0#2018-09-08 09:35:08#0#16:56:39#16:56:39#00:00:00 2
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3729628 0 0 0 0 3296466 0 0 0 0 0
3201126 B 1 BS 1 14/07/2018 15/07/2018 23/10/1998 0 1
1 S93.0;M84.37 79.87 - - None None None None M-1-70-II
None None None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN
KAKI (SEDANG) 23493100 0 0 - 0 - 0 - 0 -
0 23493100 23031099 0 2 0 0 0 AQIL FARRAS TN
0000162777701 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201729
1#0##0#0#0.0#2018-09-08 09:41:14#0#20:24:03#20:24:03#00:00:00 2
3a7ada77d174ebb6e0858679bcd73152 0 0 9865999 0 0
2521300 0 0 0 0 10643800 0 0 0 0 0
3201126 B 2 BS 1 11/07/2018 15/07/2018 05/04/1960 0 1
1 I13.0;N18.5;E14.9 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
10239662 0 5 0 0 0 HIN BENG D391934 58 21281
TANTIYO S;16137 5.2.2.201806040537 4 201763 1#0##0#0#0.0#2018-
09-08 10:50:05#0#00:00:00#00:00:00#12:00:00 2
05bd2b6a039d7a77bea2ad4e1f94660a 0 0 439172 0 0
4804606 0 0 0 0 3956884 0 0 0 0
1039000
3201126 B 2 BS 1 11/07/2018 15/07/2018 04/09/1992 0 1
- 0 - 0 - 0 - 0 4649300 11213511 0
5 0 0 0 YOSEP BADRUJAMAN TN D403106 25 9441 DR
5.2.2.201806040537 4 200510 1#0##0#0#0.0#2018-09-08
10:57:18#0#22:24:43#22:24:43#00:00:00 2 3f72b76ee8e7fdec81f529ce6cf8a640
0 5476600 1470804 0 0 3434513 0 0 0 0
759594 0 0 0 0 72000
3201126 B 3 BS 1 07/07/2018 15/07/2018 15/07/1963 0 2
1 I13.2;I48;E87.5;D63.8 38.95;39.95;99.04 - - None None None
0 - 0 - 0 8908800 37393420 0 9 0 0
0 SRI RUMTINI D399991 54 20081 DR BAMBANG DWIPUTRA SPJP
0138R0170718V002713 0001270744582 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198891 1#0##0#0#0.0#2018-09-08
11:57:12#0#00:00:00#00:00:00#00:00:00 2 61136faa708a7e08f71ef612c33edbed
0 7753500 2235743 0 0 20484052 0 0 0 0
3241625 0 0 0 0 3678500
3201126 B 2 BS 1 08/07/2018 15/07/2018 22/10/1959 0 1
1 J90;K73.9;J18.9 87.49 - - None None None None J-4-20-III
None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK (BERAT)
9325200 0 0 - 0 - 0 - 0 - 0
9325200 10005957 0 8 0 0 0 HERMAN D235517
58 21444 DR ARU, SPPD 0138R0170718V002760 0001459582727 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 198915 1#0##0#0#0.0#2018-
09-26 20:28:35#0#15:01:29#15:01:29#12:00:00 2
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4393094 0 0 0 0 4720595 0 0 0 0 0
3201126 B 3 BS 1 04/07/2018 15/07/2018 04/03/1952 0 2
1 I21.9;E14.9;E87.1;E87.6;I50.0;K65.8 00.17 - - None None None
None I-4-10-II None None None None None None INFARK MYOKARD AKUT
(SEDANG) 7219300 0 0 - 0 - 0 - 0 - 0
7219300 24292210 0 12 0 0 0 ERIKA SIMANJUNTAK
0001229154535 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 197548
1#0##0#0#0.0#2018-09-26 21:01:25#0#22:50:04#22:50:04#00:00:00 2
49ec3ae66f4c4ee765b303d847faeeb7 0 0 1197209 0 0
14670001 0 0 0 0 5949000 0 0 0 0
2476000
3201126 B 3 BS 1 13/07/2018 15/07/2018 13/11/2006 0 1
0 - 0 7987100 29747579 0 3 0 0 0
SYEKHAN ABDIL BARR AN D403207 11 4260 DR BENNY H T, SPOT
0138R0170718V004815 0001438329352 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201189 1#0##0#0#0.0#2018-10-08
16:35:30#0#07:59:26#07:59:26#00:00:00 1 7e0dc28feb85a6f2dbcefba2692b47cc
0 0 19119000 0 1226000 3661579 0 0 0 0
5672000 0 0 0 69000 0
3201126 B 1 BS 1 14/07/2018 16/07/2018 29/07/2016 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 3019766 0 3 0 0 0 BAGAS DEVANKA SUHADHA
0002213117379 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201719
1#0##0#0#0.0#2018-07-18 15:46:16#0#18:42:04#18:42:04#00:00:00 1
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0 0 0 0 2221055 0 0 0 0 0
3201126 B 1 BS 1 13/07/2018 16/07/2018 17/08/1958 0 1
None None None None None BATU URIN (SEDANG) 5770800 0 0
- 0 - 0 - 0 - 0 5770800 5747225 0
4 0 0 0 S A TANDJUNG D381404 59 21880 DR. ARU
5.2.2.201806040537 4 201457 1#0##0#0#0.0#2018-07-18
15:48:36#0#00:00:00#00:00:00#12:00:00 1 1c1edbcc62c04ab5daa8c017c7c0a8ac
0 0 518678 0 0 1702560 0 0 0 0
3525987 0 0 0 0 0
3201126 B 2 BS 1 15/07/2018 16/07/2018 09/04/2007 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1732188 0 2 0 0 0 ZAHRA AILA PUTRI
D328805 11 4115 DR RASTRA, SPA 0138R0170718V005247
0002322735074 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201736
1#0##0#0#0.0#2018-07-18 15:50:38#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1149321 0 0 0 0 0
3201126 B 2 BS 1 12/07/2018 16/07/2018 10/09/1963 0 1
0 - 0 - 0 - 0 - 0 8663100 8597111
0 5 1 2 0 AHMAD RANI NASIBU D402759 54 20029 DR
CELLY ANANTARIA. SPJP 0138R0170718V004709 0000037969121 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 201167 1#0##0#0#0.0#2018-07-18
15:52:00#0#18:40:05#18:40:05#00:00:00 1 a0b61ea24e55851ff793d88d3225cde0
0 0 832679 0 0 2681104 0 0 0 0
4189328 0 0 0 0 894000
3201126 B 2 BS 1 10/07/2018 16/07/2018 13/04/1956 0 1
1 E13.4;D64.9 99.04 - - None None None None G-4-17-II None
None None None None None GANGUAN SARAF KRANIAL DAN PERIFER (SEDANG)
7076800 0 0 - 0 - 0 - 0 - 0
7076800 11099127 0 7 0 0 0 ROHMAN D393546
62 22733 DR ARU, SPPD 0138R0170718V003432 0001284363527 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199339 1#0##0#0#0.0#2018-
07-18 15:56:27#0#08:08:24#08:08:24#12:00:00 1
705a0c12663b61654cc78c37227a89f0 0 0 581597 0 0
6230419 0 0 0 0 4287111 0 0 0 0 0
3201126 B 2 BS 1 07/07/2018 16/07/2018 14/05/1957 0 2
1 N18.5;D63.8;I50.0;R57.0 99.04 - - None None None None N-4-
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 25052997 0 10 0 0 0 HARTINI
0001792840656 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198895
1#0##0#0#0.0#2018-07-18 15:59:57#0#00:00:00#00:00:00#12:00:00 1
c2113768c051165766e9c4cdf2113915 0 0 837847 0 0
12842150 0 0 0 0 7611000 0 0 0 0
3762000
3201126 B 2 BS 1 15/07/2018 16/07/2018 11/12/1948 0 1
- 0 4958500 3142913 0 2 0 0 0 IR PAUL
RAUBUN, M.S.E D361946 69 25418 DR BETTY DWI L, SPPD
0138R0170718V005307 0001222739706 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201772 1#0##0#0#0.0#2018-07-18
16:02:03#0#00:00:00#00:00:00#00:00:00 1 913579a8e0f8148b565624818c482190
0 0 499265 0 0 1097662 0 0 0 0
1545986 0 0 0 0 0
3201126 B 3 BS 1 14/07/2018 16/07/2018 04/09/1956 0 1
1 I21.1;I25.0;I11.0;R57.0 36.07 - - YY02 None None None I-1-
- 0 45079800 55393171 0 3 0 0 0 FERDINAN R
LOEN D403318 61 22593 DR AZRI NURIZAL SPPD KKV 0138R0170718V005171
0001313695361 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201623
1#0##0#0#0.0#2018-07-18 16:04:50#0#00:00:00#00:00:00#00:00:00 1
fe579a1ca91dec567b232909c94a6083 0 10200000 6923800 0 0
29543371 0 0 0 0 1226000 0 0 0 0
7500000
3201126 B 3 BS 1 12/07/2018 16/07/2018 23/06/1959 0 1
1 I20.0;I50.0;D63.8;N18.5 99.04 - - None None None None I-4-
4854000 0 0 - 0 - 0 - 0 - 0
4854000 7446425 0 5 0 0 0 SUTARDI TN D340291
0001089737561 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 200518
1#0##0#0#0.0#2018-07-18 16:06:19#0#06:48:34#06:48:34#00:00:00 1
0bc7539dcfe4dbd2a0c6442050332a3d 0 0 489860 0 0
3996041 0 0 0 0 2637524 0 0 0 0 323000
3201126 B 3 BS 1 08/07/2018 16/07/2018 11/07/2000 0 2
1 A15.3;K67.3;E87.1;D64.9;R77.0;A41.9;E41 99.04 - - None None
None None J-4-15-III None None None None None None PERADANGAN DAN
INFEKSI PERNAFASAN (BERAT) 6970400 0 0 - 0 - 0 -
0 - 0 6970400 19972529 0 9 0 0 0
HANNISA HITRIANTI D401992 17 6571 DR HENDRIEK S, SPB
0138R0170718V002771 0001248670844 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 198918 1#0##0#0#0.0#2018-07-18
16:26:38#0#00:00:00#00:00:00#00:00:00 1 41e966642bd2a749bd18ad831704e2b8
0 0 680336 0 0 10878693 0 0 0 0
5808500 0 0 0 0 2605000
3201126 B 3 BS 1 12/07/2018 16/07/2018 18/03/2017 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2678540 0 5 0 0 0 MISHARY ALIF PRATAMA
D397501 1 481 DR RASTRA, SPA 0138R0170718V004536
0002222466952 3;JKN DR RIZKI; 5.2.2.201806040537 4 200881
1#0##0#0#0.0#2018-07-19 09:08:37#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1516232 0 0 0 0 0
3201126 B 1 BS 1 14/07/2018 16/07/2018 15/06/1949 0 1
- 0 58821400 57301310 0 3 0 0 0 ROSLIAN
0138R0170718V005240 0001335203278 3;JKN DR RIZKI; 5.2.2.201806040537
4 201732 1#0##0#0#0.0#2018-07-19
09:43:58#0#21:08:39#21:08:39#12:00:00 1 f9722dcb3c9b53965c8e5069c4585c22
0 10062000 3419040 0 0 34975270 0 0 0 0
1276000 0 0 0 0 7569000
3201126 B 1 BS 1 15/07/2018 16/07/2018 02/12/1939 0 2
4 K56.7;E87.6 99.60 - - None None None None K-4-15-II None
None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL (SEDANG)
5711300 0 0 - 0 - 0 - 0 - 0
5711300 6058836 0 2 0 0 0 NURSYAMSI D403434
78 28715 DR M YAMIN, SPPD 0138R0170718V005249 0000045056046 3;JKN
DR RIZKI; 5.2.2.201806040537 4 201737 1#0##0#0#0.0#2018-07-19
10:03:14#0#00:00:00#00:00:00#00:00:00 1 c36bbb41f899d9d2b1ca82d2a9b83cdd
0 0 827404 0 0 2957060 0 0 0 0
1984372 0 0 0 0 290000
3201126 B 1 BS 1 13/07/2018 16/07/2018 05/09/1954 0 1
0 0 - 0 - 0 - 0 - 0 5802600
5485083 0 4 0 0 0 SUMIDI D403258 63 23322
DR RIZKI; 5.2.2.201806040537 4 201803 1#0##0#0#0.0#2018-07-19
10:25:15#0#00:00:00#00:00:00#00:00:00 1 23b46be1c2e1d2db2a355104e750b064
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3515237 0 0 0 0 0
3201126 B 1 BS 1 14/07/2018 16/07/2018 22/03/1986 0 1
1 I12.0;D63.8;E87.8 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 3884144 0 3 0 0 0 ARIK IRWANTO
D402192 32 11802 DR BETTY 0138R0170718V005224 0002081673821
3;JKN DR RIZKI; 5.2.2.201806040537 4 201720 1#0##0#0#0.0#2018-
07-19 10:26:34#0#18:48:32#18:48:32#00:00:00 1
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1032900 0 0 0 0 2277603 0 0 0 0 0
3201126 B 1 BS 1 14/07/2018 16/07/2018 02/05/1957 0 2
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 4453614 0 3 0 0 0 FATIMAH D403314
61 22353 DR ARU, SPPD 0138R0170718V005573 0001261540067 3;JKN
DR RIZKI; 5.2.2.201806040537 4 201970 1#0##0#0#0.0#2018-07-19
10:42:50#0#00:00:00#00:00:00#00:00:00 2 11dd1244b938640063ad6d6a5ddaa1f7
0 0 319571 0 0 1473685 0 0 0 0
2660358 0 0 0 0 0
3201126 B 2 BS 1 14/07/2018 16/07/2018 28/01/1998 0 1
1 A09.0;I84.8 90.59 - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
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D403294 20 7472 DR ARU, SPPD 0138R0170718V005138
0001869629321 3;JKN DR RIZKI; 5.2.2.201806040537 4 201616
1#0##0#0#0.0#2018-07-19 11:16:14#0#01:45:05#01:45:05#00:00:00 1
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3201126 B 2 BS 1 11/07/2018 16/07/2018 22/06/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4422589 0 6 0 0 0 HAFLA KANA AFIFAH
D376715 1 384 DR RASTRA, SPA 0138R0170718V003810
0002260627536 3;JKN DR RIZKI; 5.2.2.201806040537 4 199846
1#0##0#0#0.0#2018-07-19 11:19:24#0#00:00:00#00:00:00#12:00:00 1
727806c2c1f3e8a48e29a6b9fd422d2a 0 0 238535 0 0 838726
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3201126 B 1 BS 1 13/07/2018 16/07/2018 26/09/2002 0 1
- 0 - 0 - 0 - 0 5424200 13634806 0
4 0 0 0 ACHMAD DAFFIAN SAPTANU D081508 15 5769 DR
ASRI RAHMAWATI SPB 0138R0170718V004941 0001438690487 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 201447 1#0##0#0#0.0#2018-07-24
07:57:07#0#00:00:00#00:00:00#00:00:00 1 2f62e6489d5a3f1700681a50ea324576
0 7878200 1571776 0 0 3197833 0 0 0 0
917997 0 0 0 0 69000
3201126 B 3 BS 1 16/07/2018 16/07/2018 02/06/1952 0 1
1 K21.9;I25.0 - - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 2954900 1651542
0 1 0 0 0 T. FIRDAUS HUSEIN D402762 66 24150 DR
DICKI PRATAMA 0138R0170718V005315 0001257761068 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201775 1#0##0#0#0.0#2018-07-24
13:28:23#0#00:00:00#00:00:00#12:00:00 1 490edb0461408d41408ea9cfcd3ac854
0 0 147745 0 0 220752 0 0 0 0 397045
0 0 0 0 886000
3201126 B 3 BS 1 16/07/2018 16/07/2018 03/11/1943 0 1
1 I95.9;A49.9;K92.1 - - - None None None None I-4-24-I
(RINGAN) 2795900 0 0 - 0 - 0 - 0 - 0
2795900 2113921 0 1 0 0 0 ASSER LOLOTAN
0000060704368 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201773
1#0##0#0#0.0#2018-07-24 13:32:51#0#00:00:00#00:00:00#12:00:00 1
53499965f7b7b5b4d70924013e298e33 0 0 139795 0 0 927832
0 0 0 0 450294 0 0 0 0 596000
3201126 B 3 BS 1 16/07/2018 16/07/2018 08/11/1945 0 1
1 I95.9;I63.9;N18.5;I50.0;J96.9 96.05 - - None None None None
- 0 8139800 9303004 0 1 0 0 0 ADJIDIN
PANGGABEAN TN D364517 72 26548 DR. SUKMARINI 0138R0170718V005695
0000060748705 3;JKN DR RIZKI; 5.2.2.201806040537 4 202074
1#0##0#0#0.0#2018-07-24 15:13:44#0#00:00:00#00:00:00#00:00:00 1
0ef66b31141d7e5d5ce82c24a57da517 0 0 732582 0 0
6785814 0 0 0 0 915608 0 0 0 0 869000
3201126 B 3 BS 1 16/07/2018 16/07/2018 12/03/1967 0 2
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2600629 0 1 0 0 0 SUHAIMI, NY
0000061100357 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201942
1#0##0#0#0.0#2018-07-24 15:58:59#0#11:38:30#11:38:30#12:00:00 1
7987dc37b038f0a4cef5b27e51cc4603 0 0 206608 0 0
1200887 0 0 0 0 477134 0 0 0 0 716000
3201126 B 2 BS 1 14/07/2018 16/07/2018 22/06/1968 0 2
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 3737184 0 3 0 0 0 YUNI FAIRANI
0001143465603 3;JKN DR RIZKI; 5.2.2.201806040537 4 201615
1#0##0#0#0.0#2018-07-24 16:31:57#0#00:44:31#00:44:31#00:00:00 1
2585bf0c3cab97a621de1a959696636b 0 0 799226 0 0
1152469 0 0 0 0 1785489 0 0 0 0 0
3201126 B 3 BS 1 16/07/2018 16/07/2018 16/08/1971 0 2
- 0 - 0 - 0 - 0 2216400 4176500 0
5.2.2.201806040537 4 201903 1#0##0#0#0.0#2018-07-31
14:08:13#0#10:57:57#10:57:57#00:00:00 1 c8c6d5c1ae17aed7240ee165272e0669
0 0 715980 0 0 2618291 0 0 0 0 842229
0 0 0 0 0
3201126 B 3 BS 1 16/07/2018 16/07/2018 12/12/1945 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2504741 0 1 0 0 0 GAWIEK SURASIAH
0001468930498 3;JKN DR RIZKI; 5.2.2.201806040537 4 202149
1#0##0#0#0.0#2018-08-01 17:54:22#0#00:00:00#00:00:00#12:00:00 1
c5bf18fcaa10efef5ad0dc0ed022ccd7 0 0 371889 0 0
1375490 0 0 0 0 629362 0 0 0 0 128000
3201126 B 1 BS 1 16/07/2018 16/07/2018 16/11/1976 0 2
- 0 - 0 - 0 - 0 3103000 4496307 0
1 0 0 0 ANNA D259488 41 15217 DR. RAHMAWATI SP.B ONK
0138R0170718V005589 0001079857089 3;JKN irene; 5.2.2.201806040537
4 201971 1#0##0#0#0.0#2018-08-02
14:46:30#0#12:57:59#12:57:59#00:00:00 2 59d34ae831e01315ff0760ce33d4b510
0 0 279270 0 0 2788581 0 0 0 0
1428456 0 0 0 0 0
3201126 B 2 BS 1 13/07/2018 16/07/2018 27/07/2017 0 1
(SEDANG) 2538800 0 0 - 0 - 0 - 0 - 0
2538800 3772947 0 4 0 0 0 MUHAMMAD FADLY SULISTYO
D403300 0 351 DR RASTRA, SPA 0138R0170718V005128
0002269971044 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201611
1#0##0#0#0.0#2018-08-13 16:09:50#0#00:00:00#00:00:00#00:00:00 1
cc846dbe16a7e054b63e97d41ee540c7 0 0 238535 0 0
1279084 0 0 0 0 2085328 0 0 0 0 170000
3201126 B 1 BS 1 15/07/2018 16/07/2018 10/03/2002 0 1
1 S68.1 86.89;86.61 - - None None None None L-1-30-I None
12436800 0 0 - 0 - 0 - 0 - 0
12436800 14177845 0 2 0 0 0 CHANDRA WIJAYA KUSUMA
0001453560085 3;JKN irene; 5.2.2.201806040537 4 201765
1#0##0#0#0.0#2018-08-14 14:48:35#0#20:13:56#20:13:56#00:00:00 2
80c292c90cb213bc37b411129a8cd7ba 0 0 2009980 0 0
1506542 0 0 0 0 10516323 0 0 0 0 145000
3201126 B 3 BS 1 13/07/2018 16/07/2018 17/07/1957 0 2
1 H81.4;E14.4;J18.0 - - - None None None None U-4-11-III
None None None None None None DYSEQUILIBRIUM (BERAT) 2321800 0
0 - 0 - 0 - 0 - 0 2321800 3235227
0 4 0 0 0 MAINAH D403279 60 22276 DR ARU, SPPD
0138R0170718V005120 0001259552417 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201604 1#0##0#0#0.0#2018-09-08
11:09:01#0#19:50:18#19:50:18#00:00:00 2 99dbdcbc2367fbc6c16254f7a4de1fa4
0 0 616661 0 0 1415416 0 0 0 0
1203150 0 0 0 0 0
3201126 B 2 BS 1 15/07/2018 16/07/2018 29/08/1978 0 1
1 N18.5;E11.9;J18.0;D63.8 39.27;99.04 - - None None None None
- 0 - 0 23198900 10677141 0 2 0 0 0
EKO PUTRANTO D403467 39 14565 SRI KUNMARTINI.DR,SPPD
0138R0170718V005304 0002422569789 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201769 1#0##0#0#0.0#2018-09-28
15:52:23#0#00:00:00#00:00:00#00:00:00 2 192120213a550d1eac99a91c2362275a
0 4586100 2276624 0 0 2970912 0 0 0 0
774505 0 0 0 0 69000
3201126 B 3 BS 1 14/07/2018 17/07/2018 24/03/1975 0 1
1 K74.6;I85.0;D64.8;B18.1 99.04;90.59 - - None None None None
(BERAT) 6747200 0 0 - 0 - 0 - 0 - 0
6747200 6138535 0 4 0 0 0 ASAN D403386 43
DR RIZKI; 5.2.2.201806040537 4 201726 1#0##0#0#0.0#2018-07-18
16:13:55#0#00:00:00#00:00:00#00:00:00 1 8c635056fa97286a92080776fcea4e40
0 0 493802 0 0 4251647 0 0 0 0
1393086 0 0 0 0 0
3201126 B 3 BS 1 14/07/2018 17/07/2018 22/09/1965 0 1
0 - 0 6909500 3303795 0 4 0 0 0
SUHARTANTO D403406 52 19288 DR MAYSAMIRAWATI SPS
0138R0170718V005233 0001425942876 3;JKN DR RIZKI; 5.2.2.201806040537
4 201728 1#0##0#0#0.0#2018-07-18
16:17:53#0#20:11:40#20:11:40#00:00:00 1 470b71e6c4ce2655db71b81aa2436c94
0 0 674855 0 0 1421304 0 0 0 0
1207635 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 17/07/2018 01/01/1965 0 1
1 G45.9;G45.0;I10 87.03;87.49;90.59;89.52 - - None None None
None G-4-16-I None None None None None None ISKEMIK TRANSIENT
(RINGAN) 4727400 0 0 - 0 - 0 - 0 - 0
4727400 4912978 0 3 0 0 0 SUKADIRMAN TN
0000039884422 3;JKN DR RIZKI; 5.2.2.201806040537 4 201762
1#0##0#0#0.0#2018-07-19 09:38:15#0#17:46:35#17:46:35#00:00:00 1
de6f8920ca876e1f0a633e7cfade58a3 0 0 478466 0 0
1744102 0 0 0 0 2690410 0 0 0 0 0
3201126 B 1 BS 1 09/07/2018 17/07/2018 21/08/1961 0 2
4 I63.9;I50.0;J18.0;J80;E14.9 87.03;87.44 - - None None None
- 0 - 0 12141100 27516920 0 9 1 7 0
ROSMALA DEWI D402844 56 20776 DR MAYSAMIRAWATI SPS
0138R0170718V003324 0000060764872 3;JKN DR RIZKI; 5.2.2.201806040537
4 199331 1#0##0#0#0.0#2018-07-19
10:29:14#0#07:38:51#07:38:51#00:00:00 1 f305ffdcacc9fbbccc095364d18a66fd
0 0 1388521 0 0 12776899 0 0 0 0
8692500 0 0 0 0 4659000
3201126 B 1 BS 1 13/07/2018 17/07/2018 11/02/1990 0 1
1 S14.3;M62.52 05.81;83.79 - - None None None None G-1-
20-II None None None None None None PROSEDUR SARAF KRANIAL DAN PERIFER
(SEDANG) 20077200 0 0 - 0 - 0 - 0 - 0
20077200 32530205 0 5 0 0 0 PAUL MONARICH HUTASOIT
0138R0170718V005129 0001427845252 3;JKN DR RIZKI; 5.2.2.201806040537
4 201807 1#0##0#0#0.0#2018-07-19
10:37:35#0#00:00:00#00:00:00#00:00:00 1 11cc1beec5e4c4b8d00b4b15131062c2
0 14504200 7543121 0 0 9004884 0 0 0 0
1333000 0 0 0 0 145000
3201126 B 1 BS 1 15/07/2018 17/07/2018 19/10/1952 0 2
1 K20;K44;K29.7;J03.9;A01.0 45.16 - - None None None None
K-4-12-III None None None None None None GANGGUAN ESOFAGUS (BERAT)
9494200 0 0 - 0 - 0 - 0 - 0
9494200 8458056 0 3 0 0 0 SRI SUDARYATI
0000042065526 3;JKN DR RIZKI; 5.2.2.201806040537 4 201770
1#0##0#0#0.0#2018-07-19 10:46:44#0#00:00:00#00:00:00#00:00:00 1
d7797742652a94a61a65bca728f8cad4 0 0 2658376 0 0
1056849 0 0 0 0 2993831 0 0 0 0
1749000
3201126 B 1 BS 1 15/07/2018 17/07/2018 06/10/1969 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3194282 0 3 0 0 0 SRI UTAMI D317717
48 17814 DR ARU, SPPD 0138R0170718V005276 0001516985199 3;JKN
DR RIZKI; 5.2.2.201806040537 4 201751 1#0##0#0#0.0#2018-07-19
10:48:29#0#14:34:44#14:34:44#00:00:00 1 cc18c973f4c6ae98bccf047a528d8c2a
0 0 269459 0 0 346851 0 0 0 0
2577972 0 0 0 0 0
3201126 B 2 BS 1 13/07/2018 17/07/2018 11/05/1972 0 1
1 I50.9;J22;I25.1;I08.9 90.59;89.52;87.49 - - None None None
(SEDANG) 4973600 0 0 - 0 - 0 - 0 - 0
4973600 4427528 0 5 0 0 0 USEP SAPUTRA
0001472682374 3;JKN DR RIZKI; 5.2.2.201806040537 4 201453
1#0##0#0#0.0#2018-07-19 10:54:49#0#13:52:09#13:52:09#12:00:00 1
f8c13b6e7627dcc167106cc711b8dc66 0 0 439175 0 0
1147702 0 0 0 0 2840651 0 0 0 0 0
3201126 B 2 BS 1 16/07/2018 17/07/2018 18/08/1993 0 2
5598300 0 0 - 0 - 0 - 0 - 0
5598300 6622782 0 2 0 0 0 LEONY CLARISSA A MALONDA
D327195 24 9098 DR ARJU A, SPOG 0138R0170718V005379
0001766487115 3;JKN DR RIZKI; 5.2.2.201806040537 4 201779
1#0##0#0#0.0#2018-07-19 10:56:32#0#07:18:35#07:18:35#00:00:00 1
4c3f3367851db936060b95df132575b6 0 0 1567524 0 0
1554992 0 0 0 0 3355266 0 0 0 0 145000
3201126 B 2 BS 1 12/07/2018 17/07/2018 13/12/2010 0 1
- 0 - 0 - 0 - 0 4649300 12398921 0
6 0 0 0 MUHAMMAD RAFKA ALDIANSYAH d302923 7 2768
DR CATUR S, SPB 0138R0170718V004444 0001959186227 3;JKN DR RIZKI;
5.2.2.201806040537 4 200585 1#0##0#0#0.0#2018-07-19
11:14:13#0#00:00:00#00:00:00#00:00:00 1 9e5d3ce0f155e7d720b0d890bb2c463c
0 6593300 1355804 0 0 3382673 0 0 0 0
922144 0 0 0 0 145000
3201126 B 2 BS 1 13/07/2018 17/07/2018 08/06/2015 0 1
1 N39.0;R10.4;B34.9 - - - None None None None N-4-12-I
2871200 0 0 - 0 - 0 - 0 - 0
2871200 4136547 0 5 0 0 0 MUHAMAD ILHAM FATHUL
AZZAM D401887 3 1131 DR RASTRA, SPA 0138R0170718V004732
0001968811097 3;JKN DR RIZKI; 5.2.2.201806040537 4 201180
1#0##0#0#0.0#2018-07-19 11:17:06#0#01:18:53#01:18:53#00:00:00 1
631bf648dbab2f0dfad70faa63f785b2 0 0 291535 0 0
1023397 0 0 0 0 2821615 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 17/07/2018 20/11/2017 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2554306 0 2 0 0 0 MUHAMMAD AL ZAIN
D403458 0 238 DR RASTRA, SPA 0138R0170718V005309
0002422860039 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201771
1#0##0#0#0.0#2018-07-24 07:56:07#0#00:00:00#00:00:00#00:00:00 1
62718859bb07c99deaf860e9d231cfa3 0 0 269459 0 0 529743
0 0 0 0 1755104 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 17/07/2018 03/03/1966 0 1
- 0 - 0 - 0 - 0 4784600 4746781 0
3 0 0 0 ANDREAS MAKOTO DARIUS D257764 52 19127 DR
MOHAMMAD JOHAN SPU 0138R0170718V005252 0002457462069 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 201738 1#0##0#0#0.0#2018-07-24
07:59:23#0#00:00:00#00:00:00#00:00:00 1 b82c1a3afc593868136c2168ffc04cee
0 0 483614 0 0 1583630 0 0 0 0
2679537 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 17/07/2018 15/01/1942 0 1
1 E11.2;I11.0;D29.1;D63.8;K30 99.04 - - None None None None
- 0 10134400 9432454 0 6 0 0 0 ACEP IPIT H.
D338054 76 27937 DR ARU, SPPD 0138R0170718V004527
0002206065666 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201715
1#0##0#0#0.0#2018-07-24 08:03:56#0#14:13:18#14:13:18#00:00:00 1
13df126dbcd8894d823217b6aa8bf8a2 0 0 512182 0 0
3583603 0 0 0 0 5336669 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 17/07/2018 08/08/1957 0 2
1 I84.3;I69.4 - - - None None None None K-4-18-I None
2033900 0 0 - 0 - 0 - 0 - 0
2033900 4743587 0 3 0 0 0 WARDHA HUSEIN
0001470992949 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201811
1#0##0#0#0.0#2018-07-24 08:09:37#0#09:20:00#09:20:00#00:00:00 1
e4e4fe7eab00d20a7d0949d1b19133e7 0 0 476674 0 0
1587585 0 0 0 0 2679328 0 0 0 0 0
3201126 B 3 BS 1 16/07/2018 17/07/2018 20/03/1991 0 1
(RINGAN) 4315600 0 0 - 0 - 0 - 0 - 0
4315600 5990070 0 2 0 0 0 ALIP PANDI ANANDA RAMDAN
d327802 27 9980 DR RAY HENDRY, SPOT 0138R0170718V005652
0002459793486 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202009
1#0##0#0#0.0#2018-07-24 09:02:53#0#00:00:00#00:00:00#00:00:00 1
7fc14022448aa3f0704f0a364ea05cc6 0 0 1261368 0 0 873628
0 0 0 0 3786074 0 0 0 0 69000
3201126 B 3 BS 1 17/07/2018 17/07/2018 27/12/1942 0 1
1 G20 - - - None None None None G-4-11-I None None
None None None None TUMOR SISTEM SARAF & GANGGUAN DEGENERATIF (RINGAN)
4571500 0 0 - 0 - 0 - 0 - 0
4571500 1263374 0 1 0 0 0 SURYAMAN
TARDAN,DR,IR,MED D119733 75 27596 DR RICO ADITYA 0138R0170718V006141
0000043306839 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202711
1#0##0#0#0.0#2018-07-24 15:56:47#0#15:01:05#15:01:05#00:00:00 1
9a95e231891c84ff6e2b1da7793f4078 0 0 228575 0 0 245148
0 0 0 0 371651 0 0 0 0 418000
3201126 B 1 BS 1 10/07/2018 17/07/2018 15/07/1964 0 2
1 D42.0 01.24;96.71 - - None None None None G-1-10-I None
None None None None None KRANIOTOMI (RINGAN) 24351000 0 0
- 0 - 0 - 0 - 0 24351000 45607033 0
8 1 4 0 RIZA DAMAYANTI D013915 53 19718 DR ARNANDA
SPBS 0138R0170718V003354 0001270441091 3;JKN DR RIZKI; 5.2.2.201806040537
4 199326 1#0##0#0#0.0#2018-07-24
15:58:12#0#00:00:00#00:00:00#12:00:00 1 a43e141c7d8aef30e6e4e9a0f88a8ccf
0 11771200 8770658 0 0 20790175 0 0 0 0
1301000 0 0 0 0 2974000
3201126 B 2 BS 1 07/07/2018 17/07/2018 18/05/1964 0 1
1 I63.9;G81.9;I11.9 - - - None None None None G-4-14-II
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 23173402 0 11 1 0 0 NIRAN D402529
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 198884
1#0##0#0#0.0#2018-07-24 18:04:52#0#00:00:00#00:00:00#00:00:00 1
d856c123c4bfc631090fa5f758e7e5ec 0 0 880980 0 0
8947422 0 0 0 0 9345000 0 0 0 0
4000000
3201126 B 2 BS 1 16/07/2018 17/07/2018 12/12/1954 0 1
0 0 - 0 - 0 - 0 - 0 14653000
12936471 0 2 0 0 0 THAMRIN ARIFIN TN D398530 63
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201969
1#0##0#0#0.0#2018-07-24 18:06:23#0#12:33:34#12:33:34#00:00:00 1
a77fa5cb8195296c8e447c1c53c77f10 0 3573000 2930600 0 0
3441560 0 0 0 0 922311 0 0 0 0
2069000
3201126 B 2 BS 1 15/07/2018 17/07/2018 04/04/1940 0 1
- 0 - 0 - 0 - 0 4101100 2748421 0
3 0 0 0 SUMADI B WIRJOMIHARDJO D403466 78 28591 DR
MOHAMMAD JOHAN SPU 0138R0170718V005300 0000060887981 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 201768 1#0##0#0#0.0#2018-07-24
18:07:50#0#00:00:00#00:00:00#00:00:00 1 fe9c0a6f0aaaf7cb85faf2ba1a399b57
0 0 422099 0 0 1092519 0 0 0 0
1233803 0 0 0 0 0
3201126 B 2 BS 1 13/07/2018 17/07/2018 29/12/1998 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3185243 0 5 0 0 0 RIZQI RAMADHAN
D403278 19 7136 DR ARU, SPPD 0138R0170718V005510
0002473129416 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201855
1#0##0#0#0.0#2018-07-24 18:09:31#0#10:20:25#10:20:25#00:00:00 1
4f96a60f5b4375150eb1438305095472 0 0 278711 0 0
1080652 0 0 0 0 1825880 0 0 0 0 0
3201126 B 2 BS 1 16/07/2018 17/07/2018 08/07/1961 0 1
9649200 0 0 - 0 - 0 - 0 - 0
9649200 11550999 0 2 0 0 0 ASMAWIH D398199
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201968
1#0##0#0#0.0#2018-07-24 18:12:36#0#12:18:29#12:18:29#00:00:00 1
cac950a24b81e61f6c88611f297127b9 0 4911100 1241828 0 0
1497398 0 0 0 0 831673 0 0 0 0
3069000
3201126 B 1 BS 1 14/07/2018 17/07/2018 25/08/2017 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4024863 0 4 0 0 0 AISYAH PUTRI SYAFII
0002280165085 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201714
1#0##0#0#0.0#2018-08-01 19:27:21#1#00:00:00#00:00:00#00:00:00 1
4d6f47b9c4248c9b509052ffd2134076 0 0 417960 0 289309
916754 0 0 0 0 2400840 0 0 0 0 0
3201126 B 1 BS 1 11/07/2018 17/07/2018 09/11/1954 0 1
1 S09.9;R51 87.03 - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 4260400 9639765 0
7 0 0 0 PARWOTO D402993 63 23255 DR HARDI PRANATA
5.2.2.201806040537 4 201733 1#0##0#0#0.0#2018-09-08
09:29:46#0#21:44:17#21:44:17#00:00:00 2 63e98ab257bfc4c19e07946a15961c8b
0 0 436436 0 0 2951690 0 0 0 0
6123639 0 0 0 0 128000
3201126 B 2 BS 1 16/07/2018 17/07/2018 24/01/1971 0 1
DIALISIS (BERAT) 23198900 0 0 - 0 - 0 - 0 -
0 23198900 9308785 0 2 0 0 0 SATIRI EKA PUTRA
0001637142614 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202152
1#0##0#0#0.0#2018-09-25 13:15:03#0#22:18:26#22:18:26#00:00:00 3
cd556e9efbebb80fd8f5418dbc1a2ac1 0 0 1147720 0 0
3006627 0 0 0 0 5074086 0 0 0 0 80352
3201126 B 3 BS 1 16/07/2018 17/07/2018 15/06/1969 0 1
1 K74.6;R57.0 - - - None None None None B-4-13-III None
None None None None None GANGGUAN HATI LAIN-LAIN (BERAT) 6747200
0 0 - 0 - 0 - 0 - 0 6747200
5947475 0 2 0 0 0 PARUDI D397320 49 17928
DR DICKI PRATAMA 0138R0170718V005317 0000042712356 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 201776 1#0##0#0#0.0#2018-09-26
19:45:00#0#00:00:00#00:00:00#00:00:00 2 62e0f42a45d7af30b114d805a7e6fd2e
0 0 337360 0 0 4208028 0 0 0 0 678087
0 0 0 0 724000
3201126 B 1 BS 1 13/07/2018 17/07/2018 21/09/1967 0 2
1 J40;J45.9 93.94 - - None None None None J-4-21-I None
LAIN-LAIN (RINGAN) 3917900 0 0 - 0 - 0 - 0
- 0 3917900 8154785 0 5 0 0 0 LILIANA
ANDRIANI D403250 50 18558 DR YUNITA ARLINY SPP 0138R0170718V004956
0002036343947 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201449
1#0##0#0#0.0#2018-09-26 19:47:38#0#00:00:00#00:00:00#00:00:00 2
feaca88c8d94d02fcead80bc18686eaf 0 0 1315340 0 0
2374954 0 0 0 0 4464491 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 18/07/2018 18/05/2004 0 1
1 K21.9;K12.1;A49.9 - - - None None None None K-4-12-II
0 0 - 0 - 0 - 0 - 0 5739000
5156713 0 4 0 0 0 RAYYAN ADAM SADIKIN D078117
14 5171 DR SUPROHAITA SPA(K) 0138R0170718V005260 0000164853797
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201742
1#0##0#0#0.0#2018-07-24 07:30:43#0#00:00:00#00:00:00#00:00:00 1
0c5630452e4e418c6709ac34ea6d75e3 0 0 569510 0 0
1099848 0 0 0 0 3487355 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 18/07/2018 09/08/1960 0 2
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 3844916 0 3 0 0 0 HERYANI
0002196159671 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201774
1#0##0#0#0.0#2018-07-24 07:53:04#0#00:37:42#00:37:42#12:00:00 1
5c41f4a2bd1e65f334a638595e829a0c 0 0 338858 0 0 885521
0 0 0 0 2620537 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 18/07/2018 08/05/2015 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2530346 0 3 0 0 0 KAYLA RIZKI PUTRI AYUNDA
D299989 3 1165 DR RASTRA, SPA 0138R0170718V005833
0001970803372 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202156
1#0##0#0#0.0#2018-07-24 08:16:44#0#23:43:04#23:43:04#00:00:00 1
6fbc064de98987668098ea109e0a67c7 0 0 269459 0 0 461350
0 0 0 0 1799537 0 0 0 0 0
3201126 B 3 BS 1 16/07/2018 18/07/2018 01/04/1962 0 1
1 I64 87.03;87.44;90.59;89.52 - - None None None None G-4-
- 0 - 0 - 0 - 0 4096200 2197827 0
3 0 0 0 HEKO HERIYOTO D403533 56 20560 DR MAYSAM
5.2.2.201806040537 4 202155 1#0##0#0#0.0#2018-07-24
15:03:26#0#23:18:04#23:18:04#00:00:00 1 c7f76bb9b2f58bfc6be8f94074e735db
0 0 504179 0 0 997865 0 0 0 0 695783
0 0 0 0 0
3201126 B 3 BS 1 17/07/2018 18/07/2018 05/02/1980 0 2
- 0 8908800 13268760 0 2 0 0 0 SATIAH
0002144830331 3;JKN DR RIZKI; 5.2.2.201806040537 4 202586
1#0##0#0#0.0#2018-07-24 15:05:13#0#13:04:57#13:04:57#00:00:00 1
a6470f9e8667a1f742d317e81e16ccf5 0 0 1906030 0 0
7354808 0 0 0 0 3956550 0 0 0 0 51372
3201126 B 3 BS 1 17/07/2018 18/07/2018 15/12/1974 0 2
1 I13.1;E87.7;D63.8;A49.9 99.04 - - None None None None N-4-
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3370338 0 2 0 0 0 ATIH D330275
3;JKN DR RIZKI; 5.2.2.201806040537 4 202580 1#0##0#0#0.0#2018-
07-24 15:06:31#0#12:03:17#12:03:17#00:00:00 1
33fb9f3f063791ac41d8775ab57af6fa 0 0 424889 0 0
1363585 0 0 0 0 1581864 0 0 0 0 0
3201126 B 3 BS 1 17/07/2018 18/07/2018 31/12/1957 0 2
1 I13.1;J81;D63.8;E14.9 38.95;99.04 - - None None None None
- 0 - 0 19332400 14671170 0 2 0 0 0
AINUN D395910 60 22113 DR SRI KUNMARTINI, SPPD 0138R0170718V006236
0001298342362 3;JKN DR RIZKI; 5.2.2.201806040537 4 202832
1#0##0#0#0.0#2018-07-24 15:08:28#0#00:00:00#00:00:00#00:00:00 1
4a771c05c67597d885bf9aa5b9b8dd99 0 3062500 1887760 0 0
8689262 0 0 0 0 985796 0 0 0 0 45852
3201126 B 3 BS 1 17/07/2018 18/07/2018 11/09/1968 0 1
- 0 8908800 10235493 0 2 0 0 0 D I D I
0001285776371 3;JKN DR RIZKI; 5.2.2.201806040537 4 202830
1#0##0#0#0.0#2018-07-24 15:10:21#0#00:00:00#00:00:00#00:00:00 1
f6db1f6abc6f77a8698f5415651772dd 0 2976000 1906030 0 0
4577499 0 0 0 0 695612 0 0 0 0 80352
3201126 B 1 BS 1 17/07/2018 18/07/2018 15/06/1957 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5261009 0 2 0 0 0 AMRIL D223585
3;JKN DR RIZKI; 5.2.2.201806040537 4 202585 1#0##0#0#0.0#2018-
07-24 15:49:41#0#12:46:06#12:46:06#00:00:00 1
b3caf62bf5540ced9b6ba882f6cdf48d 0 0 573641 0 0
1945815 0 0 0 0 2741553 0 0 0 0 0
3201126 B 3 BS 1 14/07/2018 18/07/2018 24/04/1954 0 1
1 E10.2;I11.0;I25.1 89.52;90.59 - - None None None None N-4-
16-III None None None None None None PENYAKIT GINJAL DAN SALURAN URIN
LAIN-LAIN (BERAT) 7238900 0 0 - 0 - 0 - 0 -
0 7238900 11153561 0 5 0 0 0 MUHAMMAD NADJIB
NASUTION D397190 64 23457 DR AZRI NURIZAL SPPD KKV
0138R0170718V005142 0001772159207 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201617 1#0##0#0#0.0#2018-07-24
16:03:37#0#06:22:43#06:22:43#00:00:00 1 260245c44e01d79c615d472f629b504f
0 0 373023 0 0 4443366 0 0 0 0
4217172 0 0 0 0 2120000
3201126 B 3 BS 1 14/07/2018 18/07/2018 09/12/1989 0 2
- 0 - 0 - 0 - 0 2655900 3771141 0
5 0 0 0 DELFIANAWATI D345023 28 10444 DR
S;16137 5.2.2.201806040537 4 201723 1#0##0#0#0.0#2018-07-24
16:06:31#0#00:00:00#00:00:00#12:00:00 1 634b11c700001a7a7c30929fb8942e8e
0 0 292031 0 0 1977900 0 0 0 0
1501210 0 0 0 0 0
3201126 B 3 BS 1 17/07/2018 18/07/2018 07/04/1969 0 1
1 T82.4;N18.5 39.43;90.59;89.52 - - None None None None N-1-
- 0 4340500 6997643 0 2 0 0 0 EKO
PRIAMBODO D401702 49 17998 DEDY PRATAMA,DR SPBV 0138R0170718V006008
0001228485802 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202481
1#0##0#0#0.0#2018-07-24 16:11:22#0#11:20:17#11:20:17#00:00:00 2
25b8875a354cf209815649027238edd7 0 3456800 1039960 0 0
1958155 0 0 0 0 483790 0 0 0 0 58938
3201126 B 2 BS 1 17/07/2018 18/07/2018 03/04/1957 0 2
- 0 10690500 9988999 0 2 0 0 0 IKA
SUMARTIKA D402236 61 22385 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V006274 0000069321611 3;JKN DR RIZKI; 5.2.2.201806040537
4 202833 1#0##0#0#0.0#2018-07-24
16:23:30#0#00:00:00#00:00:00#00:00:00 1 042ab0d2f03e185cc6b26cab13ae4404
0 4911100 1094720 0 0 3205224 0 0 0 0
679486 0 0 0 0 98469
3201126 B 2 BS 1 17/07/2018 18/07/2018 12/06/2008 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 7519633 0 2 0 0 0 KHESYA REGITA CAHYANI
D402365 10 3687 DR CATUR S, SPB 0138R0170718V005888
0001294729918 3;JKN DR RIZKI; 5.2.2.201806040537 4 202165
1#0##0#0#0.0#2018-07-24 16:29:26#0#07:21:19#07:21:19#00:00:00 1
653f794986e1362243721cda5fb63327 0 4933300 1217272 0 0
647898 0 0 0 0 517939 0 0 0 0 203224
3201126 B 2 BS 1 16/07/2018 18/07/2018 28/02/1972 0 2
1 K21.0;E07.9;E13.9;A01.0 45.16 - - None None None None K-4-
12-III None None None None None None GANGGUAN ESOFAGUS (BERAT)
8137900 0 0 - 0 - 0 - 0 - 0
8137900 8050516 0 3 0 0 0 FENNY VODIANI
0001265490652 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202150
1#0##0#0#0.0#2018-07-24 18:14:06#0#00:00:00#00:00:00#12:00:00 1
a1203abc7e1529df5c81bc23bbb0f524 0 0 2505212 0 0
1275593 0 0 0 0 2500669 0 0 0 0
1769042
3201126 B 2 BS 1 17/07/2018 18/07/2018 02/06/1972 0 2
2783600 0 0 - 0 - 0 - 0 - 0
2783600 5912511 0 2 0 0 0 TATI YANAH D402860
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202528
1#0##0#0#0.0#2018-07-24 18:15:24#0#11:40:17#11:40:17#00:00:00 1
f0c53ca5ca08b1140367c5ecff4bfd97 0 0 832408 0 0
1175761 0 0 0 0 2135300 0 0 0 0
1769042
3201126 B 2 BS 1 15/07/2018 18/07/2018 07/07/1983 0 2
None None None None None PENYAKIT JANTUNG KONGENITAL DAN KATUP JANTUNG
(BERAT) 10065200 0 0 - 0 - 0 - 0 - 0
10065200 10832439 0 4 0 0 0 RINAH YULIANAH
0001815864524 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201740
1#0##0#0#0.0#2018-07-24 18:19:34#0#00:00:00#00:00:00#00:00:00 1
1fbcd2e0df9b2ec10734c010629e39b6 0 0 740861 0 0
4112914 0 0 0 0 3858664 0 0 0 0
2120000
3201126 B 2 BS 1 15/07/2018 18/07/2018 20/06/1954 0 2
0 - 0 8291400 4524842 0 4 0 0 0
PARIYEM D170766 64 23401 DR HARDI PRANATA SPS
0138R0170718V005246 0001305323357 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201735 1#0##0#0#0.0#2018-07-24
18:21:01#0#00:00:00#00:00:00#00:00:00 1 69d653502707763e696ecbec499dc4c4
0 0 594422 0 0 1588402 0 0 0 0
2342018 0 0 0 0 0
3201126 B 1 BS 1 17/07/2018 18/07/2018 21/05/1947 0 1
1 A09.9;E14.9;D29.1 - - - None None None None K-4-17-I
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 6410738 0 2 0 0 0 SYAHRIZAL MISHAR,DR
D209725 71 25990 DR ARU, SPPD 0138R0170718V005841
0000060897036 3;JKN DR RIZKI; 5.2.2.201806040537 4 202160
1#0##0#0#0.0#2018-07-27 11:06:29#0#00:00:00#00:00:00#12:00:00 1
38bb7fe09201921ffc8718f2e832c7af 0 0 1132221 0 0
2233123 0 0 0 0 3045394 0 0 0 0 0
3201126 B 3 BS 1 16/07/2018 18/07/2018 02/07/1957 0 1
1 I25.0;I08.9;I21.2 90.59;89.52;88.55;36.07 - - YY02 None None
0 - 0 - 0 45079800 59227033 0 3 0 0
0 EMAN SULAEMAN RASIDI D322668 61 22294 DR AZRI NURIZAL SPPD KKV
0138R0170718V005736 0001872495145 3;JKN DR RIZKI; 5.2.2.201806040537
4 202130 1#0##0#0#0.0#2018-07-27
14:37:00#0#00:00:00#00:00:00#00:00:00 1 1d8aeeb93c62973372a24d3d6cfb2679
0 8100500 6923800 0 0 35387127 0 0 0 0
1226000 0 0 0 0 7589606
3201126 B 3 BS 1 17/07/2018 18/07/2018 26/09/1976 0 1
1 N18.5;R18 54.91 - - None None None None N-4-10-II None
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
0001743628138 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202835
1#0##0#0#0.0#2018-07-28 13:22:30#0#00:00:00#00:00:00#00:00:00 1
15af076f6915dd897610b0193862e459 0 0 578387 0 0 252291
0 0 0 0 386637 0 0 0 0 0
3201126 B 2 BS 1 17/07/2018 18/07/2018 25/01/1957 0 1
- 0 51950600 67851436 0 2 0 0 0 WIDIHARDJO
SOESANTO D399103 61 22453 DR AZRI NURIZAL SPPD KKV
0138r0170718v006040 0001458583481 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 202583 1#0##0#0#0.0#2018-07-28
15:17:07#0#12:27:37#12:27:37#00:00:00 1 7a4c619213fca6e942d6df9a5091941e
0 8986000 8244960 0 0 41676870 0 0 0 0
1226000 0 0 0 0 7717606
3201126 B 3 BS 1 16/07/2018 18/07/2018 01/12/1954 0 2
- 0 - 0 - 0 - 0 3874400 6863314 0
3 0 0 0 RINAH D402999 63 23238 YASMIN SURYANDARI
BACHTIAR. DR. SPB 0138R0170718V005411 0000512773367 3;JKN DR RIZKI;
5.2.2.201806040537 4 201780 1#0##0#0#0.0#2018-07-31
14:21:35#0#00:00:00#00:00:00#00:00:00 1 c08b09542172b1a55d68a9fec161b848
0 3543300 1190832 0 0 1510180 0 0 0 0
550002 0 0 0 0 69000
3201126 B 2 BS 1 16/07/2018 18/07/2018 31/12/1954 0 2
1 N20.1;I10 56.31;59.8;56.0 - - None None None None N-1-
(RINGAN) 9649200 0 0 - 0 - 0 - 0 - 0
9649200 16119116 0 3 0 0 0 WAHYU TUMITAH
0002220148315 3;JKN DR RIZKI; 5.2.2.201806040537 4 201975
1#0##0#0#0.0#2018-08-01 12:46:28#0#00:00:00#00:00:00#00:00:00 1
df745f1310ea4aa77b41ba9a0b3ff382 0 5326100 4701776 0 0
1891718 0 0 0 0 1130522 0 0 0 0
3069000
3201126 B 2 BS 1 15/07/2018 18/07/2018 12/04/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 6207778 0 4 0 0 0 ALMERRA SHANUM KHAIRINA
HUSODO d368603 1 459 DR HANDARMI, SPA 0138R0170718V007730
0002320190706 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208260
1#1#vvip#4#4146278#0.0#2018-08-01 19:33:22#1#00:00:00#00:00:00#00:00:00
1 4e35487cb03417ec3d1926c5e363390d 0 0 585630 0 0
1194827 0 0 0 0 3467205 0 0 0 960116
0
3201126 B 1 BS 1 17/07/2018 18/07/2018 04/03/1977 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 6591868 0 2 0 0 0 IVOLAI WALASI MARGRET
DACHI D169512 41 15110 DR MUTIA P, SPOG 0138R0170718V006171
0000201634356 3;JKN DR RIZKI; 5.2.2.201806040537 4 202759
1#0##0#0#0.0#2018-08-02 14:33:30#0#00:00:00#00:00:00#00:00:00 1
27ca2c5aeee6fd49b872b52be0ff1dd5 0 0 1017824 0 0
1620448 0 0 0 0 3873244 0 0 0 0 80352
3201126 B 2 BS 1 08/07/2018 18/07/2018 17/08/1962 0 1
0 0 - 0 - 0 - 0 - 0 4973600
20398051 0 11 1 5 0 AGUS BUDI PRAYITNO D387639
0002097419152 3;JKN DR RIZKI; 5.2.2.201806040537 4 198909
1#0##0#0#0.0#2018-08-04 11:25:14#0#13:26:38#13:26:38#12:00:00 1
44388dc824e689c14b5d97a99b2bc1cf 0 0 606624 0 0
6826027 0 0 0 0 8800400 0 0 0 0
4165000
3201126 B 1 BS 1 17/07/2018 18/07/2018 17/08/1944 0 1
1 I13.1;T82.4;E11.2;A49.9;D63.8 38.95;87.44;89.52;90.59 - - None
0 - 0 - 0 - 0 27065300 18629865 0 2
0 0 0 H.HASAN SASTRO D392030 73 26997 SRI
S;16137 5.2.2.201806040537 4 202842 1#0##0#0#0.0#2018-09-25
13:20:57#0#00:00:00#00:00:00#12:00:00 2 efc39dcb7ff5c5094cfaef8e97e9bcf5
0 0 2647238 0 0 9551627 0 0 0 0
6431000 0 0 0 0 0
3201126 B 3 BS 1 17/07/2018 18/07/2018 10/04/1971 0 2
- 0 - 0 - 0 - 0 3575600 1541972 0
2 0 0 0 NANI APRILINA SIRAIT D403563 47 17265 DR
BETTY DWI L, SPPD 0138R0170718V005839 0002326378004 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 202159 1#0##0#0#0.0#2018-09-26
20:00:07#0#02:01:34#02:01:34#00:00:00 2 902e0f2b9b41be93b948ad12deb0b96c
0 0 599993 0 0 289102 0 0 0 0 652877
0 0 0 0 0
3201126 B 1 BS 1 11/07/2018 18/07/2018 30/12/1980 0 1
1 K06.9;R02;I48;A41.9 23.19;24.2 - - None None None None
U-1-30-III None None None None None None PROSEDUR MULUT (BERAT)
19114900 0 0 - 0 - 0 - 0 - 0
19114900 13921828 0 8 0 0 0 BUDHI SANTOSA,ST
0001648724073 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 199900
1#1#vvip#8#0#0.0#2018-09-28 15:47:04#0#00:00:00#00:00:00#00:00:00 3
9f4c83d7369834e548a659f3b1981a05 0 0 779434 0 0
3808545 0 0 0 0 9300774 0 0 0 0 33075
3201126 B 1 BS 1 13/07/2018 18/07/2018 14/01/1951 0 1
0 - 0 - 0 - 0 - 0 5660200 10292985
0 6 0 0 0 TEDDY TIMOTIUS URIA TN D339959 67 24652
TANTIYO S;16137 5.2.2.201806040537 4 201603 1#0##0#0#0.0#2018-
09-28 15:55:32#0#19:49:55#19:49:55#00:00:00 2
24c677bd188ea34bbaea2aacaf5dd500 0 0 940040 0 0
2233072 0 0 0 0 4845873 0 0 0 0
2274000
3201126 B 1 BS 1 10/07/2018 18/07/2018 12/12/1975 0 1
1 K35.2;A41.9 54.11 - - None None None None K-1-40-III None
None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (BERAT)
21013600 0 0 - 0 - 0 - 0 - 0
21013600 24810516 0 9 0 0 0 SYAFARDI TN D402958
42 15551 DR ARU, SPPD 0138R0170718V003803 0001903378937 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 199842 1#0##0#0#0.0#2018-
10-03 09:23:01#0#22:42:23#22:42:23#00:00:00 3
239624f252daf38c94decbf5b70bd4c2 0 10794200 6158943 0 0
6455212 0 0 0 0 1308000 0 0 0 0 94161
3201126 B 3 BS 1 13/07/2018 19/07/2018 21/10/1962 0 1
1 I20.0;I48;I50.0 90.59;89.52;87.49 - - None None None None
I-4-20-II None None None None None None ANGINA PEKTORIS DAN NYERI
DADA (SEDANG) 4854000 0 0 - 0 - 0 - 0 -
0 4854000 11494317 0 7 0 0 0 MUSTOPA
0001126212309 3;JKN DR RIZKI; 5.2.2.201806040537 4 201184
1#0##0#0#0.0#2018-07-24 14:50:11#0#04:37:42#04:37:42#00:00:00 1
aa7cd3049dc881f106222cc87409bc48 0 0 502410 0 0
4663442 0 0 0 0 3976465 0 0 0 0
2352000
3201126 B 3 BS 1 15/07/2018 19/07/2018 01/09/1997 0 2
- 0 - 0 - 0 - 0 2655900 3697550 0
5 0 0 0 ROSALINAH D402784 20 7622 DR MAYSAM I., SPS
0138R0170718V005262 0000510921933 3;JKN DR RIZKI; 5.2.2.201806040537
4 201743 1#0##0#0#0.0#2018-07-24
14:51:40#0#00:00:00#00:00:00#00:00:00 1 3f0aaaf40ed8282859148121a10af334
0 0 292032 0 0 1822622 0 0 0 0
1582896 0 0 0 0 0
3201126 B 3 BS 1 13/07/2018 19/07/2018 15/02/1944 0 1
1 A41.9;J18.9;E87.6;L89.9;R26.3 - - - None None None None
5838600 0 0 - 0 - 0 - 0 - 0
5838600 13689629 0 7 0 0 0 MUHAMMAD DACHLAN
0001206764932 3;JKN DR RIZKI; 5.2.2.201806040537 4 201185
1#0##0#0#0.0#2018-07-24 14:58:58#0#05:17:03#05:17:03#00:00:00 1
efef4a7610b4d12aa7d731a5762b1db5 0 0 694970 0 0
5041076 0 0 0 0 5220583 0 0 0 0
2733000
3201126 B 3 BS 1 17/07/2018 19/07/2018 28/03/1991 0 2
1 A49.9;O35.8 - - - None None None None A-4-14-I None
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 3005582 0 3 0 0 0 NINIEK MARYANI
D403565 27 9973 DR ARU, SPPD 0138R0170718V005843
0000511045211 3;JKN DR RIZKI; 5.2.2.201806040537 4 202161
1#0##0#0#0.0#2018-07-24 15:00:32#0#02:45:43#02:45:43#00:00:00 1
5d10aeff5e1e3e3af63fa32abfa2b458 0 0 369898 0 0
1624057 0 0 0 0 1011627 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 19/07/2018 20/06/2016 0 2
1 A09.9;R63.8;R50.9 - - - None None None None K-4-17-I
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4614328 0 5 0 0 0 CLARISSA ZANETA
SEMBIRING D360601 2 755 DR HANDARMI, SPA 0138R0170718V005298
0002049961656 3;JKN DR RIZKI; 5.2.2.201806040537 4 201767
1#0##0#0#0.0#2018-07-24 15:28:47#0#21:42:45#21:42:45#00:00:00 1
dac919336ad4141bf1cbd09b64300185 0 0 216459 0 0 927997
0 0 0 0 3469872 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 19/07/2018 02/09/2006 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4898955 0 4 0 0 0 SHAN ARIQ HAMDANI
0001318340531 3;JKN DR RIZKI; 5.2.2.201806040537 4 202124
1#0##0#0#0.0#2018-07-24 15:31:11#0#00:00:00#00:00:00#00:00:00 1
e47e3874969f6d7559005357fc7c0304 0 0 456316 0 0 632147
0 0 0 0 3470492 0 0 0 0 340000
3201126 B 1 BS 1 18/07/2018 19/07/2018 12/02/1942 0 1
- 0 46734600 57955127 0 2 0 0 0 H.M. RIDWAN
MUGNI D380750 76 27915 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170718V006553
0001448447962 3;JKN DR RIZKI; 5.2.2.201806040537 4 203186
1#0##0#0#0.0#2018-07-24 15:43:18#0#00:00:00#00:00:00#12:00:00 1
9efce3567b766d328a758c24c5d83c3b 0 10062000 7201760 0 0
31896367 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 1 BS 1 17/07/2018 19/07/2018 05/07/1982 0 2
0 - 0 - 0 - 0 - 0 4059300 4664954
0 3 0 0 0 ERLINA MEGASARI D323532 36 13161 ENDANG
TRI KURNIADEWI DR SPOG 0138R0170718V006286 0001625298298 3;JKN DR RIZKI;
5.2.2.201806040537 4 202836 1#0##0#0#0.0#2018-07-24
15:45:35#0#00:00:00#00:00:00#00:00:00 1 2f5e88554115f8e566f3bebc902196c5
0 0 326204 0 0 1608066 0 0 0 0
2346684 0 0 0 0 384000
3201126 B 1 BS 1 17/07/2018 19/07/2018 20/12/1957 0 2
0 - 0 2772200 4729676 0 3 0 0 0
ROSMINI SIMATUPANG D385186 60 22124 DR. ARU ARIADNO, SPPD
0138R0170718V006139 0000038235879 3;JKN DR RIZKI; 5.2.2.201806040537
4 202724 1#0##0#0#0.0#2018-07-24
15:47:22#0#00:00:00#00:00:00#12:00:00 1 b5ffe9e1493c15c552445f8a76276cfe
0 0 316331 0 0 1734927 0 0 0 0
2678418 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 19/07/2018 11/01/1982 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 6152692 0 5 0 0 0 AGUNG ARBIANTO
0000163645468 3;JKN DR RIZKI; 5.2.2.201806040537 4 201752
1#0##0#0#0.0#2018-07-24 15:59:09#0#00:00:00#00:00:00#00:00:00 1
75e23d8c4142b83bbbea3945fc6bb45d 0 0 316331 0 0
1502848 0 0 0 0 4333513 0 0 0 0 0
3201126 B 1 BS 1 13/07/2018 19/07/2018 21/05/1934 0 1
1 S42.00 - - - None None None None M-4-12-I None
(RINGAN) 4126300 0 0 - 0 - 0 - 0 - 0
4126300 8423348 0 7 0 0 0 UCKIE B. BROTO H.
D364568 84 30734 DR ARU, SPPD 0138R0170718V005109
0000977261477 3;JKN DR RIZKI; 5.2.2.201806040537 4 201598
1#0##0#0#0.0#2018-07-24 16:00:41#0#00:00:00#00:00:00#00:00:00 1
822e5f8fe15e3e397f7812961c783f4b 0 0 680713 0 0
2044075 0 0 0 0 5698560 0 0 0 0 0
3201126 B 2 BS 1 15/07/2018 19/07/2018 15/04/1941 0 1
1 G25.5;I64;E16.1;E14.9 87.44;87.03 - - None None None None
- 0 10707500 6926468 0 5 0 0 0 TOYIB
EFFENDI D403442 77 28215 DR CATUR BANUAJI SPS 0138R0170718V005273
0000060995845 3;JKN DR RIZKI; 5.2.2.201806040537 4 201749
1#0##0#0#0.0#2018-07-24 16:06:27#0#00:00:00#00:00:00#00:00:00 1
a21cd23da8a8317c94947658a58a1ddd 0 0 799226 0 0
3123109 0 0 0 0 3004133 0 0 0 0 0
3201126 B 2 BS 1 17/07/2018 19/07/2018 24/10/2016 0 1
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2195651 0 3 0 0 0 HAIKAL FATHAN AL FARIZQI
D348875 1 631 DR RASTRA, SPA 0138R0170718V005835
0002194881208 3;JKN DR RIZKI; 5.2.2.201806040537 4 202157
1#0##0#0#0.0#2018-07-24 16:07:09#0#00:00:00#00:00:00#00:00:00 1
371a59d8c095172f3e98040154177de6 0 0 238535 0 0 272475
0 0 0 0 1684641 0 0 0 0 0
3201126 B 2 BS 1 14/07/2018 19/07/2018 30/12/1995 0 2
1 E07.8;E14.9;E78.5 - - - None None None None E-4-13-I
(RINGAN) 4436500 0 0 - 0 - 0 - 0 - 0
4436500 9089636 0 6 0 0 0 NURWINDA D372078
3;JKN DR RIZKI; 5.2.2.201806040537 4 201620 1#0##0#0#0.0#2018-
07-24 16:16:36#0#07:44:01#07:44:01#12:00:00 1
6fcd060586617b67eeffe0524a19647c 0 0 637892 0 0
4801095 0 0 0 0 3650649 0 0 0 0 0
3201126 B 2 BS 1 17/07/2018 19/07/2018 19/02/1980 0 1
1 A49.9 90.59;89.52 - - None None None None A-4-14-I None
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2917351 0 3 0 0 0 HERU HERMAWAN
0001772636286 3;JKN DR RIZKI; 5.2.2.201806040537 4 202840
1#0##0#0#0.0#2018-07-24 16:19:04#0#00:00:00#00:00:00#00:00:00 1
91ec4f4734809c960931f5393f6a48d7 0 0 338039 0 0
1352457 0 0 0 0 1226855 0 0 0 0 0
3201126 B 2 BS 1 16/07/2018 19/07/2018 20/02/1950 0 1
14653000 0 0 - 0 - 0 - 0 - 0
14653000 27600610 0 4 0 0 0 WARJO BIN DARJA
0002422980281 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201972
1#0##0#0#0.0#2018-07-26 16:02:06#0#13:44:47#13:44:47#00:00:00 1
2cd24722c1ae68762f88da7b2f8305c3 0 9816000 2930600 0 0
6038404 0 0 0 0 1226000 0 0 0 0
7589606
3201126 B 1 BS 1 18/07/2018 19/07/2018 19/08/1941 0 1
0 - 0 - 0 - 0 - 0 5850400 4160160
0 2 0 0 0 MARSAN A RACHIM D227446 76 28092 DR
RIZKI; 5.2.2.201806040537 4 202845 1#0##0#0#0.0#2018-07-27
15:30:19#0#01:05:02#01:05:02#00:00:00 1 6181453995778b9d1952e6c30fe98c62
0 0 503531 0 0 1796469 0 0 0 0
1860160 0 0 0 0 0
3201126 B 3 BS 1 18/07/2018 19/07/2018 13/11/1959 0 1
0 0 - 0 - 0 - 0 - 0 12210800
22277460 0 2 0 0 0 RUSWAN EFFENDI d403272 58
3;JKN DR RIZKI; 5.2.2.201806040537 4 203183 1#0##0#0#0.0#2018-
07-31 13:57:10#0#12:10:24#12:10:24#00:00:00 1
b4bda278394ef84c4e2b1e38bd116821 0 7996000 2442160 0 0
3044300 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 3 BS 1 18/07/2018 19/07/2018 01/09/1953 0 1
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 48583572 0 2 0 0 0 YADI SALEH
0000512763952 3;JKN DR RIZKI; 5.2.2.201806040537 4 203221
1#0##0#0#0.0#2018-07-31 14:00:01#0#14:04:21#14:04:21#12:00:00 1
3920f48836c8c03c02a885130265ad0b 0 7996000 6870800 0 0
24921772 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 3 BS 1 16/07/2018 19/07/2018 21/05/1977 0 1
- 0 45079800 74124581 0 4 0 0 0 BAYU DEWANTO
0000195758368 3;JKN DR RIZKI; 5.2.2.201806040537 4 201777
1#0##0#0#0.0#2018-07-31 14:10:33#0#00:00:00#00:00:00#00:00:00 1
329abbaaad21b21d6e1d40fdb1ec7186 0 10148500 6923800 0 0
47533281 0 0 0 0 1226000 0 0 0 0
8293000
3201126 B 1 BS 1 13/07/2018 19/07/2018 06/11/2017 0 1
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 6358095 0 7 0 0 0 RAFIF IKHSAN NURRAHMAN
D391402 0 249 DR RASTRA, SPA 0138R0170718V005122
0002311418125 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201607
1#0##0#0#0.0#2018-08-01 19:46:54#1#00:00:00#00:00:00#00:00:00 1
ff9456fe6be14baebf2ecc66124d360f 0 0 835920 0 0
1145245 0 0 0 0 3934980 0 0 0 441950
0
3201126 B 1 BS 1 16/07/2018 19/07/2018 03/11/1969 0 2
- 0 - 0 - 0 - 0 5005900 5236599 0
4 0 0 0 NURHAYATI D403504 48 17787 DR BAMBANG
5.2.2.201806040537 4 202142 1#0##0#0#0.0#2018-08-13
12:21:48#0#00:00:00#00:00:00#00:00:00 1 afeb37510daa0b4f4b90d985c491ed31
0 0 503531 0 0 2276987 0 0 0 0
2456081 0 0 0 0 0
3201126 B 1 BS 1 17/07/2018 19/07/2018 28/04/2015 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3506542 0 3 0 0 0 HASNA NURUL HABIBAH
RAHMAN D342067 3 1176 DR RASTRA, SPA 0138R0170718V006277
0001766363016 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202834
1#0##0#0#0.0#2018-08-13 14:07:05#0#00:00:00#00:00:00#00:00:00 1
5d9ef52e162436ecbeb59e504a9b4f17 0 0 316331 0 0 597311
0 0 0 0 2252900 0 0 0 0 340000
3201126 B 2 BS 1 18/07/2018 19/07/2018 28/12/1940 0 2
1 N18.5;T82.4;N20.0 38.95 - - None None None None N-1-12-III
- 0 23198900 9349034 0 2 0 0 0 ROHATA
0001744269028 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203334
1#0##0#0#0.0#2018-09-25 13:01:20#0#00:00:00#00:00:00#00:00:00 2
1045a471405b87f6988bfdcb2d35e81f 0 0 2276624 0 0
2182491 0 0 0 0 4869219 0 0 0 0 20700
3201126 B 1 BS 1 18/07/2018 19/07/2018 12/03/1967 0 2
1 I13.1;A49.9;E11.9;D63.8;T82.4 38.95 - - None None None None
- 0 - 0 27065300 16394375 0 2 0 0 0
SUHAIMI, NY D376840 51 18756 SRI KUNMARTINI.DR,SPPD
0138R0170718V006766 0000061100357 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 203343 1#0##0#0#0.0#2018-09-25
13:21:57#0#00:00:00#00:00:00#12:00:00 2 2695a569b16ed33020378afa9dc35ab7
0 5550500 2647238 0 0 6988210 0 0 0 0
1098529 0 0 0 0 109898
3201126 B 3 BS 1 17/07/2018 19/07/2018 18/08/1967 0 1
1 T82.4;N18.5;D63.8 38.95;99.04;90.59;89.52 - - None None None
0 - 0 - 0 8908800 15026964 0 3 0 0
0 MAHDIL D347677 50 18596 DEDY PRATAMA,DR SPBV
0138R0170718V006297 0002067090074 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 202843 1#0##0#0#0.0#2018-09-25
13:33:05#0#22:14:35#22:14:35#00:00:00 2 3ba9365ded02bd71c0f4151ce7c7d55b
0 3438800 1781760 0 0 7560730 0 0 0 0
2165322 0 0 0 0 80352
3201126 B 3 BS 1 18/07/2018 19/07/2018 23/04/1974 0 1
- 0 8908800 10717965 0 2 0 0 0 AFRIZAL
0138R0170718V006631 0002100686308 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 203281 1#0##0#0#0.0#2018-09-26
19:25:52#0#00:00:00#00:00:00#00:00:00 2 4dcc844d3f700cbf59db85cf644cd477
0 0 1853030 0 0 4750950 0 0 0 0
4070675 0 0 0 0 43310
3201126 B 3 BS 1 16/07/2018 19/07/2018 01/07/1952 0 1
1 N40;R33;I11.9;E11.9;I69.4 60.29;90.59;89.52 - - None None
None None V-1-14-I None None None None None None PENGANGKATAN
PROSTAT MELALUI URETRA (RINGAN) 8837900 0 0 - 0 - 0
- 0 - 0 8837900 19052111 0 4 0 0 0
HARUN D401821 66 24121 DR SIDDHI ANDIKA, SPU 0138R0170718V005347
0001014251995 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201778
1#0##0#0#0.0#2018-09-26 19:35:59#0#00:00:00#00:00:00#00:00:00 2
1416013cceebee46327ddb4766c85adf 0 4484800 3595536 0 0
5958775 0 0 0 0 1276000 0 0 0 0
3737000
3201126 B 3 BS 1 15/07/2018 19/07/2018 01/03/1958 0 1
1 I20.0;J90;I50.0;E87.8 90.59;89.52 - - None None None None
DADA (BERAT) 7040000 0 0 - 0 - 0 - 0 -
0 7040000 9599009 0 5 0 0 0 SAIFUL
0001014240396 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201739
1#0##0#0#0.0#2018-09-28 15:43:36#0#00:00:00#00:00:00#12:00:00 2
31ae6185d572d35b9f889edb71c55556 0 0 686200 0 0
6057836 0 0 0 0 1968973 0 0 0 0 886000
3201126 B 1 BS 1 19/07/2018 20/07/2018 22/11/2016 0 1
(SEDANG) 2961900 0 0 - 0 - 0 - 0 - 0
2961900 2203586 0 2 0 0 0 TRAVIS TIMOTIUS TOBING
d382506 1 604 DR KRISTON SILITONGA, SPA 0138R0170718V007012
0002262739083 3;JKN DR RIZKI; 5.2.2.201806040537 4 203478
1#0##0#0#0.0#2018-07-26 10:52:42#0#12:21:09#12:21:09#12:00:00 1
99a78041d14d78e195b0d85374317e19 0 0 269459 0 0 201967
0 0 0 0 1732160 0 0 0 0 0
3201126 B 2 BS 1 15/07/2018 20/07/2018 03/10/1987 0 2
0 0 - 0 - 0 - 0 - 0 5984100
12245558 0 6 0 0 0 YETI OKTARIA D403437 30
TANTIYO S;16137 5.2.2.201806040537 4 201741 1#0##0#0#0.0#2018-
07-26 15:58:55#0#00:00:00#00:00:00#00:00:00 1
a93505cd2fa8db2cb6cb80c9dcd6b813 0 6496900 2141594 0 0
2547387 0 0 0 0 837111 0 0 0 0 222566
3201126 B 2 BS 1 18/07/2018 20/07/2018 20/10/1961 0 2
- 0 3584400 3865536 0 3 0 0 0 GINAH
0001320100841 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203185
1#0##0#0#0.0#2018-07-26 16:00:04#0#00:00:00#00:00:00#00:00:00 1
8d46e5c2f107918cab24ab5a66dc5658 0 0 321830 0 0
1749820 0 0 0 0 1793886 0 0 0 0 0
3201126 B 3 BS 1 15/07/2018 20/07/2018 01/03/1958 0 1
0 0 - 0 - 0 - 0 - 0 10401900
10933047 0 6 0 0 0 HASELIH D403438 60 22051
TANTIYO S;16137 5.2.2.201806040537 4 201744 1#0##0#0#0.0#2018-
07-26 16:05:24#0#00:00:00#00:00:00#00:00:00 1
b7a910eb027e1290613f81b8cab1b5bf 0 0 989171 0 0
3829730 0 0 0 0 3891146 0 0 0 0
2223000
3201126 B 1 BS 1 18/07/2018 20/07/2018 19/10/1974 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 4380833 0 3 0 0 0 OCHE RAHMATIA
0001472123507 3;JKN DR RIZKI; 5.2.2.201806040537 4 204009
1#0##0#0#0.0#2018-07-27 10:29:13#0#00:00:00#00:00:00#00:00:00 1
00d68090251c169ee7d606120e1c64e9 0 0 1020330 0 0 686906
0 0 0 0 2673597 0 0 0 0 0
3201126 B 1 BS 1 17/07/2018 20/07/2018 11/09/1993 0 2
1 M54.29;R51 87.03 - - None None None None M-4-17-I None
(RINGAN) 5162900 0 0 - 0 - 0 - 0 - 0
5162900 5352252 0 4 0 0 0 MELLY CONTESIA SIADARI
0001657553894 3;JKN DR RIZKI; 5.2.2.201806040537 4 202831
1#0##0#0#0.0#2018-07-27 10:40:57#0#00:00:00#00:00:00#00:00:00 1
9f3c4582d19a3c015caddd9932dc2d1c 0 0 244205 0 0
1607900 0 0 0 0 3500147 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 20/07/2018 16/07/1942 0 1
1 I13.1;D63.8;A49.9;E14.9 99.04;99.17;38.95 - - None None None
0 - 0 - 0 12472300 22443951 0 5 0 0
0 MUDJITABA D403527 76 27759 SRI KUNMARTINI.DR,SPPD
0138R0170718V005798 0000061027479 3;JKN DR RIZKI; 5.2.2.201806040537
4 202144 1#0##0#0#0.0#2018-07-27
10:59:11#0#00:00:00#00:00:00#00:00:00 1 eba741b5e844b8f85cf680ef738728c7
0 0 5682582 0 0 5532063 0 0 0 0
10607250 0 0 0 0 622056
3201126 B 1 BS 1 19/07/2018 20/07/2018 21/09/2016 0 2
1 G80.3;R63.3;R62.9 - - - None None None None G-4-10-II
(SEDANG) 7248900 0 0 - 0 - 0 - 0 - 0
7248900 2949654 0 2 0 0 0 AYSA SHABRINA PINFIYANTI
D372179 1 666 DR RASTRA, SPA 0138R0170718V007107
0002315168381 3;JKN DR RIZKI; 5.2.2.201806040537 4 203489
1#0##0#0#0.0#2018-07-27 11:02:30#0#14:29:12#14:29:12#12:00:00 1
69360fdfeda6e83eab5c519673bdd161 0 0 533736 0 0 634950
0 0 0 0 1780968 0 0 0 0 0
3201126 B 3 BS 1 20/07/2018 20/07/2018 28/08/1968 0 2
- 0 8908800 9431284 0 1 0 0 0 SYECHA AL
HAMID D403784 49 18223 SRI KUNMARTINI.DR,SPPD 0138R0170718V007217
0002211308087 3;JKN DR RIZKI; 5.2.2.201806040537 4 203578
1#0##0#0#0.0#2018-07-27 14:53:29#0#00:00:00#00:00:00#00:00:00 1
6710ebe2d5ea82aa057b28045631cba2 0 2889500 1906030 0 0
3923754 0 0 0 0 643000 0 0 0 0 69000
3201126 B 3 BS 1 18/07/2018 20/07/2018 30/07/2012 0 1
1 M23.50;E66.9 77.26 - - None None None None M-1-70-I
None None None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN
KAKI (RINGAN) 15255300 0 0 - 0 - 0 - 0 -
0 15255300 17668496 0 3 0 0 0 GALANG SYAPUTRA
0138R0170718V006761 0001421014364 3;JKN DR RIZKI; 5.2.2.201806040537
4 203340 1#0##0#0#0.0#2018-07-27
14:57:01#0#00:00:00#00:00:00#00:00:00 1 913cf107216bc3233cf08babf14ce1fa
0 5654000 7475097 0 0 3042355 0 0 0 0
1181883 0 0 0 0 315161
3201126 B 3 BS 1 19/07/2018 20/07/2018 01/06/1952 0 1
1 I13.1;A49.9;J81;J44.9 39.95 - - None None None None N-4-
GINJAL (BERAT) 6077700 0 0 - 0 - 0 - 0 -
0 6077700 2117573 0 2 0 0 0 SATAR TN
0000511411612 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203566
1#0##0#0#0.0#2018-07-28 13:16:48#0#00:00:00#00:00:00#00:00:00 1
dc97141b0260294a25ff071ad81fd280 0 0 303885 0 0 329155
0 0 0 0 445533 0 0 0 0 1039000
3201126 B 2 BS 1 18/07/2018 20/07/2018 23/09/1992 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2852952 0 3 0 0 0 DWI PRAWITA LESTARI
0001852052207 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203348
1#0##0#0#0.0#2018-07-28 15:09:36#0#22:46:51#22:46:51#00:00:00 1
428c0a0a9cdfa7a2269139790324be39 0 0 351025 0 0
1011285 0 0 0 0 1490642 0 0 0 0 0
3201126 B 2 BS 1 19/07/2018 20/07/2018 08/05/1953 0 1
- 0 10690500 19366132 0 2 0 0 0 SUHANDA
0001148964118 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203567
1#0##0#0#0.0#2018-07-28 15:12:19#0#00:00:00#00:00:00#00:00:00 1
3a3c4e4e1078c8ba42d944163820f6a7 0 4231600 4878371 0 0
8995661 0 0 0 0 1226000 0 0 0 0 34500
3201126 B 2 BS 1 17/07/2018 20/07/2018 14/12/1972 0 2
1 B17.9;A01.0;K30 - - - None None None None B-4-13-III
None None None None None None GANGGUAN HATI LAIN-LAIN (BERAT)
8096600 0 0 - 0 - 0 - 0 - 0
8096600 4527550 0 4 0 0 0 DEASY SETYAWATI
0001840042405 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202584
1#0##0#0#0.0#2018-07-28 15:15:40#0#12:45:38#12:45:38#00:00:00 1
41dacfbb2b3b6acaa3b95690cc7c82db 0 0 781694 0 0
1403661 0 0 0 0 2342195 0 0 0 0 0
3201126 B 1 BS 1 18/07/2018 20/07/2018 10/08/1980 0 2
0 - 0 - 0 - 0 - 0 9150100 15646213
TANTIYO S;16137 5.2.2.201806040537 4 203339 1#0##0#0#0.0#2018-
07-31 07:45:48#0#00:00:00#00:00:00#00:00:00 1
e6b35de6ec50d51e2809a89d5e76d4fb 0 7159200 2562028 0 0
4577190 0 0 0 0 1049584 0 0 0 0 298211
3201126 B 1 BS 1 17/07/2018 20/07/2018 20/06/1943 0 1
1 A15.3;I69.4;I10;R63.0 - - - None None None None J-4-
(RINGAN) 6071100 0 0 - 0 - 0 - 0 - 0
6071100 6885778 0 4 0 0 0 NANA SUPADMA
0000060694479 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202837
1#0##0#0#0.0#2018-07-31 08:46:36#0#00:00:00#00:00:00#00:00:00 1
f660e56ae574e623e732ca3e53d7b848 0 0 599399 0 0
3397908 0 0 0 0 2888471 0 0 0 0 0
3201126 B 3 BS 1 18/07/2018 20/07/2018 03/07/1955 0 1
- 0 8908800 9289930 0 3 0 0 0 SANWANIH
0001210525896 3;JKN DR RIZKI; 5.2.2.201806040537 4 203344
1#0##0#0#0.0#2018-07-31 13:37:33#0#00:00:00#00:00:00#00:00:00 1
ac3b7288cd54cfec8639382ac2a1f2e0 0 0 1846030 0 0
3851648 0 0 0 0 3523252 0 0 0 0 69000
3201126 B 3 BS 1 15/07/2018 20/07/2018 01/03/1973 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3303453 0 6 0 0 0 RUSDI D403456 45
DR RIZKI; 5.2.2.201806040537 4 201753 1#0##0#0#0.0#2018-07-31
13:55:36#0#00:00:00#00:00:00#00:00:00 1 82449f0da5c61250841eae0a624e2916
0 0 241100 0 0 1242239 0 0 0 0
1820114 0 0 0 0 0
3201126 B 3 BS 1 18/07/2018 20/07/2018 01/06/1944 0 1
(SEDANG) 25720600 0 0 PCI 10725800 - 0 - 0 -
0 36446400 34352632 0 3 0 0 0 ONIM D386251
0001455726104 3;JKN DR RIZKI; 5.2.2.201806040537 4 203184
1#0##0#0#0.0#2018-07-31 14:13:00#0#12:37:32#12:37:32#12:00:00 1
ee70f3425b01cbf74b8308796f336337 0 8169000 1268260 0 0
16120372 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 1 BS 1 17/07/2018 20/07/2018 09/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 7464200
11961129 0 4 0 0 0 SUCIATI HANDAYANI d262531 35
12973 YASMIN SURYANDARI BACHTIAR. DR. SPB 0138R0170718V006292
0000061059914 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202841
1#0##0#0#0.0#2018-07-31 14:38:18#0#00:00:00#00:00:00#00:00:00 1
bd987aa2afc8489a83465936f9d87279 0 6587000 2164618 0 0
2328507 0 0 0 0 808504 0 0 0 0 72500
3201126 B 1 BS 1 17/07/2018 20/07/2018 20/09/1946 0 1
0 - 0 9673300 4168005 0 4 0 0 0 M
FARID D403594 71 26233 DR HARDI PRANATA SPS 0138R0170718V006299
0000045557515 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202844
1#0##0#0#0.0#2018-07-31 14:39:23#0#22:50:21#22:50:21#00:00:00 1
7fa227531b25c9ff497dd6ab519606f6 0 0 923597 0 0 602735
0 0 0 0 2641673 0 0 0 0 0
3201126 B 1 BS 1 18/07/2018 20/07/2018 17/10/1942 0 1
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 2661196 0 3 0 0 0 MARKUS ATIM D398819
TANTIYO S;16137 5.2.2.201806040537 4 203347 1#0##0#0#0.0#2018-
07-31 19:05:30#0#22:02:44#22:02:44#00:00:00 1
a2a48ce31f732a74c1833a45c4a620cf 0 0 494342 0 0 404757
0 0 0 0 1762097 0 0 0 0 0
3201126 B 1 BS 1 19/07/2018 20/07/2018 18/02/2018 0 1
2054300 0 0 - 0 - 0 - 0 - 0
2054300 5189979 0 2 0 0 0 BY NY EKA TATIEK / M
HABIBI MAULIDA D390783 0 151 DR CATUR SUZANTARA
0138R0170718V006866 0002431287167 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 203357 1#0##0#0#0.0#2018-07-31
19:06:39#0#08:06:55#08:06:55#12:00:00 1 dfe4916ca94f04aa4d2df6c052619316
0 3398000 575204 0 0 778744 0 0 0 0
365531 0 0 0 0 72500
3201126 B 1 BS 1 17/07/2018 20/07/2018 10/05/1953 0 2
- 0 10523000 15621765 0 4 0 0 0 ZARMIATY
0000061010785 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202839
1#0##0#0#0.0#2018-07-31 19:11:56#0#00:00:00#00:00:00#00:00:00 1
a755ab89e7c1ab8f8a6face8de4dab29 0 0 2946440 0 0
4105640 0 0 0 0 8207185 0 0 0 0 362500
3201126 B 1 BS 1 15/07/2018 20/07/2018 20/06/1965 0 2
1 A16.1;J91 87.49;89.52;90.59;33.93 - - None None None None
J-1-30-I None None None None None None PROSEDUR SISTEM PERNAFASAN
KOMPLEKS (RINGAN) 10235200 0 0 - 0 - 0 - 0 -
0 10235200 16127213 0 6 0 0 0 ANI BR KARO
D378464 53 19383 DR MOHAMAD NIZAM ERHAMZA SPP 0138r0170718v005291
0000038796928 3;JKN DR RIZKI; 5.2.2.201806040537 4 201760
1#0##0#0#0.0#2018-08-01 11:05:30#0#17:40:52#17:40:52#12:00:00 1
66f9952168264a3fa4d8fdae545d9cb3 0 0 2783878 0 0
5199784 0 0 0 0 8143551 0 0 0 0 0
3201126 B 2 BS 1 20/07/2018 20/07/2018 25/09/2015 0 1
1 N43.3;Q55.2 63.1 - - None None None None V-1-12-I None
None None None None None PROSEDUR PADA SKROTUM DAN PROSTAT KOMPLEK-
MODERAT (RINGAN) 10368300 0 0 - 0 - 0 - 0 -
0 10368300 9712990 0 1 0 0 0 MUHAMMAD RAFASYA
ZAIDAN d330588 2 1029 DR ASRI RAHMAWATI SPB 0138R0170718V007326
0001738629729 3;JKN DR RIZKI; 5.2.2.201806040537 4 203589
1#0##0#0#0.0#2018-08-01 13:41:03#0#08:11:46#08:11:46#00:00:00 1
d01d1126b959db1f41c02738230a18ca 0 4933300 2903124 0 0
1061942 0 0 0 0 661429 0 0 0 153195
0
3201126 B 2 BS 1 16/07/2018 20/07/2018 09/09/1955 0 2
1 I64;I10;G81.9 87.03;87.44 - - None None None None G-4-
- 0 - 0 - 0 - 0 5866300 6086515 0
5 0 0 0 SUMIATI D403537 62 22956 DR MAYSAM I., SPS
0138R0170718V005816 0001269677766 3;JKN DR RIZKI; 5.2.2.201806040537
4 202148 1#0##0#0#0.0#2018-08-01
17:51:19#0#00:00:00#00:00:00#00:00:00 1 0bd83f5303848e50ab50747d16c53d90
0 0 882140 0 0 2877692 0 0 0 0
2326683 0 0 0 0 0
3201126 B 1 BS 1 17/07/2018 20/07/2018 05/09/1943 0 1
1 D29.1 60.29;90.59 - - None None None None V-1-14-I None
None None None None None PENGANGKATAN PROSTAT MELALUI URETRA (RINGAN)
12373100 0 0 - 0 - 0 - 0 - 0
12373100 23813169 0 4 0 0 0 NAMIN D385703 74
27344 DR HERY TIERA, SPU 0138r0170718v006000 0000060832697 3;JKN
DR RIZKI; 5.2.2.201806040537 4 202444 1#0##0#0#0.0#2018-08-01
17:53:17#0#11:05:36#11:05:36#12:00:00 1 9ddb44495da05f9d1b410898b28a95b1
0 10483600 3588199 0 0 5226328 0 0 0 0
1226000 0 0 0 0 3289042
3201126 B 2 BS 1 18/07/2018 20/07/2018 27/07/2017 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1972422 0 3 0 0 0 MUHAMMAD FADLY SULISTYO
D403300 0 356 DR RASTRA, SPA 0138R0170718V006588
0002269971044 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203198
1#0##0#0#0.0#2018-08-13 16:16:07#0#00:00:00#00:00:00#00:00:00 1
5f73625cbd8b02035ca8ac16e997f09a 0 0 238535 0 0 63850
0 0 0 0 1670037 0 0 0 0 0
3201126 B 2 BS 1 18/07/2018 20/07/2018 12/07/2018 2948 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 2434761 0 3 0 0 0 BAYI NY RINI DWI
PRIMASARI D403188 0 6 DR A.D. PASARIBU SP.A 0138R0170718V006768
0002472720614 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 210984
1#0##0#0#0.0#2018-08-13 16:20:16#0#00:00:00#00:00:00#00:00:00 1
bc212152c1350f82a1977cc286aaac7c 0 0 394812 0 0 160666
0 0 0 0 1539283 0 0 0 0 340000
3201126 B 1 BS 1 15/07/2018 20/07/2018 05/04/2000 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 7050484 0 6 0 0 0 KUSUMA SYAH ALAM
0002431288372 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201754
1#0##0#0#0.0#2018-08-29 19:43:05#0#00:00:00#00:00:00#00:00:00 3
42be6f5bd420f6cbb8a975a658479b27 0 0 338858 0 0
1538379 0 0 0 0 5173247 0 0 0 0 0
3201126 B 2 BS 1 19/07/2018 20/07/2018 24/06/2018 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4950623 0 2 0 0 0 BAYI NY. ANINDITA
PRABASWARI RATNA HANDAYANI D401537 0 25 DR CATUR SUZANTARA
0138R0170718V006910 0002463984472 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 203389 1#0##0#0#0.0#2018-08-29
20:13:23#0#10:00:55#10:00:55#00:00:00 1 9c5b09ad354e87c9d8e5dc65653b0606
0 3578000 352160 0 0 598090 0 0 0 0
349873 0 0 0 0 72500
3201126 B 3 BS 1 14/07/2018 20/07/2018 17/03/1985 0 2
- 0 - 0 - 0 - 0 3874400 13898262 0
7 0 0 0 SYARIFAH D403416 33 12172 DR ARU, SPPD
0138R0170718V005239 0002213407089 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 201731 1#0##0#0#0.0#2018-09-26
19:29:31#0#20:53:36#20:53:36#00:00:00 2 093cbba3f88d14f85b3b0fc50cac3fd9
0 4667300 4775890 0 0 3381840 0 0 0 0
935232 0 0 0 0 138000
3201126 B 1 BS 1 18/07/2018 20/07/2018 07/01/1958 0 2
0 - 0 - 0 - 0 - 0 9150100 12557248
0 3 0 0 0 HILDA ELLY D309277 60 22107 DR HENDRIEK
5.2.2.201806040537 4 203341 1#0##0#0#0.0#2018-09-26
19:33:25#0#00:00:00#00:00:00#00:00:00 2 64aaa7e6b16e7e44dc06827293a88d6c
0 6241500 2653529 0 0 2455873 0 0 0 0
847502 0 0 0 0 358844
3201126 B 3 BS 1 20/07/2018 20/07/2018 18/11/1956 0 1
1 K65.8;R57.9 - - - None None None None K-4-16-II None
None None None None None INFEKSI-INFEKSI GASTROINTESTINAL (SEDANG)
4421800 0 0 - 0 - 0 - 0 - 0
4421800 1354740 0 1 0 0 0 MUHAMMAD YUSUF
0001740129952 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203581
1#0##0#0#0.0#2018-09-26 20:58:27#0#03:07:25#03:07:25#00:00:00 2
84f31eddba4b4a5b90bf9ecf26e54771 0 0 257980 0 0 131132
0 0 0 0 377628 0 0 0 0 588000
3201126 B 1 BS 1 17/07/2018 20/07/2018 24/02/1981 0 2
1 G40.0;E11.9;E87.6;I49.3 87.03;88.72 - - None None None None
G-4-22-III None None None None None None SERANGAN KEJANG (BERAT)
5551000 0 0 - 0 - 0 - 0 - 0
5551000 13001638 0 4 0 0 0 VERA WIDIASTUTI
SUGIYANTO D258689 37 13657 DR NURUL KOMARI SPS 0138R0170718V006185
0001876771495 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204046
1#0##0#0#0.0#2018-09-26 21:08:35#0#17:54:39#17:54:39#00:00:00 2
946158c9f067d2e6eaf7a44552d0e144 0 0 1021509 0 0
5473388 0 0 0 0 5760974 0 0 0 0 745767
3201126 B 2 BS 1 18/07/2018 20/07/2018 12/01/1975 0 2
4 I13.2;A41.9;E87.1 38.95;96.71 - - None None None None J-1-
KOMPLEKS (BERAT) 34963000 0 0 - 0 - 0 - 0 -
0 34963000 26149636 0 3 0 0 0 SITI NURTIAH NY
0001167836409 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203342
1#0##0#0#0.0#2018-10-03 09:14:27#0#00:00:00#00:00:00#00:00:00 2
b898c027cd38defeb741c015d45aa0d8 0 0 7526304 0 0
9927232 0 0 0 0 6213100 0 0 0 0
2483000
3201126 B 1 BS 1 17/07/2018 20/07/2018 17/08/1937 0 1
1 C76.2;D63.8;J18.0 45.23;99.04;90.59;89.52;88.72 - - None None
None None K-4-10-III None None None None None None TUMOR PENCERNAAN
(BERAT) 15540000 0 0 - 0 - 0 - 0 - 0
15540000 12451115 0 4 0 0 0 TN ABDUL BARI
0000060952105 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202163
1#0##0#0#0.0#2018-10-03 09:16:13#0#03:18:54#03:18:54#00:00:00 2
fafe03644d3e07a907769b28748ec9fb 0 0 3019400 0 0
4513756 0 0 0 0 4848959 0 0 0 0 69000
3201126 B 1 BS 1 18/07/2018 21/07/2018 19/05/1960 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5135326 0 4 0 0 0 DWIE UTAMI NY
0001888076417 3;JKN DR RIZKI; 5.2.2.201806040537 4 203349
1#0##0#0#0.0#2018-07-26 10:39:19#0#23:39:21#23:39:21#00:00:00 1
0e01d81afac55fb05650aad7bb9cb30a 0 0 338858 0 0
2091512 0 0 0 0 2704956 0 0 0 0 0
3201126 B 1 BS 1 19/07/2018 21/07/2018 21/04/1988 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 22833447 0 3 0 0 0 JUSTINA ULI KARTINI NY
0001733765455 3;JKN DR RIZKI; 5.2.2.201806040537 4 204047
1#1#vvip#3#15851947#0.0#2018-07-26 10:42:06#0#18:06:31#18:06:31#00:00:00
1 678ad991614d75405497bd0ecaa93cda 0 8023000 8719200 0
0 4773052 0 0 0 0 1241000 0 0 0 0
77195
3201126 B 1 BS 1 19/07/2018 21/07/2018 04/01/1978 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 22966553 0 3 0 0 0 NELLY ANDI LATIEF
0002375171504 3;JKN DR RIZKI; 5.2.2.201806040537 4 203355
1#1#vvip#3#15985053#0.0#2018-07-26 10:46:08#0#00:00:00#00:00:00#00:00:00
1 3a9ab3cb40ee62854b329989fe9b307b 0 8023000 9162200 0
0 4188397 0 0 0 0 1226000 0 0 0 0
366956
3201126 B 1 BS 1 19/07/2018 21/07/2018 30/08/1959 0 1
1 I63.9;G81.9 87.03;90.59;89.52 - - None None None None G-4-
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 5709720 0 3 0 0 0 AGUS AKHIRUDIN
0000036746853 3;JKN DR RIZKI; 5.2.2.201806040537 4 203352
1#0##0#0#0.0#2018-07-26 10:49:42#0#00:00:00#00:00:00#00:00:00 1
6b4c3214744bf3d9950675c47a84f832 0 0 595000 0 0 797187
0 0 0 0 4317533 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 21/07/2018 12/03/1978 0 2
0 - 0 - 0 - 0 - 0 17095200 14735157
0 2 0 0 0 HIHIN CHRISTIANA DEWI D025178 40 14740
DR RIZKI; 5.2.2.201806040537 4 203849 1#0##0#0#0.0#2018-07-27
10:09:24#0#13:35:01#13:35:01#00:00:00 2 9fec2c75a76cbc90ec8b59772825f0a9
0 4777000 3419040 0 0 3480135 0 0 0 0
989982 0 0 0 0 2069000
3201126 B 1 BS 1 20/07/2018 21/07/2018 10/05/1953 0 2
- 0 58821400 66585077 0 2 0 0 0 NUR EVA
MEIWATY D179588 65 23812 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170718V007335 0000159655544 3;JKN DR RIZKI; 5.2.2.201806040537
4 203591 1#0##0#0#0.0#2018-07-27
10:15:46#0#08:23:35#08:23:35#00:00:00 1 29a190cea062a401aae460a5ffa46db4
0 10062000 9619120 0 0 38067745 0 0 0 0
1226000 0 0 0 0 7610212
3201126 B 1 BS 1 19/07/2018 21/07/2018 17/04/1981 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3467010 0 3 0 0 0 EVA ROSDIANA
d403787 37 13607 DR ARU, SPPD 0138R0170718V007186
0001157454573 3;JKN DR RIZKI; 5.2.2.201806040537 4 203565
1#0##0#0#0.0#2018-07-27 10:22:19#0#00:00:00#00:00:00#00:00:00 1
2ceb9dac3d5cbfb65df325ed9ce7c70d 0 0 316331 0 0 900365
0 0 0 0 2250314 0 0 0 0 0
3201126 B 2 BS 1 20/07/2018 21/07/2018 16/11/1978 0 1
1 I13.1;D63.8;K21.9 99.04;39.95 - - None None None None N-4-
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 3233305 0 2 0 0 0 EDI SUGIARTO
0002325240066 3;JKN DR RIZKI; 5.2.2.201806040537 4 204213
1#0##0#0#0.0#2018-07-27 13:30:50#0#19:23:27#19:23:27#12:00:00 1
8e35d115f564d6312ab82700fa896202 0 0 499265 0 0
1694015 0 0 0 0 1040025 0 0 0 0 0
3201126 B 3 BS 1 19/07/2018 21/07/2018 18/08/1980 0 2
0 - 0 - 0 - 0 - 0 6535800 3127236
0 3 0 0 0 JUWITA PUSPA RINI d024254 37 13849
RIZKI; 5.2.2.201806040537 4 203569 1#0##0#0#0.0#2018-07-27
14:12:11#0#00:00:00#00:00:00#00:00:00 1 449349b73b9edc9aa1396b7adaf49380
0 702500 588800 0 0 1605350 0 0 0 0
230586 0 0 0 0 0
3201126 B 3 BS 1 16/07/2018 21/07/2018 07/03/2014 0 1
8041000 0 0 - 0 - 0 - 0 - 0
8041000 10307316 0 6 0 0 0 MUHAMMAD JUL FADLI
0001314028811 3;JKN DR RIZKI; 5.2.2.201806040537 4 201877
1#0##0#0#0.0#2018-07-27 14:22:38#0#10:39:56#10:39:56#12:00:00 1
6a44097fa33571fa5a35cf6e4a2ef92f 0 3728300 2251480 0 0
3407226 0 0 0 0 775310 0 0 0 0 145000
3201126 B 3 BS 1 19/07/2018 21/07/2018 11/09/1965 0 2
1 D25.9;N93.9 69.09 - - None None None None W-1-11-I None
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 6897633 0 3 0 0 0 NENA TARINA D402938
52 19304 DR FAHMIALDI, SPOG 0138R0170718V007204 0001430453766
3;JKN DR RIZKI; 5.2.2.201806040537 4 203570 1#0##0#0#0.0#2018-
07-27 14:51:20#0#00:00:00#00:00:00#00:00:00 1
9d2204d553e5bfe8162faf000af22ccd 0 0 2313976 0 0
1588910 0 0 0 0 2925747 0 0 0 0 69000
3201126 B 3 BS 1 18/07/2018 21/07/2018 16/12/1990 0 1
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2925222 0 4 0 0 0 MARJUK D403667
27 10076 DR ARU, SPPD 0138R0170718V006756 0000812245318 3;JKN
DR RIZKI; 5.2.2.201806040537 4 203337 1#0##0#0#0.0#2018-07-27
14:59:49#0#00:00:00#00:00:00#00:00:00 1 b520159eb102c3b2fdbebd20cde25d70
0 0 268343 0 0 1650509 0 0 0 0
1006370 0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 21/07/2018 01/11/1977 0 1
2 I72.5;G40.9;G44.2 - - - None None None None I-4-15-II
LAIN (SEDANG) 6097900 0 0 - 0 - 0 - 0 -
0 6097900 2503908 0 1 0 0 0 ASEP NANDANG
SUPRIHATIN D348117 40 14872 DR DINI DANIATY 0138R0170718V007765
0001743630603 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204209
1#0##0#0#0.0#2018-07-28 13:29:38#0#00:00:00#00:00:00#00:00:00 1
4ebe9726ec44fbd6591df10219a02fb3 0 0 548811 0 0
1212290 0 0 0 0 452807 0 0 0 0 290000
3201126 B 3 BS 1 21/07/2018 21/07/2018 01/09/1965 0 2
1 G91.9;I60.7 87.03;87.49;90.59;89.52 - - None None None None
- 0 8922900 3513197 0 1 0 0 0 SULASTRI
0000511010515 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204068
1#0##0#0#0.0#2018-07-28 13:33:23#0#01:32:02#01:32:02#00:00:00 1
f979903a98d20688976da23ebb3ab601 0 0 803061 0 0
1134301 0 0 0 0 536835 0 0 0 0
1039000
3201126 B 2 BS 1 19/07/2018 21/07/2018 06/09/2006 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3639588 0 3 0 0 0 FIRYAL NAZLA HANUNAH AN
D403712 11 4334 DR RASTRA, SPA 0138R0170718V006787
0001629236709 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203353
1#0##0#0#0.0#2018-07-28 13:43:28#0#01:21:54#01:21:54#00:00:00 1
683a5425ad6ddb32b57e54ca7ae72c7c 0 0 278711 0 0
1071773 0 0 0 0 1779104 0 0 0 0 510000
3201126 B 2 BS 1 15/07/2018 21/07/2018 15/10/2012 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 12061519 0 7 0 0 0 NURUL AZZAHRA HARAHAP
D324184 5 2099 DR RASTRA, SPA 0138R0170718V005271
0001309542298 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 201748
1#1#vvip#7#9553619#0.0#2018-07-28 13:49:02#0#00:00:00#00:00:00#00:00:00
1 b71f1016a2684de3918169afcdc7abad 0 0 481793 0 0
1889655 0 0 0 0 9350071 0 0 0 0 340001
3201126 B 2 BS 1 18/07/2018 21/07/2018 26/07/1973 0 1
1 E87.2;I13.1;D63.8;R56.8 99.04;39.95 - - None None None None
E-4-11-II None None None None None None HIPOVOLEMIA & GANGGUAN
- 0 5405900 12307904 0 4 0 0 0 SUMARTANA
D369438 44 16428 DR ARU, SPPD 0138R0170718V006531
0001101686411 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203182
1#0##0#0#0.0#2018-07-28 14:05:10#0#00:00:00#00:00:00#00:00:00 1
6109d99e39f7e3a1da5479e39ac1fe66 0 0 509579 0 0
7054885 0 0 0 0 4743440 0 0 0 0 0
3201126 B 2 BS 1 16/07/2018 21/07/2018 23/12/1973 0 1
1 E13.6;E87.5;M79.19;E79.9 - - - None None None None
0 - 0 - 0 5873300 7160704 0 6 0 0
0 HARDIK D403491 44 16276 DR ARU, SPPD
0138R0170718V005803 0001731428662 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 202143 1#0##0#0#0.0#2018-07-28
14:06:55#0#00:00:00#00:00:00#00:00:00 1 2877467afe8722a83a593f3be5b1b1ce
0 0 593590 0 0 3250157 0 0 0 0
3316957 0 0 0 0 0
3201126 B 2 BS 1 20/07/2018 21/07/2018 01/09/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1767710 0 2 0 0 0 SYAFIRA GHANIYAH
ALFATUNNISA D403832 0 322 DR AWIDIYA, SPA 0138R0170718V007228
0002282234398 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203583
1#0##0#0#0.0#2018-07-28 15:06:54#0#00:00:00#00:00:00#00:00:00 1
56e75240682a5c2e4c7f99f66a2cfbd8 0 0 238535 0 0 377530
0 0 0 0 1151645 0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 21/07/2018 01/08/1965 0 1
(RINGAN) 2955200 0 0 - 0 - 0 - 0 - 0
2955200 4809172 0 1 0 0 0 WARNO D404029 52
19347 DR RICO ADITYA 0138R0170718V007783 0000797529249 3;JKN DR
RIZKI; 5.2.2.201806040537 4 204219 1#0##0#0#0.0#2018-07-31
08:29:04#0#00:00:00#00:00:00#00:00:00 1 efefc2b1f25d48270fc5f4edad3c8e9f
0 0 147760 0 0 3271793 0 0 0 0 603619
0 0 0 0 786000
3201126 B 3 BS 1 20/07/2018 21/07/2018 01/03/2002 0 2
1 D64.9;I82.9 99.04 - - None None None None D-4-13-II None
- 0 4227600 2164211 0 2 0 0 0 CINDY AMELIA
SOFYANA D403866 16 5985 DR SOEGIONO, SPPD 0138R0170718V007564
0000511044963 3;JKN DR RIZKI; 5.2.2.201806040537 4 204015
1#0##0#0#0.0#2018-07-31 14:24:24#0#00:00:00#00:00:00#00:00:00 1
3b0a79270a542ff61c1022e747443a0a 0 0 321830 0 0
1148797 0 0 0 0 693584 0 0 0 0 0
3201126 B 3 BS 1 18/07/2018 21/07/2018 23/05/2018 0 2
4336500 0 0 - 0 - 0 - 0 - 0
4336500 4701213 0 4 0 0 0 BAYI NY EUIS DARYATI
0002446809658 3;JKN DR RIZKI; 5.2.2.201806040537 4 202848
1#0##0#0#0.0#2018-07-31 14:42:30#0#07:59:29#07:59:29#00:00:00 2
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1 E87.6;Q96.9;R63.0;E87.1;G31.0;J18.0 - - - None None None
ELEKROLIT (BERAT) 7552000 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-07-31 16:17:31#0#00:00:00#00:00:00#12:00:00 2
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12137727 0 2 0 0 0 KUSTINAH D383640 68 24954
DR RIZKI; 5.2.2.201806040537 4 203628 1#0##0#0#0.0#2018-08-01
11:12:23#0#09:11:45#09:11:45#12:00:00 1 e1b96e957206344dac4917dd86ddf3ea
0 3555000 1521920 0 0 4151144 0 0 0 0
820057 0 0 0 0 2089606
3201126 B 2 BS 1 20/07/2018 21/07/2018 07/04/2015 0 1
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1#0##0#0#0.0#2018-08-01 16:44:17#0#00:00:00#00:00:00#00:00:00 1
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5538724 0 0 0 0 1051647 0 0 0 0 207300
3201126 B 1 BS 1 16/07/2018 21/07/2018 29/07/1942 0 1
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(RINGAN) 7684500 0 0 - 0 - 0 - 0 - 0
7684500 15171769 0 6 0 0 0 ESO SOPANDI,IR MS
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1358599 0 0 0 0 1018546 0 0 0 0 134224
3201126 B 1 BS 1 19/07/2018 21/07/2018 19/07/2018 3109 1
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5118000 2665604 0 3 0 0 0 JUSTINA ULI KARTINI BY
NY d403786 0 0 DR AWIDIYA, SPA 0138R0170718V007435
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1 D64.9;A41.9;I11.0;I69.4 99.04 - - None None None None D-4-
- 0 - 0 6488600 3610052 0 2 0 0 0
MA'ANAH D400900 69 25471 DR BETTY DWI L, SPPD
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4 203582 1#0##0#0#0.0#2018-08-03
10:32:14#0#03:29:31#03:29:31#00:00:00 2 e5a20b5468e42daee5afc92ada7e4c27
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1272172 0 0 0 0 0
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4 203271 1#0##0#0#0.0#2018-08-03
12:43:43#0#00:00:00#00:00:00#00:00:00 2 e17640fff7bbe74fe826ce0049dc10db
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2421373 0 0 0 0 0
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1#0##0#0#0.0#2018-09-08 09:44:19#0#19:50:38#19:50:38#00:00:00 2
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2322125 0 0 0 0 1118686 0 0 0 0 102761
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S;16137 5.2.2.201806040537 4 203641 1#0##0#0#0.0#2018-09-08
09:51:41#0#09:34:13#09:34:13#00:00:00 2 cc2a2dc4cf9489c0c3b812acc1561120
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51 18660 DR ARU, SPPD 0138R0170718V007611 0001814232328 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 204210 1#0##0#0#0.0#2018-
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3201126 B 3 BS 1 18/07/2018 22/07/2018 02/08/1997 0 2
1 K36;I84.5;K29.7 - - - None None None None K-4-18-I
(RINGAN) 1452800 0 0 - 0 - 0 - 0 - 0
1452800 4785654 0 5 0 0 0 SITI NABILAH
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2090000 4206345 0 5 0 0 0 MAHESA MAHAR
d403666 13 4819 DR RASTRA, SPA 0138R0170718V006446
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1#0##0#0#0.0#2018-07-27 11:15:03#0#09:12:13#09:12:13#00:00:00 1
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1833089 0 0 0 0 1616181 0 0 0 0 510000
3201126 B 3 BS 1 21/07/2018 22/07/2018 02/04/1982 0 2
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WAHJU, SPOG 0138R0170718V007747 0001430260964 3;JKN DR RIZKI;
5.2.2.201806040537 4 204201 1#0##0#0#0.0#2018-07-27
11:18:11#0#00:00:00#00:00:00#00:00:00 1 16100b4b7f66e40e5bbff6e8e50742b7
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2167351 0 0 0 0 128000
3201126 B 3 BS 1 18/07/2018 22/07/2018 03/01/1940 0 2
1 D69.6;E87.6;M54.59 - - - None None None None D-4-
11-II None None None None None None GANGGUAN PEMBEKUAN DARAH (SEDANG)
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3;JKN DR RIZKI; 5.2.2.201806040537 4 203224 1#0##0#0#0.0#2018-
07-27 11:31:58#0#00:00:00#00:00:00#00:00:00 1
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3315382 0 0 0 0 1721510 0 0 0 0 0
3201126 B 2 BS 1 19/07/2018 22/07/2018 03/08/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 2940767 0 4 0 0 0 ALPHATTARISYA NUROSYID
D403818 1 715 DR RASTRA, SPA 0138R0170718V007206
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1#0##0#0#0.0#2018-07-27 13:39:57#0#21:12:13#21:12:13#00:00:00 2
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3201126 B 2 BS 1 19/07/2018 22/07/2018 03/07/2016 0 1
1 A09.9;B34.9;J06.9 - - - None None None None K-4-17-I
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2520907 0 4 0 0 0 ABHINAYA ABQARI ABDULLAH
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1#0##0#0#0.0#2018-07-27 13:42:00#0#09:21:44#09:21:44#00:00:00 1
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3201126 B 1 BS 1 22/07/2018 22/07/2018 11/08/1990 0 1
0 - 0 - 0 - 0 - 0 5886000 3039535
0 1 0 0 0 MUHAMMAD ISMAIL TAHIR D404025 27 10207
DR SUKAMTO SPPD 0138R0170718V007791 0000126567865 3;JKN DR RIZKI;
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13:49:39#0#00:00:00#00:00:00#00:00:00 2 7d17ff0182db5f834ad02e8f127ce9b0
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1499847 0 0 0 0 0
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5984100 25851698 0 4 0 0 0 SITI CHOIRUL
D230669 33 12309 DR FERRY SPOG 0138R0170718V006886
0001097343472 3;JKN DR RIZKI; 5.2.2.201806040537 4 204054
1#1#vvip#4#19867598#0.0#2018-07-27 13:57:40#0#19:48:47#19:48:47#00:00:00
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316556
3201126 B 1 BS 1 16/07/2018 22/07/2018 27/03/2018 0 2
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8434852 0 0 0 0 1226000 0 0 0 0
2602224
3201126 B 2 BS 1 20/07/2018 22/07/2018 20/07/2018 3056 1
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4386800 1202649 0 3 0 0 0 NINING KUSTANTI BY NY
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1#0##0#0#0.0#2018-07-28 12:35:41#0#13:57:49#13:57:49#00:00:00 1
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3201126 B 2 BS 1 20/07/2018 22/07/2018 16/05/1975 0 2
5984100 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-07-28 12:54:14#0#08:48:27#08:48:27#00:00:00 1
699e3314ce070a4e735ba0e63fadbb31 0 6132400 2632481 0 0
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3201126 B 2 BS 1 14/07/2018 22/07/2018 28/10/1960 0 1
1 G91.8;I61.9;I10 02.34 - - None None None None G-1-11-III
None None None None None None PROSEDUR VENTRICULAR SHUNT (BERAT)
43018400 0 0 - 0 - 0 - 0 - 0
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d340311 57 21078 DR MAYSAMIRAWATI SPS 0138R0170718V005229
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1#0##0#0#0.0#2018-07-28 15:19:54#0#00:00:00#00:00:00#00:00:00 1
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3795557
3201126 B 3 BS 1 19/07/2018 22/07/2018 04/10/1979 0 2
1 N18.5;E87.7;I50.0;A09.9;A49.9;E87.5;E11.9 87.49;90.59;89.52 - -
None None None None N-4-10-II None None None None None None TUMOR
GINJAL & SALURAN URIN & GAGAL GINJAL (SEDANG) 4132100 0 0 - 0
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0 0 OKKY INDARTI DEWI NY D328891 38 14168 SRI
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14:45:17#0#00:00:00#00:00:00#00:00:00 1 8e1e6f7deaa4267f3b5e1335e46203b7
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2194424 0 0 0 0 0
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2061500 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-08-01 11:20:01#0#00:00:00#00:00:00#00:00:00 1
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1 H81.1;N39.0 - - - None None None None U-4-11-II None
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3 0 0 0 FAUZIYYAH D045621 26 9679 DR BETTY DWI L,
4 203909 1#0##0#0#0.0#2018-08-01
11:51:45#0#14:37:05#14:37:05#00:00:00 1 b4b05162df8500178a45bd867420ad0a
0 0 344356 0 0 1404055 0 0 0 0
1771259 0 0 0 0 0
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SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-08-02 15:00:26#0#09:12:38#09:12:38#12:00:00 1
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2857025 0 0 0 0 1929207 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 22/07/2018 01/10/1990 0 2
3734400 0 0 - 0 - 0 - 0 - 0
3734400 10460357 0 7 0 0 0 ANNISYA EKATIANA
0002205306022 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202054
1#0##0#0#0.0#2018-08-13 13:44:10#0#00:00:00#00:00:00#00:00:00 1
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3966704 0 0 0 0 6177322 0 0 0 0 0
3201126 B 3 BS 1 17/07/2018 22/07/2018 23/02/2009 0 2
1 Q42.2 49.6;48.69 - - None None None None K-1-20-I None
12174500 0 0 - 0 - 0 - 0 - 0
12174500 9850270 0 6 0 0 0 ALUNG CAHYA UTAMI
0001739999452 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202166
1#0##0#0#0.0#2018-08-29 19:54:05#0#07:51:19#07:51:19#00:00:00 1
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3199503 0 0 0 0 670410 0 0 0 0 59281
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5118000 0 0 - 0 - 0 - 0 - 0
5118000 9909504 0 4 0 0 0 BAYI NY. MERIANA
SULISTIANI D403821 0 0 DR OTTY MITHA S, SPA 0138R0170718V007633
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1#0##0#0#0.0#2018-08-29 20:15:14#0#00:00:00#00:00:00#00:00:00 1
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1870000
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0 - 0 - 0 - 0 - 0 3802000 2183588
0 1 0 0 0 MAD DAMIN D404046 66 24142 DR IRVAN
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11:32:17#0#09:44:31#09:44:31#00:00:00 2 a368d34b08679586ff64b598cf5d8b2e
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0 0 - 0 - 0 - 0 - 0 8877800
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3;JKN TANTIYO S;16137 5.2.2.201806040537 4 221501
1#0##0#0#0.0#2018-09-28 11:40:48#0#00:00:00#00:00:00#00:00:00 1
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3498015 0 0 0 0 4777000 0 0 0 2110212
0
3201126 B 1 BS 1 21/07/2018 23/07/2018 15/08/1964 0 2
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0138R0170718V007750 0001609262177 3;JKN DR RIZKI; 5.2.2.201806040537
4 204203 1#0##0#0#0.0#2018-07-27
15:33:24#0#14:54:30#14:54:30#00:00:00 1 adf33ca22d27864e79fc5c5aabec6e45
0 0 5682582 0 0 5660052 0 0 0 0
7813000 0 0 0 0 54542
3201126 B 1 BS 1 21/07/2018 23/07/2018 04/08/1997 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4064578 0 3 0 0 0 RENALDO MANALU
D093852 20 7656 DR ARU, SPPD 0138R0170718V007706
0001743520972 3;JKN DR RIZKI; 5.2.2.201806040537 4 204102
1#0##0#0#0.0#2018-07-27 16:14:14#0#09:41:52#09:41:52#00:00:00 1
86cf3208d68f2d7346fc49e2181b24ce 0 0 316331 0 0
1113340 0 0 0 0 2634907 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 23/07/2018 12/07/1963 0 1
- 0 4903800 5899751 0 4 0 0 0 DRS H.
HASANUDDIN. AS. M.SI D048869 55 20097 DR ARU, SPPD
0138R0170718V007980 0001314409274 3;JKN DR RIZKI; 5.2.2.201806040537
4 204289 1#0##0#0#0.0#2018-07-27
16:32:00#0#08:56:47#08:56:47#00:00:00 1 d88062ef4aed6453da37b1d782650ca8
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3190465 0 0 0 0 0
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INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-07-27 16:33:03#0#13:29:32#13:29:32#00:00:00 1
03b6d9be5fbdb5ac9ca781bd67101e56 0 0 2752151 0 0
2141425 0 0 0 0 7693046 0 0 0 0 153195
3201126 B 2 BS 1 22/07/2018 23/07/2018 23/01/1956 0 2
- 0 10690500 10043220 0 2 0 0 0 RATNANINGSIH
NY D401841 62 22826 SRI KUNMARTINI.DR,SPPD 0138R0170718V007823
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37#0##0#0#0.0#2018-07-28 12:39:38#0#16:44:27#16:44:27#00:00:00 1
fdcc23ace92cb29d82789d46acb09aa4 0 4703600 2276624 0 0
2299611 0 0 0 0 683033 0 0 0 0 80352
3201126 B 2 BS 1 22/07/2018 23/07/2018 01/08/1958 0 1
- 0 10690500 10000309 0 2 0 0 0 SUNARDI
0001607940213 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204240
1#0##0#0#0.0#2018-07-28 12:55:54#0#00:00:00#00:00:00#12:00:00 1
7db83e0070a0bc0d83b1b65487839fed 0 0 1097700 0 0
3872463 0 0 0 0 4911826 0 0 0 0 118320
3201126 B 3 BS 1 20/07/2018 23/07/2018 19/08/1981 0 2
1 I12.9;J18.0;D63.8;H81.3 89.52;87.44 - - None None None None
- 0 7238900 7009038 0 4 0 0 0 IIN
SUPRIATIN D385388 36 13484 SRI KUNMARTINI.DR,SPPD 0138R0170718V007270
0002282454371 3;JKN DR RIZKI; 5.2.2.201806040537 4 203585
1#0##0#0#0.0#2018-07-31 14:19:09#0#00:00:00#00:00:00#12:00:00 1
e85ba4d338ea544a6e94e446b28db146 0 0 599993 0 0
1886260 0 0 0 0 4522785 0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 23/07/2018 01/12/1961 0 2
4854000 0 0 - 0 - 0 - 0 - 0
4854000 3075910 0 3 0 0 0 MARYANI D390224
0000510024475 3;JKN DR RIZKI; 5.2.2.201806040537 4 204685
40#0##0#0#0.0#2018-07-31 14:19:57#0#17:46:48#17:46:48#12:00:00 1
2e5b058305a03459bcafa8a6d4fcaa71 0 0 489860 0 0
1569822 0 0 0 0 1016228 0 0 0 0 0
3201126 B 3 BS 1 19/07/2018 23/07/2018 21/08/1965 0 2
1 I50.0;J90;E11.9 89.52 - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 4973600
4081729 0 5 0 0 0 MARTINI D376222 52 19325
DR RIZKI; 5.2.2.201806040537 4 203577 1#0##0#0#0.0#2018-07-31
14:27:17#0#00:12:42#00:12:42#12:00:00 1 004d83a0b8b1906773a48a7a68b35343
0 0 631691 0 0 2105009 0 0 0 0
1345029 0 0 0 0 0
3201126 B 3 BS 1 20/07/2018 23/07/2018 06/11/2017 0 1
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 5752871 0 4 0 0 0 MUHAMMAD AFIF ABDUL
GHANI D403762 0 256 DR AWIDIYA, SPA 0138R0170718V008078
0002307253476 3;JKN DR RIZKI; 5.2.2.201806040537 4 204455
1#0##0#0#0.0#2018-07-31 14:29:25#0#00:00:00#00:00:00#00:00:00 1
420775751c0d6fdc5515da72704cf48b 0 0 323585 0 0 502430
0 0 0 0 4926856 0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 23/07/2018 28/06/1980 0 2
- 0 45079800 52184297 0 3 0 0 0 ROSITA
RAHAYU.S D120131 38 13902 DR AZRI NURIZAL SPPD KKV
0138R0170718V007777 0002215537031 3;JKN DR RIZKI; 5.2.2.201806040537
4 204698 1#0##0#0#0.0#2018-07-31
14:32:34#0#19:55:22#19:55:22#00:00:00 1 ed733949a5742637270d6e57361b919e
0 8169000 6870800 0 0 28308285 0 0 0 0
1226000 0 0 0 0 7610212
3201126 B 3 BS 1 13/07/2018 23/07/2018 17/08/1953 0 1
1 E87.8;A41.9;I13.2;I69.4 87.49;87.03;90.59;89.52 - - None None
None None E-4-11-III None None None None None None HIPOVOLEMIA &
GANGGUAN ELEKROLIT (BERAT) 6293300 0 0 - 0 - 0 -
0 - 0 6293300 20101506 0 11 1 0 0 MAMAN
RAHMAN D396810 64 23706 DR NURUL KOMARI SPS 0138R0170718V005124
0000512020056 3;JKN DR RIZKI; 5.2.2.201806040537 4 201609
1#0##0#0#0.0#2018-07-31 14:39:58#0#20:29:00#20:29:00#00:00:00 2
8a51fe8b92a991603c9af1b02d38b648 0 0 758929 0 0
7890077 0 0 0 0 7082500 0 0 0 0
4370000
3201126 B 2 BS 1 21/07/2018 23/07/2018 06/06/1957 0 1
0 - 0 - 0 - 0 1821000 3142103 0 3
0 0 0 HARYONO TN D403938 61 22325 DR NURUL KOMARI SPS
0138R0170718V007727 0000211091984 3;JKN DR RIZKI; 5.2.2.201806040537
4 204172 1#0##0#0#0.0#2018-08-01
08:21:45#0#12:43:54#12:43:54#00:00:00 1 0159b78b55270b30de52c3c253ec8619
0 0 216890 0 0 1178655 0 0 0 0
1746558 0 0 0 0 0
3201126 B 2 BS 1 20/07/2018 23/07/2018 28/12/1959 0 1
1 D29.1;E14.8;R33 - - - None None None None V-4-11-II
- 0 5945900 4936463 0 4 0 0 0 YOHANES
MARYONO D386220 58 21389 DR. ARU ARIADNO, SPPD 0138R0170718V007576
0001377205975 3;JKN DR RIZKI; 5.2.2.201806040537 4 204695
1#0##0#0#0.0#2018-08-01 08:23:56#0#19:48:31#19:48:31#12:00:00 1
5af9d583ee11b8b4e5dc71b2cc2cd7de 0 0 504835 0 0
2062682 0 0 0 0 2368946 0 0 0 0 0
3201126 B 2 BS 1 19/07/2018 23/07/2018 27/12/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4280585 0 5 0 0 0 BAYI NY NITA AURORA. S
D385758 0 204 DR HUDA, SPA 0138R0170718V007208
0002319253918 3;JKN DR RIZKI; 5.2.2.201806040537 4 203574
1#0##0#0#0.0#2018-08-01 11:22:21#0#21:52:27#21:52:27#12:00:00 1
d666d5852722f019e53d17a75fcdf6b7 0 0 291535 0 0
1365512 0 0 0 0 2623538 0 0 0 0 0
3201126 B 2 BS 1 21/07/2018 23/07/2018 01/05/2018 0 1
0 - 0 - 0 - 0 - 0 2671100 3455812
0 3 0 0 0 RAFA RASYID KHAIRI d403936 0 81
RIZKI; 5.2.2.201806040537 4 204169 1#0##0#0#0.0#2018-08-01
11:30:01#0#11:55:37#11:55:37#00:00:00 1 8f5ca1f989371ed28bc98ed97a746eab
0 0 293399 0 0 1055332 0 0 0 0
1767081 0 0 0 0 340000
3201126 B 2 BS 1 21/07/2018 23/07/2018 13/07/2016 0 1
LAIN (RINGAN) 3358200 0 0 - 0 - 0 - 0 -
0 3358200 2827442 0 3 0 0 0 KHALIFA ARSEN
SYAHPUTRA d338564 2 738 DR HUDA, SPA 0138R0170718V007656
0002070183543 3;JKN DR RIZKI; 5.2.2.201806040537 4 204069
1#0##0#0#0.0#2018-08-01 11:53:31#0#00:00:00#00:00:00#00:00:00 1
675fd48e6b8e4e715373290869e32ca1 0 0 266858 0 0 834611
0 0 0 0 1725973 0 0 0 0 0
3201126 B 2 BS 1 21/07/2018 23/07/2018 24/09/1993 0 2
1 N61 85.20 - - None None None None L-1-50-I None None
0 - 0 - 0 - 0 - 0 7842900 8572256
0 3 0 0 0 SARI MAULIDA D323275 24 9066 DR
HENDRIEK SP B 0138R0170718V007781 0001014392722 3;JKN DR RIZKI;
5.2.2.201806040537 4 204218 1#0##0#0#0.0#2018-08-01
13:37:07#0#00:00:00#00:00:00#00:00:00 1 d08cd2ee9874ebaf2efe91d62a83fae2
0 4439100 584444 0 0 2672528 0 0 0 0
616802 0 0 0 0 259382
3201126 B 2 BS 1 19/07/2018 23/07/2018 20/06/2008 0 1
9649200 0 0 - 0 - 0 - 0 - 0
9649200 13111379 0 5 0 0 0 M FAHRI RUSMANA
0001183665609 3;JKN DR RIZKI; 5.2.2.201806040537 4 203388
1#0##0#0#0.0#2018-08-01 13:49:23#0#09:58:39#09:58:39#00:00:00 1
0795d1c0a64e1fa3409cd8606b15f9fb 0 6178300 1240820 0 0
4663505 0 0 0 0 883754 0 0 0 145000
0
3201126 B 3 BS 1 21/07/2018 23/07/2018 06/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 4144700
2899019 0 3 0 0 0 WARTI D379236 59 21715 DR
5.2.2.201806040537 4 204067 1#0##0#0#0.0#2018-08-01
18:00:06#0#00:00:00#00:00:00#12:00:00 1 deb43714eeaf38f1f7550320f40e7b3c
0 0 469870 0 0 1424494 0 0 0 0
1004655 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 23/07/2018 19/07/1940 0 2
1 S06.5;G81.9;I10;R47.0 01.28 - - None None None None G-1-
10-II None None None None None None KRANIOTOMI (SEDANG) 28670800 0
0 - 0 - 0 - 0 - 0 28670800 30729357
0 8 0 0 0 LIEN LAGARDE d308504 77 28486 DR
5.2.2.201806040537 4 202588 1#0##0#0#0.0#2018-08-02
14:32:19#0#13:07:06#13:07:06#00:00:00 1 a110660de78ee164ede23f587f64b9df
0 10812700 8482213 0 0 8328306 0 0 0 0
1607900 0 0 0 0 1498238
3201126 B 1 BS 1 21/07/2018 23/07/2018 19/09/2017 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5075448 0 3 0 0 0 TENGKU MUHAMMAD ABRAR
ALAMSYAH D379626 0 305 DR HUDA, SPA 0138R0170718V007649
0002445415479 3;JKN DR RIZKI; 5.2.2.201806040537 4 204066
1#1#vvip#3#2149548#0.0#2018-08-02 14:35:08#0#00:00:00#00:00:00#00:00:00
1 2ca5a1e7a68e7e1c45024a5a9f9c2e79 0 0 513829 0 0
354580 0 0 0 0 4207039 0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 23/07/2018 13/11/1955 0 1
0 - 0 - 0 - 0 - 0 9150100 7040600
0 2 0 0 0 MUHAMMAD LUTFY d403253 62 22897
RIZKI; 5.2.2.201806040537 4 204242 1#0##0#0#0.0#2018-08-02
14:37:21#0#00:00:00#00:00:00#00:00:00 1 a67233d5e4e85d5c31e57cd3e4e4f70e
0 0 2236400 0 0 2755600 0 0 0 0
2048600 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 23/07/2018 08/12/1964 0 2
1 A09.9;E14.9 - - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4221783 0 3 0 0 0 BETI NURBAITI
D023477 53 19583 DR ARU, SPPD 0138R0170718V007751
0000061104644 3;JKN DR RIZKI; 5.2.2.201806040537 4 204204
1#0##0#0#0.0#2018-08-02 14:39:02#0#00:00:00#00:00:00#00:00:00 1
c223e9181afcf02fa3ce9f937137f3b4 0 0 338858 0 0
1237734 0 0 0 0 2645191 0 0 0 0 0
3201126 B 1 BS 1 16/07/2018 23/07/2018 22/12/1974 0 1
1 I61.9;G40.9;G81.9;I10;N18.9 87.03;87.44 - - None None None
None G-4-13-II None None None None None None PERDARAHAN INTRA KRANIAL
0 - 0 7214600 18208747 0 8 0 0 0 DEDI
0001652973129 3;JKN DR RIZKI; 5.2.2.201806040537 4 201781
1#0##0#0#0.0#2018-08-02 14:51:26#0#00:00:00#00:00:00#00:00:00 1
999098d59496e8f141faaadc25e821a2 0 0 463639 0 0
8048882 0 0 0 0 7833226 0 0 0 0
1863000
3201126 B 1 BS 1 20/07/2018 23/07/2018 21/03/1958 0 1
1 A49.9;R07.4 89.52 - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4559370 0 4 0 0 0 SARBANI H D403836
60 22036 DR ARU, SPPD 0138R0170718V007450 0000061015487 3;JKN
DR RIZKI; 5.2.2.201806040537 4 203844 1#0##0#0#0.0#2018-08-02
14:52:48#0#12:18:06#12:18:06#00:00:00 1 fa5ca7cabbbfb7985093464f8850c81b
0 0 338858 0 0 772235 0 0 0 0
3448277 0 0 0 0 0
3201126 B 1 BS 1 12/07/2018 23/07/2018 23/11/1968 0 2
1 C18.7;C78.7;K66.0;A41.9 46.11;99.04 - - None None None None
K-1-20-III None None None None None None PROSEDUR INTESTINAL KOMPLEKS
(BERAT) 34761000 0 0 - 0 - 0 - 0 - 0
34761000 68224782 0 12 1 2 0 DWI RACHMA S
0000060497774 3;JKN DR RIZKI; 5.2.2.201806040537 4 202083
1#0##0#0#0.0#2018-08-02 15:04:26#0#00:00:00#00:00:00#12:00:00 1
88da3d74e1332ef860951f9e2deb13d4 0 22358100 11745528 0 0
30894650 0 0 0 0 1336000 0 0 0 0
1890504
3201126 B 1 BS 1 21/07/2018 23/07/2018 06/03/2006 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 5459149 0 3 0 0 0 M. KENZIE ANATA
0001106925939 3;JKN DR RIZKI; 5.2.2.201806040537 4 204208
1#1#vvip#3#2533249#0.0#2018-08-02 15:05:34#0#00:00:00#00:00:00#00:00:00
1 857baef8ff4bb9779fbb43952a16a748 0 0 513829 0 0
725179 0 0 0 0 4220141 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 23/07/2018 07/07/1950 0 1
0 - 0 - 0 - 0 - 0 5005900 3664114
0 3 0 0 0 ABDUR ROHMAN HMN D378967 68 24851 DR
5.2.2.201806040537 4 204205 1#0##0#0#0.0#2018-08-02
15:09:19#0#00:00:00#00:00:00#00:00:00 1 a5c176d00f4abcc22e7c43b9cb913478
0 0 679679 0 0 375727 0 0 0 0
2608708 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 23/07/2018 13/08/1964 0 2
0 - 0 - 0 - 0 4784600 4561366 0 3
0 0 0 LINA HERLINA D288076 53 19700 DR AZRI NURIZAL
SPPD KKV 0138R0170718V007647 0000061158677 3;JKN DR RIZKI;
5.2.2.201806040537 4 204065 1#0##0#0#0.0#2018-08-02
15:17:18#0#00:00:00#00:00:00#00:00:00 1 75f2c1ec5f5282a0a40f4f6bc2c1ffb6
0 0 483614 0 0 1410345 0 0 0 0
2667407 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 23/07/2018 25/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 5802600
5158700 0 4 0 0 0 DEDE TATI HARTATI D330629 59
3;JKN DR RIZKI; 5.2.2.201806040537 4 203673 1#0##0#0#0.0#2018-
08-02 15:18:26#0#10:09:05#10:09:05#12:00:00 1
065dcd2244e70433cbd5690db00a8811 0 0 633260 0 0
1037955 0 0 0 0 3487485 0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 23/07/2018 18/02/1962 0 1
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
6076700 13363563 0 2 0 0 0 HANGGODO TN D404060
3;JKN DR RIZKI; 5.2.2.201806040537 4 204238 1#0##0#0#0.0#2018-
08-02 15:19:29#0#17:29:15#17:29:15#00:00:00 1
31e4cab52131a80b5d5493e732000a0c 0 7610400 2264919 0 0
2489523 0 0 0 0 900252 0 0 0 0 98469
3201126 B 1 BS 1 14/07/2018 23/07/2018 11/04/1945 0 1
1 I64;G81.9;D29.1;I10 87.03;87.44 - - None None None None
0 0 - 0 - 0 - 0 - 0 6844000
14621745 0 10 0 0 0 SUHANAN. E D040166 73 26757
DR MAYSAMIRAWATI SPS 0138R0170718V005131 0000045451089 3;JKN DR
RIZKI; 5.2.2.201806040537 4 204699 1#0##0#0#0.0#2018-08-02
15:21:37#0#20:00:33#20:00:33#00:00:00 1 db05e4a3f530ac8da17f6f5170178897
0 0 1020329 0 0 4808853 0 0 0 0
8792563 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 23/07/2018 19/09/2017 0 1
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4337117 0 4 0 0 0 MUHAMMAD FAEYZA ELFATIH
0002308080058 3;JKN DR RIZKI; 5.2.2.201806040537 4 203584
1#0##0#0#0.0#2018-08-02 15:24:51#0#00:00:00#00:00:00#00:00:00 1
e7e5709add6129abbbc90c86717983b4 0 0 338857 0 0 564523
0 0 0 0 3433737 0 0 0 0 0
3201126 B 1 BS 1 23/07/2018 23/07/2018 29/05/1990 0 2
- 0 - 0 - 0 - 0 3103000 5269594 0
1 0 0 0 DEVI ARYANI D399111 28 10282 RACHMAWATI
5.2.2.201806040537 4 204247 1#0##0#0#0.0#2018-08-02
15:29:08#0#00:00:00#00:00:00#00:00:00 1 e5e92a823025c26e76e3daede962120f
0 0 620600 0 0 3217254 0 0 0 0
1431740 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 23/07/2018 06/04/1968 0 2
1 E14.1;A09.9;R11 - - - None None None None E-4-10-I
0 - 0 4903800 5606397 0 4 0 0 0
SUMINASIH,NY D403909 50 18367 DR BETTY DWI L, SPPD
0138R0170718V007643 0000036150401 3;JKN DR RIZKI; 5.2.2.201806040537
4 204063 1#1#vvip#4#702597#0.0#2018-08-02
15:30:34#0#00:00:00#00:00:00#00:00:00 1 909916adf6ee6da98ff24300914fe632
0 0 494342 0 0 1388281 0 0 0 0
3723774 0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 23/07/2018 28/05/2016 0 1
- 0 - 0 - 0 - 0 2655900 2160692 0
3 0 0 0 MUHAMMAD FATIH ARRIZQI D403919 2 784 DR
5.2.2.201806040537 4 204070 1#0##0#0#0.0#2018-08-13
08:40:10#0#00:00:00#00:00:00#00:00:00 1 93c9d18f9cc6c0ba04b380c7ffed289b
0 0 292031 0 0 912307 0 0 0 0 956354
0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 23/07/2018 31/10/1992 0 2
None None None None GANGGUAN POSTPARTUM (RINGAN) 1551900 0 0
- 0 - 0 - 0 - 0 1551900 1716799 0
3 0 0 0 NOVIA D403933 25 9394 DR ERDIYAN, SPOG
0138R0170718V007704 0002324306248 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 204104 1#0##0#0#0.0#2018-08-13
08:47:07#0#09:42:20#09:42:20#00:00:00 1 3126cd0f5649da3c9edca2e7f899d068
0 0 248147 0 0 541338 0 0 0 0 927314
0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 23/07/2018 05/03/1972 0 1
- 0 12472300 13510881 0 2 0 0 0 ABDUL AZIZ
TN D404055 46 16940 SRI KUNMARTINI.DR,SPPD 0138R0170718V007825
0002355547015 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204237
1#0##0#0#0.0#2018-08-13 13:31:37#0#17:10:58#17:10:58#00:00:00 1
c6a0aed29b681307c415b3e236c87bfd 0 0 2647238 0 0
4403254 0 0 0 0 6460389 0 0 0 0 0
3201126 B 2 BS 1 17/07/2018 23/07/2018 10/11/1960 0 2
1 I95.9;A41.9;D63.8;E14.7;J18.9;I13.0 99.04;93.94 - - None None
- 0 - 0 9767800 28104423 0 7 0 0 0
NANI MARDIYANTI D391261 57 21068 DR SRI KUNMARTINI, SPPD
0138R0170718V006062 0001730363848 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 202589 1#0##0#0#0.0#2018-08-13
16:37:05#0#13:33:03#13:33:03#12:00:00 1 dbc9b87019ea0f4ffcdc49e3eba0da1c
0 0 932102 0 0 13723321 0 0 0 0
7337000 0 0 0 0 6112000
3201126 B 3 BS 1 23/07/2018 23/07/2018 12/08/2014 0 1
5489000 0 0 - 0 - 0 - 0 - 0
5489000 2000000 0 1 0 0 0 MUHAMMAD JAWAD M AN
D403905 3 1441 DR ASRI RAHMAWATI SPB 00000000000000
00000000000000 3;JKN DR RIZKI; 5.2.2.201806040537 4 204319
24#0##0#0#0.0#2018-08-16 09:50:50#0#09:27:51#09:27:51#00:00:00 1
edb32cb6019a0dba0107f86563bd93ae 0 0 2000000 0 0 0
0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 23/07/2018 31/03/1950 0 2
- 0 - 0 27065300 17185825 0 2 0 0 0
NURLAELA D388786 68 24950 SRI KUNMARTINI.DR,SPPD
0138R0170718V007820 0001845558246 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 204235 1#0##0#0#0.0#2018-08-29
19:55:21#0#00:00:00#00:00:00#12:00:00 1 6f315b79f0b5d68817c831dc815da7e7
0 0 2600460 0 0 7458707 0 0 0 0
7046306 0 0 0 0 80352
3201126 B 3 BS 1 19/07/2018 23/07/2018 17/03/1972 0 2
1 I21.9;I11.0;E87.1;N18.5;D63.8 39.95 - - None None None None
10401900 0 0 - 0 - 0 - 0 - 0
10401900 12571420 0 5 0 0 0 ERLIYANI D393077
46 16925 DR ARU, SPPD 0138R0170718V007214 0001264472122 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 203576 1#0##0#0#0.0#2018-
08-29 20:17:20#0#00:10:49#00:10:49#12:00:00 1
289c39e770f2562fd11aea36bcc07f38 0 0 1093190 0 0
5415551 0 0 0 0 4886679 0 0 0 0
1176000
3201126 B 1 BS 1 19/07/2018 23/07/2018 31/12/1949 0 2
1 I20.0;N18.5;I50.0 89.52 - - None None None None I-4-20-II
6795600 0 0 - 0 - 0 - 0 - 0
6795600 7068588 0 5 0 0 0 ARMAH,NY D222920
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204617
1#0##0#0#0.0#2018-09-08 09:47:28#0#14:55:54#14:55:54#00:00:00 2
53bcfb20ad5778a63eebe3e8cfc864b7 0 0 1038600 0 0
1608182 0 0 0 0 4421806 0 0 0 0 0
3201126 B 2 BS 1 12/07/2018 23/07/2018 13/03/1936 0 2
1 I21.2;R57.0;I50.9;I48;I24.9 89.52 - - None None None None
12482300 0 0 - 0 - 0 - 0 - 0
12482300 26584150 0 12 1 8 0 TUMINAH d403110
0000164717482 3;JKN DR RIZKI; 5.2.2.201806040537 4 200519
1#0##0#0#0.0#2018-09-12 12:18:20#0#00:00:00#00:00:00#00:00:00 3
765338754c31adc9218030a6496003e9 0 0 1093189 0 0
9189961 0 0 0 0 10230000 0 0 0 0
6071000
3201126 B 3 BS 1 22/07/2018 23/07/2018 06/07/1973 0 2
1 N18.5;E14.9 38.95;99.21 - - None None None None N-1-12-I
- 0 4340500 15108798 0 2 0 0 0 SURYANIH
0000510484735 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204229
1#0##0#0#0.0#2018-09-26 20:06:24#0#10:04:51#10:04:51#00:00:00 2
32808b8be53369153fff475338229147 0 0 3972480 0 0
6900392 0 0 0 0 4166926 0 0 0 0 69000
3201126 B 1 BS 1 22/07/2018 24/07/2018 13/11/1952 0 1
- 0 12472300 18079692 0 3 0 0 0 SUJATMAN
HADI SANTOSO D391530 65 23992 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V007835 0000036424719 3;JKN DR RIZKI; 5.2.2.201806040537
4 204241 1#0##0#0#0.0#2018-07-27
15:35:33#0#00:00:00#00:00:00#12:00:00 2 07fa426cfb8d70c70bcf047c43a50cb7
0 0 2547460 0 0 7884948 0 0 0 0
7450284 0 0 0 0 197000
3201126 B 1 BS 1 21/07/2018 24/07/2018 07/08/1995 0 2
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0 - 0 - 0 3513000 12187803 0 4 0 0
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0138R0170718V008241 0001328129256 3;JKN DR RIZKI; 5.2.2.201806040537
4 204647 1#1#vvip#4#8674803#0.0#2018-07-27
16:35:15#0#00:00:00#00:00:00#00:00:00 1 463c6ee38e52038547329ee8a08196e6
0 0 3683000 0 0 1584920 0 0 0 0
6501883 0 0 0 0 418000
3201126 B 2 BS 1 21/07/2018 24/07/2018 25/07/1965 0 1
1 I50.0;I25.1;A09.9 89.52;90.59 - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4290800
5740509 0 4 0 0 0 DINO RACHMANTO D349758 52
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204074
1#0##0#0#0.0#2018-07-28 12:43:49#0#05:03:50#05:03:50#00:00:00 1
7dcda47068f662fcffd5484c600f7bd0 0 0 439172 0 0 983890
0 0 0 0 3141447 0 0 0 0 1176000
3201126 B 2 BS 1 20/07/2018 24/07/2018 11/03/1961 0 1
1 L04.0 - - - None None None None D-4-14-I None None
None None None None GANGGUAN PADA DARAH & ORGAN PEMBENTUK DARAH LAIN-LAIN
(RINGAN) 3844400 0 0 - 0 - 0 - 0 - 0
3844400 6193644 0 5 0 0 0 SUPRIYADI D403908
57 20950 DR ARU, SPPD 0138R0170718V007644 0001324658395 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 204064 1#0##0#0#0.0#2018-
07-28 12:47:37#0#00:00:00#00:00:00#00:00:00 1
63d3d60d06401757dc6db4fec9dd30df 0 0 504996 0 0
3237456 0 0 0 0 2451192 0 0 0 0 0
3201126 B 2 BS 1 21/07/2018 24/07/2018 03/04/2010 0 1
2507900 0 0 - 0 - 0 - 0 - 0
2507900 3503365 0 4 0 0 0 AHMAD FAIZ NURACHMAN
0001620091596 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204207
1#0##0#0#0.0#2018-07-28 12:48:45#0#15:26:03#15:26:03#00:00:00 1
711dc0734957f9451b3c0c56ebb390a9 0 0 278711 0 0 439462
0 0 0 0 2275192 0 0 0 0 510000
3201126 B 2 BS 1 23/07/2018 24/07/2018 11/03/1996 0 2
(RINGAN) 4425400 0 0 - 0 - 0 - 0 - 0
4425400 2667679 0 2 0 0 0 MARIA DINDA SHETA NN
D404072 22 8169 DR ARU, SPPD 0138R0170718V007846
0002306105921 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204246
1#0##0#0#0.0#2018-07-28 13:03:18#0#02:08:48#02:08:48#00:00:00 1
ad854d09521ee4c5732ecbd9740cc7c4 0 0 311408 0 0
1145750 0 0 0 0 1210521 0 0 0 0 0
3201126 B 3 BS 1 22/07/2018 24/07/2018 15/07/1970 0 1
1 I25.0;I20.0;I11.0 88.55;36.07;87.49;90.59;89.52 - - YY02 None
0 - 0 - 0 45079800 57144264 0 3 0 0
0 JAYADIH D404053 48 17539 DR AZRI NURIZAL SPPD KKV
0138R0170718V007829 0000512817096 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 204239 1#0##0#0#0.0#2018-07-28
13:13:57#0#00:00:00#00:00:00#00:00:00 1 75395bf6c2b4edcee9d0642f746e9658
0 8082500 6923800 0 0 33301752 0 0 0 0
1226000 0 0 0 0 7610212
3201126 B 3 BS 1 23/07/2018 24/07/2018 12/07/1978 0 1
1 N20.2 56.0;59.8;88.76;90.59;89.52 - - None None None None
- 0 8041000 10384392 0 2 0 0 0 AHMAD RONNIH
TN D402102 40 14621 MOHAMMAD JOHAN 0138R0170718V007932
0001310733224 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204249
1#0##0#0#0.0#2018-07-28 13:23:59#0#00:00:00#00:00:00#00:00:00 1
a0b6674b6d02cae10605067e02082910 0 5046300 3251480 0 0
1260823 0 0 0 0 705353 0 0 0 0 120436
3201126 B 1 BS 1 16/07/2018 24/07/2018 18/04/1959 0 2
1 I63.9;G81.9;N18.9;E87.5 88.76;87.03 - - None None None None
0 - 0 9673300 15333546 0 9 0 0 0 SRI
HARYATI D162225 59 21639 DR MAYSAMIRAWATI SPS 0138R0170718V005814
0000059189455 3;JKN DR RIZKI; 5.2.2.201806040537 4 202147
1#0##0#0#0.0#2018-07-30 11:42:11#0#00:00:00#00:00:00#00:00:00 1
6ca86edde756f105b192458e247b1075 0 0 1324461 0 0
6296456 0 0 0 0 7712629 0 0 0 0 0
3201126 B 2 BS 1 23/07/2018 24/07/2018 01/11/1972 0 2
- 0 10690500 10957900 0 2 0 0 0 SITI ZULAEHA
0001210274897 3;JKN DR RIZKI; 5.2.2.201806040537 4 204511
1#0##0#0#0.0#2018-07-30 12:03:30#0#00:00:00#00:00:00#00:00:00 1
1fece7ef8984c445a73f4ebde5a5a232 0 0 2276624 0 0
3418952 0 0 0 0 5181972 0 0 0 0 80352
3201126 B 3 BS 1 23/07/2018 24/07/2018 08/12/1976 0 1
4199800 0 0 - 0 - 0 - 0 - 0
4199800 2212566 0 2 0 0 0 SUPRI JAYADI
D338883 41 15202 DR ARU, SPPD 0138R0170718V008351
0001725615382 3;JKN DR RIZKI; 5.2.2.201806040537 4 204700
1#0##0#0#0.0#2018-07-31 09:06:15#0#20:26:33#20:26:33#12:00:00 1
fc174ffb618268bf0bc172585c8dc97e 0 0 430982 0 0
1171337 0 0 0 0 610247 0 0 0 0 0
3201126 B 3 BS 1 24/07/2018 24/07/2018 01/10/1964 0 1
- 0 - 0 8908800 3976230 0 1 0 0 0
SALHANI D404201 53 19654 DR ARU, SPPD 0138R0170718V008808
0000511114959 3;JKN DR RIZKI; 5.2.2.201806040537 4 205216
1#0##0#0#0.0#2018-07-31 13:32:45#0#19:15:19#19:15:19#00:00:00 1
bf33f11014c16a2d64e08621be880e1d 0 0 1906030 0 0
2070200 0 0 0 0 0 0 0 0 0 0
3201126 B 1 BS 1 23/07/2018 24/07/2018 13/12/1959 0 2
1 N95.0;E14.9;D64.9;G81.9 69.09 - - None None None None W-1-
SERVIK (SEDANG) 3554200 0 0 - 0 - 0 - 0 -
0 3554200 6073934 0 2 0 0 0 MARIA V DYAH
SOENARYO D301040 58 21407 ENDANG TRI KURNIADEWI DR SPOG
0138R0170718V008342 0001794562659 3;JKN DR RIZKI; 5.2.2.201806040537
4 204692 1#0##0#0#0.0#2018-08-01
18:01:15#0#18:37:34#18:37:34#00:00:00 1 41ac4206df3a76cbc7d390d5dc1418c9
0 0 954824 0 0 1228750 0 0 0 0
3821360 0 0 0 0 69000
3201126 B 2 BS 1 24/07/2018 24/07/2018 24/07/2018 3124 1
4386800 0 0 - 0 - 0 - 0 - 0
4386800 748464 0 1 0 0 0 BAYI NY. SITI FATIMAH
D404252 0 0 DR BENNY S, SPA 0138R0170718V009011
0002458708424 3;JKN DR RIZKI; 5.2.2.201806040537 4 205377
1#0##0#0#0.0#2018-08-03 10:16:07#0#00:00:00#00:00:00#00:00:00 1
2119180e5f346959189d31105301c933 0 0 39000 0 0 88899 0
0 0 0 620565 0 0 0 0 0
3201126 B 1 BS 1 15/07/2018 24/07/2018 12/04/1949 0 1
1 G91.2;J44.0 87.03;87.49;90.59;89.52;02.34 - - None None None
None G-1-11-II None None None None None None PROSEDUR VENTRICULAR
SHUNT (SEDANG) 30250700 0 0 - 0 - 0 - 0 -
0 30250700 31524695 0 10 0 0 0 SYAFRUDDIN,S.SOS
0000016622594 3;JKN irene; 5.2.2.201806040537 4 201746
1#0##0#0#0.0#2018-08-04 12:59:21#0#00:00:00#00:00:00#00:00:00 3
f11ff21d62a77884d2d2f8153d818792 0 12990200 3082622 0 0
13963665 0 0 0 0 1226000 0 0 0 0 262208
3201126 B 3 BS 1 14/07/2018 24/07/2018 02/12/2016 0 1
0 0 - 0 - 0 - 0 - 0 12174500
18479055 0 11 0 0 0 CALON BAYI NY NENENG SURYATI/DANIZA
PUTRI NAVILA AN D376904 1 589 DR CATUR S, SPB 0138R0170718V005170
0002205035908 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203400
1#0##0#0#0.0#2018-08-13 08:48:53#0#10:17:32#10:17:32#00:00:00 1
e05b48136475f3f7ebb3cc46e01460b5 0 5451900 3611605 0 0
7009843 0 0 0 0 1226000 0 0 0 0
1179707
3201126 B 3 BS 1 17/07/2018 24/07/2018 01/04/1951 0 1
1 I21.4;E11.2;J81 87.49;90.59;89.52 - - None None None None
10401900 0 0 - 0 - 0 - 0 - 0
10401900 23306528 0 8 1 0 0 SUWANDI D403605
0001014287747 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202720
1#0##0#0#0.0#2018-08-13 12:18:29#0#00:00:00#00:00:00#00:00:00 1
e8b652034b3f744be95b9821ebb4b920 0 0 989169 0 0
11596359 0 0 0 0 6380000 0 0 0 0
4341000
3201126 B 2 BS 1 21/07/2018 24/07/2018 30/08/1975 0 2
1 N80.1;R10.4 - - - None None None None W-4-12-I None
LAIN-LAIN (RINGAN) 3371200 0 0 - 0 - 0 - 0
- 0 3371200 4463052 0 4 0 0 0 HAPIPA M
LUHULIMA D398125 42 15666 DR ERDIYAN, SPOG 0138R0170718V007640
0001101420988 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204062
1#0##0#0#0.0#2018-08-29 20:06:46#0#23:00:39#23:00:39#00:00:00 1
69cb93a663c69cf9f03aadc433b7763b 0 0 291535 0 0
1455542 0 0 0 0 2587975 0 0 0 0 128000
3201126 B 3 BS 1 24/07/2018 24/07/2018 28/11/1951 0 2
4 I67.9;R57.1 89.52 - - None None None None G-4-26-III None
(BERAT) 6240100 0 0 - 0 - 0 - 0 - 0
6240100 3636732 0 1 0 0 0 KARTINI,HJ D404148
TANTIYO S;16137 5.2.2.201806040537 4 204716 1#0##0#0#0.0#2018-
08-29 20:22:34#0#00:00:00#00:00:00#00:00:00 4
d34eda8df60d82d072c0d35d3897e5e2 0 0 561609 0 0
2395206 0 0 0 0 526917 0 0 0 0 153000
3201126 B 1 BS 1 23/07/2018 24/07/2018 12/10/1966 0 1
0 - 0 - 0 7213800 9101129 0 2 0 0
0 RIZAFIANTO D401215 51 18912 DR. ARU ARIADNO, SPPD
0138R0170718V008224 0000037564222 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 204649 1#0##0#0#0.0#2018-09-24
12:59:45#0#15:26:56#15:26:56#00:00:00 2 f54188b10f2408e499ac937264689fdc
0 0 2125864 0 0 2330364 0 0 0 0
2895901 0 0 0 0 1749000
3201126 B 3 BS 1 19/07/2018 24/07/2018 01/02/1999 0 2
- 0 - 0 - 0 - 0 3874400 9789431 0
6 0 0 0 TENIA D402620 19 7108 DR HENDRIEK SP B
0138R0170718V007132 0000508757174 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 204686 1#0##0#0#0.0#2018-09-26
19:31:13#0#17:50:33#17:50:33#00:00:00 2 ebc7e237eebd72c864bab4f22ba6216a
0 3581500 2515750 0 0 2947654 0 0 0 0
666430 0 0 0 0 78097
3201126 B 3 BS 1 24/07/2018 24/07/2018 25/12/1946 0 2
0 0 - 0 - 0 - 0 - 0 3333000
2203699 0 1 0 0 0 ENIK SURATMI D099923 71
26144 DR DICKI PRATAMA 0138R0170718V008382 0000060707979 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 204717 1#0##0#0#0.0#2018-
09-26 20:03:21#0#04:47:42#04:47:42#00:00:00 2
1efd9956a6858fd43f3766256cefa3da 0 0 126735 0 0 985797
0 0 0 0 433167 0 0 0 0 658000
3201126 B 3 BS 1 20/07/2018 24/07/2018 10/06/1959 0 2
0 0 - 0 - 0 - 0 - 0 4973600
3265912 0 5 0 0 0 IYEM D377296 59 21590 DR
S;16137 5.2.2.201806040537 4 204061 1#0##0#0#0.0#2018-09-26
20:15:19#0#00:00:00#00:00:00#12:00:00 2 4fd30c5ede8e8c344f7eb3fd170dc02c
0 0 553624 0 0 1420630 0 0 0 0
1291658 0 0 0 0 0
3201126 B 1 BS 1 24/07/2018 25/07/2018 08/09/1956 0 1
1 I13.1;E16.2;A49.9;D63.8 99.04;90.59;89.52 - - None None None
0 - 0 5784900 3375546 0 2 0 0 0 MUSLIH
0001457564534 3;JKN DR RIZKI; 5.2.2.201806040537 4 205212
1#0##0#0#0.0#2018-07-30 10:38:58#0#17:41:53#17:41:53#00:00:00 1
ff142156dcb93fd9f4e886494806a7cf 0 0 573641 0 0
1338575 0 0 0 0 1463330 0 0 0 0 0
3201126 B 1 BS 1 23/07/2018 25/07/2018 12/03/1951 0 1
1 E87.1;I25.0 90.59;89.52 - - None None None None E-4-11-I
4136800 0 0 - 0 - 0 - 0 - 0
4136800 3463656 0 3 0 0 0 PDT. RACHMAN TUA MUNTHE
0001454870261 3;JKN DR RIZKI; 5.2.2.201806040537 4 204250
1#0##0#0#0.0#2018-07-30 10:41:07#0#00:00:00#00:00:00#00:00:00 1
00984aec16885af172f9b387c40d7f47 0 0 425312 0 0 442750
0 0 0 0 2595594 0 0 0 0 0
3201126 B 1 BS 1 24/07/2018 25/07/2018 26/03/1961 0 2
1 N18.5;A49.9;K21.9;E87.6 89.52 - - None None None None N-4-
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 4012361 0 2 0 0 0 ERNA MARDIANA NY
0000093184075 3;JKN DR RIZKI; 5.2.2.201806040537 4 205226
1#1#vvip#2#0#0.0#2018-07-30 11:06:58#0#21:55:53#21:55:53#00:00:00 2
3778b1a5ebc79eaf6a887ba64a18bc3e 0 0 783705 0 0 476957
0 0 0 0 2719741 0 0 0 0 31958
3201126 B 1 BS 1 23/07/2018 25/07/2018 12/03/1980 0 2
1 A91;K77.0 - - - None None None None A-4-13-II None
3734400 0 0 - 0 - 0 - 0 - 0
3734400 6501695 0 3 0 0 0 CUCU RUKOYAH
0000060511904 3;JKN DR RIZKI; 5.2.2.201806040537 4 204446
1#0##0#0#0.0#2018-07-30 11:07:57#0#00:00:00#00:00:00#00:00:00 1
be372b80938b7cec55912b691b0175bf 0 0 595000 0 0
1206350 0 0 0 0 4700345 0 0 0 0 0
3201126 B 1 BS 1 23/07/2018 25/07/2018 13/10/1957 0 1
1 I13.1;A49.9;K21.9 - - - None None None None N-4-10-I
GINJAL (RINGAN) 4639400 0 0 - 0 - 0 - 0 -
0 4639400 5353114 0 3 0 0 0 DEDE ROHENDI
D402446 60 22198 SRI KUNMARTINI.DR,SPPD 0138r0170718v008355
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1#0##0#0#0.0#2018-07-30 11:09:54#0#21:12:43#21:12:43#00:00:00 1
aa9bcba60110a9ae1f8b1cca74f3cfa8 0 0 903880 0 0
2060702 0 0 0 0 2373704 0 0 0 0 14828
3201126 B 1 BS 1 24/07/2018 25/07/2018 30/03/1987 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 2350795 0 2 0 0 0 KURNITA MILASARI
d315609 31 11439 DR ARU, SPPD 0138R0170718V008365
0001737941692 3;JKN DR RIZKI; 5.2.2.201806040537 4 204708
1#0##0#0#0.0#2018-07-30 11:11:12#0#00:07:12#00:07:12#00:00:00 1
2eb87b33f90c79f6d436c4da57743690 0 0 385550 0 0 223455
0 0 0 0 1741790 0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 25/07/2018 15/05/1977 0 1
1 A49.9;C48.1 - - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5323073 0 4 0 0 0 HESTY HADIATINI NY
0001620711865 3;JKN DR RIZKI; 5.2.2.201806040537 4 204230
1#0##0#0#0.0#2018-07-30 11:12:22#0#12:36:37#12:36:37#00:00:00 1
c11db8b08fdc0678954e60049c3493bb 0 0 338858 0 0
1485977 0 0 0 0 3498238 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 25/07/2018 19/06/1974 0 1
1 I61.9;G81.9;I10;E78.5 87.03;87.44 - - None None None None
0 - 0 7214600 7944403 0 6 0 0 0 TOMMY
WARDHANA D403868 44 16102 DR MAYSAMIRAWATI SPS 0138R0170718V007622
0001336793703 3;JKN DR RIZKI; 5.2.2.201806040537 4 204212
1#0##0#0#0.0#2018-07-30 11:13:51#0#19:18:36#19:18:36#00:00:00 1
57a2aae89dcfd5d9a6287d029e6fcaf2 0 0 478358 0 0
2579818 0 0 0 0 4886227 0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 25/07/2018 16/05/1963 0 2
1 I64;G81.9;E14.9;I10 87.44;87.03 - - None None None None
0 0 - 0 - 0 - 0 - 0 6844000
8615179 0 4 0 0 0 HJ. ENDANG KUNCOROWATI D199109
DR RIZKI; 5.2.2.201806040537 4 204222 1#0##0#0#0.0#2018-07-30
11:22:11#0#02:59:08#02:59:08#00:00:00 1 82cb5a1521233bb7e295bce40d2a1ee1
0 0 1020329 0 0 3971240 0 0 0 0
3623610 0 0 0 0 0
3201126 B 1 BS 1 24/07/2018 25/07/2018 22/10/1950 0 1
1 C25.9;D63.0;E14.9 99.04 - - None None None None B-4-11-II
None None None None None None TUMOR SISTEM HEPATOBILLIARI DAN PANCREAS
(SEDANG) 9554800 0 0 - 0 - 0 - 0 - 0
9554800 4324906 0 2 0 0 0 ACHMAD SAIDUN ALI, SH
0000043180378 3;JKN DR RIZKI; 5.2.2.201806040537 4 204970
1#0##0#0#0.0#2018-07-30 11:34:54#0#00:00:00#00:00:00#00:00:00 2
371f0a18ab736f7613c392c7811bf7cb 0 0 573641 0 0
1880327 0 0 0 0 1870938 0 0 0 0 0
3201126 B 1 BS 1 24/07/2018 25/07/2018 10/08/1968 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2410035 0 2 0 0 0 ETI SUMIATI NY
D404166 49 18245 DR ARU, SPPD 0138R0170718V008367
0001454681351 3;JKN DR RIZKI; 5.2.2.201806040537 4 205717
1#0##0#0#0.0#2018-07-30 11:36:23#0#17:50:47#17:50:47#00:00:00 1
3314322f6d15217f029933e59690a134 0 0 269459 0 0 394910
0 0 0 0 1745666 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 25/07/2018 08/10/2000 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 6049888 0 5 0 0 0 EKO DARMA MANALU
D064678 17 6495 DR ARU, SPPD 0138R0170718V007708
0001743520961 3;JKN DR RIZKI; 5.2.2.201806040537 4 204109
1#0##0#0#0.0#2018-07-30 11:43:41#0#09:45:44#09:45:44#00:00:00 1
8da30d753bde10ca496bc110a16dd6cb 0 0 316331 0 0
1406770 0 0 0 0 4326787 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 25/07/2018 06/08/1964 0 2
1 G44.2;R50.8;J40 87.44 - - None None None None G-4-23-I
None None None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN)
3710200 0 0 - 0 - 0 - 0 - 0
3710200 10153384 0 5 0 0 0 ERMANILA,NY D403983
53 19707 DR BETTY 0138R0170718V007768 0000045139364 3;JKN DR
RIZKI; 5.2.2.201806040537 4 204211 1#1#vvip#5#6443184#0.0#2018-
07-30 11:46:39#0#00:00:00#00:00:00#00:00:00 1
41a771755a501b9a36602e1eab5b3118 0 0 526430 0 0
3836714 0 0 0 0 5790240 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 25/07/2018 20/04/2013 0 1
1 R11;E86 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 1515398 0 2 0 0 0 BENEDIKTUS BIMA ADITYA
D249874 5 1921 DR RASTRA, SPA 0138R0170718V008451
0001295357949 3;JKN DR RIZKI; 5.2.2.201806040537 4 204718
1#0##0#0#0.0#2018-07-30 11:54:40#0#00:00:00#00:00:00#00:00:00 1
9e5f23dd0b52bc94053430f7352910d2 0 0 238535 0 0 141725
0 0 0 0 1135138 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 25/07/2018 05/07/1964 0 1
1 I12.0;I63.9;A41.9;E87.8 87.03;90.59;89.52;99.21 - - None None
None None N-4-10-III None None None None None None TUMOR GINJAL &
SALURAN URIN & GAGAL GINJAL (BERAT) 7293200 0 0 - 0 - 0
- 0 - 0 7293200 4627030 0 2 0 0 0
BANTA AYUSAN d389649 54 19742 DR BETTY DWI L, SPPD
0138R0170718V008377 0001874825436 3;JKN DR RIZKI; 5.2.2.201806040537
4 204715 1#0##0#0#0.0#2018-07-30
11:58:16#0#02:27:01#02:27:01#12:00:00 1 8b4195ee8eab17a29e08f8a8caea5882
0 0 782320 0 0 2506007 0 0 0 0
1338703 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 25/07/2018 15/02/1986 0 2
1 N85.0;N93.9;D62;M32.9 99.04 - - None None None None W-4-
0 - 0 4628500 3034749 0 2 0 0 0
SUPRIYATI D404149 32 11847 DR ENDANG T. K, SPOG
0138R0170718V008816 0001652652404 3;JKN DR RIZKI; 5.2.2.201806040537
4 205219 1#0##0#0#0.0#2018-07-30
12:02:06#0#00:00:00#00:00:00#00:00:00 1 573c0cf05d6a72e6c891457a7e7d9ac9
0 0 428596 0 0 1579118 0 0 0 0
1027035 0 0 0 0 0
3201126 B 2 BS 1 23/07/2018 25/07/2018 28/04/1972 0 2
0 - 0 - 0 - 0 1821000 3511130 0 3
0 0 0 CHRISTINA WAGIRAH d404094 46 16887 DR MAYSAMIRAWATI
4 204662 1#0##0#0#0.0#2018-07-30
12:05:40#0#15:48:40#15:48:40#00:00:00 1 8918683d7542423e297dc7bd3c28eb97
0 0 216890 0 0 1523540 0 0 0 0
1770700 0 0 0 0 0
3201126 B 3 BS 1 23/07/2018 25/07/2018 09/07/1947 0 1
1 E14.8;I10;M54.56;R11 99.17;90.59;88.76;89.52 - - None None
None None E-4-10-I None None None None None None PENYAKIT KENCING
MANIS & GANGGUAN NUTRISI/ METABOLIK (RINGAN) 3502700 0 0 - 0
- 0 - 0 - 0 3502700 3143526 0 3 0
0 0 TARDI D396953 71 25947 DR ARU, SPPD
0138R0170718V008358 0001456832889 3;JKN DR RIZKI; 5.2.2.201806040537
4 204703 1#0##0#0#0.0#2018-07-31
08:42:23#0#22:41:31#22:41:31#00:00:00 1 ef78951d48bec7d797e7565626a59dee
0 0 268243 0 0 1934590 0 0 0 0 940693
0 0 0 0 0
3201126 B 3 BS 1 22/07/2018 25/07/2018 15/04/1991 0 2
1 C56;K30 - - - None None None None W-4-10-I None
None None None None None TUMOR SISTEM REPRODUKSI WANITA (RINGAN)
3476100 0 0 - 0 - 0 - 0 - 0
3476100 4717910 0 4 0 0 0 ALFIRITA SUSANTI
0000510855309 3;JKN DR RIZKI; 5.2.2.201806040537 4 204232
1#0##0#0#0.0#2018-07-31 08:47:49#0#12:40:29#12:40:29#00:00:00 1
c56a0016967fb8d903efca6694f85680 0 0 289752 0 0
3041510 0 0 0 0 1386648 0 0 0 0 0
3201126 B 3 BS 1 22/07/2018 25/07/2018 15/06/1970 0 1
0 0 - 0 - 0 - 0 - 0 2954900
2511188 0 4 0 0 0 YANTO TN D404049 48 17569
RIZKI; 5.2.2.201806040537 4 204233 1#0##0#0#0.0#2018-07-31
08:48:56#0#13:20:30#13:20:30#00:00:00 1 94e805a73a1453064e0c02e4d407b339
0 0 318941 0 0 949964 0 0 0 0
1242283 0 0 0 0 0
3201126 B 3 BS 1 23/07/2018 25/07/2018 15/06/1954 0 2
- 0 3502700 2691951 0 3 0 0 0 INOH
D404073 64 23414 DR ARU, SPPD 0138R0170718V008089
0001739671604 3;JKN DR RIZKI; 5.2.2.201806040537 4 204464
1#0##0#0#0.0#2018-07-31 08:49:59#0#11:32:09#11:32:09#00:00:00 1
2d7914b7efd6c535d8bd162e251033e6 0 0 368243 0 0
1332599 0 0 0 0 991109 0 0 0 0 0
3201126 B 3 BS 1 20/07/2018 25/07/2018 20/01/1970 0 2
0 - 0 - 0 - 0 - 0 4144700 9926060
0 6 1 2 0 ANIH D388414 48 17713 DR AZRI NURIZAL
5.2.2.201806040537 4 204055 1#0##0#0#0.0#2018-07-31
09:11:27#0#00:00:00#00:00:00#12:00:00 1 66f797658922e307c60f19dc29315a7f
0 0 426023 0 0 5372169 0 0 0 0
3386868 0 0 0 0 741000
3201126 B 3 BS 1 22/07/2018 25/07/2018 10/01/1979 0 2
1 S82.1;M24.06;M21.76 79.36;81.45 - - None None None None
M-1-70-II None None None None None None PROSEDUR LUTUT DAN TUNGKAI
BAWAH SELAIN KAKI (SEDANG) 16780800 0 0 - 0 - 0 -
0 - 0 16780800 18793548 0 4 0 0 0 EMA
INDAH SARI D224087 39 14438 DR BENNY H TUMBELAKA 0138R0170718V008111
0001208614836 3;JKN DR RIZKI; 5.2.2.201806040537 4 204509
1#0##0#0#0.0#2018-07-31 09:16:30#0#00:00:00#00:00:00#00:00:00 1
0b61fd8b3ac3e04c30464d0e01a7afc9 0 0 8275592 0 0
3039284 0 0 0 0 7226000 0 0 0 0 252672
3201126 B 3 BS 1 22/07/2018 25/07/2018 27/08/2006 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2118975 0 4 0 0 0 MUTIA SARI HARAHAP
d404057 11 4347 DR OTTY MITHA S, SPA 0138r0170718v007819
0001478807526 3;JKN DR RIZKI; 5.2.2.201806040537 4 204234
1#0##0#0#0.0#2018-07-31 09:18:08#0#14:59:52#14:59:52#00:00:00 1
383d461f77e78039d230ba248753e55a 0 0 241100 0 0 661250
0 0 0 0 1216625 0 0 0 0 0
3201126 B 3 BS 1 19/07/2018 25/07/2018 10/05/1965 0 1
1 I63.9;G81.9;D45;I10 87.44;87.03 - - None None None None
0 - 0 6909500 6206551 0 7 0 0 0 ACHMAD
FAUZI D403792 53 19428 DR MAYSAM I., SPS 0138R0170718V007486
0001284335188 3;JKN DR RIZKI; 5.2.2.201806040537 4 203848
1#0##0#0#0.0#2018-07-31 09:23:08#0#13:30:13#13:30:13#00:00:00 1
ffc97ff1a7e2bc0f3ba6b33c3c63fdad 0 0 920221 0 0
3099794 0 0 0 0 2186536 0 0 0 0 0
3201126 B 3 BS 1 23/07/2018 25/07/2018 01/06/1953 0 2
1 K30;H81.3 - - - None None None None K-4-18-I None
1452800 0 0 - 0 - 0 - 0 - 0
1452800 2280715 0 3 0 0 0 MUNIH D353712 65
23793 DR SOEGIONO, SPPD 0138R0170718V007974 0001310092435 3;JKN DR
RIZKI; 5.2.2.201806040537 4 204282 1#0##0#0#0.0#2018-07-31
09:24:47#0#08:52:43#08:52:43#00:00:00 1 63901883fe527fafa724c3f13689c0fb
0 0 261764 0 0 1054745 0 0 0 0 964206
0 0 0 0 0
3201126 B 3 BS 1 24/07/2018 25/07/2018 17/02/1977 0 2
0 - 0 - 0 - 0 - 0 2954900 4923748
0 2 0 0 0 IRMA SOLIHA d403244 41 15132 DR BETTY DWI
L, SPPD 0138R0170718V008814 0001739717019 3;JKN DR RIZKI;
5.2.2.201806040537 4 205218 1#0##0#0#0.0#2018-07-31
13:26:18#0#00:00:00#00:00:00#00:00:00 1 b20d75fe12753a4fbf8943dcb62c1f07
0 1152000 755488 0 0 953646 0 0 0 0
348114 0 0 0 0 1714500
3201126 B 3 BS 1 24/07/2018 25/07/2018 01/04/1957 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 9204854 0 2 0 0 0 DEDEH KURNIASIH
D404196 61 22394 DR ARU, SPPD 0138R0170718V008777
0000366397817 3;JKN DR RIZKI; 5.2.2.201806040537 4 205525
1#0##0#0#0.0#2018-07-31 13:34:23#0#11:43:47#11:43:47#00:00:00 1
371f9db61033c5364b5c2f4cdc465161 0 0 1906030 0 0
3539137 0 0 0 0 3690687 0 0 0 0 69000
3201126 B 3 BS 1 19/07/2018 25/07/2018 20/12/1956 0 2
1 N18.5;I50.0;D63.8 99.04;38.95;39.95 - - None None None None
- 0 - 0 8908800 17927899 0 7 0 0 0
MASTOAH NY D403741 61 22491 DR. ARU ARIADNO, SPPD
0138R0170718V006783 0000510740447 3;JKN DR RIZKI; 5.2.2.201806040537
4 203350 1#0##0#0#0.0#2018-07-31
14:51:08#0#01:14:43#01:14:43#00:00:00 1 592551f17abaf74ccc1abcfb4e5b0193
0 3754500 1959030 0 0 9004039 0 0 0 0
3164478 0 0 0 0 45852
3201126 B 3 BS 1 16/07/2018 25/07/2018 10/09/1965 0 1
1 C26.0;K56.6 88.01;87.44 - - None None None None K-4-10-II
0 0 - 0 - 0 - 0 - 0 7062900
9691287 0 10 0 0 0 SUPRIHATIN TN D400283 52
DR RIZKI; 5.2.2.201806040537 4 202153 1#0##0#0#0.0#2018-07-31
15:01:05#0#00:00:00#00:00:00#00:00:00 1 8bb412a51a51f3ae9b643f218bdc1484
0 0 741661 0 0 5746117 0 0 0 0
3203509 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 25/07/2018 08/12/1965 0 1
(SEDANG) 8291400 0 0 - 0 - 0 - 0 - 0
8291400 3368319 0 2 0 0 0 RUSMIYANTO d401376
DR RIZKI; 5.2.2.201806040537 4 205217 1#0##0#0#0.0#2018-08-01
14:16:02#0#19:25:28#19:25:28#00:00:00 1 ddd4fb966f5e16d8b13d4ca048f39dd9
0 0 594422 0 0 1725040 0 0 0 0
1048857 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 25/07/2018 24/05/1975 0 2
(RINGAN) 5208600 0 0 - 0 - 0 - 0 - 0
5208600 8701315 0 2 0 0 0 AMINAH D404179
43 15767 DR ARU, SPPD 0138R0170718V008519 0001292505974 3;JKN
DR RIZKI; 5.2.2.201806040537 4 204839 1#0##0#0#0.0#2018-08-01
14:17:38#0#10:07:21#10:07:21#00:00:00 1 3f9f9d65b8b46efee7511d316944cba4
0 4439100 1147720 0 0 2450250 0 0 0 0
595245 0 0 0 0 69000
3201126 B 1 BS 1 24/07/2018 25/07/2018 13/02/1947 0 1
11257400 0 0 - 0 - 0 - 0 - 0
11257400 12825753 0 2 0 0 0 WARNO KRISTIANTO
0001301036591 3;JKN DR RIZKI; 5.2.2.201806040537 4 204736
1#0##0#0#0.0#2018-08-03 10:29:38#0#08:15:23#08:15:23#00:00:00 1
125b18a18e5c31bc026d9a2d6c9f1740 0 5826600 1448776 0 0
1572342 0 0 0 0 865068 0 0 0 0
3112967
3201126 B 1 BS 1 23/07/2018 25/07/2018 06/05/1944 0 2
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 9720594 0 3 0 0 0 IPAH. SK D066032
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204705
1#0##0#0#0.0#2018-08-13 15:37:23#0#23:13:05#23:13:05#12:00:00 1
4b1f108099c4629b53d3fea1362c2ab6 0 0 527658 0 0
5784009 0 0 0 0 3280927 0 0 0 0 128000
3201126 B 3 BS 1 24/07/2018 25/07/2018 30/06/1972 0 1
- 0 - 0 8908800 8092720 0 2 0 0 0
JUMRI D404197 46 16825 DEDY PRATAMA,DR SPBV 0138R0170718V008795
0002469041032 3;JKN irene; 5.2.2.201806040537 4 205214
1#0##0#0#0.0#2018-08-14 14:44:00#0#18:03:56#18:03:56#00:00:00 2
5ce1fc14bb9bd5eb91173ffe47985639 0 5326100 939400 0 0
1126790 0 0 0 0 555430 0 0 0 0 145000
3201126 B 3 BS 1 18/07/2018 25/07/2018 06/05/1986 0 2
1 I77.2;N18.5;A41.9;M32.1 99.04;99.71 - - None None None None
0 - 0 7317500 18255972 0 8 0 0 0 SITI
AMALIA D353116 32 11761 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V006758 0002196827987 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 203338 1#0##0#0#0.0#2018-08-29
19:59:04#0#00:00:00#00:00:00#12:00:00 1 56425fff1119d543ca5a349e0891ecc8
0 3927500 1628040 0 0 11045727 0 0 0 0
1220316 0 0 0 0 434389
3201126 B 2 BS 1 20/07/2018 25/07/2018 13/02/1948 0 1
4 I61.5;I50.0;I10;J18.9 02.42;96.71 - - None None None None
G-1-11-III None None None None None None PROSEDUR VENTRICULAR SHUNT
(BERAT) 43018400 0 0 - 0 - 0 - 0 - 0
43018400 42360229 0 6 1 4 0 TB HARDJA KUSUMAH
0001256484115 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204058
1#0##0#0#0.0#2018-08-29 20:21:26#0#00:00:00#00:00:00#12:00:00 1
7533ac5cdb1eac7bb13f4a368aa9c6d7 0 0 10727212 0 0
16546317 0 0 0 0 9122700 0 0 0 0
5964000
3201126 B 3 BS 1 22/07/2018 25/07/2018 06/08/1983 0 1
1 D64.9;K29.6;K92.1 99.04 - - None None None None D-4-13-I
0 - 0 2987000 4110900 0 4 0 0 0 WARYAN
0002439073192 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204225
1#0##0#0#0.0#2018-09-26 20:12:13#0#08:24:43#08:24:43#00:00:00 2
5a0c8ee6e76b4c582d4175304a46e2e8 0 0 349676 0 0
2414287 0 0 0 0 1346937 0 0 0 0 0
3201126 B 3 BS 1 21/07/2018 26/07/2018 05/12/1941 0 2
1 S72.00;M81.56;M21.76 81.51 - - None None None None M-1-
04-II None None None None None None PROSEDUR PADA SENDI TUNGKAI BAWAH
(SEDANG) 14857800 0 0 - 0 - 0 - 0 - 0
14857800 33125919 0 6 0 0 0 NANI D328633 76
27987 DR MARQUEE KENNY TUMBELAKA SPOT 0138R0170718V007779
0002094769653 3;JKN DR RIZKI; 5.2.2.201806040537 4 204217
1#0##0#0#0.0#2018-07-31 11:32:21#0#00:00:00#00:00:00#00:00:00 1
668dc299c95f7256ed96eb4a4ee7906e 0 0 6649484 0 0
17082371 0 0 0 0 8617600 0 0 0 0 776464
3201126 B 3 BS 1 24/07/2018 26/07/2018 07/07/1998 0 2
1 D44.0 06.39 - - None None None None E-1-20-I None None
- 0 7516400 11340522 0 3 0 0 0 NADA AYU
SALSABILLA D396932 20 7322 RACHMAWATI DR,SPB(K)ONK 0138R0170718V008820
0001733036949 3;JKN DR RIZKI; 5.2.2.201806040537 4 205222
1#0##0#0#0.0#2018-07-31 13:28:41#0#20:12:31#20:12:31#00:00:00 1
e597e0d162ff55d1832e891bc4780633 0 3525300 2104592 0 0
4643630 0 0 0 0 767903 0 0 0 0 299097
3201126 B 3 BS 1 23/07/2018 26/07/2018 30/12/1952 0 2
1 I86.4;K29.8 45.16 - - None None None None I-4-15-II None
(SEDANG) 6097900 0 0 - 0 - 0 - 0 - 0
6097900 9027828 0 4 0 0 0 UTAMA ALAMSYAH
d404129 65 23946 DR ARU, SPPD 0138R0170718V008341
0001740579219 3;JKN DR RIZKI; 5.2.2.201806040537 4 204691
1#0##0#0#0.0#2018-07-31 14:58:04#0#18:27:18#18:27:18#00:00:00 1
cb05f0b0480ed34fbe2989a719e42f4c 0 0 1134992 0 0
4115730 0 0 0 0 2028106 0 0 0 0
1749000
3201126 B 2 BS 1 23/07/2018 26/07/2018 22/02/1950 0 1
1 C44.3;D29.1;R33 86.3 - - None None None None L-1-40-I
None None None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH
KULIT DAN PAYUDARA (RINGAN) 5974200 0 0 - 0 - 0 -
0 - 0 5974200 11116502 0 4 0 0 0 TAUFIK
RIVAI d296365 68 24988 DR HENDRIEK S, SPB 0138R0170718V008352
0000037752502 3;JKN DR RIZKI; 5.2.2.201806040537 4 204701
1#0##0#0#0.0#2018-08-01 14:05:41#0#20:54:46#20:54:46#00:00:00 1
27831955d4576053f16d3e9cfe0c5a53 0 4854100 1844412 0 0
3171375 0 0 0 0 753248 0 0 0 0 493367
3201126 B 2 BS 1 23/07/2018 26/07/2018 07/02/1943 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3500486 0 4 0 0 0 ACHMAD SYAMSUDIN
0001727223783 3;JKN DR RIZKI; 5.2.2.201806040537 4 204630
1#0##0#0#0.0#2018-08-01 14:10:40#0#15:08:42#15:08:42#00:00:00 1
f67d6b72554110163b75754af4bbfc84 0 0 298025 0 0 927457
0 0 0 0 2275004 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 26/07/2018 20/04/1973 0 2
1 C50.9;D17.3 85.45 - - None None None None L-1-50-I None
0 0 - 0 - 0 - 0 - 0 7842900
16224863 0 3 0 0 0 TETY POLMASARI D073586 45
DR RIZKI; 5.2.2.201806040537 4 205223 1#0##0#0#0.0#2018-08-01
14:13:22#0#21:33:31#21:33:31#12:00:00 1 b97a0912fde298db2bc5c19f5da779b8
0 7031500 2249012 0 0 5821477 0 0 0 0
1087440 0 0 0 0 35434
3201126 B 2 BS 1 20/07/2018 26/07/2018 31/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 4290800
5824025 0 7 0 0 0 MOCH NOOR AROEMRINANG D295552
0002229345257 3;JKN DR RIZKI; 5.2.2.201806040537 4 203680
1#0##0#0#0.0#2018-08-01 14:15:02#0#10:14:05#10:14:05#12:00:00 1
482e65709858273e345d0505020ff71e 0 0 504322 0 0
1377692 0 0 0 0 3942011 0 0 0 0 0
3201126 B 1 BS 1 22/07/2018 26/07/2018 31/03/1954 0 1
1 D29.1;K81.8;I11.0;J45.9 90.59;89.52;88.76;93.94 - - None None
None None V-4-11-III None None None None None None PENYAKIT SISTEM
REPRODUKSI LAKI-LAKI SELAIN TUMOR (BERAT) 9579300 0 0 - 0 -
0 - 0 - 0 9579300 8447008 0 5 0 0
0 PRAYITNO RAMONA D021524 64 23489 DR. ARU ARIADNO, SPPD
0138R0170718V007841 0001460946802 3;JKN DR RIZKI; 5.2.2.201806040537
4 204245 1#0##0#0#0.0#2018-08-01
14:20:35#0#22:55:46#22:55:46#00:00:00 1 ef1acac6a206c0fd9e769e2b892102be
0 0 879956 0 0 3864444 0 0 0 0
3702608 0 0 0 0 0
3201126 B 1 BS 1 24/07/2018 26/07/2018 15/02/1952 0 1
1 K83.1;C25.0 88.76 - - None None None None B-4-14-I None
5879800 0 0 - 0 - 0 - 0 - 0
5879800 4888224 0 3 0 0 0 SAIFUL BACHRI
0001335976154 3;JKN DR RIZKI; 5.2.2.201806040537 4 206715
1#0##0#0#0.0#2018-08-01 14:23:38#0#00:00:00#00:00:00#00:00:00 1
f96de98ac6ea88584f5439f44954cd4e 0 0 667241 0 0
1877693 0 0 0 0 2343290 0 0 0 0 0
3201126 B 1 BS 1 25/07/2018 26/07/2018 01/03/2012 0 1
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 3851413 0 2 0 0 0 AQMARUL IKHSAN
0001274835126 3;JKN DR RIZKI; 5.2.2.201806040537 4 205359
1#0##0#0#0.0#2018-08-01 14:25:26#0#09:49:18#09:49:18#00:00:00 1
08b472553d1b97a148f8ffa1ce05e8be 0 0 236635 0 0
1774816 0 0 0 0 1839962 0 0 0 0 0
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17:36:59#0#11:12:43#11:12:43#12:00:00 1 baff918e30de077df13e43a693d324bd
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1717167 0 0 0 0 5836415 0 0 0 0
1069000
3201126 B 2 BS 1 24/07/2018 26/07/2018 08/01/2014 0 1
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2941900 0 0 - 0 - 0 - 0 - 0
2941900 2225703 0 3 0 0 0 MATHEOZ MORENZO
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3201126 B 2 BS 1 24/07/2018 26/07/2018 27/09/2001 0 2
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0001717604098 3;JKN DR RIZKI; 5.2.2.201806040537 4 205263
1#0##0#0#0.0#2018-08-03 10:03:24#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 24/07/2018 26/07/2018 08/10/1993 0 2
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3201126 B 1 BS 1 18/07/2018 26/07/2018 13/08/1953 0 1
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0138R0170718V006708 0001744707881 3;JKN TANTIYO S;16137
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15:49:12#0#00:00:00#00:00:00#00:00:00 1 1e11dcf48f7baa4423e63a30ca96385c
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15716000 0 0 0 0 2147000
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1#0##0#0#0.0#2018-08-13 15:57:16#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 3 BS 1 26/07/2018 26/07/2018 19/06/1993 0 1
1 I21.3;K21.9 90.59;89.52 - - None None None None I-4-10-I
None None None None None None INFARK MYOKARD AKUT (RINGAN) 4043000
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3201126 B 1 BS 1 25/07/2018 26/07/2018 16/12/1958 0 2
DIALISIS (SEDANG) 12472300 0 0 - 0 - 0 - 0 -
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0138R0170718V009067 0002072703486 3;JKN TANTIYO S;16137
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13:22:51#0#00:00:00#00:00:00#00:00:00 2 148a5e72ac05bc37ba89376462cddeea
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6994404 0 0 0 0 34500
3201126 B 1 BS 1 24/07/2018 26/07/2018 24/07/2018 3295 1
1 Q38.5;P03.4 - - - None None None None P-8-14-I None
None None None None None NEONATAL, BBL > 2499 GR DENGAN ANOMALI MAYOR
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20:13:33#0#00:00:00#00:00:00#00:00:00 2 5a2c3d69636d084a128fae4e51c7caed
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2201939 0 0 0 0 0
3201126 B 3 BS 1 25/07/2018 26/07/2018 01/03/1982 0 1
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- 0 4340500 6334109 0 2 0 0 0 NURHASAN
0138R0170718V009297 0000512831722 3;JKN TANTIYO S;16137
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20:24:39#0#19:30:30#19:30:30#00:00:00 2 e6ccf8473aa740b610a9931449903743
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440381 0 0 0 0 105234
3201126 B 2 BS 1 25/07/2018 26/07/2018 16/11/1978 0 1
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- 0 - 0 23198900 12174569 0 2 0 0 0
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20:53:59#0#00:00:00#00:00:00#12:00:00 3 b8517c53f6724f8c99daba424dbc4aa1
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822467 0 0 0 0 80352
3201126 B 1 BS 1 22/07/2018 26/07/2018 07/05/1996 0 2
1 A49.9;O21.1 - - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
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0001458192295 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204223
1#0##0#0#0.0#2018-10-09 11:10:11#0#00:00:00#00:00:00#00:00:00 3
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3201126 B 3 BS 1 24/07/2018 27/07/2018 01/04/1948 0 1
1 I25.0;I21.2;I50.0;I48 88.55 - - None None None None I-1-
12210800 0 0 - 0 - 0 - 0 - 0
12210800 20574230 0 4 0 0 0 NIMAN TN D404157
0000511653993 3;JKN DR RIZKI; 5.2.2.201806040537 4 204712
1#0##0#0#0.0#2018-07-31 15:08:27#0#01:41:58#01:41:58#00:00:00 2
45ae3fb81fc5edf90da3717a1641ce5f 0 4957000 2495160 0 0
8158070 0 0 0 0 1226000 0 0 0 0
3738000
3201126 B 3 BS 1 23/07/2018 27/07/2018 20/11/1995 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3137106 0 5 0 0 0 MUHAMAD RENO
D404163 22 8281 DR ARU, SPPD 0138R0170718V008363
0001454893672 3;JKN DR RIZKI; 5.2.2.201806040537 4 204706
1#0##0#0#0.0#2018-07-31 15:09:23#0#00:00:00#00:00:00#00:00:00 1
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1390809 0 0 0 0 1283231 0 0 0 0 170000
3201126 B 3 BS 1 20/07/2018 27/07/2018 19/11/1964 0 1
12174500 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.2.201806040537 4 204049 1#0##0#0#0.0#2018-
07-31 16:02:09#0#00:00:00#00:00:00#00:00:00 1
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5504940 0 0 0 0 1226000 0 0 0 0 410260
3201126 B 3 BS 1 25/07/2018 27/07/2018 07/01/1962 0 1
- 0 3502700 2090479 0 3 0 0 0 RUDY ERWIN
D404312 56 20653 DR ARU, SPPD 0138R0170718V009505
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1#0##0#0#0.0#2018-07-31 16:04:27#0#10:05:11#10:05:11#00:00:00 1
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1041467 0 0 0 0 865260 0 0 0 0 0
3201126 B 3 BS 1 24/07/2018 27/07/2018 25/05/1933 0 2
1 E14.8;R42;R63.0 - - - None None None None E-4-10-I
0 - 0 3502700 3381517 0 4 0 0 0 OEY
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1#0##0#0#0.0#2018-07-31 16:07:46#0#01:08:28#01:08:28#00:00:00 1
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3201126 B 2 BS 1 27/07/2018 27/07/2018 08/04/1973 0 2
SERVIK (SEDANG) 3046400 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-08-01 15:46:20#0#17:30:48#17:30:48#00:00:00 2
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3201126 B 3 BS 1 25/07/2018 27/07/2018 14/08/1954 0 1
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1#0##0#0#0.0#2018-08-01 16:14:43#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 2 BS 1 26/07/2018 27/07/2018 10/07/1959 0 2
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0138R0170718V009682 0001616113449 3;JKN DR RIZKI; 5.2.2.201806040537
4 206141 1#0##0#0#0.0#2018-08-01
16:51:57#0#15:41:05#15:41:05#00:00:00 1 a3c69f59388d891d1b13f996ace2aa12
0 4439100 2191100 0 0 3840400 0 0 0 0
767181 0 0 0 0 91704
3201126 B 1 BS 1 25/07/2018 27/07/2018 12/12/1957 0 1
1 I63.9;I10;G81.9;E78.5 87.03;87.44 - - None None None None
0 - 0 9673300 7233704 0 3 0 0 0 IMAM
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1#0##0#0#0.0#2018-08-01 16:59:57#0#08:37:37#08:37:37#00:00:00 1
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3174772 0 0 0 0 2860233 0 0 0 0 0
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0 0 - 0 - 0 - 0 - 0 17044400
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1#0##0#0#0.0#2018-08-01 17:33:36#0#09:13:26#09:13:26#00:00:00 1
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2573590 0 0 0 0 1119614 0 0 0 0 329828
3201126 B 1 BS 1 25/07/2018 27/07/2018 13/06/1971 0 1
- 0 5784900 6749414 0 3 0 0 0 ARIS
MUNENDAR TN D330910 47 17209 SRI KUNMARTINI.DR,SPPD 0138R0170718V009300
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1#0##0#0#0.0#2018-08-01 17:38:33#0#19:53:21#19:53:21#00:00:00 1
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2954348 0 0 0 0 3274425 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 27/07/2018 02/06/1994 0 2
0 - 0 - 0 - 0 - 0 2009900 9189771
0 4 0 0 0 BUNGA ZULRATUL AINI D354001 24 8818
DR ERDIYAN, SPOG 0138R0170718V008597 0002098471364 3;JKN DR RIZKI;
5.2.2.201806040537 4 204995 1#0##0#0#0.0#2018-08-02
08:37:20#0#00:00:00#00:00:00#00:00:00 1 076c38c0c7b35fefa41524d52005e718
0 0 601178 0 0 4014561 0 0 0 0
4536500 0 0 0 0 37532
3201126 B 2 BS 1 26/07/2018 27/07/2018 02/06/1952 0 1
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0138R0170718V009397 0001257761068 3;JKN DR RIZKI; 5.2.2.201806040537
4 205743 1#0##0#0#0.0#2018-08-02
09:20:39#0#07:37:11#07:37:11#12:00:00 1 4e4577c801f4bf300299f38e627de255
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10212000 0 0 0 0 7569000
3201126 B 3 BS 1 24/07/2018 27/07/2018 08/09/1972 0 2
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1#0##0#0#0.0#2018-08-02 10:26:15#0#15:11:39#15:11:39#00:00:00 1
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5738629 0 0 0 0 9285375 0 0 0 0 359000
3201126 B 3 BS 1 27/07/2018 27/07/2018 29/10/1992 0 1
1 I20.0;N18.5;K30 89.52 - - None None None None I-4-20-I
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1709091 0 1 0 0 0 REZA ANDENI P
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1#0##0#0#0.0#2018-08-02 12:38:17#0#10:58:51#10:58:51#00:00:00 1
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3201126 B 3 BS 1 27/07/2018 27/07/2018 16/11/1964 0 2
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(RINGAN) 1452800 0 0 - 0 - 0 - 0 - 0
1452800 688643 0 1 0 0 0 SITI CHOLILAH
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1#0##0#0#0.0#2018-08-02 12:45:01#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 3 BS 1 27/07/2018 27/07/2018 23/04/2011 0 1
1 S52.50 - - - None None None None M-4-12-I None
(RINGAN) 2947400 0 0 - 0 - 0 - 0 - 0
2947400 1083215 0 1 0 0 0 MUHAMMAD QEANU AL
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1#0##0#0#0.0#2018-08-02 12:55:12#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 26/07/2018 27/07/2018 26/01/1957 0 2
1 R04.0 - - - None None None None U-4-12-I None None
None None None None EPISTAKSIS/PERDARAHAN HIDUNG (RINGAN) 3041300
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3877702 0 2 0 0 0 FAUZIA YUANITA d308937 61
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1#0##0#0#0.0#2018-08-03 10:01:01#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 24/07/2018 27/07/2018 07/04/1958 0 2
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5.2.2.201806040537 4 205292 1#0##0#0#0.0#2018-08-03
10:12:00#0#00:00:00#00:00:00#12:00:00 1 e45b25696c90ae1ca9f1b4aadfbab743
0 0 439172 0 0 1784331 0 0 0 0
2190008 0 0 0 0 128000
3201126 B 2 BS 1 24/07/2018 27/07/2018 19/08/2017 0 1
2061500 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-08-03 10:13:52#0#16:09:47#16:09:47#00:00:00 1
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3201126 B 2 BS 1 26/07/2018 27/07/2018 10/02/1960 0 1
1 I25.0;I08.9;I13.1;E11.9 88.55;90.59;89.52 - - None None None
None I-1-15-II None None None None None None KATETERISASI JANTUNG
(SEDANG) 7609600 0 0 - 0 - 0 - 0 - 0
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0001381332407 3;JKN DR RIZKI; 5.2.2.201806040537 4 205737
1#0##0#0#0.0#2018-08-03 10:21:04#0#05:58:42#05:58:42#00:00:00 1
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3190623 0 0 0 0 849986 0 0 0 0
2069000
3201126 B 1 BS 1 25/07/2018 27/07/2018 25/04/1948 0 2
0 - 0 - 0 - 0 - 0 5005900 4972326
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5.2.2.201806040537 4 205730 1#0##0#0#0.0#2018-08-03
10:26:12#0#23:31:47#23:31:47#00:00:00 1 0c0eb422445c9690adf685d4a4daa3ed
0 0 841429 0 0 295025 0 0 0 0
2835872 0 0 0 0 0
3201126 B 1 BS 1 26/07/2018 27/07/2018 17/05/1958 0 2
(RINGAN) 6076700 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.2.201806040537 4 206008 1#0##0#0#0.0#2018-
08-03 10:31:04#0#00:00:00#00:00:00#12:00:00 1
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872698 0 0 0 0 596037 0 0 0 0 80352
3201126 B 1 BS 1 25/07/2018 27/07/2018 07/12/1961 0 2
1 E14.9;K30 - - - None None None None E-4-10-I None
- 0 4903800 3938582 0 3 0 0 0 SRI NURYATI
0001256606098 3;JKN DR RIZKI; 5.2.2.201806040537 4 205234
1#0##0#0#0.0#2018-08-03 10:38:12#0#08:02:26#08:02:26#00:00:00 1
6e0610154f6d84e6be602d22c59c57ee 0 0 494342 0 0 817576
0 0 0 0 2626664 0 0 0 0 0
3201126 B 1 BS 1 19/07/2018 27/07/2018 18/05/2015 0 1
10909500 0 0 - 0 - 0 - 0 - 0
10909500 27252805 0 9 0 0 0 RAYI ARSA GARDANA
0002469727743 3;JKN DR RIZKI; 5.2.2.201806040537 4 203351
1#0##0#0#0.0#2018-08-03 10:41:07#0#01:16:49#01:16:49#00:00:00 1
a3f8df14b767a21599c5ed40867d29f0 0 11184100 3247936 0 0
10058398 0 0 0 0 1301000 0 0 0 0
1461371
3201126 B 1 BS 1 26/07/2018 27/07/2018 26/05/1969 0 2
0 0 - 0 - 0 - 0 - 0 7464200
11204220 0 2 0 0 0 MILKA TRIANA d006050 49
DR RIZKI; 5.2.2.201806040537 4 205741 1#0##0#0#0.0#2018-08-03
10:43:49#0#07:30:53#07:30:53#00:00:00 1 e316d7c1155e8fe153f721d730496dc1
0 5896000 2089976 0 0 2279388 0 0 0 0
758986 0 0 0 0 179870
3201126 B 1 BS 1 25/07/2018 27/07/2018 16/02/1970 0 2
- 0 12472300 12710105 0 3 0 0 0 MASUROH
0000040969001 3;JKN DR RIZKI; 5.2.2.201806040537 4 205721
1#0##0#0#0.0#2018-08-03 10:45:51#0#18:04:36#18:04:36#00:00:00 1
cdc287e6d149a1ca906a45feebb26ed5 0 6813700 2647238 0 0
2322665 0 0 0 0 857502 0 0 0 0 69000
3201126 B 1 BS 1 25/07/2018 27/07/2018 21/02/1959 0 2
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5530574 0 3 0 0 0 ROSIYATI
0000044937145 3;JKN DR RIZKI; 5.2.2.201806040537 4 205714
1#0##0#0#0.0#2018-08-03 10:48:04#0#16:31:29#16:31:29#12:00:00 1
881aaefa035873f39c6626a2caef70a0 0 0 520641 0 0
1469745 0 0 0 0 3540188 0 0 0 0 0
3201126 B 1 BS 1 25/07/2018 27/07/2018 01/04/1979 0 2
- 0 - 0 - 0 - 0 5424200 12056823 0
3 0 0 0 HERNAWATI D398827 39 14360 E. SURYA POHAN
0138R0170718V009012 0001455811749 3;JKN DR RIZKI; 5.2.2.201806040537
4 205382 1#0##0#0#0.0#2018-08-03
10:53:54#0#00:00:00#00:00:00#00:00:00 1 b86ec675de17ae605cea63e734a38a9c
0 7159200 2723736 0 0 1290123 0 0 0 0
814764 0 0 0 0 69000
3201126 B 1 BS 1 26/07/2018 27/07/2018 20/06/1947 0 2
1 D64.9;K92.0;K92.1;E14.9;N18.9 99.04 - - None None None None
0 - 0 - 0 5918600 4178396 0 2 0 0
0 SUMARNI D401073 71 25969 DR BETTY DWI L, SPPD
0138R0170718V009325 0000061021462 3;JKN DR RIZKI; 5.2.2.201806040537
4 205736 1#0##0#0#0.0#2018-08-03
10:56:18#0#05:12:01#05:12:01#00:00:00 1 8525e7e97f2d7874cf92a35453528ce6
0 0 361898 0 0 1955145 0 0 0 0
1861353 0 0 0 0 0
3201126 B 1 BS 1 26/07/2018 27/07/2018 02/04/1956 0 1
1 I12.0;D63.8;E11.9 39.27;90.59;89.52 - - None None None None
- 0 - 0 12472300 11945771 0 2 0 0 0
BUDHI HENDRI SUSENO D404345 62 22760 DR SRI KUNMARTINI, SPPD
0138R0170718V009489 0001453769313 3;JKN DR RIZKI; 5.2.2.201806040537
4 205829 1#0##0#0#0.0#2018-08-03
10:57:38#0#00:00:00#00:00:00#00:00:00 1 c0104f877234c19f146bcef97eff7b94
0 6468200 2647238 0 0 1953834 0 0 0 0
807499 0 0 0 0 69000
3201126 B 1 BS 1 24/07/2018 27/07/2018 13/01/1968 0 1
- 0 58821400 58133219 0 4 0 0 0 HERIYADI
MASKUN D404170 50 18455 DR AZRI NURIZAL SPPD KKV
0138R0170718V009112 0002044955114 3;JKN DR RIZKI; 5.2.2.201806040537
4 205586 1#0##0#0#0.0#2018-08-03
11:04:29#0#00:00:00#00:00:00#00:00:00 1 78a82b31813367c4cc3ca36e7c410fa9
0 11808000 9672120 0 0 27208199 0 0 0 0
1577900 0 0 0 0 7867000
3201126 B 1 BS 1 23/07/2018 27/07/2018 16/07/1942 0 1
1 I63.9;A41.9;I13.0 39.95 - - None None None None G-4-14-III
INFARK (BERAT) 12141100 0 0 - 0 - 0 - 0 -
0 12141100 11454752 0 5 0 0 0 MUDJITABA
0000061027479 3;JKN irene; 5.2.2.201806040537 4 204291
1#0##0#0#0.0#2018-08-03 13:57:43#0#00:00:00#00:00:00#00:00:00 2
41990154b251424f044ac4a94b08721b 0 0 743950 0 0
4619051 0 0 0 0 5213751 0 0 0 0 878000
3201126 B 1 BS 1 27/07/2018 27/07/2018 16/12/2011 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3828909 0 1 0 0 0 NAYLA SAYYIDAH NAFISA
0001660078337 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206321
1#0##0#0#0.0#2018-08-09 16:37:35#1#11:07:23#11:07:23#00:00:00 1
5d44171629dfb6523f523351756af966 0 0 417960 0 288489
551620 0 0 0 0 2400840 0 0 0 170000
0
3201126 B 1 BS 1 26/07/2018 27/07/2018 23/05/1994 0 2
3349800 0 0 - 0 - 0 - 0 - 0
3349800 2481106 0 2 0 0 0 INTAN MANDASARI
0138R0170718V009763 0002297960818 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206199 1#0##0#0#0.0#2018-08-13
16:25:16#0#21:48:20#21:48:20#00:00:00 1 18013eb9f36d6bbc5348db27dbcd1cec
0 0 269459 0 0 806832 0 0 0 0
1404815 0 0 0 0 0
3201126 B 1 BS 1 24/07/2018 27/07/2018 05/06/2000 0 2
1 A49.9;M79.69 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 5096276 0 4 0 0 0 KRISANTI
KLASKI PUTRI D064516 18 6623 DR ARU, SPPD 0138R0170718V008800
0001312386096 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 205215
1#0##0#0#0.0#2018-09-08 09:57:07#0#18:40:00#18:40:00#00:00:00 2
70e3437673db1df396961a758edd7d91 0 0 385550 0 0
1572825 0 0 0 0 3137901 0 0 0 0 0
3201126 B 3 BS 1 26/07/2018 27/07/2018 07/04/1969 0 1
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 7608184 0 2 0 0 0 EKO PRIAMBODO
D401702 49 18007 DEDY PRATAMA,DR SPBV 0138R0170718V009600
0001228485802 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206031
1#0##0#0#0.0#2018-09-25 13:03:40#0#00:00:00#00:00:00#00:00:00 2
c713e8f57b86a75e6bef717b5ca6c064 0 3438800 1834760 0 0
1741892 0 0 0 0 523732 0 0 0 0 69000
3201126 B 3 BS 1 26/07/2018 27/07/2018 27/04/2009 0 2
4 D65;A91;R57.1 90.59 - - None None None None D-4-11-III
None None None None None None GANGGUAN PEMBEKUAN DARAH (BERAT)
10288700 0 0 - 0 - 0 - 0 - 0
10288700 6058536 0 2 0 0 0 HAURA NUR AZIZAH
0001194683038 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206189
1#0##0#0#0.0#2018-09-26 20:19:19#0#16:50:25#16:50:25#00:00:00 2
33471d49c0da04e556d0f0812699e581 0 0 614935 0 0
4450248 0 0 0 0 703353 0 0 0 0 290000
3201126 B 3 BS 1 22/07/2018 27/07/2018 01/07/1971 0 1
1 K35.2;K66.0;R02 54.19 - - None None None None K-1-40-II
(SEDANG) 8857200 0 0 - 0 - 0 - 0 - 0
8857200 18912602 0 6 0 0 0 ATOYO D404061 47
17188 DR ARU, SPPD 0138R0170718V007838 0001730026732 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 204243 1#0##0#0#0.0#2018-
09-26 21:06:06#0#00:00:00#00:00:00#00:00:00 2
f61fab8166769a2c26370649383257a2 0 6037700 4511813 0 0
6596394 0 0 0 0 1226000 0 0 0 0 540695
3201126 B 2 BS 1 26/07/2018 27/07/2018 12/03/1960 0 2
- 0 10690500 13696719 0 2 0 0 0 RATI
d404367 58 21320 DR SRI KUNMARTINI, SPPD 0138r0170718v009747
0001313844614 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206192
1#0##0#0#0.0#2018-09-27 12:13:09#0#18:38:06#18:38:06#00:00:00 2
885860cc6cffb645fcbe920e25424508 0 4703600 4878371 0 0
3087467 0 0 0 0 922047 0 0 0 0 105234
3201126 B 3 BS 1 25/07/2018 27/07/2018 01/12/1957 0 1
- 0 8908800 8620771 0 3 0 0 0 MURTOWO
0000511824982 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 205716
1#0##0#0#0.0#2018-09-27 12:16:19#0#17:46:03#17:46:03#12:00:00 2
ac9a300cbc977c3419d50da34c525557 0 3525300 1906030 0 0
2530465 0 0 0 0 589976 0 0 0 0 69000
3201126 B 1 BS 1 25/07/2018 27/07/2018 17/04/1974 0 1
1 N18.5;J18.0;T82.4;D63.8 39.53;99.04;39.95 - - None None None
None I-1-20-III None None None None None None PROSEDUR SISTIM
- 0 - 0 28247300 27666387 0 3 0 0 0
BRAMADYA PRADIKO D229245 44 16170 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V009186 0001620785215 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 205702 1#0##0#0#0.0#2018-09-28
16:06:34#0#15:56:08#15:56:08#00:00:00 2 da521d9043292b22ee070689ed5b4067
0 7159200 8538222 0 0 9265532 0 0 0 0
2382250 0 0 0 0 321183
3201126 B 1 BS 1 27/07/2018 28/07/2018 22/11/1954 0 2
1 I25.0;I11.0;E14.9;E78.5 88.55 - - None None None None I-1-
17095200 0 0 - 0 - 0 - 0 - 0
17095200 14246532 0 2 0 0 0 ANA MARSANA, NY
0000039475203 3;JKN DR RIZKI; 5.2.2.201806040537 4 206344
1#0##0#0#0.0#2018-08-01 16:08:17#0#00:00:00#00:00:00#00:00:00 1
a562570e133d16636be904b35d743848 0 4777000 2019040 0 0
4477648 0 0 0 0 958016 0 0 0 0
2014828
3201126 B 3 BS 1 27/07/2018 28/07/2018 28/09/1993 0 2
- 0 - 0 - 0 - 0 2168300 1408598 0
2 0 0 0 RAHMA NURBAITI D389767 24 9068 DR ERDIYAN,
4 206272 1#0##0#0#0.0#2018-08-01
16:11:12#0#10:33:15#10:33:15#00:00:00 1 a833311da70502ae85aefb69688b5ad7
0 0 248147 0 0 266300 0 0 0 0 894151
0 0 0 0 0
3201126 B 3 BS 1 25/07/2018 28/07/2018 22/12/1952 0 1
1 S09.9;A09.9 - - - None None None None G-4-24-I None
- 0 - 0 - 0 - 0 3043100 3256792 0
4 0 0 0 HANAPIH D404316 65 23956 DR CATUR BANUAJI
4 205744 1#0##0#0#0.0#2018-08-01
16:15:45#0#00:00:00#00:00:00#00:00:00 1 bae8f22b7ed56f6acd1ca2d181a52777
0 0 326879 0 0 1901852 0 0 0 0
1028061 0 0 0 0 0
3201126 B 3 BS 1 25/07/2018 28/07/2018 26/09/1998 0 2
1 S00.9;S06.41;S02.10 01.24;90.59;87.49 - - None None None
None G-1-10-III None None None None None None KRANIOTOMI (BERAT)
22563700 0 0 - 0 - 0 - 0 - 0
22563700 25406804 0 4 0 0 0 NADIYYA HASANAH
D404231 19 7242 ARNANDA NOOR DR SPBS 0138R0170718V008985
0001717817444 3;JKN DR RIZKI; 5.2.2.201806040537 4 205338
1#0##0#0#0.0#2018-08-01 16:18:56#0#00:00:00#00:00:00#00:00:00 1
1761a255d61ccf38daf428aa05e9d113 0 5225800 5991888 0 0
11764124 0 0 0 0 1226000 0 0 0 0
1198992
3201126 B 3 BS 1 27/07/2018 28/07/2018 15/04/1983 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 6975546 0 2 0 0 0 IIS SURATNA D404217
DR RIZKI; 5.2.2.201806040537 4 206206 1#0##0#0#0.0#2018-08-01
16:20:42#0#00:00:00#00:00:00#00:00:00 1 51eb7b77ee4941616c27f81200f726c1
0 3343500 1249832 0 0 1829601 0 0 0 0
497344 0 0 0 0 55269
3201126 B 3 BS 1 27/07/2018 28/07/2018 28/08/1968 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8050923 0 2 0 0 0 SYECHA AL HAMID
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1#0##0#0#0.0#2018-08-01 16:22:49#0#16:56:31#16:56:31#00:00:00 1
387dc54d4ae2755fc24a3a0e7d678e15 0 3438800 1906030 0 0
2153397 0 0 0 0 552696 0 0 0 0 0
3201126 B 3 BS 1 26/07/2018 28/07/2018 31/08/1971 0 1
- 0 - 0 19332400 10736541 0 3 0 0 0
JUHAINI D404365 46 17131 DR SRI KUN, SPPD 0138R0170718V009744
0001209671638 3;JKN DR RIZKI; 5.2.2.201806040537 4 206190
1#0##0#0#0.0#2018-08-01 16:25:11#0#00:00:00#00:00:00#00:00:00 1
3188576978dc552965ae2a26bdcfa3ee 0 3525300 4074139 0 0
2235380 0 0 0 0 728391 0 0 0 0 173331
3201126 B 3 BS 1 23/07/2018 28/07/2018 04/02/1986 0 1
1 A18.3;D64.9 99.04 - - None None None None K-4-18-II None
2451500 0 0 - 0 - 0 - 0 - 0
2451500 8810484 0 6 0 0 0 FIRMANSYAH EFFENDI
d399830 32 11857 DR ARU, SPPD 0138R0170718V008276
0001740600887 3;JKN DR RIZKI; 5.2.2.201806040537 4 204667
1#0##0#0#0.0#2018-08-01 16:28:58#0#16:13:10#16:13:10#00:00:00 2
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6303463 0 0 0 0 2180387 0 0 0 0 0
3201126 B 2 BS 1 25/07/2018 28/07/2018 27/07/1982 0 1
1 K80.8;R17;E14.9 - - - None None None None B-4-14-II
(SEDANG) 5879600 0 0 - 0 - 0 - 0 - 0
5879600 4236842 0 4 0 0 0 MOCHAMAD FACHRURROZIE TN
D404332 35 13147 E. SURYA POHAN 0138R0170718V009311
0001149038627 3;JKN DR RIZKI; 5.2.2.201806040537 4 205729
1#0##0#0#0.0#2018-08-01 16:41:24#0#23:21:00#23:21:00#00:00:00 1
65647064c60c3cb01331f5912076b88d 0 0 506582 0 0 977504
0 0 0 0 1752756 0 0 0 0 0
3201126 B 2 BS 1 26/07/2018 28/07/2018 17/12/1991 0 2
1 S62.61 86.22;87.49;90.59 - - None None None None M-4-
(RINGAN) 3536800 0 0 - 0 - 0 - 0 - 0
3536800 10747547 0 3 0 0 0 NATALIA DESLIANA
0138R0170718V009921 0001859767536 3;JKN DR RIZKI; 5.2.2.201806040537
4 206221 1#0##0#0#0.0#2018-08-01
16:42:35#0#09:42:12#09:42:12#00:00:00 1 d9126aa7550caa72fd4454d7e70b87f4
0 7765000 1043304 0 0 1129964 0 0 0 0
729111 0 0 0 0 80168
3201126 B 2 BS 1 27/07/2018 28/07/2018 05/06/1988 0 2
0 - 0 - 0 - 0 - 0 2009900 5063794
0 2 0 0 0 GRACE ELIZABETH BURING LUNG D383027 30
11009 DR ERDIYAN, SPOG 0138R0170718V009866 0001458758564 3;JKN DR
RIZKI; 5.2.2.201806040537 4 206210 1#0##0#0#0.0#2018-08-01
16:45:27#0#08:05:47#08:05:47#00:00:00 1 b0d28e228d9b098e752f6f92dd3d3ff2
0 0 734673 0 0 936852 0 0 0 0
3329576 0 0 0 0 62693
3201126 B 2 BS 1 24/07/2018 28/07/2018 04/01/2002 0 2
1 K92.2;D64.9 99.04 - - None None None None K-4-18-II None
2941900 0 0 - 0 - 0 - 0 - 0
2941900 8351390 0 5 0 0 0 RATU CAHYA CHUMAIROH
0002469093153 3;JKN DR RIZKI; 5.2.2.201806040537 4 204714
1#0##0#0#0.0#2018-08-01 16:47:39#0#01:53:48#01:53:48#00:00:00 1
c7661f8fad325b55fc84c6f75da46aae 0 0 689974 0 0
4564063 0 0 0 0 3097353 0 0 0 0 0
3201126 B 2 BS 1 24/07/2018 28/07/2018 05/12/1948 0 1
1 I63.8;G81.9;I10;M17.9 87.03;87.49;90.59;89.52 - - None None
- 0 - 0 - 0 8291400 6695479 0 5 0
0 0 ZAINAL HALIM D360378 69 25433 DR MAYSAMIRAWATI SPS
0138R0170718V008828 0000060643901 3;JKN DR RIZKI; 5.2.2.201806040537
4 205225 1#0##0#0#0.0#2018-08-01
16:49:23#0#21:49:22#21:49:22#00:00:00 1 182d9148d466ecb11b0775d6f93ac399
0 0 882140 0 0 3329317 0 0 0 0
2484022 0 0 0 0 0
3201126 B 2 BS 1 23/07/2018 28/07/2018 02/05/1960 0 2
1 D64.9;D69.6 99.04 - - None None None None D-4-13-II None
- 0 5073100 9085938 0 6 0 0 0 IPAH
0002091179891 3;JKN DR RIZKI; 5.2.2.201806040537 4 204689
1#0##0#0#0.0#2018-08-01 16:54:41#0#18:23:25#18:23:25#00:00:00 1
3ce5fb4882f690e6f8385b9e2b60f69a 0 0 539531 0 0
4933500 0 0 0 0 3442907 0 0 0 0 170000
3201126 B 1 BS 1 24/07/2018 28/07/2018 07/07/1974 0 2
1 D43.2;E14.9;R47.0 87.03;87.44 - - None None None None G-4-
LAIN (SEDANG) 6023100 0 0 - 0 - 0 - 0 -
0 6023100 9699158 0 5 0 0 0 TINI SETIAWATI
0000042715462 3;JKN DR RIZKI; 5.2.2.201806040537 4 204993
1#0##0#0#0.0#2018-08-01 17:03:27#0#12:37:51#12:37:51#00:00:00 1
dbd7c112072a0913e6e977082904a200 0 0 595079 0 0
4538555 0 0 0 0 4565524 0 0 0 0 0
3201126 B 1 BS 1 25/07/2018 28/07/2018 02/11/1969 0 2
1 D24;N61 85.21 - - None None None None L-1-50-I None
0 0 - 0 - 0 - 0 - 0 9150100
19613764 0 4 0 0 0 REGINA NURATIP D036623 48
DR RIZKI; 5.2.2.201806040537 4 205728 1#0##0#0#0.0#2018-08-01
17:12:18#0#00:00:00#00:00:00#00:00:00 1 de56114e978a27325261136fcdf0f3d3
0 8741400 4536549 0 0 4862659 0 0 0 0
1226000 0 247156 0 0 0
3201126 B 1 BS 1 27/07/2018 28/07/2018 14/02/1958 0 2
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 3473007 0 2 0 0 0 SRI MOELYATI
0000060943612 3;JKN DR RIZKI; 5.2.2.201806040537 4 206365
1#0##0#0#0.0#2018-08-01 17:15:21#0#00:00:00#00:00:00#12:00:00 1
5c2b55585e306ccf31bfa3601c2d86b0 0 0 573641 0 0
1084160 0 0 0 0 1815206 0 0 0 0 0
3201126 B 1 BS 1 27/07/2018 28/07/2018 25/12/1949 0 2
- 0 12472300 17642316 0 2 0 0 0 SUMIAH
0138R0170718V009999 0001456293429 3;JKN DR RIZKI; 5.2.2.201806040537
4 206364 1#0##0#0#0.0#2018-08-01
17:17:02#0#00:00:00#00:00:00#00:00:00 1 c952f7d789919eab03f387cff6873be8
0 5896000 2547460 0 0 8018686 0 0 0 0
1180170 0 0 0 0 0
3201126 B 1 BS 1 27/07/2018 28/07/2018 09/10/1956 0 1
- 0 58821400 55935797 0 2 0 0 0 DWI HARTOTO
d228569 61 22571 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170718V009882
0000042258115 3;JKN DR RIZKI; 5.2.2.201806040537 4 206211
1#0##0#0#0.0#2018-08-01 17:18:36#0#00:00:00#00:00:00#00:00:00 1
7a809d3a42a0c49d2f20423f6e22693b 0 10062000 9619120 0 0
27528677 0 0 0 0 1226000 0 0 0 0
7500000
3201126 B 1 BS 1 20/07/2018 28/07/2018 09/02/1964 0 2
1 C41.9;D63.0;R63.0 99.04 - - None None None None M-4-13-II
None None None None None None TUMOR MUSKULOSKLETAL,JARINGAN KONEKTIF
DAN FRAKTUR PATOLOGIS (SEDANG) 10322900 0 0 - 0 - 0
- 0 - 0 10322900 21501876 0 9 1 4 0
ITA ANGGRIANI d403819 54 19885 DR ARU, SPPD
0138R0170718V007220 0000166908069 3;JKN DR RIZKI; 5.2.2.201806040537
4 203579 1#0##0#0#0.0#2018-08-01
17:23:06#0#01:19:06#01:19:06#00:00:00 1 7912fb7fad3dea4758084cb8165e9d6b
0 0 982061 0 0 8344815 0 0 0 0
8531000 0 0 0 0 3644000
3201126 B 1 BS 1 27/07/2018 28/07/2018 09/12/2016 0 1
1 A49.9;D69.3;B34.9 - - - None None None None A-4-14-II
LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0 - 0
- 0 3855500 3162372 0 2 0 0 0 CALON BAYI
NY NURMA YULIAN D404416 1 595 KRISTYANINGESTI,DR.SPA
0138R0170718V009932 0002207012782 3;JKN DR RIZKI; 5.2.2.201806040537
4 206238 1#0##0#0#0.0#2018-08-01
17:27:33#0#00:00:00#00:00:00#00:00:00 1 cf857763ff236cdef502067693b6d7c1
0 0 562400 0 0 805088 0 0 0 0
1794884 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 28/07/2018 12/10/1953 0 1
1 S09.9;M54.56 87.03;87.44 - - None None None None G-4-
24-I None None None None None None TRAUMA KEPALA (RINGAN) 4260400 0
0 - 0 - 0 - 0 - 0 4260400 9984685
0 8 0 0 0 THOMAS SARJONO D392504 64 23658 DR
CATUR BANUAJI SPS 0138R0170718V007773 0000061087105 3;JKN DR RIZKI;
5.2.2.201806040537 4 204214 1#0##0#0#0.0#2018-08-01
17:30:35#0#00:00:00#00:00:00#12:00:00 1 611ecf1cbbe65d9e7e9a5ae077665151
0 0 542436 0 0 2515045 0 0 0 0
6927204 0 0 0 0 0
3201126 B 1 BS 1 26/07/2018 28/07/2018 16/01/1958 0 2
I-4-19-II None None None None None None GANGGUAN KONDUKSI & ARITMIA
JANTUNG (SEDANG) 8555800 0 0 - 0 - 0 - 0 -
0 8555800 3602357 0 3 0 0 0 WASILAH
0001262618706 3;JKN DR RIZKI; 5.2.2.201806040537 4 205977
1#0##0#0#0.0#2018-08-01 17:32:25#0#11:28:54#11:28:54#00:00:00 1
c481788123d3c7a2a6f23b93be92d444 0 0 823022 0 0 174667
0 0 0 0 2604668 0 0 0 0 0
3201126 B 1 BS 1 25/07/2018 28/07/2018 01/12/1949 0 2
1 K80.8;M54.59 88.76 - - None None None None B-4-14-I
(RINGAN) 5879800 0 0 - 0 - 0 - 0 - 0
5879800 9555694 0 4 0 0 0 ELIDA RAMLI D394012
68 25073 DR ARU, SPPD 0138R0170718V008840 0000039797662 3;JKN
DR RIZKI; 5.2.2.201806040537 4 205228 1#0##0#0#0.0#2018-08-01
17:41:12#0#02:40:47#02:40:47#00:00:00 1 99e616cc9275ca7eddfdfb708dcb1290
0 0 866000 0 0 2386555 0 0 0 0
6303139 0 0 0 0 0
3201126 B 2 BS 1 27/07/2018 28/07/2018 06/07/1976 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 11006641 0 2 0 0 0 YULIANTO
0001386886116 3;JKN DR RIZKI; 5.2.2.201806040537 4 206370
1#0##0#0#0.0#2018-08-02 08:36:18#0#13:43:01#13:43:01#00:00:00 1
55e93c888ceab4f9c3b2fd0e0bf79ba1 0 0 2223624 0 0
3517504 0 0 0 0 5185161 0 0 0 0 80352
3201126 B 2 BS 1 26/07/2018 28/07/2018 26/07/1973 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 6149136 0 3 0 0 0 SUMARTANA D369438
44 16436 DR ARU, SPPD 0138R0170718V009760 0001101686411 3;JKN
DR RIZKI; 5.2.2.201806040537 4 206196 1#0##0#0#0.0#2018-08-02
09:07:23#0#20:06:22#20:06:22#00:00:00 1 207e32271a05f041bdba9029aa8fee9b
0 0 156906 0 0 3447075 0 0 0 0
2545153 0 0 0 0 0
3201126 B 3 BS 1 28/07/2018 28/07/2018 18/05/2014 0 2
2 C76.2;R40.0 - - - None None None None K-4-10-II None
0 - 0 - 0 - 0 - 0 7062900 3259675
0 1 0 0 0 THALITA ZAHRA D404502 4 1532 DR
WIDHI DEWANTA K AJI 0138R0170718V010210 0001310747949 3;JKN DR RIZKI;
5.2.2.201806040537 4 206443 1#0##0#0#0.0#2018-08-02
10:20:11#0#10:15:34#10:15:34#00:00:00 1 1682f329406cf9a59246de051b84f599
0 0 735661 0 0 1263764 0 0 0 0 502245
0 0 0 0 758000
3201126 B 2 BS 1 27/07/2018 28/07/2018 05/09/1945 0 1
1 I20.9;I21.3;I50.0;I25.0;K30 88.55;89.52 - - None None None
None I-1-15-III None None None None None None KATETERISASI JANTUNG
(BERAT) 14653000 0 0 - 0 - 0 - 0 - 0
14653000 13042621 0 2 0 0 0 DUL HALIM D402764
0000060707226 3;JKN DR RIZKI; 5.2.2.201806040537 4 206256
1#0##0#0#0.0#2018-08-02 11:56:37#0#10:19:25#10:19:25#00:00:00 1
c59cb9472bcac54dbd0e8c2797508484 0 3555000 2930600 0 0
3677765 0 0 0 0 879256 0 0 0 0
2000000
3201126 B 1 BS 1 26/07/2018 28/07/2018 16/08/1985 0 2
0 0 - 0 - 0 - 0 - 0 6981500
13573093 0 3 0 0 0 ERNA AGUSTINA D285682 32
12032 DR RM DHENI DANARDHONO SPOG 0138R0170718V009359 0001642978001
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 205738
1#0##0#0#0.0#2018-08-02 12:34:18#0#06:59:51#06:59:51#12:00:00 1
fc8d109b490ed21f269bbaeefaa2cee8 0 0 2113950 0 0
2811324 0 0 0 0 8393859 0 0 0 0 253960
3201126 B 3 BS 1 27/07/2018 28/07/2018 01/03/1955 0 1
- 0 - 0 - 0 - 0 3575600 1569211 0
2 0 0 0 DEDE ILYAS D404475 63 23159 DR ADRIAN HANDARU
0138R0170718V010161 0000510932248 3;JKN DR RIZKI; 5.2.2.201806040537
4 206410 1#0##0#0#0.0#2018-08-02
14:03:22#0#20:05:26#20:05:26#00:00:00 1 f86e1ddd59936a54d5431b0faa5c0efb
0 0 305565 0 0 137987 0 0 0 0 409659
0 0 0 0 716000
3201126 B 3 BS 1 28/07/2018 28/07/2018 14/07/1945 0 2
None None None None FRAKTUR FEMUR (RINGAN) 2963200 0 0 -
0 - 0 - 0 - 0 2963200 1308876 0 1
0 0 0 RUMSIH S. D404489 73 26677 DR DINI DANIATY
0138R0170718V010176 0000028932322 3;JKN DR RIZKI; 5.2.2.201806040537
4 206420 1#0##0#0#0.0#2018-08-02
14:09:45#0#00:00:00#00:00:00#00:00:00 1 be3bbb5b1fe5613fa6307c008eb5148d
0 0 148160 0 0 350089 0 0 0 0 392627
0 0 0 0 418000
3201126 B 3 BS 1 27/07/2018 28/07/2018 31/12/1955 0 2
12210800 0 0 - 0 - 0 - 0 - 0
12210800 11554008 0 2 0 0 0 MARWATI D402081
0000510851812 3;JKN DR RIZKI; 5.2.2.201806040537 4 206207
1#0##0#0#0.0#2018-08-02 14:19:32#0#06:35:39#06:35:39#00:00:00 1
945b2ac0ce89523cef87db330b1a6c7f 0 2421000 2442160 0 0
3908978 0 0 0 0 781870 0 0 0 0
2000000
3201126 B 1 BS 1 26/07/2018 28/07/2018 08/04/1987 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2963185 0 3 0 0 0 RUMENDA D404160
0001370391941 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206197
1#0##0#0#0.0#2018-08-09 16:33:42#1#21:00:35#21:00:35#00:00:00 1
a6cef35763ff9593cfcde9fec92e5530 0 0 278640 0 0
1246272 0 0 0 0 1218420 0 0 0 219853
0
3201126 B 2 BS 1 27/07/2018 28/07/2018 05/02/1968 0 1
4 I21.2;R57.0 - - - None None None None I-4-10-III None
0 - 0 - 0 - 0 - 0 12482300 10207692
0 2 0 0 0 SARKAM D317802 50 18435 DR AGOES
KOOSHARTORO SPPD-KKV 0138r0170718v010128 0001795851404 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 206403 1#0##0#0#0.0#2018-08-13
12:26:47#0#16:17:29#16:17:29#00:00:00 1 36a2db1e3097d81d7634985d77942aa4
0 0 416870 0 0 6287029 0 0 0 0
2439793 0 0 0 0 1064000
3201126 B 1 BS 1 26/07/2018 28/07/2018 24/09/2005 0 1
1 R59.1 40.29 - - None None None None D-1-20-I None None
LAIN (RINGAN) 7229800 0 0 - 0 - 0 - 0 -
0 7229800 12100666 0 3 0 0 0 NINDY RASYA
CAHYANI D095295 12 4688 RACHMAWATI DR,SPB(K)ONK 0138R0170718V009753
0001200501775 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206194
1#0##0#0#0.0#2018-08-13 14:05:07#0#19:03:18#19:03:18#00:00:00 1
f6cabb537b1ef500dbe02cc9c95fa438 0 6259500 2024344 0 0
2839362 0 0 0 0 817632 0 0 0 0 159828
3201126 B 2 BS 1 18/07/2018 28/07/2018 18/07/2018 1742 1
- 0 13344800 22681405 0 11 1 2 0 YETI OKTARIA
BY NY D403671 0 0 DR KHARINA CHATAR SPA 0138R0170718V007096
0002474685808 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 203479
1#0##0#0#0.0#2018-08-29 20:03:51#0#14:11:16#14:11:16#00:00:00 1
94b3708e421bb2117912e71a7c3af9b6 0 0 1160696 0 0
6576209 0 0 0 0 10472500 0 0 0 0
4472000
3201126 B 2 BS 1 26/07/2018 28/07/2018 19/01/1978 0 2
None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN KAKI (RINGAN)
18306300 0 0 - 0 - 0 - 0 - 0
18306300 18318619 0 3 0 0 0 SRIRETNOWATI NY
0001181967041 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206198
1#0##0#0#0.0#2018-09-08 09:58:37#0#21:01:11#21:01:11#00:00:00 2
c749a038e4b5d3a5b2c86af9ee93bbe4 0 0 8361827 0 0
2962822 0 0 0 0 6964314 0 0 0 0 29656
3201126 B 3 BS 1 26/07/2018 28/07/2018 12/10/1940 0 2
1 I13.1;E11.9;D63.8;T82.4 86.28;99.04 - - None None None None
- 0 6077700 7480005 0 3 0 0 0 MUNYANIH
0002020722862 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206058
1#0##0#0#0.0#2018-09-25 13:31:38#0#00:00:00#00:00:00#00:00:00 2
4eefff86713cdb98943f2867ba939a0b 0 0 879420 0 0
2838387 0 0 0 0 3750839 0 0 0 0 11352
3201126 B 3 BS 1 27/07/2018 28/07/2018 25/05/1958 0 1
0 0 - 0 - 0 - 0 - 0 12210800
11448626 0 2 0 0 0 SYAH PUDIN SAHADI D365008 60
21978 DR AGOES KOOSHARTORO SPPD 0138R0170718V009975 0001454617181
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206359
1#0##0#0#0.0#2018-09-26 20:21:17#0#00:00:00#00:00:00#00:00:00 2
176774a3dec87a2aed644c620e57f70f 0 2421000 2442160 0 0
3810490 0 0 0 0 774976 0 0 0 0
2000000
3201126 B 2 BS 1 25/07/2018 28/07/2018 07/04/1939 0 1
1 D29.1;R33;I10;E11.9;I69.4 60.29;88.76;90.59;89.52 - - None
None None None V-1-14-I None None None None None None PENGANGKATAN
PROSTAT MELALUI URETRA (RINGAN) 10605500 0 0 - 0 - 0
- 0 - 0 10605500 20257141 0 4 0 0 0
SUPARLAN B IMAN AMAT D401931 79 28964 R SIDHI SPU
0138R0170718V009022 0000060729175 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 205412 1#0##0#0#0.0#2018-09-26
20:23:10#0#00:00:00#00:00:00#00:00:00 2 55199c9230c78e90e7adb578979678c3
0 5741100 4367660 0 0 5653381 0 0 0 0
1226000 0 0 0 0 3269000
3201126 B 1 BS 1 25/07/2018 28/07/2018 30/03/1984 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 16646804 0 4 0 0 0 SISKA KURNIAWATI
0000171652206 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 205230
1#0##0#0#0.0#2018-09-27 11:55:34#0#04:27:05#04:27:05#00:00:00 2
38f31b6be25e876d20f629a67799aad9 0 8094900 2883228 0 0
4110467 0 0 0 0 1207643 0 0 0 0 350566
3201126 B 3 BS 1 25/07/2018 29/07/2018 31/12/1959 0 2
- 0 - 0 - 0 9508900 14839263 0 5 0
0 0 NANIK BIN HASAN JAKFAR D404237 58 21391 DR HENDRIEK SP B
0138R0170718V008933 0001339470753 3;JKN DR RIZKI; 5.2.2.201806040537
4 205236 1#0##0#0#0.0#2018-08-01
14:39:16#0#00:00:00#00:00:00#00:00:00 1 7d78632c7b17053e0d0873ab1903913f
0 3581500 2848492 0 0 6890368 0 0 0 0
996793 0 0 0 0 522110
3201126 B 3 BS 1 26/07/2018 29/07/2018 06/03/2005 0 1
0 - 0 - 0 - 0 - 0 2225900 3005048
0 4 0 0 0 ANCA KAREFESINA D402031 13 4890 DR
5.2.2.201806040537 4 206129 1#0##0#0#0.0#2018-08-01
14:40:30#0#15:30:30#15:30:30#00:00:00 1 a8913bd82acdd11711fc642988644292
0 0 253331 0 0 1477125 0 0 0 0
1274592 0 0 0 0 0
3201126 B 3 BS 1 25/07/2018 29/07/2018 31/12/2000 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 3298796 0 5 0 0 0 NANDA CAHYADI
0000512735938 3;JKN DR RIZKI; 5.2.2.201806040537 4 205229
1#0##0#0#0.0#2018-08-01 15:05:22#0#03:37:43#03:37:43#00:00:00 1
a858d44f29e538f5593944134e645f63 0 0 241100 0 0 990887
0 0 0 0 1556809 0 0 0 0 510000
3201126 B 2 BS 1 25/07/2018 29/07/2018 27/03/2005 0 2
- 0 - 0 - 0 - 0 4649300 11885488 0
5 0 0 0 NAILA FAHIRA AHMAD AN D404334 13 4868 DR
CATUR SUZANTARA 0138R0170718V009315 0000196447667 3;JKN DR RIZKI;
5.2.2.201806040537 4 205731 1#0##0#0#0.0#2018-08-01
15:09:49#0#23:50:47#23:50:47#00:00:00 1 ceab26c9227174aad284787ce9fbaac4
0 5602500 1540804 0 0 3619629 0 0 0 0
1053555 0 0 0 0 69000
3201126 B 2 BS 1 25/07/2018 29/07/2018 18/06/2017 0 1
1 K40.9;A09.9 53.02 - - None None None None K-1-14-I None
6586700 0 0 - 0 - 0 - 0 - 0
6586700 11472346 0 5 0 0 0 BY NY RIRI REGAR
0002259178874 3;JKN DR RIZKI; 5.2.2.201806040537 4 205231
1#0##0#0#0.0#2018-08-01 15:44:04#0#00:00:00#00:00:00#00:00:00 1
efe6ad4d4baffacb20cf0aead79b6914 0 6178300 1313272 0 0
3033865 0 0 0 0 776527 0 0 0 0 170382
3201126 B 1 BS 1 25/07/2018 29/07/2018 14/07/1971 0 2
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 7875792 0 5 0 0 0 YULIANTI D268148
47 17178 DR ARU, SPPD 0138R0170718V009265 0001301056209 3;JKN
DR RIZKI; 5.2.2.201806040537 4 205722 1#0##0#0#0.0#2018-08-01
15:49:30#0#18:04:54#18:04:54#12:00:00 1 90b7becbfa1b3008cd5c58591c19bc71
0 0 722698 0 0 2706855 0 0 0 0
4446239 0 0 0 0 0
3201126 B 1 BS 1 26/07/2018 29/07/2018 31/12/1987 0 2
0 0 - 0 - 0 - 0 - 0 6981500
18174991 0 4 0 0 0 LISA DEWI SURYANTI D201089
30 11165 DR FX BHIMANTORO, SPOG 0138R0170718V009771 0001272042696
3;JKN DR RIZKI; 5.2.2.201806040537 4 206202
1#1#vip#2#5236125#75.0#2018-08-01 15:58:45#0#00:00:00#00:00:00#00:00:00
1 f4aa4a8aabc7ad420189a51d5713c8c1 0 9654600 4181870 0
0 2833337 0 0 0 0 1282618 0 0 0 0
222566
3201126 B 1 BS 1 27/07/2018 29/07/2018 05/04/1953 0 2
- 0 58821400 68775796 0 3 0 0 0 TUTI
MURDIYATMI D402532 65 23854 DR AGOES KOOSHARTORO SPPD-KKV
0138R0170718V009925 0002308269868 3;JKN DR RIZKI; 5.2.2.201806040537
4 206225 1#0##0#0#0.0#2018-08-01
16:03:11#0#00:00:00#00:00:00#00:00:00 2 94a65543aa4a8205e3611c2de83df3a0
0 10062000 9619120 0 0 40253730 0 0 0 0
1226000 0 0 0 0 7614946
3201126 B 1 BS 1 27/07/2018 29/07/2018 20/06/1970 0 1
- 0 58821400 67919613 0 3 0 0 0 SUNARLI
0000061062851 3;JKN DR RIZKI; 5.2.2.201806040537 4 206416
1#0##0#0#0.0#2018-08-01 16:05:40#0#00:00:00#00:00:00#12:00:00 1
f7780852e4d6f53c6dfa2de281e5df1c 0 0 9619120 0 0
39398625 0 0 0 0 18901868 0 0 0 0 0
3201126 B 2 BS 1 27/07/2018 29/07/2018 05/07/1964 0 1
1 E11.2;D63.8;T82.4 99.04;39.42 - - None None None None N-1-
- 0 - 0 23198900 22855508 0 3 0 0 0
BANTA AYUSAN d389649 54 19745 SRI KUNMARTINI.DR,SPPD
0138R0170718V010005 0001874825436 3;JKN DR RIZKI; 5.2.2.201806040537
4 206366 1#0##0#0#0.0#2018-08-02
09:09:21#0#00:00:00#00:00:00#12:00:00 1 ed1909c7bacfa10a26e0ddd0dfaa159f
0 0 4878371 0 0 10662690 0 0 0 0
7236350 0 0 0 0 78097
3201126 B 2 BS 1 28/07/2018 29/07/2018 13/12/1954 0 1
- 0 - 0 10690500 11950339 0 2 0 0 0
ABDUL HAMID D404528 63 23238 DR SRI KUNMARTINI, SPPD
0138R0170718V010223 0001454273526 3;JKN DR RIZKI; 5.2.2.201806040537
4 206476 1#0##0#0#0.0#2018-08-02
09:11:39#0#00:00:00#00:00:00#00:00:00 1 2eb560e23afd55cc137c792f76c7b7d2
0 0 2276624 0 0 4374317 0 0 0 0
5264898 0 0 0 0 34500
3201126 B 2 BS 1 28/07/2018 29/07/2018 14/04/1953 0 2
1 N18.5;I50.0;D63.8 38.95 - - None None None None N-1-12-II
- 0 10690500 13293912 0 2 0 0 0 SITI
KOMARIYAH D392764 65 23846 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170718V010217 0000060656646 3;JKN DR RIZKI; 5.2.2.201806040537
4 206466 1#0##0#0#0.0#2018-08-02
09:14:38#0#00:00:00#00:00:00#12:00:00 1 3d43a83269686c780f237611e791d5e7
0 0 1094720 0 0 6841693 0 0 0 0
5334795 0 0 0 0 22704
3201126 B 2 BS 1 26/07/2018 29/07/2018 22/10/1959 0 1
4 J96.0;J18.0;J91;M54.59 99.04;90.59;89.52;88.76 - - None None
None None J-4-11-III None None None None None None KEGAGALAN
- 0 6158000 9338940 0 4 0 0 0 HERMAN
D235517 58 21462 DR ARU, SPPD 0138R0170718V009322
0001459582727 3;JKN DR RIZKI; 5.2.2.201806040537 4 205733
1#0##0#0#0.0#2018-08-02 09:19:03#0#02:59:14#02:59:14#12:00:00 1
055b66bd598eff3cd2dff81ed4d3a03c 0 0 746333 0 0
5915042 0 0 0 0 2656959 0 0 0 0 20606
3201126 B 2 BS 1 24/07/2018 29/07/2018 27/11/1991 0 2
1 A16.1;J91 34.91 - - None None None None J-4-15-I None
5203800 0 0 - 0 - 0 - 0 - 0
5203800 8374960 0 6 0 0 0 TRI ISTANTI D340194
0001774066421 3;JKN DR RIZKI; 5.2.2.201806040537 4 204996
1#0##0#0#0.0#2018-08-02 09:22:45#0#00:00:00#00:00:00#00:00:00 1
6f5041059120bce2c7ee001f8e1ce430 0 0 1166720 0 0
3314345 0 0 0 0 3603895 0 0 0 0 290000
3201126 B 3 BS 1 29/07/2018 29/07/2018 14/05/1970 0 2
1 Z51.1;C50.9;D63.8 99.25;99.04 - - None None None None C-4-
13-II None None None None None None KEMOTERAPI (SEDANG) 4171300 0
0 - 0 - 0 - 0 - 0 4171300 7188860
0 1 0 0 0 RANITI D391895 48 17608 RACHMAWATI
5.2.2.201806040537 4 206571 1#0##0#0#0.0#2018-08-02
09:52:32#0#11:08:53#11:08:53#12:00:00 1 011dc4bfa208a9d1ffd0182ee3b14b3b
0 0 984040 0 0 4902521 0 0 0 0
1302299 0 0 0 0 0
3201126 B 3 BS 1 27/07/2018 29/07/2018 17/03/2010 0 1
SICKLE (RINGAN) 2987000 0 0 - 0 - 0 - 0 -
0 2987000 4091663 0 3 0 0 0 ALFATHIRA
0001265724505 3;JKN DR RIZKI; 5.2.2.201806040537 4 206414
1#0##0#0#0.0#2018-08-02 11:35:21#0#20:52:14#20:52:14#12:00:00 1
3950d48a8f4c9700281ffbf301d5a216 0 0 268830 0 0
2826654 0 0 0 0 996171 0 0 0 0 0
3201126 B 3 BS 1 25/07/2018 29/07/2018 18/04/1975 0 1
1 G04.9;R51 87.03;87.49;90.59;89.52 - - None None None None
G-4-19-I None None None None None None INFEKSI NON BAKTERI SISTEM
SARAF ,TIDAK TERMASUK MENINGITIS VIRUS (RINGAN) 3695600 0 0 - 0
- 0 - 0 - 0 3695600 5387446 0 5 0
0 0 BAHRUDIN d404243 43 15804 DR HARDI PRANATA SPS
0138R0170718V008838 0001739930758 3;JKN DR RIZKI; 5.2.2.201806040537
4 205227 1#0##0#0#0.0#2018-08-02
11:37:58#0#00:00:00#00:00:00#00:00:00 1 18ffa143542fce36c6eb0ab35abdb47f
0 0 552604 0 0 3141392 0 0 0 0
1693445 0 0 0 0 0
3201126 B 3 BS 1 28/07/2018 29/07/2018 23/05/1979 0 1
1 N18.5;I50.0;D63.8 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 2892409 0 2 0 0 0 SYAHBANA
0002077303375 3;JKN DR RIZKI; 5.2.2.201806040537 4 206419
1#0##0#0#0.0#2018-08-02 11:39:14#0#00:00:00#00:00:00#12:00:00 1
94ac8e97af5999ce674055638e10563f 0 0 424889 0 0
1726297 0 0 0 0 741223 0 0 0 0 0
3201126 B 1 BS 1 20/07/2018 29/07/2018 25/11/1951 0 2
1 S72.00;E14.9;M21.75;D64.9 99.04;81.51 - - YY01 RR04 None
None M-1-04-II None None YY-01-II RR-04-III None None PROSEDUR
PADA SENDI TUNGKAI BAWAH (SEDANG) 20800900 0 0 HIP REPLACEMENT / KNEE
REPLACEMENT 5782600 HIP IMPLANT/ KNEE IMPLANT 11565100 - 0 -
0 38148600 47827123 0 10 0 0 0 SUHAEME
0000044571846 3;JKN DR RIZKI; 5.2.2.201806040537 4 203854
1#0##0#0#0.0#2018-08-02 11:41:47#0#14:05:32#14:05:32#00:00:00 1
5968b3556a0e242c55cd17a1ef4ccfa1 0 0 8010342 0 0
20889150 0 0 0 0 17140000 0 0 0 0
1787631
3201126 B 3 BS 1 29/07/2018 29/07/2018 17/09/1946 0 2
1 I50.0;I49.3;J90 89.52 - - None None None None I-4-12-III
0 0 - 0 - 0 - 0 - 0 4973600
4553713 0 1 0 0 0 ASMANI NY D392341 71 26248
DR RENDRA RAMADYA 0138R0170718V010286 0001259525351 3;JKN DR RIZKI;
5.2.2.201806040537 4 206564 1#0##0#0#0.0#2018-08-02
12:44:00#0#00:20:15#00:20:15#00:00:00 1 e583bb6f6d4d2e36eeda9f193636cffe
0 0 248680 0 0 2960127 0 0 0 0 586906
0 0 0 0 758000
3201126 B 3 BS 1 29/07/2018 29/07/2018 15/01/1962 0 2
4 I47.1;I10;E87.6;A49.9;I64 96.05;99.60 - - None None None
None I-4-19-III None None None None None None GANGGUAN KONDUKSI &
ARITMIA JANTUNG (BERAT) 7295800 0 0 - 0 - 0 - 0
- 0 7295800 6247049 0 1 0 0 0 RUMTINAH
0002290972421 3;JKN DR RIZKI; 5.2.2.201806040537 4 206575
1#0##0#0#0.0#2018-08-02 14:12:37#0#14:32:48#14:32:48#00:00:00 1
7d06e1d2fdb5e1a5b072f4dc1048ba6a 0 0 364790 0 0
4450574 0 0 0 0 715685 0 0 0 0 716000
3201126 B 1 BS 1 27/07/2018 29/07/2018 03/03/1966 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 65469223 0 3 0 0 0 A LALAN PRADESA TN
0002137119759 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206408
1#0##0#0#0.0#2018-08-02 14:30:53#0#19:34:33#19:34:33#00:00:00 2
9adc29932bfd09ebb064cd4a87259fb9 0 0 9619120 0 0
36300235 0 0 0 0 11979000 0 0 0 0
7570868
3201126 B 1 BS 1 26/07/2018 29/07/2018 14/05/1976 0 1
1 I72.1;N18.5;D63.8 99.04;39.52;38.95;39.95 - - None None None
None I-1-20-II None None None None None None PROSEDUR SISTIM
PEREDARAN DARAH LAIN-LAIN (SEDANG) 26871300 0 0 - 0 - 0
- 0 - 0 26871300 31566955 0 4 0 0 0
ADLIN BIN HISYAMUDDIN D404368 42 15413 DR IRFIANSYAH LESMANA DR
5.2.2.201806040537 4 206193 1#0##0#0#0.0#2018-08-02
14:39:13#0#19:01:35#19:01:35#00:00:00 1 70320fdc36686c6a9b905181ee7eaf8f
0 0 8741384 0 0 10444546 0 0 0 0
12166197 0 0 0 0 214825
3201126 B 2 BS 1 27/07/2018 29/07/2018 17/04/2000 0 2
1 D21.0;D63.0 83.39;86.11;99.04 - - None None None None M-1-
50-II None None None None None None PROSEDUR JARINGAN LUNAK (SEDANG)
10617200 0 0 - 0 - 0 - 0 - 0
10617200 9853350 0 3 0 0 0 TYAS UTAMI AMARTIWI
0001337795469 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206208
1#0##0#0#0.0#2018-08-13 08:37:51#0#00:00:00#00:00:00#00:00:00 1
8b8cf64cae49d5201130a72e55c1f4ae 0 4854100 1897412 0 0
2419874 0 0 0 0 670612 0 0 0 0 11352
3201126 B 3 BS 1 29/07/2018 29/07/2018 15/12/1966 0 1
1 H81.1;I10;E11.6 - - - None None None None U-4-11-II
0 - 0 - 0 - 0 - 0 2207000 1654966
0 1 0 0 0 ARIFFUDIN DUMRONI D404616 51 18854 DR
ANGGA TOMALA PUTRA 0138R0170718V010306 0001894999779 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 206573 1#0##0#0#0.0#2018-08-29
19:45:51#0#13:55:47#13:55:47#00:00:00 1 5422e5cd28924a3fac72781d5b5807d5
0 0 110350 0 0 243347 0 0 0 0 415269
0 0 0 0 886000
3201126 B 3 BS 1 24/07/2018 29/07/2018 15/12/1999 0 1
- 0 - 0 - 0 - 0 3874400 13038218 0
6 0 0 0 RIVALDI ADITYA R D404161 18 6796 DR HENDRIEK
5.2.2.201806040537 4 204871 1#0##0#0#0.0#2018-09-08
12:01:04#0#10:32:26#10:32:26#00:00:00 2 67e0fe1428421473fc385a16cb3fef21
0 0 2621588 0 0 4755269 0 0 0 0
5009768 0 0 0 0 651593
3201126 B 3 BS 1 26/07/2018 29/07/2018 13/08/1998 0 2
- 0 - 0 - 0 - 0 3874400 11025913 0
4 0 0 0 GEBRILIA ANGGRIANI D404314 19 7287 DR
5.2.2.201806040537 4 205732 1#0##0#0#0.0#2018-09-08
12:03:42#0#00:24:21#00:24:21#00:00:00 2 e06c2ef5203f29e3d7fd01942fb7602d
0 3784800 2340900 0 0 3902892 0 0 0 0
997321 0 0 0 0 0
3201126 B 1 BS 1 21/07/2018 29/07/2018 19/01/2000 0 1
- 0 4181800 19937697 0 9 0 0 0 THORIQ
KAISAR FADILLAH D052293 18 6758 DR VERA MUNA MANOE, SPA
0138R0170718V007665 0001258228012 3;JKN DR RIZKI; 5.2.2.201806040537
4 204073 1#0##0#0#0.0#2018-09-12
12:08:01#0#04:27:02#04:27:02#00:00:00 3 9a43742160e2295568b16eb4098923ad
0 0 429362 0 0 11253335 0 0 0 0
8255000 0 0 0 0 0
3201126 B 3 BS 1 24/07/2018 29/07/2018 22/12/1955 0 2
- 0 8908800 29930762 0 6 1 3 0 PARTI
GIYARTI D392028 62 22860 DR. ARU ARIADNO, SPPD 0138R0170718V008553
0001228971508 3;JKN DR RIZKI; 5.2.2.201806040537 4 204931
1#0##0#0#0.0#2018-09-12 12:31:01#0#00:00:00#00:00:00#12:00:00 4
232b198497efc40e1cc8359b4207b396 0 0 2057760 0 0
15449166 0 0 0 0 8051250 0 0 0 0
4372586
3201126 B 3 BS 1 28/07/2018 29/07/2018 26/01/1981 0 1
- 0 - 0 19332400 7775242 0 2 0 0 0
ANSORRULOH D401816 37 13697 SRI KUNMARTINI.DR,SPPD
0138R0170718V010205 0001483752069 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206441 1#0##0#0#0.0#2018-09-26
20:51:01#0#00:00:00#00:00:00#00:00:00 2 3f004795f8b0e4f31c42b549b930d1fa
0 0 1906030 0 508661 1790517 0 0 0 0
3438800 0 0 0 131234 0
3201126 B 2 BS 1 28/07/2018 30/07/2018 26/06/1989 0 2
0 0 - 0 - 0 - 0 - 0 2009900
4226775 0 3 0 0 0 YATI PRIHATIN D404603 29
3;JKN DR RIZKI; 5.2.2.201806040537 4 206559 1#0##0#0#0.0#2018-
08-02 08:48:23#0#00:00:00#17:00:00#00:00:00 1
f36262a7873203995fbaaab517c0f852 0 0 454980 0 0 823577
0 0 0 0 2948218 0 0 0 0 0
3201126 B 2 BS 1 27/07/2018 30/07/2018 04/07/1957 0 1
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 4382283 0 4 0 0 0 RIRIS SUGIONO TN
0001089140095 3;JKN DR RIZKI; 5.2.2.201806040537 4 206411
1#0##0#0#0.0#2018-08-02 08:50:42#0#20:07:53#20:07:53#00:00:00 1
bdf296a32669495ba2cd5c89b2fb7b3e 0 0 541422 0 0
2013170 0 0 0 0 1827691 0 0 0 0 0
3201126 B 2 BS 1 29/07/2018 30/07/2018 13/07/1986 0 2
1 H81.1;K29.7;J06.9 - - - None None None None U-4-11-I
0 - 0 - 0 - 0 - 0 1821000 2154867
0 2 0 0 0 OSA INDAH SARI D325720 32 11704 DR
5.2.2.201806040537 4 206572 1#0##0#0#0.0#2018-08-02
08:56:50#0#00:00:00#00:00:00#00:00:00 1 726f8641be3c2a89d2cafc6087e256d1
0 0 303524 0 0 674370 0 0 0 0
1176973 0 0 0 0 0
3201126 B 2 BS 1 27/07/2018 30/07/2018 01/02/1960 0 2
0 - 0 8291400 4704550 0 4 0 0 0
SUNARTI D404405 58 21361 DR NURUL KOMARI SPS
0138R0170718V009776 0001464110886 3;JKN DR RIZKI; 5.2.2.201806040537
4 206204 1#0##0#0#0.0#2018-08-02
08:59:22#0#01:04:24#01:04:24#00:00:00 1 e69aa7d399edfdd3afb70da5e8c213ac
0 0 882140 0 0 1442636 0 0 0 0
2379774 0 0 0 0 0
3201126 B 2 BS 1 25/07/2018 30/07/2018 03/05/1962 0 1
1 I63.9;I49.9;G81.9 87.03;87.44 - - None None None None G-4-
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 8737270 0 6 0 0 0 HENDRI KUSNADI
0001792476933 3;JKN DR RIZKI; 5.2.2.201806040537 4 205427
1#0##0#0#0.0#2018-08-02 09:03:35#0#00:00:00#00:00:00#00:00:00 2
49185f9dc7f57a0a50418cfd7c213aff 0 0 799226 0 0
3892447 0 0 0 0 3627597 0 0 0 0 418000
3201126 B 2 BS 1 26/07/2018 30/07/2018 08/09/1927 0 2
1 J18.0;I11.9 87.44 - - None None None None J-4-16-I None
4335900 0 0 - 0 - 0 - 0 - 0
4335900 10676986 0 5 0 0 0 SITI RODIYAH
0000060697282 3;JKN DR RIZKI; 5.2.2.201806040537 4 206200
1#1#vvip#5#6341086#0.0#2018-08-02 09:05:49#0#00:00:00#00:00:00#00:00:00
1 6f0e054494228aa7e203605d413f26fa 0 0 1408000 0 0
2892492 0 0 0 0 6376494 0 0 0 0 0
3201126 B 3 BS 1 20/07/2018 30/07/2018 10/08/1956 0 2
1 I21.2;R57.0;I21.9;I50.0;I34.0;E87.8 89.52 - - None None None
None I-4-10-III None None None None None None INFARK MYOKARD AKUT
(BERAT) 10401900 0 0 - 0 - 0 - 0 - 0
10401900 27923794 0 11 1 7 0 REMIYATI D378158
3;JKN DR RIZKI; 5.2.2.201806040537 4 203580 1#0##0#0#0.0#2018-
08-02 09:44:50#0#00:00:00#00:00:00#12:00:00 2
e1be2e218f4edda70126acd8faea7962 0 0 1095168 0 0
11680626 0 0 0 0 8125999 0 0 0 0
7022000
3201126 B 3 BS 1 30/07/2018 30/07/2018 19/08/1981 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 1710233 0 1 0 0 0 IIN SUPRIATIN
0002282454371 3;JKN DR RIZKI; 5.2.2.201806040537 4 206590
1#0##0#0#0.0#2018-08-02 09:49:21#0#00:37:11#00:37:11#12:00:00 1
4a682ecc89cda63ec257b8de58ea8802 0 0 424889 0 0 884460
0 0 0 0 400884 0 0 0 0 0
3201126 B 3 BS 1 28/07/2018 30/07/2018 01/06/1957 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3155209 0 3 0 0 0 PONIAH d373295
3;JKN DR RIZKI; 5.2.2.201806040537 4 206558 1#0##0#0#0.0#2018-
08-02 09:55:38#0#00:00:00#00:00:00#12:00:00 1
fce5d364366ba6dcc6290e9d9f898afa 0 0 424889 0 0
1795404 0 0 0 0 934916 0 0 0 0 0
3201126 B 3 BS 1 27/07/2018 30/07/2018 29/09/2016 0 2
LAIN (RINGAN) 2798500 0 0 - 0 - 0 - 0 -
0 2798500 3157667 0 4 0 0 0 RAVITA KHALISTA
PUTRI D373464 1 666 DR OTTY MITHA S, SPA 0138R0170718V010163
0002276507823 3;JKN DR RIZKI; 5.2.2.201806040537 4 206413
1#0##0#0#0.0#2018-08-02 10:01:29#0#20:21:32#20:21:32#12:00:00 1
c04e46ca7e923c4e61e73862461e4ab1 0 0 378188 0 0
1581403 0 0 0 0 1198076 0 0 0 0 0
3201126 B 3 BS 1 27/07/2018 30/07/2018 11/07/1992 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 4312391 0 4 0 0 0 RIDWAN JUANDA
D404453 26 9512 DR ARU, SPPD 0138R0170718V010105
0001340172189 3;JKN DR RIZKI; 5.2.2.201806040537 4 206393
1#0##0#0#0.0#2018-08-02 10:02:21#0#15:13:25#15:13:25#00:00:00 1
f66b48162592e097458fac9397eb09fd 0 0 241100 0 0
2711172 0 0 0 0 1360119 0 0 0 0 0
3201126 B 2 BS 1 28/07/2018 30/07/2018 26/11/1987 0 1
0 0 - 0 - 0 - 0 - 0 5043100
4926137 0 3 0 0 0 MUHAMMAD RANU ANDRIAN D404530
0001282617551 3;JKN DR RIZKI; 5.2.2.201806040537 4 206540
1#0##0#0#0.0#2018-08-02 11:54:51#0#13:51:43#13:51:43#00:00:00 1
57b889efa68cefcd635db3b94d01492b 0 0 506879 0 0
2199987 0 0 0 0 2219272 0 0 0 0 0
3201126 B 2 BS 1 25/07/2018 30/07/2018 07/03/1995 0 2
1743400 0 0 - 0 - 0 - 0 - 0
1743400 4358250 0 6 0 0 0 WINDAH YANI MARGARET
BAKARA D404294 23 8541 DR H. H PUAR, SPB 0138R0170718V009302
0002355992065 3;JKN DR RIZKI; 5.2.2.201806040537 4 205727
1#0##0#0#0.0#2018-08-02 11:57:36#0#20:16:04#20:16:04#00:00:00 1
660977c1699294ecd7b04fab448fd007 0 0 209906 0 0
1014725 0 0 0 0 3133619 0 0 0 0 0
3201126 B 3 BS 1 28/07/2018 30/07/2018 18/08/1967 0 1
1 I13.1;K30 - - - None None None None N-4-10-I None
(RINGAN) 3313800 0 0 - 0 - 0 - 0 - 0
3313800 1586480 0 3 0 0 0 MAHDIL D347677
3;JKN DR RIZKI; 5.2.2.201806040537 4 206471 1#0##0#0#0.0#2018-
08-02 12:17:30#0#11:32:50#11:32:50#00:00:00 1
52fd6e06e3bd6a21e0e304405e971b47 0 0 351242 0 0 316450
0 0 0 0 918788 0 0 0 0 0
3201126 B 3 BS 1 30/07/2018 30/07/2018 01/09/1965 0 2
4 J22;N18.1;R57.2 90.59;89.52 - - None None None None J-4-
21-I None None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM
0 - 0 2798500 2236623 0 1 0 0 0
SULASTRI D403912 52 19325 DR AHMAD HIBBAN A WRIYA
0138r0170718v010828 0000511010515 3;JKN DR RIZKI; 5.2.2.201806040537
4 207129 1#0##0#0#0.0#2018-08-02
12:33:17#0#19:58:17#19:58:17#00:00:00 1 0107aed1c801af4f6f6ea229f8a9cef6
0 0 269180 0 0 1209122 0 0 0 0 435321
0 0 0 0 323000
3201126 B 3 BS 1 30/07/2018 30/07/2018 20/01/2018 0 2
4 A09.9;E86;E16.2 99.60 - - None None None None K-4-17-I
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 3870066 0 1 0 0 0 SAHILA AZZAHRA PUTRI
0002421928629 3;JKN DR RIZKI; 5.2.2.201806040537 4 206787
1#0##0#0#0.0#2018-08-02 12:47:47#0#11:38:26#11:38:26#00:00:00 1
473676f884d782f6e905237a31c036e3 0 0 85900 0 0 2653984
0 0 0 0 542182 0 0 0 0 588000
3201126 B 1 BS 1 28/07/2018 30/07/2018 22/04/1963 0 2
0 - 0 - 0 - 0 2124500 2907538 0 3
0 0 0 SURYATI S D093973 55 20186 DR MAYSAMIRAWATI SPS
0138R0170718V010271 0000045251201 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206557 1#0##0#0#0.0#2018-08-02
14:14:14#0#20:56:39#20:56:39#00:00:00 1 b0b3823a80d1af5acf6833cf745b7c9d
0 0 244205 0 0 1230620 0 0 0 0
1432713 0 0 0 0 0
3201126 B 1 BS 1 28/07/2018 30/07/2018 24/04/1989 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4275648 0 3 0 0 0 ATIKAH AMALINA G
0001654904452 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206422
1#0##0#0#0.0#2018-08-02 14:16:32#0#00:00:00#00:00:00#00:00:00 1
3c06b1456614e77c2af1232064426263 0 0 338858 0 0
1288075 0 0 0 0 2648715 0 0 0 0 0
3201126 B 3 BS 1 29/07/2018 30/07/2018 08/11/1997 0 2
LAIN-LAIN (RINGAN) 2268700 0 0 - 0 - 0 - 0
- 0 2268700 1543029 0 2 0 0 0 ERFANI
AGUSTIN D404602 20 7568 DR BETTY DWI L, SPPD 0138R0170718V010290
0001739631093 3;JKN DR RIZKI; 5.2.2.201806040537 4 206565
1#0##0#0#0.0#2018-08-02 14:18:02#0#00:00:00#00:00:00#00:00:00 1
28584e55df1b9adf44e728b4b24c47c9 0 0 257183 0 0 632900
0 0 0 0 652946 0 0 0 0 0
3201126 B 1 BS 1 30/07/2018 30/07/2018 04/01/1961 0 2
- 0 - 0 - 0 - 0 3103000 5220032 0
1 0 0 0 SITI ANISAH D037066 57 21026 RACHMAWATI
5.2.2.201806040537 4 206811 1#0##0#0#0.0#2018-08-02
14:26:14#0#11:54:48#11:54:48#00:00:00 1 4c5c87f5e86dc9a2a9ad6ed39e83098f
0 0 279270 0 0 3429055 0 0 0 0
1500355 0 0 0 0 11352
3201126 B 1 BS 1 30/07/2018 30/07/2018 02/03/1970 0 2
- 0 - 0 - 0 - 0 3103000 5862902 0
1 0 0 0 WIWIK TRI WAHYUNI D402152 48 17682 RACHMAWATI
DR,SPB(K)ONK 0138r0170718v010433 0001630438593 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206739 1#0##0#0#0.0#2018-08-02
14:29:35#0#10:16:13#10:16:13#00:00:00 1 3863a4c26287b2d2efa326bda13ff852
0 0 279270 0 0 781000 0 0 0 0
4791280 0 0 0 0 11352
3201126 B 1 BS 1 28/07/2018 30/07/2018 27/01/1989 0 2
0 - 0 - 0 - 0 - 0 2344900 11462162
0 3 0 0 0 TITU PARFITA RAHAYU NY D385505 29 10774
DR MUTIA P, SPOG 0138R0170718V010277 0001339557052 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 206560 1#1#vvip#3#9117262#0.0#2018-
08-02 14:32:08#0#23:19:35#23:19:35#00:00:00 1
e9140acaa6f5435ce0fb04b4f0175ac6 0 0 3733484 0 0
2002831 0 0 0 0 5542011 0 0 0 0 183836
3201126 B 1 BS 1 27/07/2018 30/07/2018 30/09/1990 0 2
None None None None GANGGUAN POSTPARTUM (RINGAN) 2172700 0 0
- 0 - 0 - 0 - 0 2172700 4776053 0
4 0 0 0 ADE LISNAWATI D404493 27 10162 DR ERDIYAN,
5.2.2.201806040537 4 206418 1#0##0#0#0.0#2018-08-02
14:38:02#0#00:00:00#00:00:00#00:00:00 1 abc81c607285b449f99eb4f99599855e
0 0 498543 0 0 757050 0 0 0 0
2709451 0 0 0 0 811008
3201126 B 2 BS 1 29/07/2018 30/07/2018 16/12/1965 0 2
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
4958500 3557232 0 2 0 0 0 RUMONDANG NABABAN NY
0001436760786 3;JKN irene; 5.2.2.201806040537 4 206583
1#0##0#0#0.0#2018-08-03 14:42:53#0#15:59:10#15:59:10#00:00:00 2
4ae9e7a8ba4a4e52fe9ac328252e1f75 0 0 424889 0 0
1054252 0 0 0 0 2078091 0 0 0 0 0
3201126 B 3 BS 1 30/07/2018 30/07/2018 02/03/1995 0 2
0 - 0 - 0 - 0 3043100 862158 0 1
0 0 0 KIKI RIANA d404650 23 8551 DR ADITIA NATA KUSUMA
0138R0170718V010480 0001258945705 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206761 1#0##0#0#0.0#2018-08-10
14:03:51#0#11:11:57#11:11:57#00:00:00 1 800414c32349ca8db86b556cb7d6f0cd
0 0 152155 0 0 56600 0 0 0 0 363403
0 0 0 0 290000
3201126 B 1 BS 1 27/07/2018 30/07/2018 03/05/1993 0 2
3349800 0 0 - 0 - 0 - 0 - 0
3349800 4516731 0 4 0 0 0 MEI SURYANINGSIH
D290484 25 9216 DR ARU, SPPD 0138R0170718V010167
0002092430125 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206415
1#0##0#0#0.0#2018-08-13 12:07:54#0#21:11:37#21:11:37#00:00:00 1
3161c858140757fc98d84794dc91a2cf 0 0 433304 0 0
1418940 0 0 0 0 2664487 0 0 0 0 0
3201126 B 3 BS 1 26/07/2018 30/07/2018 09/11/1973 0 2
4 B20.0;R41.8;E87.6 87.03 - - None None None None A-4-15-II
None None None None None None INFEKSI HIV (SEDANG) 18017100 0
0 - 0 - 0 - 0 - 0 18017100 6923967
0 5 0 0 0 NUR ASIA D404375 44 16330 DR
S;16137 5.2.2.201806040537 4 206212 1#0##0#0#0.0#2018-08-13
13:21:44#0#00:00:00#00:00:00#00:00:00 1 21863610c81b256f38c28e30d02f4b52
0 0 1034519 0 0 2817978 0 0 0 0
3071470 0 0 0 0 0
3201126 B 3 BS 1 29/07/2018 30/07/2018 06/07/1973 0 2
1 E11.2;N18.5;A49.9;T82.4 39.42 - - None None None None N-1-
- 0 - 0 19332400 7626596 0 2 0 0 0
SURYANIH D404044 45 16459 SRI KUNMARTINI.DR,SPPD
0138R0170718V010300 0000510484735 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207123 1#0##0#0#0.0#2018-09-08
10:01:38#0#18:45:54#18:45:54#00:00:00 2 f7a7b5ae4c9fa5918aa4bcc2f8af69b6
0 0 1906030 0 0 2052778 0 0 0 0
3587436 0 0 0 0 80352
3201126 B 2 BS 1 29/07/2018 30/07/2018 13/09/1962 0 1
1 E11.2;T82.4 38.95;87.44 - - None None None None N-1-12-III
- 0 23198900 16946931 0 2 0 0 0 DJOKO
SUPRIYANTO D395828 55 20408 DR IRFIANSYAH LESMANA DR SPBTKV
0138r0170718v010298 0001226677116 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206569 1#0##0#0#0.0#2018-09-25
13:23:56#0#10:05:07#10:05:07#00:00:00 2 71a20dfb4a689ee3cd5eeaccc9220fae
0 0 3010238 0 0 6809801 0 0 0 0
7030678 0 0 0 0 96214
3201126 B 3 BS 1 29/07/2018 30/07/2018 02/05/1958 0 2
- 0 8908800 10462426 0 2 0 0 0 DINA
INDRIANI d401661 60 22003 SRI KUNMARTINI.DR,SPPD 0138R0170718V010385
0001813459195 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207120
1#0##0#0#0.0#2018-09-27 12:35:15#0#18:04:21#18:04:21#00:00:00 2
dbe06fefabf2f8a8cc572468a89912a8 0 0 4021139 0 0
2806829 0 0 0 0 3599958 0 0 0 0 34500
3201126 B 1 BS 1 21/07/2018 30/07/2018 09/03/1942 0 2
1 I50.0;I25.1;N18.5;M17.9 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 5005900
22356225 0 10 0 0 0 ELSYE D PARENGKUAN L D403915
0001212670113 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204071
1#0##0#0#0.0#2018-09-28 16:00:57#0#00:00:00#00:00:00#00:00:00 2
39f021b9657d8f4de1170b4f0053acea 0 0 483539 0 0
7179786 0 0 0 0 9847900 0 0 0 0
4845000
3201126 B 3 BS 1 28/07/2018 30/07/2018 01/12/1939 0 2
1 I13.1;I25.0 38.95 - - None None None None N-1-12-I None
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 7193884 0 3 0 0 0 JUMENA
A404072 78 28729 SRI KUNMARTINI.DR,SPPD 0138R0170718V010228
0000998483815 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206486
1#0##0#0#0.0#2018-10-09 08:04:57#0#11:57:30#11:57:30#00:00:00 3
048fd5c45a8e5bfb126387fde90462ad 0 0 974100 0 0
2443227 0 0 0 0 3732128 0 0 0 0 44429
3201126 B 1 BS 1 28/07/2018 31/07/2018 29/06/2017 0 1
- 0 - 0 - 0 - 0 3718200 3926053 0
4 0 0 0 SAKA SYAILENDRA AZIM D370982 1 394 DR
5.2.2.201806040537 4 206561 1#0##0#0#0.0#2018-08-02
11:42:55#0#00:00:00#00:00:00#00:00:00 1 58a8d51206fca34a7640d48579f7b25e
0 0 387638 0 0 912570 0 0 0 0
2625845 0 0 0 0 0
3201126 B 1 BS 1 29/07/2018 31/07/2018 12/02/1952 0 2
1 E11.9;A09.9;E87.6;A41.9 90.59;89.52 - - None None None None
- 0 - 0 8768000 5197108 0 3 0 0 0
S KARMINAH D303816 66 24274 DR BETTY DWI L, SPPD
0138R0170718V010314 0000043753151 3;JKN DR RIZKI; 5.2.2.201806040537
4 206579 1#0##0#0#0.0#2018-08-02
11:50:42#0#15:13:59#15:13:59#00:00:00 1 3dbda253da2e9fe9f95d3898b43ae375
0 0 842120 0 0 1645990 0 0 0 0
2708998 0 0 0 0 0
3201126 B 2 BS 1 28/07/2018 31/07/2018 21/01/1998 0 2
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 3376364 0 4 0 0 0 SHINTIA ROHMAH
0001266097375 3;JKN DR RIZKI; 5.2.2.201806040537 4 206549
1#0##0#0#0.0#2018-08-02 12:02:07#0#15:49:58#15:49:58#12:00:00 1
2c15c56ca4c2088832375d562dcfef58 0 0 298025 0 0 811455
0 0 0 0 2266884 0 0 0 0 0
3201126 B 3 BS 1 31/07/2018 31/07/2018 27/01/1983 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1947310 0 1 0 0 0 RUDY SAHATA PUTRA
D404748 35 12969 DR YOHANNES DWINANDA 0138R0170718V010852
0000205313051 3;JKN DR RIZKI; 5.2.2.201806040537 4 207143
1#0##0#0#0.0#2018-08-02 12:19:17#0#00:00:00#00:00:00#00:00:00 1
5dc5afc7fb50c50898c686efa5e948cb 0 0 210130 0 0 884786
0 0 0 0 434394 0 0 0 0 418000
3201126 B 3 BS 1 30/07/2018 31/07/2018 09/09/2017 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 2774537 0 2 0 0 0 MISYKA NOURA CITRA
RAMADHAN D386883 0 324 DR OTTY MITHA S, SPA 0138R0170718V010426
0002268859983 3;JKN DR RIZKI; 5.2.2.201806040537 4 206742
1#0##0#0#0.0#2018-08-02 12:23:00#0#10:25:21#10:25:21#12:00:00 1
d0892bd84e39f9ff42fb7658240346a5 0 0 378188 0 0
1662837 0 0 0 0 733512 0 0 0 0 0
3201126 B 3 BS 1 29/07/2018 31/07/2018 23/08/1978 0 1
1 K74.6;I85.0;B17.1 99.04;87.44 - - None None None None B-4-
6747200 0 0 - 0 - 0 - 0 - 0
6747200 3763852 0 3 0 0 0 IRMANDA HUSEIN
0001820940467 3;JKN DR RIZKI; 5.2.2.201806040537 4 206568
1#0##0#0#0.0#2018-08-02 12:27:03#0#00:00:00#00:00:00#00:00:00 2
fcf4ff7f7e5b1937b6ed167bbb3ddeb9 0 0 493802 0 0
2208817 0 0 0 0 1061233 0 0 0 0 0
3201126 B 2 BS 1 30/07/2018 31/07/2018 09/05/1942 0 1
- 0 51950600 63841468 0 2 0 0 0 TUKIYAR
0138r0170718v010350 0000060700803 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206599 1#0##0#0#0.0#2018-08-10
14:16:29#0#08:43:40#08:43:40#00:00:00 1 9169ca26b33c94353972cef1f8388036
0 8986000 8244960 0 0 37774296 0 0 0 0
1226000 0 0 0 0 7610212
3201126 B 3 BS 1 30/07/2018 31/07/2018 01/04/1998 0 2
- 0 - 0 19332400 16060624 0 2 0 0 0
ELSA HEPRILIANI D386256 20 7425 SRI KUNMARTINI.DR,SPPD
0138R0170718V010704 0000511675863 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207097 1#0##0#0#0.0#2018-08-13
12:24:23#0#16:14:49#16:14:49#12:00:00 1 9e3b34b64cde639930bb5a215b52b3de
0 0 4074139 0 0 7679759 0 0 0 0
4157195 0 0 0 0 149531
3201126 B 1 BS 1 24/07/2018 31/07/2018 11/09/1952 0 1
1 D42.0;R90.0;H81.3;K30;E78.5 89.52;90.59;87.03 - - None None
None None G-4-26-I None None None None None None GANGGUAN -
PENYAKIT SISTEM SARAF LAIN-LAIN (RINGAN) 5022200 0 0 - 0 -
0 - 0 - 0 5022200 13649769 0 8 0 0
0 H. ASMAWIH D404162 65 24057 DR CATUR BANUAJI SPS
0138R0170718V008369 0001267571428 3;JKN DR RIZKI; 5.2.2.201806040537
4 204710 1#0##0#0#0.0#2018-09-12
12:10:41#0#00:00:00#00:00:00#00:00:00 5 afa28ef3647ec1019e344480add06792
0 0 504998 0 0 5977795 0 0 0 0
7166976 0 0 0 0 0
3201126 B 2 BS 1 20/07/2018 31/07/2018 31/12/1958 0 1
1 I63.9;I48 87.03;87.44 - - None None None None G-4-14-II
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 33549513 0 12 1 11 0 SOLIHIN
0001821425769 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204023
1#0##0#0#0.0#2018-09-28 16:03:22#0#00:00:00#00:00:00#00:00:00 2
644b4cdb81321b6b69c364a43bb9f8f9 0 0 1093660 0 0
13345353 0 0 0 0 10781500 0 0 0 0
8329000
3201126 B 1 BS 1 29/07/2018 31/07/2018 10/06/2015 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2286161 0 3 0 0 0 DAMIANUS BISMA
KRISNUGRAHA D320053 3 1145 DR RIANITA SYAMSU, SPA 0138R0170718V010518
0002078343821 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206837
1#0##0#0#0.0#2018-10-10 16:13:21#0#12:04:56#12:04:56#00:00:00 1
78284d0dc469a05f71cc885023431e68 0 0 269459 0 0 279140
0 0 0 0 1562000 0 0 0 175562 0
3201126 B 2 BS 1 29/07/2018 31/07/2018 28/09/2017 0 1
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2279865 0 3 0 0 0 FATHAN RIZKY ATHALLAH
d404604 0 304 DR RASTRA, SPA 0138R0170718V010287
0002291253748 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207297
1#0##0#0#0.0#2018-10-10 16:21:57#0#00:00:00#00:00:00#00:00:00 2
66e0b5006a5e9a95ca6644bdc102ec84 0 0 238535 0 0 351180
0 0 0 0 1690150 0 0 0 0 0
3201126 B 1 BS 1 30/07/2018 31/07/2018 18/09/1975 0 1
12140800 0 0 - 0 - 0 - 0 - 0
12140800 15507708 0 2 0 0 0 HINDRADJID HARSONO
D118349 42 15656 DR BENNY H TUMBELAKA 0138r0170718v010353
0001462948716 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206597
1#0##0#0#0.0#2018-10-10 16:22:58#0#08:42:56#08:42:56#00:00:00 2
ff51ee6bdc3c17fe2c63cced5c60baa7 0 0 3399424 0 0
1224109 0 0 0 0 10803823 0 0 0 0 80352
3201126 B 2 BS 1 29/07/2018 31/07/2018 13/05/1973 0 2
1 D62;E13.9 99.04 - - None None None None D-4-13-I None
- 0 3584400 5384170 0 3 0 0 0 NAFSIAH
DHIAN HANDAYANI D338032 45 16513 DR. ARU ARIADNO, SPPD
0138R0170718V010328 0001275244683 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206586 1#0##0#0#0.0#2018-10-10
16:24:26#0#00:00:00#00:00:00#00:00:00 2 1a2cc57ca4060e3c528d10bc2f765a40
0 0 924780 0 0 2821155 0 0 0 0
1638235 0 0 0 0 0
3201126 B 1 BS 1 28/07/2018 31/07/2018 24/06/1987 0 2
1 K30;K80.8 88.76;90.59;89.52 - - None None None None K-4-
(RINGAN) 2033900 0 0 - 0 - 0 - 0 - 0
2033900 6339213 0 4 0 0 0 KUSUMA PARAHITA
D234180 31 11357 DR MUHAMMAD YAMIN LUBIS DR SP-PD-KGEH
0138R0170718V010237 0001079062424 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206538 1#0##0#0#0.0#2018-10-10
16:25:30#0#13:51:04#13:51:04#00:00:00 2 bce88893c31fbb753a6e4521d4bc82d9
0 0 582182 0 0 2192316 0 0 0 0
3564715 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 31/07/2018 26/07/1973 0 1
GINJAL (BERAT) 7293200 0 0 - 0 - 0 - 0 -
0 7293200 4683524 0 1 0 0 0 SUMARTANA
D369438 45 16441 DR ARU, SPPD 0138R0170718V010840
0001101686411 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207138
1#0##0#0#0.0#2018-10-10 18:32:09#0#00:00:00#00:00:00#00:00:00 2
1fec3f9503ad5921ab671bcc6ac35d7a 0 0 499265 0 0
3056860 0 0 0 0 837399 0 0 0 0 290000
3201126 B 2 BS 1 28/07/2018 01/08/2018 28/07/2018 3225 1
1 P22.8;P59.9 99.82 - - None None None None P-8-08-I None
0 - 0 - 0 5066300 8459641 0 5 1 2
0 YATI PRIHATIN BY NY D404591 0 0 DR KHARINA CHATAR SPA
0138R0170718V010475 0002477986593 3;JKN DR RIZKI; 5.2.2.201806040537
4 206751 1#0##0#0#0.0#2018-08-06
08:42:14#0#10:52:31#10:52:31#00:00:00 1 073a58c9190aaab460c014444817bcc1
0 0 508967 0 0 2844240 0 0 0 0
4209434 0 0 0 0 897000
3201126 B 2 BS 1 31/07/2018 01/08/2018 14/07/1957 0 2
INTERNAL (RINGAN) 5178700 0 0 - 0 - 0 - 0 -
0 5178700 8792346 0 2 0 0 0 SRI SUHARSI
0138R0170718V011010 0001261337321 3;JKN DR RIZKI; 5.2.2.201806040537
4 207449 1#0##0#0#0.0#2018-08-06
09:19:52#0#11:23:39#11:23:39#00:00:00 1 0d14a808a43978ec6ba1035ff4c1b3a6
0 0 1450036 0 0 1415610 0 0 0 0
5781700 0 0 0 0 145000
3201126 B 1 BS 1 31/07/2018 01/08/2018 07/04/1955 0 2
0 - 0 - 0 - 0 4784600 7215877 0 2
0 0 0 TOWIYAH D331982 63 23126 DR MOHAMMAD JOHAN SPU
0138R0170718V011211 0001260558718 3;JKN DR RIZKI; 5.2.2.201806040537
4 207759 1#1#vvip#2#2431277#0.0#2018-08-06
09:36:19#0#00:00:00#00:00:00#00:00:00 1 0d3445a85c5a3af0d1b3c4c01ca0ead1
0 0 866000 0 0 3025810 0 0 0 0
3324067 0 0 0 0 0
3201126 B 1 BS 1 30/07/2018 01/08/2018 22/03/1960 0 2
1 E11.4;I50.0;J18.0;N39.0;A49.9 90.59;89.52;87.44 - - None None
None None G-4-17-III None None None None None None GANGUAN SARAF
KRANIAL DAN PERIFER (BERAT) 10695200 0 0 - 0 - 0 -
0 - 0 10695200 4969791 0 3 0 0 0
SUHARTINI, NY D347136 58 21314 SRI KUNMARTINI.DR,SPPD
0138R0170718V010334 0000061046335 3;JKN DR RIZKI; 5.2.2.201806040537
4 206588 1#0##0#0#0.0#2018-08-06
09:40:18#0#00:26:52#00:26:52#00:00:00 1 abd15c3874ede7fe24f5076770e07f62
0 0 493342 0 0 1782257 0 0 0 0
2694192 0 0 0 0 0
3201126 B 2 BS 1 30/07/2018 01/08/2018 16/09/1954 0 1
1 M86.56;M84.26 78.60;77.07 - - None None None None M-1-
40-II None None None None None None EKSISI LOKAL DAN PENGANGKATAN ALAT
0 - 0 9184300 14804915 0 3 0 0 0 SUGENG
0001336394744 3;JKN DR RIZKI; 5.2.2.201806040537 4 207020
1#0##0#0#0.0#2018-08-06 09:45:59#0#15:06:34#15:06:34#12:00:00 1
a834f0309086f6f9dd8b974bf4299b9c 0 0 4071604 0 0
1697265 0 0 0 0 8967044 0 0 0 0 69000
3201126 B 3 BS 1 29/07/2018 01/08/2018 23/08/1961 0 2
8672000 0 0 - 0 - 0 - 0 - 0
8672000 13306756 0 4 0 0 0 YAYU RAHAYU D404644
56 20794 DR BENNY H TUMBELAKA 0138R0170718V010382 0000510964828
3;JKN DR RIZKI; 5.2.2.201806040537 4 206631 1#0##0#0#0.0#2018-
08-06 10:14:52#0#09:03:40#09:03:40#00:00:00 2
ddeeb6608cd693119d43731762fe1f14 0 5827000 4241320 0 0
2085686 0 0 0 0 1007750 0 0 0 145000
0
3201126 B 1 BS 1 30/07/2018 01/08/2018 17/05/1992 0 2
2033900 0 0 - 0 - 0 - 0 - 0
2033900 8947304 0 3 0 0 0 HASNA ZAHIDAH
0000043592499 3;JKN DR RIZKI; 5.2.2.201806040537 4 207023
1#0##0#0#0.0#2018-08-06 10:26:07#0#15:07:01#15:07:01#00:00:00 1
9fb96ad06c4f515ad423acd7658f2ccb 0 0 1049611 0 0
1119855 0 0 0 0 5028838 0 0 0 0
1749000
3201126 B 2 BS 1 27/07/2018 01/08/2018 28/08/1963 0 2
1 I64;G81.9;I10;E78.5;K29.7 87.03;87.44;90.59;89.52 - - None
5866300 0 0 - 0 - 0 - 0 - 0
5866300 6441383 0 6 0 0 0 USMARIA D404396
3;JKN DR RIZKI; 5.2.2.201806040537 4 206203 1#0##0#0#0.0#2018-
08-06 14:23:58#0#00:58:30#00:58:30#00:00:00 1
1f66074497f92c69aca81fb5649344cd 0 0 882140 0 0
2081844 0 0 0 0 3477397 0 0 0 0 0
3201126 B 3 BS 1 01/08/2018 01/08/2018 01/04/1956 0 1
1 I95.9;A41.9;R40.2;K21.9;D64.9;K92.1 - - - None None None
- 0 8139800 10995854 0 1 0 0 0 WAHID
0000510625405 3;JKN DR RIZKI; 5.2.2.201806040537 4 207703
1#0##0#0#0.0#2018-08-06 16:07:08#0#00:53:08#00:53:08#00:00:00 1
27bb837d18c8464d0c2c7189fc6034f7 0 0 406990 0 0
8523509 0 0 0 0 1026355 0 0 0 0
1039000
3201126 B 2 BS 1 31/07/2018 01/08/2018 27/07/2015 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 5341754 0 2 0 0 0 REVI JULIAN MAHARDIKA
0002431732151 3;JKN DR RIZKI; 5.2.2.201806040537 4 207304
1#0##0#0#0.0#2018-08-06 16:19:35#0#09:49:14#09:49:14#00:00:00 1
88388915305cd73f27825cc5cc18544f 0 2846000 493024 0 0
1482269 0 0 0 0 375461 0 0 0 0 144999
3201126 B 2 BS 1 31/07/2018 01/08/2018 18/02/1961 0 2
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
0 5208600 7897556 0 2 0 0 0 SUBARDINI
0000042834611 3;JKN DR RIZKI; 5.2.2.201806040537 4 207695
1#0##0#0#0.0#2018-08-08 08:39:58#0#20:10:18#20:10:18#00:00:00 1
313c26a271db4f95104481b2d3d587f8 0 4793600 974100 0 0
1518193 0 0 0 0 542663 0 0 0 0 69000
3201126 B 3 BS 1 29/07/2018 01/08/2018 06/09/1962 0 2
1 E16.2;E14.9;J18.0;N18.5 - - - None None None None E-4-
0 - 0 6262900 6882963 0 4 0 0 0 YULI
0001740523656 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206566
1#0##0#0#0.0#2018-08-10 14:08:18#0#00:00:00#00:00:00#00:00:00 1
1f60ad0e97037f1d775380c2b28b946e 0 0 616661 0 0
2582015 0 0 0 0 2748287 0 0 0 0 936000
3201126 B 3 BS 1 30/07/2018 01/08/2018 01/04/1968 0 1
(BERAT) 34354000 0 0 PCI 10725800 - 0 - 0 -
0 45079800 46884898 0 3 0 0 0 TARYANI
0000512614776 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206683
1#0##0#0#0.0#2018-08-10 14:20:01#0#09:31:38#09:31:38#00:00:00 1
0f72945cff39dec32e7d3abed6633173 0 8169000 6870800 0 0
23029492 0 0 0 0 1226000 0 0 0 0
7589606
3201126 B 3 BS 1 30/07/2018 01/08/2018 03/07/1989 0 2
- 0 2987000 3341486 0 3 0 0 0 SISKA
YULIYANTI D404680 29 10619 DR SOEGIONO, SPPD 0138R0170718V010682
0001270901046 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207105
1#0##0#0#0.0#2018-08-10 14:21:30#0#16:21:02#16:21:02#00:00:00 1
e24f4ee6c6d32dffc566aa77a4a70b97 0 0 321830 0 0
1986054 0 0 0 0 1033602 0 0 0 0 0
3201126 B 3 BS 1 20/07/2018 01/08/2018 21/10/1962 0 1
1 I63.9;I48;J18.9;K92.1;I13.0;A41.9 - - - None None None
- 0 - 0 8672200 33211273 0 13 1 4 0
MUSTOPA D403218 55 20361 DR ADRIAN HANDARU 0138R0170718V007632
0001126212309 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 204059
1#0##0#0#0.0#2018-08-10 14:26:53#0#00:00:00#00:00:00#00:00:00 1
dee73cffe7bb6b6122289b59cc4fd49e 0 0 1006941 0 0
20082332 0 0 0 0 8042000 0 0 0 0
4080000
3201126 B 1 BS 1 31/07/2018 01/08/2018 30/11/1972 0 2
1 I98.3;K74.6;D64.9 45.16;42.33;99.04 - - None None None None
LAIN-LAIN (SEDANG) 3432200 0 0 - 0 - 0 - 0
- 0 3432200 7607891 0 2 0 0 0 SITI
SUWARSIH D050729 45 16679 DR ARU, SPPD 0138r0170718v010958
0002308555361 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207267
1#0##0#0#0.0#2018-08-10 16:13:09#0#09:06:19#09:06:19#00:00:00 1
847a97ccb4dfc581f5e59fda00781100 0 0 1014016 0 0
1653396 0 0 0 0 3171437 0 0 0 0
1769042
3201126 B 2 BS 1 29/07/2018 01/08/2018 23/10/2015 0 1
- 0 - 0 - 0 - 0 3187000 3878445 0
4 0 0 0 ANUGERAH AKHTAR OKTARA D351598 2 1010 DR
OTTY MITHA S, SPA 0138R0170718V010294 0002103052511 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206567 1#0##0#0#0.0#2018-08-13
07:49:36#0#00:00:00#00:00:00#12:00:00 1 954a7052cfd7e8bcb8e57166d87600a6
0 0 339830 0 0 1238885 0 0 0 0
2299730 0 0 0 0 0
3201126 B 3 BS 1 27/07/2018 01/08/2018 17/11/1997 0 2
2954900 0 0 - 0 - 0 - 0 - 0
2954900 5042327 0 6 0 0 0 ADELIA NOPI YANTI
D394604 20 7557 DR ARU, SPPD 0138R0170718V010147
0000511269208 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206407
1#0##0#0#0.0#2018-08-13 07:53:56#0#17:54:45#17:54:45#12:00:00 1
e1a55dacac056a5d246a45338ec91773 0 0 339830 0 0
2855125 0 0 0 0 1847372 0 0 0 0 0
3201126 B 3 BS 1 29/07/2018 01/08/2018 25/10/2013 0 1
- 0 - 0 - 0 - 0 2655900 2655895 0
4 0 0 0 FAIZ FAEYZA D404608 4 1738 DR RASTRA, SPA
0138R0170718V010473 0001789148834 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206750 1#0##0#0#0.0#2018-08-13
08:00:03#0#10:48:16#10:48:16#00:00:00 1 51a5809aa8943b4e96147f4140412b4a
0 0 292031 0 0 1112114 0 0 0 0
1251750 0 0 0 0 0
3201126 B 3 BS 1 31/07/2018 01/08/2018 16/01/2017 0 1
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2202429 0 2 0 0 0 M. FADLY HENDRAWAN
0002216341203 3;JKN DR RIZKI; 5.2.2.201806040537 4 207691
1#0##0#0#0.0#2018-08-13 09:47:44#0#00:00:00#00:00:00#00:00:00 1
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0 0 0 0 1135584 0 0 0 0 0
3201126 B 3 BS 1 29/07/2018 01/08/2018 16/09/1980 0 1
1 N18.5;D63.8 99.04;89.52;90.59;39.27 - - None None None None
- 0 - 0 8908800 8301490 0 4 0 0 0
YAYAN WARDIYANA D403037 37 13830 DR SRI KUNMARTINI, SPPD
0138R0170718V010321 0002446150408 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206585 1#0##0#0#0.0#2018-08-23
09:08:15#0#16:02:51#16:02:51#00:00:00 1 5a607079927ea2be5b69d5747d5e72cb
0 3235500 1906030 0 0 2521872 0 0 0 0
569088 0 0 0 0 69000
3201126 B 3 BS 1 01/08/2018 01/08/2018 17/04/1927 0 1
None None None None OBSTRUKSI SALURAN GASTROINTESTINAL (RINGAN)
2646600 0 0 - 0 - 0 - 0 - 0
2646600 2398011 0 1 0 0 0 SUGIONO D404865
91 33344 DR WIDHI DEWANTA K AJI 0138R0170818V000638 0001465515268
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208589
1#0##0#0#0.0#2018-08-25 10:40:50#0#10:34:02#10:34:02#00:00:00 1
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0 0 0 0 463879 0 0 0 0 1039000
3201126 B 1 BS 1 31/07/2018 01/08/2018 03/03/2002 0 1
1 M08.0 - - - None None None None M-4-16-I None None
None None None None GANGGUAN JARINGAN KONEKTIF (RINGAN) 3978000 0
0 - 0 - 0 - 0 - 0 3978000 18091239
0 2 0 0 0 DIMAS HAKIM MAULANA D359775 16 5994
DR NIA KURNIATI, SPA 0138R0170718V011208 0001620848485 3;JKN ECHI;
5.2.2.201806040537 4 207701 1#0##0#0#0.0#2018-08-28
10:47:48#0#00:00:00#00:00:00#12:00:00 2 109417b57a0b634cd9267013cd0635d2
0 0 358020 0 0 16018680 0 0 0 0
1714539 0 0 0 0 0
3201126 B 1 BS 1 30/07/2018 01/08/2018 12/04/1958 0 1
(SEDANG) 9673300 0 0 - 0 - 0 - 0 - 0
9673300 3651702 0 3 0 0 0 GENTUR EKO CHRISTIANTO
0000158002604 3;JKN DR RIZKI; 5.2.2.201806040537 4 206591
1#0##0#0#0.0#2018-08-28 14:30:49#0#00:00:00#00:00:00#00:00:00 1
7ad04e4f9c115bea39516fa39e372c7d 0 0 684656 0 0 359150
0 0 0 0 2607896 0 0 0 0 0
3201126 B 2 BS 1 30/07/2018 01/08/2018 04/03/1955 0 2
1 N18.5;D63.8;I15.0;I11.0 99.04;38.95 - - None None None None
- 0 - 0 23198900 19243796 0 3 0 0 0
FATIMAH D404711 63 23159 SRI KUNMARTINI.DR,SPPD
0138R0170718V010757 0001455784571 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207116 1#0##0#0#0.0#2018-10-10
09:51:22#0#17:20:16#17:20:16#00:00:00 3 915636a0ff8f8e41b301c7e8ba515b05
0 0 4878371 0 0 7542073 0 0 0 0
6777500 0 0 0 0 45852
3201126 B 2 BS 1 21/07/2018 01/08/2018 04/07/2018 0 1
1 P23.9;P36.9 - - - None None None None J-4-15-II None
6217100 0 0 - 0 - 0 - 0 - 0
6217100 27004585 0 12 1 12 0 BAYI NY. RIKA
SULISTYAWATI D403965 0 17 DR KHARINA CHATAR SPA
0138R0170718V007764 0002469988664 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207805 1#0##0#0#0.0#2018-10-10
10:22:02#0#00:00:00#00:00:00#00:00:00 1 7ef1c5cf8ab387da8d6c690a168f95fb
0 0 746333 0 2726000 9203252 0 0 0 0
9372000 0 0 0 4957000 0
3201126 B 1 BS 1 17/07/2018 01/08/2018 25/11/2000 0 2
1 Q21.0;I33.9 - - - None None None None I-4-18-III None
(BERAT) 11742700 0 0 - 0 - 0 - 0 - 0
11742700 28437113 0 16 0 0 0 PUTRI AULIA FARADILLAH
A. D014474 17 6443 DR SUPROHAITA SPA(K) 0138R0170718V006200
0001897450029 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 202825
1#0##0#0#0.0#2018-10-10 10:39:46#0#00:00:00#00:00:00#12:00:00 1
e9ede4fdc81a23053db809529a763b04 0 0 1291697 0 1577900
11201516 0 0 0 0 12496000 0 0 0 1870000
0
3201126 B 3 BS 1 28/07/2018 01/08/2018 01/12/1960 0 2
0 - 0 - 0 - 0 - 0 3575600 2462937
0 5 0 0 0 ONIH D346462 57 21058 DR SUPONO SPJP
0138R0170718V010181 0000510388839 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206423 1#0##0#0#0.0#2018-10-10
10:55:49#0#00:00:00#00:00:00#00:00:00 1 4eee38f6b587a739e2d677022eb93916
0 0 429100 0 0 531710 0 0 0 0
1502127 0 0 0 0 0
3201126 B 2 BS 1 30/07/2018 01/08/2018 20/01/1959 0 1
1 N18.5;E14.9;D63.8 99.04 - - None None None None N-4-10-II
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4361128 0 3 0 0 0 MOKH. MASKUR
D392480 59 21741 DR ARU, SPPD 0138R0170718V010775
0001882347118 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207118
1#0##0#0#0.0#2018-10-10 10:57:39#0#17:53:01#17:53:01#12:00:00 3
627889838c03b6cf43d2a10cd7f0d170 0 0 499265 0 0
2243056 0 0 0 0 1618807 0 0 0 0 0
3201126 B 3 BS 1 30/07/2018 01/08/2018 21/08/1956 0 1
- 0 3502700 2973456 0 3 0 0 0 AGUS DJAINI
D404689 61 22623 DR ARU, SPPD 0138R0170718V010820
0000511930945 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207126
1#0##0#0#0.0#2018-10-10 10:59:29#0#00:00:00#00:00:00#00:00:00 1
f38b2876583f59b615b2b5110a492445 0 0 431234 0 0
1601197 0 0 0 0 941025 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 01/08/2018 15/02/1986 0 2
1 N85.1;M32.9 69.09 - - None None None None W-1-11-I None
(RINGAN) 2760700 0 0 - 0 - 0 - 0 - 0
2760700 5005572 0 2 0 0 0 SUPRIYATI D404149
32 11854 DR ENDANG T. K, SPOG 0138R0170718V011205 0001652652404
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207699
1#0##0#0#0.0#2018-11-14 13:21:01#0#22:57:19#22:57:19#00:00:00 3
49bcced7c660a4bea270824156a0ca96 0 0 825996 0 0
1314757 0 0 0 0 2784467 0 0 0 0 80352
3201126 B 2 BS 1 31/07/2018 01/08/2018 04/04/1965 0 1
1 K74.6;I98.3;E14.9 42.33 - - None None None None B-4-13-I
5045200 0 0 - 0 - 0 - 0 - 0
5045200 6412719 0 2 0 0 0 SARYADI D386719
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207258
1#0##0#0#0.0#2018-11-14 13:23:57#0#08:56:38#08:56:38#00:00:00 2
14061226abefe480eaf02c823a702f24 0 0 1698672 0 0 942020
0 0 0 0 2023027 0 0 0 0 1749000
3201126 B 2 BS 1 31/07/2018 01/08/2018 18/02/1961 0 2
DIALISIS (RINGAN) 5208600 0 0 - 0 - 0 - 0 -
0 5208600 7897556 0 2 0 0 0 SUBARDINI
0000042834611 3;JKN Adinda; 5.2.2.201806040537 4 207695
1#0##0#0#0.0#2018-12-06 08:27:31#0#20:10:18#20:10:18#00:00:00 3
21ef1773a181d570581e2c01489f4ad9 0 4793600 974100 0 0
1518193 0 0 0 0 542663 0 0 0 0 69000
3201126 B 3 BS 1 31/07/2018 01/08/2018 08/10/1957 0 2
(RINGAN) 3502700 0 0 - 0 - 0 - 0 - 0
3502700 3747705 0 2 0 0 0 IDA FARIDA D316427
3;JKN Adinda; 5.2.2.201806040537 4 207256 1#0##0#0#0.0#2018-
12-06 08:32:47#0#08:51:26#08:51:26#00:00:00 4
e7e65abaa8f124ff8386c40078ab2985 0 0 345690 0 0
1956838 0 0 0 0 534177 0 0 0 0 911000
3201126 B 1 BS 1 25/07/2018 02/08/2018 18/04/1969 0 1
0 - 0 - 0 - 0 - 0 5005900 15453359
0 9 1 3 0 SETIAWAN D404326 49 17995 DR AZRI
5.2.2.201806040537 4 205955 1#0##0#0#0.0#2018-08-03
09:20:04#0#00:00:00#00:00:00#00:00:00 1 0ffc2b1e3fb41b50468999aada947c05
0 0 2130000 0 0 4006892 0 0 0 0
7544467 0 0 0 0 1772000
3201126 B 1 BS 1 01/08/2018 02/08/2018 27/05/1988 0 2
(RINGAN) 3220800 0 0 - 0 - 0 - 0 - 0
3220800 5343808 0 2 0 0 0 MERSI MEILINA
D168677 30 11023 DR ATJANG 0138R0170818V000140 0001483964987
3;JKN DR RIZKI; 5.2.2.201806040537 4 207758 1#0##0#0#0.0#2018-
08-06 14:42:18#0#00:00:00#00:00:00#00:00:00 1
6767f1fdf1992908863ad1779f3ec748 0 0 1007824 0 0
1001209 0 0 0 0 3239595 0 0 0 0 95180
3201126 B 2 BS 1 02/08/2018 02/08/2018 03/01/1985 0 2
1 K29.7;K31.7;R63.0 44.13 - - None None None None K-4-11-I
2783600 0 0 - 0 - 0 - 0 - 0
2783600 5063120 0 1 0 0 0 SUMARYANI D318768
3;JKN DR RIZKI; 5.2.2.201806040537 4 208364 1#0##0#0#0.0#2018-
08-06 14:44:08#0#07:59:56#07:59:56#00:00:00 1
3d40ab7ae01299ac860c855447b04148 0 0 895408 0 0 788480
0 0 0 0 1664732 0 0 0 0 1714500
3201126 B 2 BS 1 29/07/2018 02/08/2018 10/02/1972 0 1
1 I63.8;G81.9;I10 87.03;87.44;90.59;89.52 - - None None None
- 0 - 0 8291400 5478571 0 5 0 0 0
FRANKIE SAMMY BOSEKE D404624 46 16971 DR NURUL KOMARI SPS
0138R0170718V010317 0001870065303 3;JKN DR RIZKI; 5.2.2.201806040537
4 206581 1#0##0#0#0.0#2018-08-06
14:45:44#0#15:58:32#15:58:32#00:00:00 1 1b9b522b9ca8ca686d8d9933e0e18f67
0 0 882140 0 0 1687020 0 0 0 0
2909411 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 02/08/2018 29/03/1983 0 1
1 K80.1;K30 90.59;89.52 - - None None None None B-4-14-I
(RINGAN) 5039800 0 0 - 0 - 0 - 0 - 0
5039800 4057275 0 3 0 0 0 SURYADI D404722
0001514852886 3;JKN DR RIZKI; 5.2.2.201806040537 4 207137
1#0##0#0#0.0#2018-08-06 14:51:06#0#00:00:00#00:00:00#00:00:00 1
beea5e26b85f6409482e0a23c304a70a 0 0 756305 0 0
1494541 0 0 0 0 1806429 0 0 0 0 0
3201126 B 2 BS 1 30/07/2018 02/08/2018 16/10/2012 0 2
0 - 0 - 0 - 0 - 0 2671100 4552049
0 4 0 0 0 ZAZKI ROFIFAH SUNGKAR D274207 5 2113
5.2.2.201806040537 4 207128 1#0##0#0#0.0#2018-08-06
14:52:08#0#00:00:00#00:00:00#12:00:00 1 52e5f396a2ece038e8b004dcec1ab18a
0 0 293399 0 0 2122352 0 0 0 0
2136298 0 0 0 0 0
3201126 B 2 BS 1 28/07/2018 02/08/2018 31/12/1954 0 2
1 J18.9 87.44;90.59;89.52 - - None None None None J-4-16-I
(RINGAN) 4335900 0 0 - 0 - 0 - 0 - 0
4335900 6715620 0 6 0 0 0 KINI NY D397676
0001456259714 3;JKN DR RIZKI; 5.2.2.201806040537 4 206548
1#0##0#0#0.0#2018-08-06 14:54:17#0#15:49:07#15:49:07#00:00:00 1
324d40cccf1a825a9dc55f86e41f500f 0 0 679076 0 0
2541204 0 0 0 0 3495340 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 02/08/2018 03/08/1993 0 2
5984100 0 0 - 0 - 0 - 0 - 0
5984100 9586814 0 3 0 0 0 SINTA AGUSTIN
0001338867909 3;JKN DR RIZKI; 5.2.2.201806040537 4 207162
1#0##0#0#0.0#2018-08-06 14:56:36#0#07:58:05#07:58:05#00:00:00 1
82c25ff946f0a8f89966422d781c8e7c 0 5251900 1849230 0 0
1699619 0 0 0 0 691499 0 0 0 0 94566
3201126 B 1 BS 1 30/07/2018 02/08/2018 02/10/2017 0 1
1 A09.9;E86;R63.8 - - - None None None None K-4-17-I
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 8714015 0 4 0 0 0 BAYI NY. RIMA MINTA SARI
SITANGGANG D377858 0 301 DR TRI LESTARI, SPA 0138R0170718V010335
0002292672767 3;JKN DR RIZKI; 5.2.2.201806040537 4 206589
1#1#vvip#4#6308915#0.0#2018-08-06 14:58:49#0#00:33:11#00:33:11#12:00:00
1 5622371b88921387dbd9173fb24e510a 0 0 431786 0 0
2064153 0 0 0 0 5708076 0 0 0 0 510000
3201126 B 3 BS 1 31/07/2018 02/08/2018 24/09/2016 0 1
1 A09.9;R56.0 - - - None None None None K-4-17-II None
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 2904575 0 3 0 0 0 MUHAMAD SATURA HAIKAL
0002098394965 3;JKN DR RIZKI; 5.2.2.201806040537 4 207139
1#0##0#0#0.0#2018-08-06 15:01:25#0#00:00:00#00:00:00#00:00:00 2
cfc644c7390b0f787cebfb7f3c72da2c 0 0 292031 0 0
1607525 0 0 0 0 1005019 0 0 0 0 0
3201126 B 1 BS 1 28/07/2018 02/08/2018 21/07/1952 0 1
1 I61.8;I60.9;J18.0;G91.9 87.03;87.44 - - None None None None
G-4-13-III None None None None None None PERDARAHAN INTRA KRANIAL
BUKAN TRAUMATIK (BERAT) 8556600 0 0 - 0 - 0 - 0
- 0 8556600 12133781 0 6 1 3 0 MALIDU AHMAD
TN D404541 66 24113 DR MAYSAM I., SPS 0138R0170718V010261
0000208483852 3;JKN DR RIZKI; 5.2.2.201806040537 4 206550
1#0##0#0#0.0#2018-08-06 15:03:52#0#16:05:21#16:05:21#00:00:00 1
8ea6b2923b04c6fcdc6dfeb5e1802ae8 0 0 1018970 0 0
2973512 0 0 0 0 5747299 0 0 0 0
2394000
3201126 B 3 BS 1 30/07/2018 02/08/2018 05/10/1982 0 2
1 I50.0;I25.0;I31.3;J22 - - - None None None None I-4-
0 0 - 0 - 0 - 0 - 0 4144700
3648495 0 4 0 0 0 SAANIH NY D404646 35 13082
DR RIZKI; 5.2.2.201806040537 4 206819 1#0##0#0#0.0#2018-08-06
16:17:54#0#11:57:49#11:57:49#00:00:00 1 583c1a758759c003076fab86162ce1f5
0 0 345732 0 0 1344176 0 0 0 0
1668587 0 0 0 0 290000
3201126 B 3 BS 1 30/07/2018 02/08/2018 22/11/1944 0 1
1 N21.0;D29.1;I10;J98.1 57.19;59.8;57.49 - - None None None
None N-1-30-II None None None None None None PROSEDUR KANDUNG KEMIH
DAN SALURAN URIN BAWAH (SEDANG) 13138800 0 0 - 0 - 0
- 0 - 0 13138800 14120993 0 4 0 0 0
DARUSMAN D395476 73 26913 DR SIDDHI ANDIKA, SPU
0138R0170718V010478 0001474052646 3;JKN DR RIZKI; 5.2.2.201806040537
4 206753 1#0##0#0#0.0#2018-08-06
16:29:38#0#11:00:33#11:00:33#00:00:00 1 135dd5f1c82e52b9b6d3ebdca4382732
0 3784800 2431828 0 0 3798687 0 0 0 0
949803 0 0 0 0 3155875
3201126 B 1 BS 1 27/07/2018 02/08/2018 22/04/1966 0 1
1 I25.0;I13.0 88.55;36.07;39.95 - - YY02 None None None I-1-
- 0 58821400 82511261 0 7 0 0 0 JOHN TUA TN
0001423898605 3;JKN DR RIZKI; 5.2.2.201806040537 4 206362
1#0##0#0#0.0#2018-08-08 08:38:22#0#00:00:00#00:00:00#00:00:00 1
9e7c6d296937e96c3f61f0646875edcf 0 0 12287851 0 0
40578558 0 18462500 0 0 0 0 0 0 0
11182355
3201126 B 1 BS 1 01/08/2018 02/08/2018 05/09/1954 0 1
1 I25.0;I08.9;I50.0;N18.5 88.55;00.40 - - None None None None
0 - 0 26871300 40222708 0 2 0 0 0 SUMIDI
0001440831644 3;JKN DR RIZKI; 5.2.2.201806040537 4 207778
1#0##0#0#0.0#2018-08-08 08:43:05#0#00:00:00#00:00:00#00:00:00 1
e89755dcff49e8d6ed239b4bba1c3b45 0 10062000 1775560 0 0
19564148 0 0 0 0 1252000 0 0 0 0
7569000
3201126 B 1 BS 1 31/07/2018 02/08/2018 03/03/1954 0 2
1 C50.9;E13.9;T81.3 85.20 - - None None None None L-1-50-III
None None None None None None PROSEDUR PADA PAYUDARA (BERAT)
21064200 0 0 - 0 - 0 - 0 - 0
21064200 12115200 0 3 0 0 0 TJUTJU SUMARNI
0000061157665 3;JKN DR RIZKI; 5.2.2.201806040537 4 207694
1#0##0#0#0.0#2018-08-09 09:37:29#0#20:08:04#20:08:04#00:00:00 1
97751f069d92fb2ed266e9c74a74bdac 0 6241500 2562028 0 0
2295102 0 0 0 0 818583 0 0 0 0 197987
3201126 B 1 BS 1 01/08/2018 02/08/2018 11/06/1966 0 1
1 I12.0;E14.9 99.17;39.27;89.52;90.59 - - None None None None
- 0 - 0 6076700 14532989 0 2 0 0 0
SUGIYONO, SPD D404652 52 19044 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170818V000423 0000023583969 3;JKN DR RIZKI; 5.2.2.201806040537
4 208261 1#0##0#0#0.0#2018-08-09
09:44:55#0#19:37:21#19:37:21#00:00:00 1 81cfbeb077bb427de09dc2d6238ba18d
0 7610400 4365305 0 0 1546028 0 0 0 0
976756 0 34500 0 0 0
3201126 B 2 BS 1 01/08/2018 02/08/2018 10/07/1959 0 2
- 0 10690500 10237678 0 2 0 0 0 ELY SUPRIATI
0138R0170818V000418 0001616113449 3;JKN DR RIZKI; 5.2.2.201806040537
4 208259 1#0##0#0#0.0#2018-08-09
09:48:59#0#19:16:00#19:16:00#00:00:00 1 42bdb67bb2212349087c9ada4d5a960d
0 4703600 2223624 0 0 2545699 0 0 0 0
695755 0 0 0 0 69000
3201126 B 2 BS 1 01/08/2018 02/08/2018 06/12/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1636763 0 2 0 0 0 BAYI NY NIHAYATUL AENI
0002207090518 3;JKN DR RIZKI; 5.2.2.201806040537 4 207704
1#0##0#0#0.0#2018-08-09 09:49:50#0#00:00:00#00:00:00#00:00:00 1
4b0620c7d805ad06557ef10a2860f800 0 0 238535 0 0 255150
0 0 0 0 1143078 0 0 0 0 0
3201126 B 1 BS 1 01/08/2018 02/08/2018 27/08/1958 0 1
1 I13.1;N18.5;D63.8;A49.9;K21.9 99.04;90.59;89.52 - - None None
0 - 0 - 0 5784900 3448311 0 2 0 0
0 SUTARNO TN D362350 59 21889 SRI KUNMARTINI.DR,SPPD
0138R0170818V000223 0000043741427 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207946 1#0##0#0#0.0#2018-08-14
07:50:03#0#00:00:00#00:00:00#00:00:00 1 ed86fb381fa71eac3ad008787ed6652d
0 0 573641 0 0 1061080 0 0 0 0
1813590 0 0 0 0 0
3201126 B 1 BS 1 01/08/2018 02/08/2018 04/10/1964 0 2
1 N60.0 85.20 - - None None None None L-1-50-I None None
0 - 0 - 0 - 0 - 0 9150100 9932205
0 2 0 0 0 ANIEK ARDIATI,NY d401349 53 19659
TANTIYO S;16137 5.2.2.201806040537 4 211888 1#0##0#0#0.0#2018-
08-14 08:10:50#0#00:00:00#00:00:00#00:00:00 1
916d1253503d4466c0fe67c61ae3e597 0 5205000 2152976 0 0
1829459 0 0 0 0 675770 0 0 0 0 69000
3201126 B 2 BS 1 01/08/2018 02/08/2018 21/05/1968 0 2
LAIN (RINGAN) 3371200 0 0 - 0 - 0 - 0 -
0 3371200 3890303 0 2 0 0 0 INDRA PURWANINGSIH
D403856 50 18334 DR AFRA FONDA SPOG 0138R0170818V000384
0002080585271 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208254
1#0##0#0#0.0#2018-08-15 12:26:21#0#17:38:37#17:38:37#00:00:00 1
68e6198cb4f91613bb3baf4b6639f400 0 0 234171 0 0
2573126 0 0 0 0 1083005 0 0 0 0 1
3201126 B 3 BS 1 01/08/2018 02/08/2018 27/09/1964 0 1
- 0 8908800 7099126 0 2 0 0 0 ABDUL KHOLIK
SUWARTO D403056 53 19666 SRI KUNMARTINI.DR,SPPD 0138R0170818V000393
0000385522975 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208256
1#0##0#0#0.0#2018-08-23 08:48:27#0#17:43:42#17:43:42#00:00:00 1
94cd0afd2125b7415754feac6a2da38e 0 0 1906030 0 0
1350367 0 0 0 0 3842729 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 02/08/2018 22/04/1967 0 1
1 T82.4;E14.9;I12.0 39.42 - - None None None None N-1-12-II
- 0 10690500 8435137 0 3 0 0 0 TAUFIK
QURRAKHMAN TN D316253 51 18728 DEDY PRATAMA,DR SPBV
0138R0170718V011128 0001900946597 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207658 1#0##0#0#0.0#2018-08-23
09:00:27#0#15:29:19#15:29:19#00:00:00 1 f858a7181f88bfbfd65eb7227d3e1443
0 4872100 2223624 0 0 692582 0 0 0 0
577831 0 0 0 0 69000
3201126 B 2 BS 1 31/07/2018 02/08/2018 29/04/2017 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 7937973 0 3 0 0 0 ARYASUTA ATYA ABIMANYU
D399285 1 458 DR CATUR SUZANTARA 0138r0170718v011034
0002242955305 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207506
1#0##0#0#0.0#2018-08-23 09:11:43#0#12:13:49#12:13:49#00:00:00 1
cf7b5e53999d2a531a19dbb490e6b2c6 0 5348300 945360 0 0
954006 0 0 0 0 545307 0 0 0 0 145000
3201126 B 2 BS 1 26/07/2018 02/08/2018 05/06/2005 0 2
1 K36;J11.0 47.99;93.94 - - None None None None K-1-13-III
None None None None None None PROSEDUR APPENDIK (BERAT) 5160700
0 0 - 0 - 0 - 0 - 0 5160700
15276518 0 8 0 0 0 ALYSSA SOFIANDA ZIJKRA P
d404361 13 4799 DR RASTRA, SPA 0138R0170718V009706
0001339340062 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206188
1#0##0#0#0.0#2018-08-23 14:45:46#0#16:38:24#16:38:24#00:00:00 1
0d15e6308fc0833aa076d9fe641a37fe 0 7575800 1566804 0 0
4963516 0 0 0 0 1025398 0 0 0 0 145000
3201126 B 3 BS 1 25/07/2018 02/08/2018 13/07/1956 0 2
1 I63.9;I11.0;J18.0 87.03;93.94 - - None None None None G-4-
- 0 8672200 27508662 0 9 1 6 0 RUSMAELITA
D298020 62 22657 DR AGOES KOOSHARTORO SPPD 0138R0170818V009166
0000159388492 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 205673
1#0##0#0#0.0#2018-08-23 15:09:10#0#15:17:06#15:17:06#00:00:00 1
d35419c6ae0fafa97d43e3d6491b2d65 0 0 833498 0 0
14773664 0 0 0 0 7218500 0 0 0 0
4683000
3201126 B 1 BS 1 01/08/2018 02/08/2018 19/05/1973 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 59646276 0 2 0 0 0 SABDA ABADI
0001655863615 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208000
1#0##0#0#0.0#2018-08-25 13:53:59#0#00:00:00#00:00:00#00:00:00 1
fcd0b829c97a8efa044e6721c7b24d75 0 10080000 9619120 0 0
31126156 0 0 0 0 1252000 0 0 0 0
7569000
3201126 B 3 BS 1 01/08/2018 02/08/2018 28/08/1968 0 2
1 I13.1;T82.4;E11.9;A49.9 38.95 - - None None None None N-1-
- 0 - 0 19332400 12982108 0 2 0 0 0
SYECHA AL HAMID D403784 49 18235 SRI KUNMARTINI.DR,SPPD
0138R0170818V000343 0002211308087 3;JKN DR RIZKI; 5.2.2.201806040537
4 208191 1#0##0#0#0.0#2018-08-27
13:11:32#0#16:27:54#16:27:54#00:00:00 1 b6b2b8e363808e630e34c9767903a24b
0 3062500 1906030 0 0 7069281 0 0 0 0
875297 0 0 0 0 69000
3201126 B 3 BS 1 01/08/2018 02/08/2018 22/12/1967 0 1
- 0 8908800 9657778 0 2 0 0 0 WAHYU
WINDRADI D399274 50 18485 SRI KUNMARTINI.DR,SPPD 0138R0170818V000231
0002375862524 3;JKN DR RIZKI; 5.2.2.201806040537 4 207943
1#0##0#0#0.0#2018-08-27 13:13:13#0#14:03:25#14:03:25#00:00:00 1
198fb0ddd1015985191d1ab9193cbba8 0 3062500 1906030 0 0
3834431 0 0 0 0 657817 0 0 0 0 197000
3201126 B 2 BS 1 01/08/2018 02/08/2018 02/07/1957 0 2
1 N18.5;D63.8;E11.9 99.04;39.95 - - None None None None N-4-
GINJAL (SEDANG) 4958500 0 0 - 0 - 0 - 0 -
0 4958500 4445103 0 2 0 0 0 MUHAYATI NY
0001293884651 3;JKN DR RIZKI; 5.2.2.201806040537 4 208215
1#0##0#0#0.0#2018-08-27 13:18:50#0#16:41:16#16:41:16#00:00:00 1
86efbde133d391aeeacf889f1b841dcb 0 0 569727 0 0
1739200 0 0 0 0 2136176 0 0 0 0 0
3201126 B 3 BS 1 31/07/2018 02/08/2018 14/10/1969 0 1
1 K92.0;K92.1;D64.9;E11.9;I25.0 99.04 - - None None None None
LAIN-LAIN (SEDANG) 2451500 0 0 - 0 - 0 - 0
- 0 2451500 5023076 0 3 0 0 0 ANANG RUSDI
0001446446575 3;JKN DR RIZKI; 5.2.2.201806040537 4 207141
1#0##0#0#0.0#2018-08-29 09:54:11#0#00:00:00#00:00:00#12:00:00 2
e8a8fc302fea6b3705e2c40026904617 0 0 426023 0 0
3101541 0 0 0 0 1495512 0 0 0 0 0
3201126 B 3 BS 1 01/08/2018 02/08/2018 18/05/1961 0 1
- 0 8908800 13917256 0 2 0 0 0 JHON RIZAL
0138R0170818V000422 0001281285685 3;JKN ECHI; 5.2.2.201806040537
4 208264 1#0##0#0#0.0#2018-09-05
18:29:35#0#20:40:17#20:40:17#00:00:00 3 9380b01a787a3530f66a432c95216c1b
0 2976000 1853030 0 0 8082751 0 0 0 0
936475 0 0 0 69000 0
3201126 B 2 BS 1 01/08/2018 02/08/2018 17/07/1964 0 1
1 N18.5;E10.9;I11.9 39.27;99.17;90.59;89.52 - - None None None
None N-1-12-I None None None None None None MEMBUAT BARU, MEREVISI
DAN MEMINDAHKAN ALAT DIALISIS (RINGAN) 5208600 0 0 - 0 -
0 - 0 - 0 5208600 12575835 0 2 0 0
0 MAHMUD YUNUS ABD QOSIM D401037 54 19738 DR SRI KUNMARTINI, SPPD
0138R0170818V000427 0001272013244 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 208262 1#0##0#0#0.0#2018-10-10
10:13:29#0#20:08:04#20:08:04#00:00:00 1 0b0f957d5200dcf46ca06a5c8fbb9c5f
0 0 4878371 0 823372 2067375 0 0 0 0
4703600 0 0 0 103117 0
3201126 B 1 BS 1 30/07/2018 02/08/2018 16/09/1947 0 1
1 D29.1;R33;I10;E87.1 60.29;90.59 - - None None None None
V-1-14-II None None None None None None PENGANGKATAN PROSTAT MELALUI
URETRA (SEDANG) 17977700 0 0 - 0 - 0 - 0 -
0 17977700 25178146 0 4 0 0 0 SANGGAM SIHOMBING
0000061039271 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206765
1#0##0#0#0.0#2018-10-10 10:31:06#0#11:13:47#11:13:47#00:00:00 3
9912b771defa7eb2a24a394209570740 0 7997700 5033756 0 0
7333084 0 0 0 0 1226000 0 0 0 0
3587606
3201126 B 2 BS 1 31/07/2018 02/08/2018 15/05/2017 0 1
1760800 0 0 - 0 - 0 - 0 - 0
1760800 4750361 0 3 0 0 0 DARREL ALCANDER SANTOSO
0002303520311 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207338
1#0##0#0#0.0#2018-10-10 10:42:49#0#10:17:45#10:17:45#00:00:00 1
21f2799d988c0191e478692d24b50bd6 0 0 493024 0 310771
867566 0 0 0 0 2908000 0 0 0 171000
0
3201126 B 2 BS 1 31/07/2018 02/08/2018 14/04/1982 0 2
1 O42.0;O80.9;Z37.0;N93.9 73.59 - - None None None None O-6-
0 0 - 0 - 0 - 0 - 0 2379000
5410973 0 3 0 0 0 OLIVA KUNDRE D404758 36
TANTIYO S;16137 5.2.2.201806040537 4 207142 1#0##0#0#0.0#2018-
10-10 10:44:08#0#00:00:00#00:00:00#00:00:00 1
ddb00fc99e87b2118748ce1d20f561b8 0 0 528800 0 0
1411476 0 0 0 0 3232689 0 0 0 0 238008
3201126 B 2 BS 1 31/07/2018 02/08/2018 31/01/1985 0 2
0 0 - 0 - 0 - 0 - 0 2379000
3089859 0 3 0 0 0 NURHASANAH NY D404805 33
12234 DR ATJANG 0138R0170718V011212 0001381777558 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 207763 1#0##0#0#0.0#2018-11-02
16:26:36#0#10:24:25#10:24:25#00:00:00 2 1e4d55c4042311613daeeb0ed114e67f
0 0 623960 0 0 1174071 0 0 0 0 678640
0 0 0 0 613188
3201126 B 3 BS 1 25/07/2018 02/08/2018 13/07/1956 0 2
1 J18.0;I11.0;E14.9 87.03;93.94 - - None None None None J-4-
(BERAT) 6419700 0 0 - 0 - 0 - 0 - 0
6419700 27508662 0 9 1 6 0 RUSMAELITA D298020
0000159388492 3;JKN Adinda; 5.2.2.201806040537 4 205673
1#0##0#0#0.0#2018-12-06 10:07:33#0#15:17:06#15:17:06#00:00:00 4
30d2fff49fb8731079feb0ed5d5448fb 0 0 833498 0 0
14773664 0 0 0 0 7218500 0 0 0 0
4683000
3201126 B 1 BS 1 02/08/2018 03/08/2018 05/02/1969 0 1
- 0 - 0 27065300 3848937 0 2 0 0 0
M YUNUS D395655 49 18075 DR DEDY PRATAMA SPBV
0138R0170818V000602 0001457654657 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 208494 1#0##0#0#0.0#2018-08-14
07:46:03#0#09:39:22#09:39:22#00:00:00 1 0608f52f3898acb8dde8f045865432cc
0 0 578490 0 0 1411100 0 0 0 0
1839800 0 0 0 0 19547
3201126 B 3 BS 1 02/08/2018 03/08/2018 02/01/1962 0 1
1 I13.1;A49.9;I25.0 39.27;90.59;89.52 - - None None None None
- 0 - 0 4340500 6684832 0 2 0 0 0
KHAERONI D404993 56 20666 SRI KUNMARTINI.DR,SPPD
0138R0170818V000859 0000369136956 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 208759 1#0##0#0#0.0#2018-08-15
11:47:16#0#17:33:06#17:33:06#00:00:00 1 b482562be4e1f0f31dc34cfb4974be67
0 3532300 974100 0 0 1646107 0 0 0 0
463325 0 0 0 0 69000
3201126 B 1 BS 1 01/08/2018 03/08/2018 06/12/1981 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 15193618 0 3 0 0 0 NENENG HASANAH
D401785 36 13387 DR FERI S, SPOG 0138r0170818V000171
0001650818788 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207809
1#0##0#0#0.0#2018-08-15 12:08:30#0#11:34:46#11:34:46#00:00:00 1
84f2294772c3bd4f6499050c16dd5bb7 0 7464900 2471363 0 0
3789386 0 0 0 0 1102575 0 0 0 0 365394
3201126 B 1 BS 1 31/07/2018 03/08/2018 02/04/1960 0 1
1 I67.9;G81.9;E75.6;I10 - - - None None None None G-4-
LAIN (SEDANG) 6023100 0 0 - 0 - 0 - 0 -
0 6023100 4412606 0 4 0 0 0 SYAMSURI
0000061069318 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207690
1#0##0#0#0.0#2018-08-15 12:10:52#0#18:30:27#18:30:27#00:00:00 1
4a0abf3446be37c80fc986abb9b699c3 0 0 415079 0 0 904352
0 0 0 0 3093175 0 0 0 0 0
3201126 B 2 BS 1 02/08/2018 03/08/2018 25/07/2009 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1468131 0 2 0 0 0 RAKHA ZUHDI NAUFAL
D404847 9 3295 DR RASTRA, SPA 0138R0170818V000441
0001620150603 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208275
1#0##0#0#0.0#2018-08-16 08:37:29#0#00:15:48#00:15:48#00:00:00 1
e33ea129fb3017b83fd6d9fb97393cd0 0 0 238535 0 0 97550
0 0 0 0 1132046 0 0 0 0 0
3201126 B 1 BS 1 31/07/2018 03/08/2018 30/09/1990 0 2
1 O44.1;O82.9;Z37.0;O99.0 74.0;99.04 - - None None None None
(SEDANG) 7567300 0 0 - 0 - 0 - 0 - 0
7567300 14834440 0 4 0 0 0 ADE LISNAWATI
0001149544168 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207534
1#0##0#0#0.0#2018-08-20 17:17:37#0#13:43:26#13:43:26#00:00:00 1
0ac91191971d45ac3f69d29f914ff503 0 6788900 2376190 0 0
4413624 0 0 0 0 1034801 0 0 0 0 220925
3201126 B 1 BS 1 02/08/2018 03/08/2018 24/03/1956 0 1
1 K29.8;K29.7;K31.7 45.16 - - None None None None K-4-11-I
3247500 0 0 - 0 - 0 - 0 - 0
3247500 6481659 0 2 0 0 0 FAREL SIMARMATA
0000137904399 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208607
1#0##0#0#0.0#2018-08-23 08:52:27#0#10:45:48#10:45:48#00:00:00 1
4be4ee9b76e0004918c0f2a2c4932811 0 0 962300 0 0
1045825 0 0 0 0 2724534 0 0 0 0
1749000
3201126 B 2 BS 1 02/08/2018 03/08/2018 21/09/1969 0 1
0 0 - 0 - 0 - 0 - 0 3955700
5374196 0 2 0 0 0 JOHN T MANTOUW D357650 48
17847 DR ZULFAN, SPPD 0138R0170818V000893 0001379784161 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 208766 1#0##0#0#0.0#2018-
08-23 08:56:03#0#20:38:54#20:38:54#00:00:00 1
e8fb379ad962e079ddc3fadb108ca1c1 0 0 541152 0 0
1063461 0 0 0 0 1892583 0 0 0 0
1877000
3201126 B 3 BS 1 02/08/2018 03/08/2018 01/10/1986 0 1
1 N18.5;T82.4;D63.8 39.42;38.95;99.04 - - None None None None
- 0 - 0 19332400 16923294 0 2 0 0 0
AHMAD FAUZI D403837 31 11628 DEDY PRATAMA,SPBV 0138R0170818V000762
0000367244774 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208693
1#0##0#0#0.0#2018-08-23 15:33:21#0#14:46:26#14:46:26#00:00:00 1
ea57022f2fdfb7c63f0efb9802dbdaf0 0 0 4021139 0 0
8626172 0 0 0 0 4195631 0 0 0 0 80352
3201126 B 1 BS 1 02/08/2018 03/08/2018 09/10/1948 0 1
DIALISIS (BERAT) 27065300 0 0 - 0 - 0 - 0 -
0 27065300 14717608 0 2 0 0 0 SUWATRIL
0000060733888 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208670
1#0##0#0#0.0#2018-08-23 15:35:25#0#12:12:27#12:12:27#00:00:00 2
e3436ed03bb4bb2fd93c99c2b46a5295 0 0 1268340 0 0
6484082 0 0 0 0 6884834 0 0 0 0 80352
3201126 B 2 BS 1 01/08/2018 03/08/2018 12/09/1971 0 1
1 A01.0;R51 90.59;89.52 - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 2461016 0 3 0 0 0 ASEP DJAYA
SAPUTRA D206719 46 17125 DR BETTY DWI L, SPPD 0138R0170818V000009
0001436859764 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207705
1#0##0#0#0.0#2018-08-24 17:11:29#0#00:00:00#00:00:00#00:00:00 1
4d5d1ef798dc56928cc34b158ad8e946 0 0 298025 0 0 460990
0 0 0 0 1702001 0 0 0 0 0
3201126 B 3 BS 1 01/08/2018 03/08/2018 04/06/1973 0 2
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8144742 0 3 0 0 0 SARTIKA
0138R0170818V000428 0002289509706 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 208265 1#0##0#0#0.0#2018-08-25
10:42:58#0#20:51:53#20:51:53#00:00:00 1 e7abab4f53404301eb3d3bb983c55ea5
0 3438800 1853030 0 0 2166140 0 0 0 0
558834 0 0 0 0 127938
3201126 B 1 BS 1 30/07/2018 03/08/2018 05/04/1953 0 2
1 E16.2;I25.0;I11.9 - - - None None None None E-4-10-I
0 - 0 4903800 6121590 0 5 0 0 0 TUTI
MURDIYATMI D402532 65 23857 DR AZRI NURIZAL SPPD KKV
0138R0170718V010691 0002308269868 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207085 1#0##0#0#0.0#2018-08-25
11:05:19#0#15:45:25#15:45:25#00:00:00 1 587670d705fb7b2262e5d34717e8d09d
0 0 494342 0 0 1295770 0 0 0 0
4331478 0 0 0 0 0
3201126 B 1 BS 1 02/08/2018 03/08/2018 18/05/1966 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 9019696 0 2 0 0 0 SULISTYARTO
WIDAGDO H097931 52 19069 DEDY PRATAMA,SPBV 0138R0170818V000797
0001642474719 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208715
1#0##0#0#0.0#2018-08-25 12:36:05#0#15:30:13#15:30:13#00:00:00 1
277ecf42f8b09848ac614d40c4377a75 0 0 1215340 0 0
1257782 0 0 0 0 6512074 0 0 0 0 34500
3201126 B 1 BS 1 30/07/2018 03/08/2018 20/12/1948 0 1
1 K43.0;L02.2 53.51;86.99 - - None None None None K-1-12-II
None None None None None None PROSEDUR HERNIA TIDAK TERMASUK INGUINAL &
FEMORAL (SEDANG) 6255300 0 0 - 0 - 0 - 0 -
0 6255300 11433934 0 5 0 0 0 M.SYAFRI HR
d402832 69 25424 YASMIN SURYANDARI BACHTIAR. DR. SPB
0138R0170718V010833 0001257462628 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 207134 1#0##0#0#0.0#2018-08-25
13:07:20#0#20:36:30#20:36:30#00:00:00 1 4821a67966a124ad6ef366e0d7efefc4
0 7803500 686440 0 0 2092202 0 0 0 0
774014 0 0 0 0 77778
3201126 B 3 BS 1 29/07/2018 03/08/2018 12/12/1943 0 1
1 I63.9;E16.2;G81.9;E75.6 87.03 - - None None None None G-4-
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 4884225 0 6 0 0 0 HERY SUGIMIN
0001720084882 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 206587
1#0##0#0#0.0#2018-08-25 13:58:05#0#00:00:00#00:00:00#00:00:00 1
f2868254efec6a2d0d03ec27de928059 0 0 428857 0 0
2794839 0 0 0 0 1660529 0 0 0 0 0
3201126 B 1 BS 1 31/07/2018 03/08/2018 16/02/1984 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 18238698 0 4 0 0 0 DEVI SUSANTI
0001626892154 3;JKN DR RIZKI; 5.2.2.201806040537 4 207696
1#1#vip#4#5236125#75.0#2018-08-27 09:12:39#0#22:26:31#22:26:31#00:00:00
1 85ac4e66f345861146f2d03aec0d4b50 0 9636600 4210815 0
0 3009931 0 0 0 0 1286786 0 94566 0 0
0
3201126 B 2 BS 1 02/08/2018 03/08/2018 05/10/1956 0 2
0 - 0 - 0 - 0 - 0 3545800 5754696
0 2 0 0 0 SAAMAH d404685 61 22581 DR ZULFAN,
4 208772 1#0##0#0#0.0#2018-08-27
09:19:02#0#00:00:00#00:00:00#00:00:00 1 963e978e16eed8c59940c0a03f6ddc1c
0 0 594152 0 0 1286569 0 0 0 0
2124975 0 0 0 0 1749000
3201126 B 1 BS 1 01/08/2018 03/08/2018 30/07/1968 0 2
1 B49;E11.9;I11.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 2533354 0 3 0 0 0 ELITA MOULIN
LEANDER D002169 50 18264 DR BETTY DWI L, SPPD 0138R0170818V000429
0001337184077 3;JKN DR RIZKI; 5.2.2.201806040537 4 208266
1#0##0#0#0.0#2018-08-27 09:20:31#0#21:05:05#21:05:05#00:00:00 1
673553e77c7f0f1718f51975f170b7b4 0 0 319571 0 0 460050
0 0 0 0 1753733 0 0 0 0 0
3201126 B 2 BS 1 02/08/2018 03/08/2018 28/12/1940 0 2
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
0 10690500 12165531 0 2 0 0 0 ROHATA
0001744269028 3;JKN DR RIZKI; 5.2.2.201806040537 4 208673
1#0##0#0#0.0#2018-08-27 09:23:08#0#00:00:00#00:00:00#00:00:00 1
20b4ae06d77f4934671f144c41f1855f 0 4439100 4825371 0 0
1998832 0 0 0 0 821876 0 0 0 0 80352
3201126 B 1 BS 1 30/07/2018 03/08/2018 15/05/1935 0 1
1 D29.1;R33;I11.9 60.29 - - None None None None V-1-14-I
(RINGAN) 12373100 0 0 - 0 - 0 - 0 - 0
12373100 22519482 0 5 0 0 0 H.M.SOLEH D397745
3;JKN DR RIZKI; 5.2.2.201806040537 4 206600 1#0##0#0#0.0#2018-
08-27 09:29:58#0#08:44:22#08:44:22#00:00:00 1
bfc5c5a2d112ee8baecb2d1f8d9d8a9c 0 7570600 3464468 0 0
6474419 0 0 0 0 1226000 0 0 0 0
3783995
3201126 B 1 BS 1 01/08/2018 03/08/2018 27/02/1962 0 1
- 0 - 0 - 0 - 0 6844000 4186033 0
3 0 0 0 ERIES ERWANTO D404902 56 20609 DR
5.2.2.201806040537 4 208672 1#0##0#0#0.0#2018-08-27
09:36:17#0#12:35:11#12:35:11#00:00:00 1 2aadb1ab1afee08f78e2adf93354a352
0 0 504998 0 0 1819182 0 0 0 0
1861853 0 0 0 0 0
3201126 B 1 BS 1 30/07/2018 03/08/2018 07/02/1960 0 1
- 0 - 0 - 0 - 0 6844000 6581270 0
5 0 0 0 SYAMSUDIN d404696 58 21358 DR MAYSAMIRAWATI
4 211896 1#0##0#0#0.0#2018-08-27
09:41:42#0#00:00:00#00:00:00#00:00:00 1 c156617a236932cc8b440299441cc5c9
0 0 621855 0 0 1943365 0 0 0 0
4016050 0 0 0 0 0
3201126 B 3 BS 1 27/07/2018 03/08/2018 13/03/2003 0 1
7792500 0 0 - 0 - 0 - 0 - 0
7792500 18345450 0 8 0 0 0 MUHAMAD ARI MARDIANSYAH
0000512094104 3;JKN DR RIZKI; 5.2.2.201806040537 4 206205
1#0##0#0#0.0#2018-08-27 09:56:05#0#02:34:34#02:34:34#00:00:00 1
c8b6b5a3397511337c4e922476217aab 0 6268000 2586016 0 0
7722455 0 0 0 0 1296000 0 0 0 0 472979
3201126 B 3 BS 1 31/07/2018 03/08/2018 11/05/1975 0 2
1 G04.2;E87.1;E87.6 87.03 - - None None None None G-4-18-II
5920800 0 0 - 0 - 0 - 0 - 0
5920800 3907802 0 4 0 0 0 MUINAH D404753
3;JKN DR RIZKI; 5.2.2.201806040537 4 207136 1#0##0#0#0.0#2018-
08-27 10:28:57#0#00:00:00#00:00:00#00:00:00 1
d44c9a37863221d5a149fe9f3b1fd5d8 0 0 385604 0 0
2188547 0 0 0 0 1333651 0 0 0 0 0
3201126 B 2 BS 1 01/08/2018 03/08/2018 01/08/2018 3173 2
1 P21.9;P03.4;P22.1 - - - None None None None P-8-08-I
- 0 - 0 - 0 5066300 8434766 0 3 0
0 0 BAYI NY NURHASANAH D404849 0 0 DR AULIA TANGKARI,
4 208520 1#0##0#0#0.0#2018-08-27
12:54:52#0#00:00:00#00:00:00#00:00:00 1 ad2f04aab3baf12c8749e80cee88dc58
0 0 360075 0 0 3306884 0 0 0 0
3426807 0 0 0 0 1341000
3201126 B 1 BS 1 03/08/2018 03/08/2018 04/04/1987 0 2
0 - 0 - 0 - 0 - 0 2344900 6087170
0 1 0 0 0 ERNAWATI HASAN D405048 31 11444 DR
ATJANG S, SPOG 0138R0170818V000924 0001248957617 3;JKN DR RIZKI;
5.2.2.201806040537 4 208781 1#0##0#0#0.0#2018-08-27
13:05:16#0#00:00:00#00:00:00#00:00:00 1 181f0f99882c6e3a098a8a60d23209b1
0 0 658725 0 0 887731 0 0 0 0
4207526 0 0 333188 0 0
3201126 B 2 BS 1 01/08/2018 03/08/2018 29/10/1989 0 2
(RINGAN) 5984100 0 0 - 0 - 0 - 0 - 0
5984100 9693182 0 3 0 0 0 PRASTIKA RAHMAWATI
d404908 28 10503 DR ARIS WAHJU, SPOG 0138R0170818V000306
0002200742291 3;JKN DR RIZKI; 5.2.2.201806040537 4 208149
1#0##0#0#0.0#2018-08-27 13:09:26#0#16:07:02#16:07:02#00:00:00 1
d0697698325356a6b75611cfad0685d6 0 4608500 1920730 0 0
2219672 0 0 0 0 727733 0 0 0 0 216547
3201126 B 2 BS 1 29/07/2018 03/08/2018 02/07/1971 0 2
1 N36.9;R33;N39.0;Q61.9;D64.9 57.32;57.49;99.04 - - None None
None None N-1-40-II None None None None None None PROSEDUR PADA
URETRA DAN TRANSURETRA (SEDANG) 13103400 0 0 - 0 - 0
- 0 - 0 13103400 18426784 0 6 0 0 0
MILLA RUSMIATI A038875 47 17194 DR MOHAMMAD JOHAN SPU
0138R0170718V010313 0002097407812 3;JKN DR RIZKI; 5.2.2.201806040537
4 206576 1#0##0#0#0.0#2018-08-27
13:58:11#0#00:00:00#00:00:00#00:00:00 1 c7ba2793cd33a6578b27918ff8385fde
0 6841100 1226160 0 0 5489522 0 0 0 0
1577900 0 0 0 0 3292102
3201126 B 2 BS 1 24/07/2018 03/08/2018 28/08/1935 0 2
1 S72.00;M81.55;M21.75 81.51 - - YY01 RR04 None None M-1-
04-II None None YY-01-II RR-04-III None None PROSEDUR PADA SENDI TUNGKAI
BAWAH (SEDANG) 17829300 0 0 HIP REPLACEMENT / KNEE REPLACEMENT
35177000 43535179 0 11 0 0 0 CH RIKA RATNA JUWITA
0000203747049 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 205111
1#0##0#0#0.0#2018-11-02 16:21:56#0#15:03:57#15:03:57#00:00:00 2
a50370ef57822833f7c1a143e6ce6d4d 0 14182600 10090155 0 0
16829670 0 0 0 0 1577900 0 0 0 0 854854
3201126 B 2 BS 1 30/07/2018 03/08/2018 17/08/1949 0 1
1 I63.9;G81.9;I10;E78.5 87.03;87.44 - - None None None None
0 - 0 8291400 4545305 0 5 0 0 0
NGADELAR D376988 68 25184 DR MAYSAM I., SPS 0138R0170718V010831
0000060604086 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 207130
1#0##0#0#0.0#2018-11-02 16:23:43#0#20:15:41#20:15:41#12:00:00 2
024420454bb23417884a6b75e9812696 0 0 594422 0 0
1310027 0 0 0 0 2640856 0 0 0 0 0
3201126 B 1 BS 1 01/08/2018 04/08/2018 15/07/1984 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 21136755 0 4 0 0 0 NITA KEMALA DEWI
0000196782693 3;JKN DR RIZKI; 5.2.2.201806040537 4 208273
1#0##0#0#0.0#2018-08-27 09:48:28#0#00:00:00#00:00:00#00:00:00 1
55daa8404e4c7e27b964bfce6d8c18e8 0 8371000 8762200 0 0
2472389 0 0 0 0 1308600 0 0 0 0 222566
3201126 B 2 BS 1 01/08/2018 04/08/2018 08/02/1962 0 1
1 I85.9;B16.9;K29.5 45.16 - - None None None None K-4-12-II
0 0 - 0 - 0 - 0 - 0 4919200
13243464 0 4 0 0 0 UDIN TOHARUDIN D404864 56
DR RIZKI; 5.2.2.201806040537 4 209124 1#0##0#0#0.0#2018-08-27
09:51:22#0#16:47:27#16:47:27#00:00:00 1 2126c3b4afbf2b34ee69c161479c0245
0 5592500 2635580 0 0 2056589 0 0 0 0
1244295 0 0 0 0 1714500
3201126 B 1 BS 1 31/07/2018 04/08/2018 20/03/1969 0 2
1 D25.9;I11.0 68.39 - - None None None None W-1-20-III None
None None None None None PROSEDUR PADA RAHIM & ADNEKSA (BERAT)
16759100 0 0 - 0 - 0 - 0 - 0
16759100 33268682 0 5 0 0 0 DR. FITRIAH SHERLY
MARLEEN. SP.P D034919 49 18030 DR BAGUS T, SPOG 0138R0170718V010907
0000976580019 3;JKN DR RIZKI; 5.2.2.201806040537 4 208910
1#1#vip#5#12569325#75.0#2018-08-27 10:00:03#0#07:42:39#12:49:31#00:00:00
1 65de81a46b6eb26516139e69e2d2cdb1 0 12923000 4985832 0
0 12403414 0 0 0 0 1577900 0 0 0 0
1378536
3201126 B 3 BS 1 02/08/2018 04/08/2018 01/07/2000 0 1
1 A18.2 40.3 - - None None None None D-1-20-I None None
LAIN (RINGAN) 5164200 0 0 - 0 - 0 - 0 -
0 5164200 8815526 0 3 0 0 0 MAULANA YUSUF
0000511606091 3;JKN DR RIZKI; 5.2.2.201806040537 4 208769
1#0##0#0#0.0#2018-08-27 10:04:14#0#21:41:07#21:41:07#00:00:00 1
e337cff45bd2cb6de7c44322fe6fdb86 0 3062500 1445976 0 0
3559333 0 0 0 0 602717 0 0 0 0 145000
3201126 B 3 BS 1 30/07/2018 04/08/2018 01/06/1966 0 2
1 M06.88;S32.00 - - - None None None None M-4-16-II
4691000 0 0 - 0 - 0 - 0 - 0
4691000 4472824 0 6 0 0 0 YUNIAR BAYU NIRWANA
0001014225208 3;JKN DR RIZKI; 5.2.2.201806040537 4 206963
1#0##0#0#0.0#2018-08-27 10:09:59#0#14:42:44#14:42:44#00:00:00 1
b2a8b88dbca358bf574f79faf205fe0b 0 0 308734 0 0
2267475 0 0 0 0 1896615 0 0 0 0 0
3201126 B 1 BS 1 02/08/2018 04/08/2018 16/09/1976 0 2
1 K21.9;K30 - - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 4136800 3840011
0 3 0 0 0 PUJI RAHAYU D036015 41 15295 DR AZRI
5.2.2.201806040537 4 208675 1#0##0#0#0.0#2018-08-27
10:11:59#0#13:19:48#13:19:48#00:00:00 1 585a2839379a75a4ad6d17e6dcf84bdb
0 0 236051 0 0 631844 0 0 0 0
2972116 0 0 0 0 0
3201126 B 1 BS 1 01/08/2018 04/08/2018 30/11/1953 0 1
1 I27.0;I48;J81 37.28;87.49;90.59;89.52 - - None None None
None I-1-15-III None None None None None None KATETERISASI JANTUNG
(BERAT) 17095200 0 0 - 0 - 0 - 0 - 0
17095200 6133892 0 4 0 0 0 MANSYUR D373629
0000039703623 3;JKN DR RIZKI; 5.2.2.201806040537 4 207702
1#0##0#0#0.0#2018-08-27 10:14:24#0#00:00:00#00:00:00#12:00:00 1
1a5e77aac8fb56df43c5569e6f67524d 0 0 625157 0 0
1176452 0 0 0 0 4332283 0 0 0 0 0
3201126 B 1 BS 1 31/07/2018 04/08/2018 01/10/1959 0 1
0 0 - 0 - 0 - 0 - 0 5005900
8670041 0 5 0 0 0 ADELIR SAID D267408 58 21488
DR RIZKI; 5.2.2.201806040537 4 207793 1#0##0#0#0.0#2018-08-27
10:20:37#0#00:00:00#00:00:00#00:00:00 1 0f470149f00e6fc3822645ddab5757d8
0 0 951760 0 0 3565582 0 0 0 0
4152699 0 0 0 0 0
3201126 B 1 BS 1 30/07/2018 04/08/2018 05/11/1978 0 1
1 E87.1;G81.9;G40.4 - - - None None None None E-4-11-II
6306900 0 0 - 0 - 0 - 0 - 0
6306900 7210017 0 6 0 0 0 RAHMAT NOVIAN
D394587 39 14512 DR ARU, SPPD 0138R0170718V010723
0001728497215 3;JKN DR RIZKI; 5.2.2.201806040537 4 207115
1#0##0#0#0.0#2018-08-27 10:26:53#0#16:50:23#16:50:23#12:00:00 1
2cc52d77cc3b0e84c31b819d5b7b2d61 0 0 595079 0 0
1431255 0 0 0 0 5183683 0 0 0 0 0
3201126 B 1 BS 1 31/07/2018 04/08/2018 20/06/1942 0 1
1 E87.1;A41.9;F03;J18.9 87.03;87.44 - - None None None None
ELEKROLIT (BERAT) 8810600 0 0 - 0 - 0 - 0 -
0 8810600 7062240 0 5 0 0 0 JAN VICTOR
PINONTOAN D401433 76 27800 DR ARU, SPPD 0138R0170718V011207
0001338464608 3;JKN DR RIZKI; 5.2.2.201806040537 4 207700
1#0##0#0#0.0#2018-08-27 10:32:15#0#00:00:00#00:00:00#00:00:00 1
4e57d4751d025bcfe837a785a5fcb968 0 0 845954 0 0
2434270 0 0 0 0 3612016 0 0 0 0 170000
3201126 B 1 BS 1 01/08/2018 04/08/2018 03/09/1945 0 1
0 - 0 - 0 - 0 - 0 17095200 16091559
0 4 0 0 0 DALIMUN SANTONO, SPD D296788 72 26630
DR RIZKI; 5.2.2.201806040537 4 208267 1#0##0#0#0.0#2018-08-27
10:34:27#0#21:20:08#21:20:08#00:00:00 1 ba75ef31a6a2987beda48601cabc6aea
0 4777000 3419040 0 0 4706588 0 0 0 0
1078719 0 0 0 0 2110212
3201126 B 3 BS 1 01/08/2018 04/08/2018 14/06/1978 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 11562056 0 4 0 0 0 DJAMILAH D404855
0001457936818 3;JKN DR RIZKI; 5.2.2.201806040537 4 208258
1#0##0#0#0.0#2018-08-27 10:37:16#0#18:21:19#18:21:19#00:00:00 2
fe20f8dbc11073f9c6765db773703289 0 4633750 3161112 0 0
2649976 0 0 0 0 864996 0 0 0 0 252222
3201126 B 2 BS 1 30/07/2018 04/08/2018 11/05/1972 0 1
(RINGAN) 4869200 0 0 - 0 - 0 - 0 - 0
4869200 16454475 0 6 1 4 0 USEP SAPUTRA
0001472682374 3;JKN DR RIZKI; 5.2.2.201806040537 4 207112
1#0##0#0#0.0#2018-08-27 10:53:28#0#16:27:36#16:27:36#12:00:00 1
9f440cd1a5c464b370d77034952fbddb 0 0 590156 0 0
5829858 0 0 0 0 5224461 0 0 0 0
4810000
3201126 B 3 BS 1 02/08/2018 04/08/2018 10/05/1957 0 2
- 0 - 0 - 0 - 0 4888600 2248529 0
3 0 0 0 HEPI RUMINTANG D404962 61 22364 DR MAYSAM
5.2.2.201806040537 4 209120 1#0##0#0#0.0#2018-08-27
12:17:06#0#16:03:06#16:03:06#00:00:00 1 9ce3960df5ee2a084f519ec7818fb51b
0 0 504179 0 0 1045250 0 0 0 0 699100
0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 04/08/2018 31/07/2018 3246 1
0 - 0 - 0 5066300 9338355 0 5 0 0
0 BAYI NY SINTA AGUSTIN D404833 0 0 DR AULIA TANGKARI, SPA
0138R0170718V011210 0002473709973 3;JKN DR RIZKI; 5.2.2.201806040537
4 207757 1#0##0#0#0.0#2018-08-27
12:49:17#0#00:00:00#00:00:00#00:00:00 1 bb8ea403bddf642fa528dafaf521660e
0 0 307075 0 0 3439360 0 0 0 0
4070920 0 0 0 0 1521000
3201126 B 3 BS 1 03/08/2018 04/08/2018 12/04/1958 0 2
1 N18.5;I50.0;I21.2;D63.8;E14.9 99.17;39.27 - - None None None
0 - 0 - 0 19332400 7641491 0 2 0 0
0 TURYATI D374697 60 22028 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170818V001143 0001435178845 3;JKN DR RIZKI; 5.2.2.201806040537
4 208907 1#0##0#0#0.0#2018-08-27
12:53:23#0#00:00:00#00:00:00#12:00:00 1 9bc966955b84847bcfeda44de5605261
0 3438800 1870848 0 0 1736932 0 0 0 0
525911 0 0 0 0 69000
3201126 B 3 BS 1 29/07/2018 04/08/2018 01/01/1950 0 2
1 I61.9;I11.0;G81.9 87.03;87.44 - - None None None None G-4-
TRAUMATIK (BERAT) 6111900 0 0 - 0 - 0 - 0 -
0 6111900 14079741 0 7 1 4 0 SOMI D404601
3;JKN DR RIZKI; 5.2.2.201806040537 4 206563 1#0##0#0#0.0#2018-
08-27 12:57:54#0#00:09:52#00:09:52#00:00:00 1
103ce6d5bdf6320ac56880407046958a 0 0 886498 0 0
4491138 0 0 0 0 5228105 0 0 0 0
3474000
3201126 B 1 BS 1 01/08/2018 04/08/2018 31/07/1986 0 2
1 O46.9;O62.4;O30.1 - - - None None None None W-4-16-I
None None None None None None GANGGUAN ANTEPARTUM (RINGAN) 3035600
0 0 - 0 - 0 - 0 - 0 3035600
6248968 0 4 0 0 0 LUKLUK MAWADDAH D279611 32
11689 DR MARLY, SPOG 0138R0170818V000154 0000203619464 3;JKN DR
RIZKI; 5.2.2.201806040537 4 207770 1#0##0#0#0.0#2018-08-27
13:23:01#0#00:00:00#00:00:00#00:00:00 1 0afbc1fc4cae6781f1c26533c7876aef
0 0 480779 0 0 2094534 0 0 0 0
3576811 0 0 0 0 96844
3201126 B 3 BS 1 03/08/2018 04/08/2018 22/03/1967 0 2
1 G56.0;M67.4 04.43;80.93 - - None None None None M-1-80-I
8672000 0 0 - 0 - 0 - 0 - 0
8672000 10654935 0 2 0 0 0 ROSALINA D399639
3;JKN DR RIZKI; 5.2.2.201806040537 4 208875 1#0##0#0#0.0#2018-
08-27 13:24:14#0#00:00:00#00:00:00#00:00:00 1
002e5d32f373a00f2b501ac8d238e6c1 0 0 2428160 0 0
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3201126 B 3 BS 1 01/08/2018 04/08/2018 29/08/1975 0 2
1 D64.9;K30 99.04 - - None None None None D-4-13-I None
- 0 2987000 4308692 0 4 0 0 0 DEDE NUR
ASIAH D404942 42 15678 DR ARU, SPPD 0138R0170818V000437
0001731142754 3;JKN DR RIZKI; 5.2.2.201806040537 4 208272
1#0##0#0#0.0#2018-08-27 13:25:15#0#22:47:00#22:47:00#00:00:00 1
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2295985 0 0 0 0 1078877 0 0 0 0 612000
3201126 B 1 BS 1 31/07/2018 04/08/2018 26/02/1955 0 2
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 6298110 0 5 0 0 0 ENDANG SISWATI
D404828 63 23166 DR ARU, SPPD 0138R0170718V011204
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1#0##0#0#0.0#2018-08-27 13:29:37#0#00:00:00#00:00:00#00:00:00 2
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2188742 0 0 0 0 3562026 0 0 0 0 0
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1#1#vvip#1#16560161#0.0#2018-08-27 14:03:27#0#00:40:20#00:40:20#00:00:00
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689259
3201126 B 3 BS 1 03/08/2018 04/08/2018 24/10/1948 0 2
1 I63.9;I50.0;N18.9;E87.0;A41.9;J80 99.60 - - None None None
- 0 - 0 8672200 4654052 0 2 0 0 0
MA'ANAH D400900 69 25485 DR. SUKMARINI 0138R0170818V001306
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1#0##0#0#0.0#2018-08-28 08:37:44#0#19:24:51#19:24:51#00:00:00 2
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2451902 0 0 0 0 611471 0 0 0 0
1039000
3201126 B 3 BS 1 03/08/2018 04/08/2018 07/11/1954 0 1
1 N18.5;J91;I50.9 39.27 - - None None None None N-1-12-III
- 0 19332400 7298897 0 2 0 0 0 RIKIN
0002044632464 3;JKN DR RIZKI; 5.2.2.201806040537 4 209123
1#0##0#0#0.0#2018-08-28 08:45:15#0#16:25:13#16:25:13#00:00:00 1
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2372499 0 0 0 0 3942298 0 0 0 0 0
3201126 B 2 BS 1 01/08/2018 04/08/2018 17/10/1985 0 1
1 K40.4;I12.0 53.04;39.95 - - None None None None K-1-14-II
(SEDANG) 7719500 0 0 - 0 - 0 - 0 - 0
7719500 16251293 0 4 0 0 0 SAPRUL HADI SATRIA
0001281304427 3;JKN DR RIZKI; 5.2.2.201806040537 4 209380
1#0##0#0#0.0#2018-08-28 09:04:34#0#00:00:00#00:00:00#00:00:00 2
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2814506 0 0 0 0 1898544 0 0 0 0
2513000
3201126 B 2 BS 1 02/08/2018 04/08/2018 04/09/2000 0 2
L-1-40-II None None None None None None PROSEDUR PADA KULIT,
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- 0 - 0 - 0 11982900 13864682 0 3 0
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0138R0170818V000446 0001629482308 3;JKN DR RIZKI; 5.2.2.201806040537
4 208281 1#0##0#0#0.0#2018-08-28
09:21:40#0#00:00:00#00:00:00#00:00:00 1 d7bc46def9f5c839888cf499848e3757
0 7285900 2298346 0 0 2528371 0 0 0 0
958035 0 0 0 0 794030
3201126 B 1 BS 1 01/08/2018 04/08/2018 28/11/1975 0 2
0 - 0 - 0 - 0 - 0 6981500 21950655
0 4 0 0 0 NOVI YULIA D214168 42 15587 DR FX
BHIMANTORO, SPOG 0138R0170818V000439 0000072332302 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 208278 1#1#vvip#4#14969155#0.0#2018-10-10
10:29:26#0#00:00:00#00:00:00#00:00:00 1 33e12697f2df40f39f5f4347ec999472
0 0 8762200 0 1200000 3833061 0 0 0 0
8005000 0 0 0 150394 0
3201126 B 1 BS 1 30/07/2018 05/08/2018 04/06/2018 0 1
0 0 - 0 - 0 - 0 - 0 3695000
4745506 0 7 0 0 0 BAYI NY. ARUM INDRIASTI D402944
0 56 DR HUDA HILMAN 0138R0170718V010835 0002356225086 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 207135 1#0##0#0#0.0#2018-
08-09 16:42:28#1#00:00:00#00:00:00#00:00:00 1
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1449612 0 0 0 0 1841940 0 0 0 846454
0
3201126 B 2 BS 1 02/08/2018 05/08/2018 23/07/1975 0 1
1 D64.9;K92.1;K92.0 99.04 - - None None None None D-4-13-II
0 - 0 5073100 5284827 0 4 0 0 0
MUHAMAD RUSYDI D392580 43 15716 DR. ARU ARIADNO, SPPD
0138R0170818V000901 0002267864616 3;JKN DR RIZKI; 5.2.2.201806040537
4 208768 1#0##0#0#0.0#2018-08-13
09:34:07#0#21:15:55#21:15:55#12:00:00 1 12e2b15f8c63a310d22048646458ede4
0 0 375596 0 0 3527495 0 0 0 0
1381736 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 05/08/2018 18/08/1980 0 2
1 K56.6;A16.1 87.44;88.19;88.76 - - None None None None K-4-
15-II None None None None None None OBSTRUKSI SALURAN GASTROINTESTINAL
(SEDANG) 4895400 0 0 - 0 - 0 - 0 - 0
4895400 8252679 0 6 0 0 0 SUKARTI D404804
37 13861 DR ARU, SPPD 0138R0170718V011166 0001626849088 3;JKN
DR RIZKI; 5.2.2.201806040537 4 207686 1#0##0#0#0.0#2018-08-13
09:37:52#0#16:44:18#16:44:18#00:00:00 1 bbb986fec4f5d525f0f8ddf067e9a823
0 0 444830 0 0 4211954 0 0 0 0
3595895 0 0 0 0 0
3201126 B 1 BS 1 02/08/2018 05/08/2018 24/05/2018 0 1
2405100 0 0 - 0 - 0 - 0 - 0
2405100 4529139 0 4 0 0 0 BAYI NY ENDANG ANDRIANI
0002454924453 3;JKN DR RIZKI; 5.2.2.201806040537 4 208699
1#0##0#0#0.0#2018-08-13 09:41:25#0#15:12:25#15:12:25#00:00:00 1
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0 0 0 0 3446299 0 0 0 0 340000
3201126 B 2 BS 1 02/08/2018 05/08/2018 04/02/2012 0 1
1 A09.9;F82 - - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 3101252 0 4 0 0 0 MUHAMMAD KASYIF ALI
SETIAWAN D246781 6 2371 DR AWIDIYA, SPA 0138R0170818V000823
0001879126571 3;JKN DR RIZKI; 5.2.2.201806040537 4 208757
1#0##0#0#0.0#2018-08-13 09:44:58#0#16:27:54#16:27:54#00:00:00 1
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3201126 B 2 BS 1 03/08/2018 05/08/2018 09/01/2012 0 1
6586700 0 0 - 0 - 0 - 0 - 0
6586700 9337507 0 3 0 0 0 KAMILAH MAULIDA PUTRI
0001468620461 3;JKN DR RIZKI; 5.2.2.201806040537 4 208998
1#0##0#0#0.0#2018-08-13 09:46:30#0#19:35:01#19:35:01#00:00:00 1
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1313666 0 0 0 0 636865 0 0 0 0 145000
3201126 B 3 BS 1 04/08/2018 05/08/2018 17/03/2010 0 1
1 D56.1;T80.8 99.04 - - None None None None D-4-13-III None
SEL SICKLE (BERAT) 5407200 0 0 - 0 - 0 - 0
- 0 5407200 3780200 0 2 0 0 0 ALFATHIRA
0001265724505 3;JKN DR RIZKI; 5.2.2.201806040537 4 211828
1#0##0#0#0.0#2018-08-13 09:53:50#0#00:00:00#00:00:00#12:00:00 1
17e6b21a2a736d21aba43c8a4fac69a6 0 0 268830 0 0
2712067 0 0 0 0 799303 0 0 0 0 0
3201126 B 1 BS 1 03/08/2018 05/08/2018 26/11/2014 0 1
7684500 0 0 - 0 - 0 - 0 - 0
7684500 11582093 0 3 0 0 0 NOVAN GIFARI YUSUF
D386717 3 1346 DR CATUR S, SPB 0138R0170818V001347
0001856065871 3;JKN DR RIZKI; 5.2.2.201806040537 4 208999
1#0##0#0#0.0#2018-08-13 09:59:21#0#19:38:55#19:38:55#12:00:00 1
16714cbea826368611ef06b36e2fa217 0 7187200 2204660 0 0
1261526 0 0 0 0 783707 0 0 0 0 145000
3201126 B 1 BS 1 02/08/2018 05/08/2018 18/12/1958 0 1
INFARK (SEDANG) 9673300 0 0 - 0 - 0 - 0 -
0 9673300 4827806 0 4 0 0 0 EDY SURYANTO
0001650156107 3;JKN DR RIZKI; 5.2.2.201806040537 4 208277
1#0##0#0#0.0#2018-08-13 10:14:52#0#00:00:00#00:00:00#00:00:00 1
987e656eb73b8b98c9a0fed78059ef10 0 0 684656 0 0 677312
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3201126 B 1 BS 1 03/08/2018 05/08/2018 17/06/2010 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 2804963 0 3 0 0 0 HAZRINA AZKA KIRANI
PUTRI D372444 8 2969 DR RASTRA, SPA 0138R0170818V001360
0000208479295 3;JKN DR RIZKI; 5.2.2.201806040537 4 209004
1#0##0#0#0.0#2018-08-28 08:26:14#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 03/08/2018 05/08/2018 10/05/2015 0 1
(RINGAN) 10368300 0 0 - 0 - 0 - 0 - 0
10368300 10514468 0 3 0 0 0 GOUVENIAIL CORNEL
SIMANJUNTAK D043733 3 1181 DR CATUR SUZANTARA 0138R0170818V001356
0002249496707 3;JKN DR RIZKI; 5.2.2.201806040537 4 209003
1#0##0#0#0.0#2018-08-28 08:46:32#0#00:00:00#00:00:00#00:00:00 1
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1766182 0 0 0 0 713862 0 0 0 0 145000
3201126 B 1 BS 1 02/08/2018 05/08/2018 10/10/1945 0 1
(RINGAN) 6275300 0 0 - 0 - 0 - 0 - 0
6275300 12363604 0 4 0 0 0 SARDJONO D097720
3;JKN DR RIZKI; 5.2.2.201806040537 4 208681 1#0##0#0#0.0#2018-
08-28 08:47:57#0#00:00:00#00:00:00#00:00:00 1
32cd907743190d4ca4c8584b14ce4428 0 7278000 1978837 0 0
1773308 0 0 0 0 1186734 0 0 0 0 146725
3201126 B 2 BS 1 04/08/2018 05/08/2018 02/02/1950 0 2
(RINGAN) 3536800 0 0 - 0 - 0 - 0 - 0
3536800 8448381 0 2 0 0 0 CHRISTINE SRI WAHYUNI
0138R0170818V001444 0000060706585 3;JKN DR RIZKI; 5.2.2.201806040537
4 209205 1#0##0#0#0.0#2018-08-28
09:47:54#0#00:00:00#00:00:00#00:00:00 1 fbb24fa2375c409cc1a49adc0e38121d
0 0 1096304 0 0 1395879 0 0 0 0
5759198 0 0 0 0 197000
3201126 B 1 BS 1 02/08/2018 05/08/2018 23/05/1994 0 2
10909500 0 0 - 0 - 0 - 0 - 0
10909500 13617373 0 4 0 0 0 INTAN MANDASARI
0002297960818 3;JKN DR RIZKI; 5.2.2.201806040537 4 208760
1#0##0#0#0.0#2018-08-28 10:07:57#0#17:36:59#17:36:59#00:00:00 1
16b129e5d1de43aad8281ec2d04d3c6b 0 6932500 3269755 0 0
1929262 0 0 0 0 1416856 0 0 0 0 69000
3201126 B 2 BS 1 04/08/2018 05/08/2018 08/08/1971 0 1
- 0 10690500 15938905 0 2 0 0 0 SANUSI
0001303469278 3;JKN DR RIZKI; 5.2.2.201806040537 4 209058
1#0##0#0#0.0#2018-08-28 10:12:39#0#00:00:00#00:00:00#00:00:00 1
4fae27d3087126f11f526abf4a8f32ff 0 0 2276624 0 0
7542843 0 0 0 0 6029832 0 0 0 0 89606
3201126 B 1 BS 1 24/07/2018 05/08/2018 08/07/1955 0 1
4 I95.9;A41.9;J18.9;I63.9 96.72;93.94;87.03;87.44 - - None None
None None J-1-02-III None None None None None None VENTILASI
- 0 - 0 - 0 92864200 67672657 0 13 1
7 0 SUPARMAN D354209 63 23027 DR NURUL KOMARI SPS
0138R0170718V008647 0001469291152 3;JKN Keuangan; 5.2.2.201806040537
4 205046 1#0##0#0#0.0#2018-08-31
16:10:18#0#00:00:00#00:00:00#00:00:00 2 a723665a3a058706a1e8ccc7209a688e
0 0 3358434 0 0 38258223 0 0 0 0
12908000 0 0 0 0 13148000
3201126 B 3 BS 1 05/08/2018 05/08/2018 27/11/1962 0 1
1 I63.9;K30 87.03;87.44 - - None None None None G-4-14-I
INFARK (RINGAN) 5013100 0 0 - 0 - 0 - 0 -
0 5013100 1625533 0 1 0 0 0 SUBENDI
0001831728486 3;JKN ECHI; 5.2.2.201806040537 4 209463
1#0##0#0#0.0#2018-09-05 17:50:56#0#10:46:22#10:46:22#00:00:00 2
091aceaf56f9d217d0cbed69d8bae2a9 0 0 345475 0 0 150715
0 0 0 0 413343 0 0 0 0 716000
3201126 B 3 BS 1 01/08/2018 05/08/2018 02/06/1961 0 2
1 I12.0;E11.9;D63.8;A41.9 99.17;99.21;38.95 - - None None None
0 - 0 - 0 19332400 24080301 0 5 1 0
0 SUNINGSIH D404862 57 20879 SRI KUNMARTINI.DR,SPPD
0138R0170818V000193 0002143332549 3;JKN ECHI; 5.2.2.201806040537
4 207876 1#0##0#0#0.0#2018-09-05
18:53:04#0#00:00:00#00:00:00#00:00:00 3 9487e12c9fd879529f59bb7234d7d2d9
0 0 4074139 0 0 6805412 0 0 0 0
11044750 0 0 0 0 2156000
3201126 B 3 BS 1 04/08/2018 05/08/2018 21/04/1990 0 2
0 - 0 - 0 - 0 - 0 1674900 4841052
0 2 0 0 0 RISCA SETIAWATI d405121 28 10332 DR
MAMAN H, SPOG 0138R0170818V001363 0001740456279 3;JKN ECHI;
5.2.2.201806040537 4 209006 1#0##0#0#0.0#2018-09-27
15:51:35#0#00:00:00#00:00:00#00:00:00 2 49945860b3b7eb3a37f9beb896a0225f
0 0 1249832 0 0 954908 0 0 0 0
2191304 0 0 0 0 445008
3201126 B 3 BS 1 03/08/2018 05/08/2018 04/03/2018 0 2
1 D42.9;G81.9 87.03 - - None None None None G-4-26-II None
(SEDANG) 4302200 0 0 - 0 - 0 - 0 - 0
4302200 8023463 0 3 0 0 0 N ROSWATI LIA
0001285949068 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209194
1#0##0#0#0.0#2018-10-10 09:55:25#0#00:00:00#00:00:00#00:00:00 1
fcbb42b46dd1413acc6471483c2181a1 0 0 428857 0 0
4804707 0 0 0 0 2239000 0 0 0 550899
0
3201126 B 1 BS 1 04/08/2018 05/08/2018 29/07/2018 3000 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 2602974 0 2 0 0 0 TITU PARFITA RAHAYU BY
NY D404607 0 6 KRISTYANINGESTI,DR.SPA 0138R0170818V001365
0002478020264 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209007
1#0##0#0#0.0#2018-10-10 10:10:27#0#00:00:00#00:00:00#00:00:00 1
099c1beb3916ef38a8b8713d0194fe82 0 0 513620 0 196288
199066 0 0 0 0 1354000 0 0 0 340000
0
3201126 B 3 BS 1 03/08/2018 05/08/2018 30/07/1992 0 2
(SEDANG) 5405200 0 0 - 0 - 0 - 0 - 0
5405200 9033766 0 3 0 0 0 FARIHA AKMALIA TUSHOLIHA
0001971720562 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 208976
1#0##0#0#0.0#2018-11-02 16:17:16#0#15:59:55#15:59:55#00:00:00 2
7d9ead7983e304f4562c6106231221d9 0 0 1928716 0 0
2340893 0 0 0 0 4532494 0 0 0 0 231663
3201126 B 1 BS 1 03/08/2018 05/08/2018 13/05/1971 0 2
0 - 0 - 0 - 0 - 0 17095200 16052632
0 3 0 0 0 MAIMUNAH D395640 47 17249 DR BAMBANG
5.2.2.201806040537 4 209000 1#0##0#0#0.0#2018-11-14
13:55:11#0#19:52:22#19:52:22#00:00:00 2 f6cca434e74266ff6fd800453ee14b19
0 5813500 3419040 0 0 3674920 0 0 0 0
1076172 0 0 0 0 2069000
3201126 B 1 BS 1 04/08/2018 06/08/2018 17/12/1949 0 1
1 D29.1;R33 - - - None None None None V-4-11-I None
TUMOR (RINGAN) 5170000 0 0 - 0 - 0 - 0 -
0 5170000 4413583 0 3 0 0 0 SASRO
HARDONO,BC.AK. D319828 68 25067 DR MOHAMMAD JOHAN SPU
0138R0170818V001421 0000060867729 3;JKN DR RIZKI; 5.2.2.201806040537
4 209088 1#0##0#0#0.0#2018-08-27
14:30:59#0#00:00:00#00:00:00#00:00:00 1 ccfdc52fbaf1bdf7a4761995c5e5d7e1
0 0 407482 0 0 1348362 0 0 0 0
2657739 0 0 0 0 0
3201126 B 3 BS 1 02/08/2018 06/08/2018 15/12/1963 0 1
INFARK (SEDANG) 6909500 0 0 - 0 - 0 - 0 -
0 6909500 3345705 0 5 0 0 0 SUPARYANTO
0001619782907 3;JKN DR RIZKI; 5.2.2.201806040537 4 208456
1#0##0#0#0.0#2018-08-27 14:33:46#0#09:13:45#09:13:45#00:00:00 1
a2831ba4e7a3a08ce3a27bca42ea94c0 0 0 674855 0 0
1373972 0 0 0 0 1296878 0 0 0 0 0
3201126 B 3 BS 1 03/08/2018 06/08/2018 13/03/2007 0 2
1 K12.2;E86 - - - None None None None U-4-14-I None
None None None None None PENYAKIT MULUT DAN GIGI (RINGAN) 3688200
0 0 - 0 - 0 - 0 - 0 3688200
2291232 0 4 0 0 0 SYARIFAH HAFSOH FADLUN D405074
3;JKN DR RIZKI; 5.2.2.201806040537 4 208975 1#0##0#0#0.0#2018-
08-27 14:37:58#0#15:59:29#15:59:29#00:00:00 1
1a7664abbacc36a9391d99d7caf5f100 0 0 437938 0 0 625400
0 0 0 0 1227894 0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 06/08/2018 06/04/1947 0 2
4 J22;R40.2;R57.2;E87.1;K25.0 99.60 - - None None None None
J-4-21-III None None None None None None GEJALA, TANDA DAN DIAGNOSIS
SISTEM PERNAFASAN LAIN-LAIN (BERAT) 6291000 0 0 - 0 - 0
- 0 - 0 6291000 5772572 0 1 0 0 0
ALIFA ARBIE D048514 71 26055 DR YOHANNES DWINANDA
0138R0170818V001536 0002059434303 3;JKN DR RIZKI; 5.2.2.201806040537
4 209169 1#0##0#0#0.0#2018-08-27
14:46:55#0#00:00:00#00:00:00#12:00:00 2 7fb507f8cc846bc50e240a9393395589
0 0 406990 0 0 3836937 0 0 0 0 684645
0 0 0 0 844000
3201126 B 3 BS 1 06/08/2018 06/08/2018 23/03/2017 0 1
4 J22;Q21.0 99.60 - - None None None None J-4-21-II None
LAIN-LAIN (SEDANG) 4508300 0 0 - 0 - 0 - 0
- 0 4508300 4367857 0 1 0 0 0 BY NY
MELINDA KRISNAWATI/ ELVINO ZAVIER D369058 1 501 DR YOHANES DWINANDA R P
0138R0170818V001541 0002236690034 3;JKN DR RIZKI; 5.2.2.201806040537
4 209171 1#0##0#0#0.0#2018-08-27
15:03:14#0#05:48:13#05:48:13#12:00:00 2 225e0e82f7ea9ed324558c9d59fd9403
0 0 253875 0 0 2628234 0 0 0 0 574748
0 0 0 0 911000
3201126 B 2 BS 1 05/08/2018 06/08/2018 11/12/1948 0 1
(SEDANG) 4958500 0 0 - 0 - 0 - 0 - 0
0001222739706 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209162
1#0##0#0#0.0#2018-08-28 08:39:35#0#00:00:00#00:00:00#00:00:00 1
d5c1fa5b5cf4ddf1744b63a340e8b661 0 0 499265 0 0
1697300 0 0 0 0 2277442 0 0 0 0 0
3201126 B 2 BS 1 05/08/2018 06/08/2018 09/06/1973 0 2
1 K51.9;D25.9;I84.3 - - - None None None None K-4-13-I
0 - 0 - 0 4780000 5723312 0 2 0 0
0 NINI JUNNAINI D119924 45 16493 DR BETTY DWI L, SPPD
0138R0170818V001483 0001635029469 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 209146 1#0##0#0#0.0#2018-08-28
08:43:31#0#01:20:40#01:20:40#00:00:00 1 185150935d67c537570e5edec06d4d01
0 0 541152 0 0 923746 0 0 0 0
2137622 0 0 0 0 2120792
3201126 B 1 BS 1 03/08/2018 06/08/2018 21/04/1943 0 2
1 I21.3;E14.1 - - - None None None None I-4-10-III None
0 - 0 - 0 - 0 - 0 14562700 9494111
0 4 0 0 0 MARIYAH ULFAH NY D405055 75 27498 DR.
5.2.2.201806040537 4 208876 1#0##0#0#0.0#2018-08-28
08:54:44#0#11:08:03#11:08:03#00:00:00 1 41c169d7fc3cb8b54fa4878cb58ce984
0 0 989170 0 0 4549831 0 0 0 0
3955110 0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 06/08/2018 03/10/1976 0 1
0 - 0 - 0 - 0 3417600 1735908 0 1
0 0 0 TAUPIK D385740 41 15282 DR SIDDHI ANDIKA, SPU
0138R0170818V001623 0002249447962 3;JKN DR RIZKI; 5.2.2.201806040537
4 209185 1#0##0#0#0.0#2018-08-28
08:56:26#0#08:05:02#08:05:02#12:00:00 1 c87df0a056b699075161a6850a2c8b33
0 0 360584 0 0 972760 0 0 0 0 402564
0 0 0 0 0
3201126 B 1 BS 1 02/08/2018 06/08/2018 02/08/2018 3208 1
1 Q03.9;Q43.1 87.03 - - None None None None P-8-14-II None
None None None None None NEONATAL, BBL > 2499 GR DENGAN ANOMALI MAYOR
ATAU KONDISI HEREDITER (SEDANG) 10415300 0 0 - 0 - 0
- 0 - 0 10415300 19853957 0 5 1 5 0
BAYI NY KARTIKA FAJARWATI D405001 0 0 DR AULIA TANGKARI, SPA
0138R0170818V001147 0002479724155 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 208908 1#0##0#0#0.0#2018-08-28
08:56:58#0#00:00:00#00:00:00#00:00:00 1 05b2910ba56633adac6c84b8fa404d3c
0 0 1145683 0 0 7116985 0 0 0 0
6631000 0 0 0 0 4960289
3201126 B 1 BS 1 04/08/2018 06/08/2018 15/07/1980 0 1
0 - 0 - 0 - 0 - 0 4136800 3921584
0 3 0 0 0 ANTHONY DREIKING D310895 38 13899 DR
5.2.2.201806040537 4 209129 1#0##0#0#0.0#2018-08-28
08:58:17#0#18:18:33#18:18:33#00:00:00 1 87bdb5bdf7fb85fb5bc55c858f64a71d
0 0 425312 0 0 1997220 0 0 0 0
1499052 0 0 0 0 0
3201126 B 1 BS 1 03/08/2018 06/08/2018 01/11/1949 0 2
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 4814453 0 4 0 0 0 MARIA OLIVIA IRWAN
D370355 68 25112 DR ARU, SPPD 0138R0170818V001331
0001264253771 3;JKN DR RIZKI; 5.2.2.201806040537 4 208993
1#0##0#0#0.0#2018-08-28 09:00:26#0#17:49:46#17:49:46#00:00:00 1
91020b381b6ebdd38653df0d2c8ce853 0 0 269459 0 0
1425530 0 0 0 0 3119464 0 0 0 0 0
3201126 B 3 BS 1 28/07/2018 06/08/2018 17/03/1960 0 1
12174500 0 0 - 0 - 0 - 0 - 0
12174500 17101950 0 10 0 0 0 KHOLIL D404556
3;JKN DR RIZKI; 5.2.2.201806040537 4 206554 1#0##0#0#0.0#2018-
08-28 09:07:23#0#18:12:53#18:12:53#00:00:00 1
b155e93355cf6e522b35c157fcf29db9 0 4736300 3636605 0 0
6719246 0 0 0 0 1144819 0 0 0 0 864980
3201126 B 1 BS 1 28/07/2018 06/08/2018 16/12/1936 0 1
4 I20.0;K80.8;E87.1;I50.0;D64.9;J18.9;J80;E88.0
99.04;90.59;89.52;88.76;99.60 - - None None None None I-4-20-III
9856000 0 0 - 0 - 0 - 0 - 0
9856000 22101172 0 10 1 5 0 DJAMILUDDIN NASUTION H,
SH,MM D352241 81 29809 DR AGOES KOOSHARTORO SPPD-KKV 0138R0170718V010268
0000060786527 3;JKN DR RIZKI; 5.2.2.201806040537 4 206555
1#0##0#0#0.0#2018-08-28 09:42:09#0#18:26:33#18:26:33#00:00:00 1
880ad0c141db5e7cdc1946a6d493387e 0 0 489860 0 0
8739812 0 0 0 0 9081500 0 0 0 0
3790000
3201126 B 2 BS 1 02/08/2018 06/08/2018 16/04/1988 0 1
0 0 - 0 - 0 - 0 - 0 4973600
8255775 0 5 0 0 0 AHMAD AMRI D381452 30 11065
DR RIZKI; 5.2.2.201806040537 4 208820 1#0##0#0#0.0#2018-08-28
10:28:15#0#00:00:00#00:00:00#12:00:00 1 b867d6dd942d3f1839d285d941465f55
0 0 713024 0 0 1504654 0 0 0 0
3815097 0 0 0 0 2223000
3201126 B 3 BS 1 03/08/2018 06/08/2018 01/05/1971 0 2
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2400144 0 4 0 0 0 WIWIN WINARTI
D405077 47 17261 DR ARU, SPPD 0138R0170818V001141
0001014144895 3;JKN DR RIZKI; 5.2.2.201806040537 4 208906
1#0##0#0#0.0#2018-08-28 10:29:36#0#00:00:00#00:00:00#00:00:00 1
9835f1d261ee14ca4e9d8cb562380085 0 0 241100 0 0 924025
0 0 0 0 1235019 0 0 0 0 0
3201126 B 1 BS 1 02/08/2018 06/08/2018 17/05/1971 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 5522931 0 5 0 0 0 ERIKA MAI FINE PARHUSIP
0000061158429 3;JKN DR RIZKI; 5.2.2.201806040537 4 208771
1#0##0#0#0.0#2018-08-28 10:30:47#0#21:58:55#21:58:55#00:00:00 1
f88dfdad1c911be81cc4ff00578cf2c9 0 0 338858 0 0
1237260 0 0 0 0 3946813 0 0 0 0 0
3201126 B 2 BS 1 03/08/2018 06/08/2018 09/07/1947 0 2
1 E87.1;E87.6;K29.7;D64.9 99.04 - - None None None None E-4-
5405900 0 0 - 0 - 0 - 0 - 0
5405900 5431219 0 4 0 0 0 HJ. UUN UMROH
0002086474127 3;JKN DR RIZKI; 5.2.2.201806040537 4 208995
1#0##0#0#0.0#2018-08-28 10:34:16#0#18:38:25#18:38:25#12:00:00 1
256c51ff4a6bb2ef6724a92979bbbd19 0 0 539531 0 0
2569875 0 0 0 0 2193813 0 0 0 0 128000
3201126 B 2 BS 1 03/08/2018 06/08/2018 16/11/1955 0 1
1 M51.1;G82.5 - - - None None None None M-4-17-III None
(BERAT) 8643100 0 0 - 0 - 0 - 0 - 0
8643100 3858895 0 4 0 0 0 HASBULLAH D399673
3;JKN DR RIZKI; 5.2.2.201806040537 4 208996 1#0##0#0#0.0#2018-
08-28 10:36:35#0#18:43:48#18:43:48#00:00:00 1
c8ac5158980da351b2f7e52018e6b40a 0 0 830879 0 0 937065
0 0 0 0 2090951 0 0 0 0 0
3201126 B 3 BS 1 04/08/2018 06/08/2018 01/01/1961 0 2
1 E14.9;R11;R51 - - - None None None None E-4-10-I
0 - 0 3502700 1639415 0 3 0 0 0 AMIH B
AYAT d405152 57 21034 DR ZULFAN, SPPD 0138R0170818V001450
0001740400143 3;JKN DR RIZKI; 5.2.2.201806040537 4 209122
1#0##0#0#0.0#2018-08-28 10:44:57#0#16:13:06#16:13:06#00:00:00 1
2c178b4c5fcfca697b31ad1e58da2248 0 0 261764 0 0 455400
0 0 0 0 922251 0 0 0 0 0
3201126 B 2 BS 1 02/08/2018 06/08/2018 14/11/1973 0 1
- 0 - 0 - 0 - 0 5866300 5152859 0
5 0 0 0 SLAMET PUJIONO D405034 44 16332 DR HARDI
5.2.2.201806040537 4 208777 1#0##0#0#0.0#2018-08-28
10:50:19#0#22:58:47#22:58:47#00:00:00 1 9c46417d2fb6eb9af7083a9714d3fd2e
0 0 799226 0 0 1970530 0 0 0 0
2383103 0 0 0 0 0
3201126 B 1 BS 1 03/08/2018 06/08/2018 25/11/1989 0 2
1 O00.9 54.19 - - None None None None K-1-40-I None None
10909500 0 0 - 0 - 0 - 0 - 0
10909500 21207241 0 4 0 0 0 SANTY KURNIAWATI
0001279472567 3;JKN DR RIZKI; 5.2.2.201806040537 4 208997
1#1#vvip#4#10297741#0.0#2018-08-28 10:56:13#0#19:15:44#19:15:44#00:00:00
1 98b2a0836543b2fff9f56198547f137f 0 0 7170901 0 0
3257150 0 0 0 0 10616900 0 0 0 0 162290
3201126 B 2 BS 1 04/08/2018 06/08/2018 07/07/1970 0 1
1 E87.6;E27.9;I10 - - - None None None None E-4-11-I
3545800 0 0 - 0 - 0 - 0 - 0
3545800 3632572 0 3 0 0 0 KEMAS ZAINAL ARIFIN
AZHARY D297305 48 17560 DR BETTY DWI L, SPPD 0138R0170818V001413
0001272485733 3;JKN DR RIZKI; 5.2.2.201806040537 4 209067
1#0##0#0#0.0#2018-08-28 11:46:25#0#00:00:00#00:00:00#00:00:00 1
fd1210ef7be429208c7765ff3b54d6f5 0 0 372122 0 0
1481805 0 0 0 0 1778645 0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 06/08/2018 16/08/1971 0 2
- 0 - 0 - 0 - 0 2216400 2226597 0
5.2.2.201806040537 4 209524 1#0##0#0#0.0#2018-08-28
12:30:43#0#11:42:27#11:42:27#00:00:00 1 ba30ddd85220d46a3a23fedcafaf50ea
0 0 199476 0 0 1312456 0 0 0 0 714665
0 0 0 0 0
3201126 B 1 BS 1 06/08/2018 06/08/2018 29/12/1976 0 2
1 C50.9;Z51.1 99.25 - - None None None None L-4-11-II None
None None None None None TUMOR PAYUDARA (SEDANG) 6888300 0 0
- 0 - 0 - 0 - 0 6888300 5330108 0
1 0 0 0 DEASY MERIANI RUMOPA, SE d404679 41 15195
TANTIYO S;16137 5.2.2.201806040537 4 209565 1#0##0#0#0.0#2018-
08-28 12:32:54#0#12:06:48#12:06:48#00:00:00 1
7800bb46be6d00fd306f84e6fcbb8c2d 0 0 109719 0 0
3784690 0 0 0 0 1435699 0 0 0 0 0
3201126 B 1 BS 1 06/08/2018 06/08/2018 16/11/1976 0 2
- 0 - 0 - 0 - 0 3103000 4266614 0
1 0 0 0 ANNA D259488 41 15238 RACHMAWATI DR,SPB(K)ONK
0138r0170818v001721 0001079857089 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 209480 1#0##0#0#0.0#2018-08-28
12:34:26#0#11:09:18#11:09:18#00:00:00 1 81ba32350f59a705037274c21c2e07e0
0 0 279270 0 0 2621220 0 0 0 0
1366124 0 0 0 0 0
3201126 B 2 BS 1 26/07/2018 06/08/2018 09/09/2002 0 2
1 N01.3;I15.1;D64.9;E83.5;J18.9 99.04;39.27;39.95 - - None None
- 0 - 0 - 0 23198900 40333005 0 12 0
0 0 FANI MULYANI D404362 15 5799 DR OTTY MITHA S, SPA
0138R0170718V009606 0000061724327 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206048 1#0##0#0#0.0#2018-09-03
19:47:12#0#00:00:00#00:00:00#00:00:00 2 fc62843655c03c648d614c0d5982f741
0 0 4878370 0 0 21709429 0 0 0 0
13724600 0 0 0 0 20606
3201126 B 2 BS 1 03/08/2018 06/08/2018 24/04/2018 0 1
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 2774761 0 4 0 0 0 YOHANES ALBIANO HARTMANN
LIMBONG D404958 0 101 DR HUDA HILMAN 0138R0170818V001354
0002453177924 3;JKN ECHI; 5.2.2.201806040537 4 209002
1#0##0#0#0.0#2018-09-05 17:36:03#0#20:53:54#20:53:54#00:00:00 2
e952671431586ac94a91938b8bce5529 0 0 238535 0 0 473700
0 0 0 0 1722526 0 0 0 0 340000
3201126 B 3 BS 1 04/08/2018 06/08/2018 08/11/1970 0 2
- 0 8908800 6368246 0 3 0 0 0 MARYANIH
0000511439038 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209026
1#0##0#0#0.0#2018-10-09 13:14:21#0#00:00:00#00:00:00#00:00:00 1
5c51a56c165ab1c0ca0b4f50d73947d8 0 3062500 974100 0 0
1820032 0 0 0 0 442614 0 0 0 0 69000
3201126 B 3 BS 1 06/08/2018 06/08/2018 07/10/1949 0 1
0 - 0 - 0 - 0 - 0 3575600 5094240
0 1 0 0 0 ASMADIH D405286 68 25140 DR YOHANNES
DWINANDA 0138R0170818V001543 0001443511091 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 211247 1#0##0#0#0.0#2018-11-14
13:06:06#0#00:00:00#00:00:00#00:00:00 3 13854af41a0d9915d4393388c21f8ab8
0 0 283780 0 0 3600192 0 0 0 0 622268
0 0 0 0 588000
3201126 B 3 BS 1 06/08/2018 07/08/2018 07/06/1980 0 2
0 - 0 - 0 - 0 - 0 1674900 4040929
0 2 0 0 0 EVI D405300 38 13939 DR ATJANG S, SPOG
0138R0170818V001649 0002459791326 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 209302 1#0##0#0#0.0#2018-08-28
08:30:56#0#09:04:58#09:04:58#00:00:00 1 e72c6a17348978ca96d64ebe5aabf464
0 0 532980 0 0 929973 0 0 0 0
2367960 0 0 0 0 210016
3201126 B 3 BS 1 06/08/2018 07/08/2018 01/12/1939 0 2
- 0 8908800 14310178 0 2 0 0 0 JUMENA
A404072 78 28738 SRI KUNMARTINI.DR,SPPD 0138R0170818V001845
0000998483815 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209642
1#0##0#0#0.0#2018-08-28 08:36:45#0#00:00:00#00:00:00#00:00:00 1
7eb5919ae5c85ff3b70010a84ffb654a 0 0 1834760 0 0
8327076 0 0 0 0 4024680 0 0 0 0 123662
3201126 B 3 BS 1 04/08/2018 07/08/2018 04/08/2018 3000 1
None None None None NEONATAL, BBL > 2499 GR DENGAN KONGENITAL/INFEKSI
PERINATAL (RINGAN) 2480700 0 0 - 0 - 0 - 0
- 0 2480700 4901770 0 4 1 3 0 BY NY RISCA
SETIAWATI D405123 0 0 DR HANDARMI, SPA 0138R0170818V001703 123
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209460
1#0##0#0#0.0#2018-08-28 08:47:44#0#10:39:29#10:39:29#00:00:00 1
c4307efafa2570134966d5752759663d 0 0 376263 0 0
1054830 0 0 0 0 3470677 0 0 0 0 0
3201126 B 2 BS 1 02/08/2018 07/08/2018 25/03/1941 0 2
1 F03;E16.2;R64;R63.6;I69.4;E87.6;R77.0;E14.0 - - - None
None None None F-4-16-III None None None None None None GANGGUAN
OTAK ORGANIK LAIN-LAIN TERMASUK KETERBELAKANGAN MENTAL (BERAT) 10525500 0
0 - 0 - 0 - 0 - 0 10525500 19430358
0 6 0 0 0 SEMIYEM D082868 77 28254 DR. ARU
5.2.2.201806040537 4 210302 1#1#vvip#6#8904858#0.0#2018-08-28
09:11:31#0#17:22:45#17:22:45#12:00:00 1 94233c068c1143018e08e64a42a23a8a
0 0 1894962 0 0 9246896 0 0 0 0
8288500 0 0 0 0 0
3201126 B 3 BS 1 05/08/2018 07/08/2018 12/09/1957 0 2
1 K74.6;I98.3;B16.9;R77.0;D64.9 44.43 - - None None None None
(SEDANG) 4897800 0 0 - 0 - 0 - 0 - 0
4897800 7816326 0 3 0 0 0 UMYANAH D404257
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209161
1#0##0#0#0.0#2018-08-28 10:25:29#0#17:50:49#17:50:49#00:00:00 1
00810660febc5f6e37ae38785eb53e4e 0 0 1477384 0 0 979344
0 0 0 0 1862348 0 0 0 0 3497250
3201126 B 1 BS 1 30/07/2018 07/08/2018 10/04/1965 0 2
1 B37.0;R63.0;R64 - - - None None None None U-4-14-II
None None None None None None PENYAKIT MULUT DAN GIGI (SEDANG)
6183200 0 0 - 0 - 0 - 0 - 0
6183200 16044274 0 9 0 0 0 NURMINI NY D102148
53 19469 DR ARU, SPPD 0138R0170718V010386 0000059129526 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 206647
1#1#vvip#9#9861074#0.0#2018-08-28 12:45:29#0#09:11:51#09:11:51#00:00:00
1 638c119c90d9477b4b8dff01da0615a3 0 0 866250 0 0
2627399 0 0 0 0 12550625 0 0 0 0 0
3201126 B 1 BS 1 04/08/2018 07/08/2018 26/01/1993 0 2
7567300 0 0 - 0 - 0 - 0 - 0
7567300 24402943 0 4 0 0 0 ANNISA KURNIASIH
FAUZIYAH D372298 25 9321 DR NINING H, SPOG 0138R0170818V001464
0001894424938 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209135
1#1#vvip#4#16835643#0.0#2018-08-28 12:48:58#0#00:00:00#00:00:00#00:00:00
1 eb7d1eb7047a5cab1e607cbb20db0192 0 8976500 8960054 0
0 4178222 0 0 0 0 1373601 0 0 0 0
914566
3201126 B 1 BS 1 05/08/2018 07/08/2018 14/09/1936 0 2
1 A49.9;K92.1;D63.8;H81.1 99.04;90.59;89.52 - - None None None
None A-4-14-II None None None None None None PENYAKIT INFEKSI BAKTERI
DAN PARASIT LAIN-LAIN (SEDANG) 3855500 0 0 - 0 - 0
- 0 - 0 3855500 7700863 0 3 0 0 0
LARASATI D405252 81 29910 DR BETTY DWI L, SPPD
0138R0170818V001481 0000060806597 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 209147 1#0##0#0#0.0#2018-08-28
12:52:12#0#01:23:20#01:23:20#00:00:00 1 fb08ac1f74d710103d56861d836dacb5
0 0 660241 0 0 2557827 0 0 0 0
4354795 0 0 0 0 128000
3201126 B 2 BS 1 03/08/2018 07/08/2018 16/05/1956 0 2
1 I50.0;E11.9;I25.0 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
4953349 0 5 0 0 0 MURNI SAWIDJI D405046 62
22724 DR SUPONO SPJP 0138R0170818V000920 0001337669043 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 208780 1#0##0#0#0.0#2018-
08-28 12:55:36#0#00:00:00#00:00:00#00:00:00 1
02e18c5cb31e1d54879258a2012d7303 0 0 699568 0 0
1378730 0 0 0 0 2875051 0 0 0 0 0
3201126 B 1 BS 1 04/08/2018 07/08/2018 07/11/1992 0 2
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
3176200 4234087 0 4 0 0 0 FANI ANGGRAINI
D405196 25 9401 DR ARU, SPPD 0138R0170818V001455
0001295779083 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209128
1#0##0#0#0.0#2018-08-28 13:03:48#0#17:50:02#17:50:02#00:00:00 1
baeb166ff18aabbcf62786e5d908a00a 0 0 391858 0 0 724220
0 0 0 0 3081496 0 0 0 0 36513
3201126 B 1 BS 1 05/08/2018 07/08/2018 22/07/2016 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 2318673 0 3 0 0 0 HALWA AZKADINA HASANAH
0002281222754 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209150
1#0##0#0#0.0#2018-08-28 13:05:11#0#04:31:46#04:31:46#00:00:00 1
59ed724c8b829cef77db85e3fcd0ca90 0 0 269459 0 0 309525
0 0 0 0 1739689 0 0 0 0 0
3201126 B 1 BS 1 07/08/2018 07/08/2018 30/08/1988 0 2
1 K29.6;R63.0;R11 45.16 - - None None None None K-4-11-I
3247500 0 0 - 0 - 0 - 0 - 0
3247500 5687267 0 1 0 0 0 YENI HANDAYANI
0001640363466 3;JKN DR RIZKI; 5.2.2.201806040537 4 210304
1#0##0#0#0.0#2018-08-28 13:51:33#0#17:57:06#17:57:06#00:00:00 1
b34b72dc2729ad00ec9502b2c978ffe3 0 0 1015300 0 0 806253
0 0 0 0 2048464 0 0 0 0 1817250
3201126 B 3 BS 1 06/08/2018 07/08/2018 08/10/1953 0 2
1 E14.9;R07.4;K29.7 89.52 - - None None None None E-4-10-I
0 - 0 3502700 1416300 0 2 0 0 0 NINING
MASJONI D405385 64 23678 DR ELISABETH DYAH NOVIANI
0138R0170818V001951 0001771761036 3;JKN DR RIZKI; 5.2.2.201806040537
4 209797 1#0##0#0#0.0#2018-08-28
13:57:30#0#22:58:57#22:58:57#00:00:00 1 9e3b1632042d28fa3363b7031982d499
0 0 360965 0 0 673680 0 0 0 0 381655
0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 07/08/2018 15/04/1991 0 2
1 K21.9;D39.1 - - - None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 2954900 1302827
0 2 0 0 0 ALFIRITA SUSANTI D404042 27 9975 DR
ELISABETH DYAH NOVIANI 0138R0170818V001938 0000510855309 3;JKN DR RIZKI;
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13:58:35#0#00:00:00#00:00:00#00:00:00 1 2c0d0fab84d181fea043f31527b248e0
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0 0 0 0 418000
3201126 B 3 BS 1 03/08/2018 07/08/2018 14/02/2018 0 2
1 A09.9;N39.0 90.59 - - None None None None K-4-17-II None
(SEDANG) 2115600 0 0 - 0 - 0 - 0 - 0
2115600 3617920 0 5 0 0 0 FARADILLA ANANDYA
ABDULLAH D405096 0 170 DR RASTRA, SPA 0138R0170818V001669
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1#0##0#0#0.0#2018-08-28 14:46:55#0#10:04:56#10:04:56#00:00:00 1
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1571103 0 0 0 0 1491186 0 0 0 0 170000
3201126 B 2 BS 1 02/08/2018 07/08/2018 11/06/2015 0 1
1 A91;N39.0;J06.9 - - - None None None None A-4-13-II
(SEDANG) 3200900 0 0 - 0 - 0 - 0 - 0
3200900 6121931 0 6 0 0 0 ALTAF FATHURRAHMAN
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1#0##0#0#0.0#2018-08-28 17:01:51#0#06:35:38#06:35:38#00:00:00 1
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1984350 0 0 0 0 3456500 0 0 0 0 340000
3201126 B 3 BS 1 06/08/2018 07/08/2018 13/12/1962 0 1
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0 4315600 9376966 0 2 0 0 0 PARDOMUAN
SIMATUPANG TN D402120 55 20325 DR MARQUEE KENNY TUMBELAKA SPOT
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5.2.2.201806040537 4 209572 1#0##0#0#0.0#2018-08-28
17:03:45#0#12:24:21#12:24:21#00:00:00 1 f88f5b5fe2e455ce53fdb0b4f88e3512
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6311446 0 0 0 0 87328
3201126 B 1 BS 1 06/08/2018 07/08/2018 06/06/1953 0 1
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0138R0170818V001766 0000037182295 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 209575 1#0##0#0#0.0#2018-08-28
17:07:36#0#12:47:48#12:47:48#00:00:00 1 3800d3a19f5a917bfc0415a59edb42cb
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7372327 0 0 0 0 87117
3201126 B 1 BS 1 06/08/2018 07/08/2018 01/10/1996 0 2
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0 6041900 15256622 0 2 0 0 0 ANNISATUS SHALIHAH
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08:51:47#0#10:19:12#10:19:12#00:00:00 1 74b04f0133e17f696252bd3efa4ca2ad
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10787397 0 0 0 0 145000
3201126 B 3 BS 1 01/08/2018 07/08/2018 27/08/1956 0 1
1 I64;R47.0;J20.9 - - - None None None None G-4-15-II
- 0 - 0 - 0 - 0 4888600 4766980 0
7 0 0 0 EDY ACHMAD D404924 61 22619 DR HARDI PRANATA
5.2.2.201806040537 4 208269 1#0##0#0#0.0#2018-08-29
10:28:29#0#21:34:20#21:34:20#00:00:00 2 338f4228bbf4e711ca233496c2325ece
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1412136 0 0 0 0 460000
3201126 B 1 BS 1 04/08/2018 07/08/2018 27/08/1958 0 1
1 N18.5;J18.0 39.95 - - None None None None N-4-10-III None
(BERAT) 8508800 0 0 - 0 - 0 - 0 - 0
8508800 5915791 0 4 0 0 0 SUTARNO TN D362350
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209115
1#0##0#0#0.0#2018-08-29 10:34:41#0#15:11:01#15:11:01#00:00:00 1
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3201126 B 2 BS 1 06/08/2018 07/08/2018 14/07/1959 0 1
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0 4958500 4955512 0 2 0 0 0 SARJANI
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1#0##0#0#0.0#2018-08-29 10:37:21#0#00:00:00#00:00:00#00:00:00 1
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2147305 0 0 0 0 2308942 0 0 0 0 0
3201126 B 2 BS 1 03/08/2018 07/08/2018 16/08/1971 0 2
5039800 0 0 - 0 - 0 - 0 - 0
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46 17154 DR ARU, SPPD 0138R0170818V001349 0002314788805 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 209001 1#0##0#0#0.0#2018-
08-30 12:08:39#1#19:55:26#19:55:26#00:00:00 1
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3873550 0 0 0 0 1775925 0 0 0 470231
0
3201126 B 1 BS 1 05/08/2018 07/08/2018 05/02/1970 0 1
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1#0##0#0#0.0#2018-09-05 17:29:13#0#16:32:37#16:32:37#00:00:00 4
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4183608 0 0 0 0 2382250 0 0 0 0 69000
3201126 B 3 BS 1 07/08/2018 07/08/2018 04/08/2000 0 1
1 S00.9;S02.60 87.17 - - None None None None L-4-13-II
None None None None None None TRAUMA PADA KULIT, JARINGAN BAWAH KULIT
DAN PAYUDARA (SEDANG) 2801600 0 0 - 0 - 0 - 0
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KURNIANTO D405401 18 6577 DR DICKI PRATAMA 0138R0170818V002118
0001257769034 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209930
1#0##0#0#0.0#2018-11-09 13:50:48#0#10:07:28#10:07:28#00:00:00 2
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1165150 0 0 0 0 420896 0 0 0 0 290000
3201126 B 2 BS 1 05/08/2018 07/08/2018 20/05/2016 0 2
- 0 - 0 - 0 - 0 3187000 3801380 0
3 0 0 0 SHIVANA ARTAMEIFIA ZIEHA D334044 2 807
DR OTTY MITHA S, SPA 0138R0170818V001503 0002064784206 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 209153 1#0##0#0#0.0#2018-
11-14 13:02:46#0#00:00:00#00:00:00#00:00:00 1
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1671862 0 0 0 0 1515000 0 0 0 274688
0
3201126 B 1 BS 1 05/08/2018 08/08/2018 20/08/1962 0 2
1 B49;A01.4;E87.6 - - - None None None None A-4-14-III
LAIN-LAIN (BERAT) 4626600 0 0 - 0 - 0 - 0 -
0 4626600 5087668 0 4 0 0 0 FARIDA TETTY M
TAMPUBOLON D405279 55 20439 DR BETTY DWI L, SPPD 0138R0170818V001527
0000036530043 3;JKN DR RIZKI; 5.2.2.201806040537 4 209165
1#0##0#0#0.0#2018-08-28 11:26:11#0#00:00:00#00:00:00#00:00:00 1
c818936dffc7396ae27eae5c2a45e80a 0 0 645380 0 0
1740450 0 0 0 0 2701838 0 0 0 0 0
3201126 B 1 BS 1 06/08/2018 08/08/2018 17/08/1937 0 1
1 C20;K59.0 - - - None None None None K-4-10-I None
0 - 0 - 0 - 0 - 0 6881700 4419977
0 3 0 0 0 TN ABDUL BARI D401257 80 29574 DR.
5.2.2.201806040537 4 209795 1#0##0#0#0.0#2018-08-28
11:31:40#0#00:00:00#00:00:00#00:00:00 1 a7ffe20bbaf1a302e5e7895f3a4b139a
0 0 741170 0 0 1801650 0 0 0 0
1877157 0 0 0 0 0
3201126 B 1 BS 1 02/08/2018 08/08/2018 22/12/1974 0 1
1 I95.9;I61.9;N18.5 38.95 - - None None None None N-1-12-III
- 0 27065300 28343479 0 7 0 0 0 DEDI
0001652973129 3;JKN DR RIZKI; 5.2.2.201806040537 4 208764
1#0##0#0#0.0#2018-08-28 11:41:35#0#20:13:42#20:13:42#00:00:00 1
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16750149 0 0 0 0 6413000 0 0 0 0
2691453
3201126 B 2 BS 1 04/08/2018 08/08/2018 12/07/1962 0 2
1 I61.9;G81.9;M51.1;I10 87.03;87.44 - - None None None None
0 - 0 6183900 4710464 0 5 0 0 0 ANAH
0002457485548 3;JKN DR RIZKI; 5.2.2.201806040537 4 209143
1#0##0#0#0.0#2018-08-28 11:43:22#0#00:00:00#00:00:00#00:00:00 1
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1554483 0 0 0 0 2354161 0 0 0 0 0
3201126 B 1 BS 1 06/08/2018 08/08/2018 09/04/2001 0 2
1 R11;R63.0 - - - None None None None K-4-17-I None
(RINGAN) 2405100 0 0 - 0 - 0 - 0 - 0
2405100 3960102 0 3 0 0 0 SONIA AULIA D023406
3;JKN DR RIZKI; 5.2.2.201806040537 4 210300 1#0##0#0#0.0#2018-
08-28 11:48:08#0#17:06:26#17:06:26#00:00:00 1
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1332255 0 0 0 0 2282572 0 0 0 0 0
3201126 B 2 BS 1 02/08/2018 08/08/2018 26/09/2003 0 2
2507900 0 0 - 0 - 0 - 0 - 0
2507900 5222821 0 7 0 0 0 ZULFA AQILAH YUSFAIZA
D064404 14 5424 DR RASTRA, SPA 0138R0170818V000909
0001264234588 3;JKN DR RIZKI; 5.2.2.201806040537 4 208775
1#0##0#0#0.0#2018-08-28 13:44:32#0#00:00:00#00:00:00#12:00:00 1
2a1d36e1276283364692f62d55fc569c 0 0 278711 0 0
1206430 0 0 0 0 3397680 0 0 0 0 340000
3201126 B 1 BS 1 07/08/2018 08/08/2018 06/08/2018 3500 1
0 - 0 5910700 3088143 0 2 0 0 0 BAYI
NY. KARTIKA D405400 0 1 DR AULIA TANGKARI, SPA
0138R0170818V002167 0002480632874 3;JKN DR RIZKI; 5.2.2.201806040537
4 210084 1#0##0#0#0.0#2018-08-28
13:46:25#0#12:17:40#12:17:40#00:00:00 1 e45329e75f46311a9c6e3a49ea08077d
0 0 584963 0 0 399152 0 0 0 0
1790028 0 0 0 0 314000
3201126 B 1 BS 1 06/08/2018 08/08/2018 27/03/1988 0 2
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0138R0170818V001952 0001640252349 3;JKN DR RIZKI; 5.2.2.201806040537
4 209796 1#0##0#0#0.0#2018-08-28
13:50:20#0#00:00:00#00:00:00#00:00:00 1 f5957bd4770b5beeb2b6d606d7ea0c7f
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2963381 0 0 0 0 0
3201126 B 2 BS 1 06/08/2018 08/08/2018 30/07/2018 3000 1
0 - 0 - 0 - 0 - 0 5045200 4518880
0 3 1 0 0 BAYI NY ZENIA S D405355 0 7 DR
AULIA TANGKARI, SPA 0138R0170818V001929 0002469369519 3;JKN DR RIZKI;
5.2.2.201806040537 4 209789 1#0##0#0#0.0#2018-08-28
13:53:48#0#00:00:00#00:00:00#00:00:00 1 4fa6c87c03a870db828f533d20b0362b
0 0 507086 0 0 160666 0 0 0 0
2059128 0 0 0 0 1792000
3201126 B 1 BS 1 06/08/2018 08/08/2018 24/06/1970 0 1
7464200 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.2.201806040537 4 209794 1#0##0#0#0.0#2018-
08-28 14:06:48#0#00:00:00#00:00:00#12:00:00 2
ff22a8acbc00c467a2bc89567bf1ec0f 0 5896000 2142976 0 0
1755044 0 0 0 0 715816 0 0 0 0 34500
3201126 B 3 BS 1 07/08/2018 08/08/2018 19/08/1981 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 3013483 0 2 0 0 0 IIN SUPRIATIN
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1#0##0#0#0.0#2018-08-28 14:08:09#0#00:00:00#00:00:00#12:00:00 1
10469dab9b38b53197ac2cffcc56e879 0 0 424889 0 0
1549450 0 0 0 0 749144 0 0 0 0 290000
3201126 B 2 BS 1 07/08/2018 08/08/2018 06/11/1960 0 2
(RINGAN) 5178700 0 0 - 0 - 0 - 0 - 0
5178700 11544991 0 2 0 0 0 MINTARSIH NY
0001895122045 3;JKN DR RIZKI; 5.2.2.201806040537 4 210218
1#0##0#0#0.0#2018-08-28 14:11:22#0#00:00:00#00:00:00#00:00:00 1
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1134175 0 0 0 0 781280 0 0 0 0 69000
3201126 B 1 BS 1 04/08/2018 08/08/2018 12/05/1957 0 2
1 K30;I11.9 - - - None None None None K-4-18-I None
2033900 0 0 - 0 - 0 - 0 - 0
2033900 6777001 0 5 0 0 0 FRANSISCA SULASTRI
0001469500672 3;JKN DR RIZKI; 5.2.2.201806040537 4 209005
1#0##0#0#0.0#2018-08-28 14:21:10#0#00:00:00#00:00:00#00:00:00 1
4b1c44fab50cb1d83f7c6b2aba5908b6 0 0 289051 0 0
2113595 0 0 0 0 4374355 0 0 0 0 0
3201126 B 1 BS 1 07/08/2018 08/08/2018 04/10/1965 0 2
(RINGAN) 6041900 0 0 - 0 - 0 - 0 - 0
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52 19300 DR MOHAMMAD AULIA HERDIYANA,SPOT 0138T0170818V002153
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1#0##0#0#0.0#2018-08-28 14:28:38#0#11:31:08#11:31:08#00:00:00 1
575de95c4be170b09acc58b69780d55d 0 6833600 1752151 0 0
1454630 0 0 0 0 735477 0 0 0 0 69000
3201126 B 3 BS 1 05/08/2018 08/08/2018 24/10/2008 0 1
2090000 0 0 - 0 - 0 - 0 - 0
2090000 2310028 0 4 0 0 0 MUHAMMAD FADLY REYNALDY
D405273 9 3572 DR A WIDYA 0138R0170818V001522 0001771731977
3;JKN DR RIZKI; 5.2.2.201806040537 4 209163 1#0##0#0#0.0#2018-
08-28 14:29:45#0#19:22:08#19:22:08#00:00:00 1
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756305 0 0 0 0 177123 0 0 0 0 170000
3201126 B 2 BS 1 05/08/2018 08/08/2018 07/04/2008 0 1
1743400 0 0 - 0 - 0 - 0 - 0
1743400 2822452 0 4 0 0 0 TRY LAKSONO P
0001258248251 3;JKN DR RIZKI; 5.2.2.201806040537 4 209164
1#0##0#0#0.0#2018-08-28 14:32:28#0#20:09:09#20:09:09#00:00:00 1
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0 0 0 0 1725646 0 0 0 0 0
3201126 B 2 BS 1 05/08/2018 08/08/2018 19/02/2017 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 4976233 0 4 0 0 0 SHAQUEENA ALFATHUNISA
0002326686669 3;JKN DR RIZKI; 5.2.2.201806040537 4 209154
1#0##0#0#0.0#2018-08-28 14:35:39#0#00:00:00#00:00:00#00:00:00 1
4998bdb8ed128eb00524498c4fcdd51e 0 0 238535 0 0
2366150 0 0 0 0 2371548 0 0 0 0 0
3201126 B 3 BS 1 05/08/2018 08/08/2018 26/07/1984 0 1
0 0 - 0 - 0 - 0 - 0 2954900
1721748 0 4 0 0 0 NURHALI D402136 34 12428
DR SOEGIONO, SPPD 0138R0170818V001529 0001463769898 3;JKN DR RIZKI;
5.2.2.201806040537 4 209166 1#0##0#0#0.0#2018-08-28
14:45:12#0#00:00:00#00:00:00#00:00:00 1 218e3f2ed119c6c73e243b1a7ea2fca4
0 0 317960 0 0 476150 0 0 0 0 927638
0 0 0 0 0
3201126 B 2 BS 1 05/08/2018 08/08/2018 26/07/1993 0 2
6486300 0 0 - 0 - 0 - 0 - 0
6486300 12768480 0 4 0 0 0 CYNTHIA DEWI
D405272 25 9141 DR MAMAN H, SPOG 0138r0170818v001530
0001767348358 3;JKN DR RIZKI; 5.2.2.201806040537 4 209167
1#0##0#0#0.0#2018-08-28 14:58:36#0#00:12:07#00:12:07#00:00:00 1
6d93b38342ef7cac16a9458ed61fdcb9 0 5635900 2136253 0 0
3195387 0 0 0 0 1295821 0 0 0 0 505119
3201126 B 2 BS 1 28/07/2018 08/08/2018 01/08/1945 0 2
1 K45.0;E87.1;N39.0 54.11 - - None None None None K-1-40-II
(SEDANG) 10628600 0 0 - 0 - 0 - 0 - 0
10628600 26117028 0 12 0 0 0 SURJATI,NY D261480
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1#0##0#0#0.0#2018-08-28 15:05:59#0#00:00:00#00:00:00#00:00:00 1
34802a524b1a15074ea9fbecaa3d5c66 0 9511100 6036076 0 0
8722077 0 0 0 0 1577900 0 0 0 0 269875
3201126 B 3 BS 1 07/08/2018 08/08/2018 10/04/1975 0 2
1 N18.5;J91 39.27 - - None None None None N-1-12-III None
DIALISIS (BERAT) 19332400 0 0 - 0 - 0 - 0 -
0 19332400 10732559 0 2 0 0 0 AMAMI D405416
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1#0##0#0#0.0#2018-08-28 15:34:22#0#16:40:58#16:40:58#00:00:00 1
08c996dfeb0b0133d30ec40150036573 0 3438800 3919480 0 0
2577149 0 0 0 0 728130 0 0 0 0 69000
3201126 B 3 BS 1 08/08/2018 08/08/2018 20/06/1955 0 1
- 0 8908800 7687909 0 1 0 0 0 RUBANI
0001229175033 3;JKN DR RIZKI; 5.2.2.201806040537 4 210321
1#0##0#0#0.0#2018-08-29 09:35:08#0#00:00:00#00:00:00#00:00:00 1
9f87cb4c801e507388d2007b1d5bcfa9 0 2889500 974100 0 0
3260862 0 0 0 0 528947 0 0 0 0 34500
3201126 B 3 BS 1 06/08/2018 08/08/2018 30/06/1959 0 2
1 N18.5;I50.0;D63.8;E11.9;K59.0;A49.9 99.04;38.95 - - None None
- 0 - 0 - 0 8908800 14382468 0 3 0
0 0 ENTING D398768 59 21587 SRI KUNMARTINI.DR,SPPD
0138R0170818V001804 0001212360309 3;JKN DR RIZKI; 5.2.2.201806040537
4 209578 1#0##0#0#0.0#2018-08-29
09:37:32#0#13:56:25#13:56:25#00:00:00 1 62250ff33c8851bbe266af2906822203
0 3253500 1906030 0 0 8175677 0 0 0 0
966909 0 0 0 0 80352
3201126 B 3 BS 1 08/08/2018 08/08/2018 16/02/1989 0 1
None None None None None GANGGUAN METABOLIK BAWAAN (RINGAN) 3395100
0 0 - 0 - 0 - 0 - 0 3395100
2682907 0 1 0 0 0 RICO ADITYA D260481 29 10765
DR LIDYA SANTALIA 0138R0170818V002736 0001623403765 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 210548 1#0##0#0#0.0#2018-09-03
15:47:35#0#12:40:16#12:40:16#00:00:00 1 0bca6cf6a04fbcd1e5f851650b32cf6c
0 0 72640 0 0 1411750 0 0 0 0 482517
0 0 0 0 716000
3201126 B 3 BS 1 08/08/2018 08/08/2018 02/07/1943 0 1
4202600 0 0 - 0 - 0 - 0 - 0
4202600 1763725 0 1 0 0 0 M SOLEH D234638
TANTIYO S;16137 5.2.2.201806040537 4 210550 1#0##0#0#0.0#2018-
09-03 15:51:46#0#12:57:48#12:57:48#00:00:00 1
efde9caf5592e36712e4d02c675238cf 0 0 210130 0 0 433211
0 0 0 0 404384 0 0 0 0 716000
3201126 B 3 BS 1 08/08/2018 08/08/2018 15/01/2018 0 2
3613200 0 0 - 0 - 0 - 0 - 0
3613200 3061850 0 1 0 0 0 BAYI NY NITA SUKAMTI
D390131 0 205 DR LIDYA SANTALIA 0138R0170818V002708
0002322328419 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 210539
1#0##0#0#0.0#2018-09-03 16:07:30#0#11:45:41#11:45:41#12:00:00 1
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1633882 0 0 0 0 489308 0 0 0 0 758000
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0
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1#0##0#0#0.0#2018-11-02 16:15:33#0#11:31:08#11:31:08#00:00:00 2
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3201126 B 3 BS 1 30/07/2018 08/08/2018 14/05/1957 0 2
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5345423
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(BERAT) 3046500 0 0 - 0 - 0 - 0 - 0
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ROIKHAN HAROWI SPTHT-KL-M.KES 0138R0170818V002715 0000202525378 3;JKN DR
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15:24:57#0#12:04:38#12:04:38#00:00:00 1 1f4348fee97c2b519f86c5672cf42f5a
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4910928 0 0 0 0 83828
3201126 B 2 BS 1 07/08/2018 09/08/2018 16/04/2006 0 2
5405900 0 0 - 0 - 0 - 0 - 0
5405900 2552803 0 3 0 0 0 SHAFIRA KURNICOVA A
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1#0##0#0#0.0#2018-08-28 15:27:15#0#00:00:00#00:00:00#00:00:00 1
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3201126 B 2 BS 1 07/08/2018 09/08/2018 16/01/2000 0 2
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0 0 - 0 - 0 - 0 - 0 3187000
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3;JKN DR RIZKI; 5.2.2.201806040537 4 210305 1#0##0#0#0.0#2018-
08-28 15:29:18#0#18:27:37#18:27:37#00:00:00 2
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0 0 0 0 1510083 0 0 0 0 0
3201126 B 3 BS 1 08/08/2018 09/08/2018 17/06/1973 0 1
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4340500 6425225 0 2 0 0 0 AGUS GUMILAR
0138R0170818V002987 0000490444593 3;JKN DR RIZKI; 5.2.2.201806040537
4 210658 1#0##0#0#0.0#2018-08-28
15:30:41#0#00:00:00#00:00:00#00:00:00 1 6d92b6c8754196dac221874e1e9f48ab
0 3265800 868100 0 0 1739749 0 0 0 0
446342 0 0 0 0 105234
3201126 B 1 BS 1 04/08/2018 09/08/2018 31/12/1951 0 2
1 I64;G81.9;N18.3;E78.5;I12.0 87.03;87.44;88.76 - - None None
6844000 0 0 - 0 - 0 - 0 - 0
6844000 8594521 0 6 0 0 0 NANIK CHAERONY
0000089875866 3;JKN DR RIZKI; 5.2.2.201806040537 4 210301
1#0##0#0#0.0#2018-08-28 15:36:48#0#17:08:22#17:08:22#12:00:00 1
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2530700 0 0 0 0 4946758 0 0 0 0 0
3201126 B 2 BS 1 31/07/2018 09/08/2018 17/08/1962 0 1
1 I50.0;J91;R18;R77.0;D64.9 96.71;34.91;93.94 - - None None
- 0 - 0 34963000 46941904 0 10 1 6 0
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0138R0170718V010844 0002097419152 3;JKN DR RIZKI; 5.2.2.201806040537
4 207140 1#0##0#0#0.0#2018-08-28
15:41:44#0#00:00:00#00:00:00#12:00:00 1 c33d838a261823725aae46937038d75f
0 0 4167578 0 0 27360326 0 0 0 0
8484000 0 0 0 0 6930000
3201126 B 3 BS 1 09/08/2018 09/08/2018 01/09/1986 0 2
(RINGAN) 2300600 0 0 - 0 - 0 - 0 - 0
2300600 3915501 0 1 0 0 0 SEPTIA D405583
DR RIZKI; 5.2.2.201806040537 4 210666 1#0##0#0#0.0#2018-08-28
15:47:11#0#00:00:00#00:00:00#00:00:00 1 ad5f7cd0942c42b6a92c1dbb7ea3629b
0 0 750168 0 0 641679 0 0 0 0
2489154 0 0 0 0 34500
3201126 B 3 BS 1 06/08/2018 09/08/2018 11/09/1965 0 2
1 D25.9;D63.0 99.04;68.69 - - None None None None W-1-20-II
10326200 0 0 - 0 - 0 - 0 - 0
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52 19322 DR FAHMIALDI, SPOG 0138R0170818V001942 0001430453766
3;JKN DR RIZKI; 5.2.2.201806040537 4 209792 1#0##0#0#0.0#2018-
08-28 15:48:52#0#00:00:00#00:00:00#00:00:00 1
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2853839 0 0 0 0 676688 0 0 0 0 109394
3201126 B 2 BS 1 06/08/2018 09/08/2018 21/09/1957 0 1
4 E14.1;G93.4;N18.9;J18.9 38.95;96.71 - - None None None None
- 0 34963000 43554336 0 4 1 4 0 SRI LANGGENG
D405285 60 22234 DR ARU, SPPD 0138R0170818V001534
0001094228627 3;JKN DR RIZKI; 5.2.2.201806040537 4 209168
1#0##0#0#0.0#2018-08-28 16:00:03#0#00:00:00#00:00:00#00:00:00 1
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22718626 0 0 0 0 9135750 0 0 0 0
4067656
3201126 B 2 BS 1 08/08/2018 09/08/2018 03/05/1962 0 1
1 I64;J81;E11.1;J80;K92.0 96.71;87.03 - - None None None None
- 0 34963000 15101252 0 2 1 2 24 HENDRI
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0001792476933 3;JKN DR RIZKI; 5.2.2.201806040537 4 210657
1#0##0#0#0.0#2018-08-28 16:08:20#0#22:12:35#22:12:35#00:00:00 1
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6603450 0 0 0 0 3710632 0 0 0 0
1487000
3201126 B 2 BS 1 07/08/2018 09/08/2018 05/05/1979 0 1
1 I13.2;D63.8;E87.5;A49.9 99.04;39.95 - - None None None None
4973600 0 0 - 0 - 0 - 0 - 0
4973600 8401076 0 3 1 1 0 NINING RUSTINI
0002437157665 3;JKN DR RIZKI; 5.2.2.201806040537 4 209799
1#0##0#0#0.0#2018-08-28 16:10:43#0#00:51:05#00:51:05#00:00:00 2
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2830835 0 0 0 0 3982853 0 0 0 0 878000
3201126 B 3 BS 1 08/08/2018 09/08/2018 22/07/1954 0 1
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
4132100 2120086 0 2 0 0 0 MADRAIS D328121
3;JKN DR RIZKI; 5.2.2.201806040537 4 210659 1#0##0#0#0.0#2018-
08-28 16:11:56#0#00:00:00#00:00:00#12:00:00 1
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1267500 0 0 0 0 427697 0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 09/08/2018 01/06/1976 0 1
2392700 0 0 - 0 - 0 - 0 - 0
2392700 2938276 0 4 0 0 0 SAAMAN d405338
42 15406 DR BETTY DWI L, SPPD 0138r0170818v001893 0000512865325
3;JKN DR RIZKI; 5.2.2.201806040537 4 209784 1#0##0#0#0.0#2018-
08-28 16:12:42#0#16:49:59#16:49:59#00:00:00 1
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1343405 0 0 0 0 1270224 0 0 0 0 0
3201126 B 3 BS 1 07/08/2018 09/08/2018 24/12/1956 0 2
(SEDANG) 4132100 0 0 - 0 - 0 - 0 - 0
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3;JKN DR RIZKI; 5.2.2.201806040537 4 210306 1#0##0#0#0.0#2018-
08-28 16:27:13#0#00:00:00#00:00:00#00:00:00 1
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1880840 0 0 0 0 940896 0 0 0 0 0
3201126 B 1 BS 1 04/08/2018 09/08/2018 31/12/1946 0 2
1 I61.9;G81.9;I10;I11.9 87.03;87.44 - - None None None None
0 - 0 7214600 7558202 0 6 0 0 0
ARJAN,HJ D357882 71 26149 DR NURUL KOMARI SPS
0138R0170818V001453 0000061012179 3;JKN DR RIZKI; 5.2.2.201806040537
4 209126 1#0##0#0#0.0#2018-08-28
16:33:53#0#16:54:00#16:54:00#12:00:00 1 44bb07d670440257dab65ac48aa3e781
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4860962 0 0 0 0 128000
3201126 B 1 BS 1 04/08/2018 09/08/2018 16/03/1959 0 2
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(SEDANG) 8537100 0 0 - 0 - 0 - 0 - 0
8537100 10939628 0 6 0 0 0 MARLITJE PALELE
0001340158959 3;JKN DR RIZKI; 5.2.2.201806040537 4 209117
1#0##0#0#0.0#2018-08-28 16:37:25#0#15:37:17#15:37:17#00:00:00 1
7219e0e8215d821511e090a4f02eec80 0 0 906709 0 0
3671625 0 0 0 0 6215177 0 0 0 0 146117
3201126 B 1 BS 1 06/08/2018 09/08/2018 21/07/1947 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4057651 0 4 0 0 0 ANIDAR A LATIF,NY
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1#0##0#0#0.0#2018-08-28 16:39:42#0#00:00:00#00:00:00#00:00:00 1
1d749ca4ef6e00e19a32c27f0f7c1b08 0 0 456317 0 0 531380
0 0 0 0 3069954 0 0 0 0 0
3201126 B 2 BS 1 06/08/2018 09/08/2018 04/03/1951 0 1
1 I13.1;N12;E11.9 39.95 - - None None None None N-4-10-I
GINJAL (RINGAN) 3976600 0 0 - 0 - 0 - 0 -
0 3976600 6433929 0 4 0 0 0 SLAMET
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1#0##0#0#0.0#2018-08-29 08:44:39#0#14:09:33#14:09:33#00:00:00 2
24ca4db4878a98aadba26596c7a0ac81 0 0 378548 0 0
2117220 0 0 0 0 3938161 0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 09/08/2018 02/01/1979 0 1
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4504900 0 0 - 0 - 0 - 0 - 0
4504900 3618618 0 4 0 0 0 SUTEJO D405346
3;JKN DR RIZKI; 5.2.2.201806040537 4 209788 1#0##0#0#0.0#2018-
08-29 08:49:56#0#00:00:00#00:00:00#00:00:00 1
c1a6952990a820f8ed256616c788279e 0 0 540404 0 0
1423482 0 0 0 0 1314732 0 0 0 0 340000
3201126 B 2 BS 1 05/08/2018 09/08/2018 14/04/1944 0 1
1 I63.9;E14.9;G81.9;I10 87.03;87.44 - - None None None None
0 - 0 8291400 5907255 0 5 0 0 0 MUCH
SUPAAT D405248 74 27141 DR NURUL KOMARI SPS 0138R0170818V001476
0000060851204 3;JKN DR RIZKI; 5.2.2.201806040537 4 209144
1#0##0#0#0.0#2018-08-29 08:51:44#0#00:00:00#00:00:00#00:00:00 1
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2509745 0 0 0 0 2432456 0 0 0 0 0
3201126 B 1 BS 1 07/08/2018 09/08/2018 11/06/1959 0 2
1 A01.0;K30;J02.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
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KUSMIYULIA D054471 59 21607 DR BETTY DWI L, SPPD 0138R0170818V001960
0001320207276 3;JKN DR RIZKI; 5.2.2.201806040537 4 209800
1#0##0#0#0.0#2018-08-29 08:52:55#0#01:16:41#01:16:41#12:00:00 1
151e665a4169a7e766a533390597cddb 0 0 338858 0 0 669140
0 0 0 0 2605390 0 0 0 0 0
3201126 B 3 BS 1 08/08/2018 09/08/2018 23/07/1972 0 2
1 L04.0 40.3 - - None None None None D-1-20-I None None
LAIN (RINGAN) 5164200 0 0 - 0 - 0 - 0 -
0 5164200 6711792 0 2 0 0 0 SUKINI
0138R0170818V002582 0000512473847 3;JKN DR RIZKI; 5.2.2.201806040537
4 210324 1#0##0#0#0.0#2018-08-29
08:56:01#0#07:31:46#07:31:46#00:00:00 1 4c332c6c08fd9a65cab61edc12daad27
0 3062500 1492848 0 0 1520175 0 0 0 0
465089 0 0 0 0 171180
3201126 B 1 BS 1 08/08/2018 09/08/2018 12/06/1966 0 2
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0001458312794 3;JKN DR RIZKI; 5.2.2.201806040537 4 210570
1#0##0#0#0.0#2018-08-29 08:58:28#0#14:29:21#14:29:21#00:00:00 1
074881fc0de7dcfe2c28cb91f8de571c 0 10062000 9672120 0 0
38275189 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 3 BS 1 03/08/2018 09/08/2018 01/06/1958 0 2
1 L03.9;A41.9;M62.46;E87.6;E88.0 86.28 - - None None None
None L-4-12-III None None None None None None PERADANGAN
KULIT/CELLULITIS (BERAT) 7665300 0 0 - 0 - 0 -
0 - 0 7665300 18850037 0 7 0 0 0 NYAI
D405032 60 21978 BENNY TUMBALEKA SPOT 0138R0170818V000915
0001014196779 3;JKN DR RIZKI; 5.2.2.201806040537 4 208779
1#0##0#0#0.0#2018-08-29 09:07:03#0#00:28:56#00:28:56#00:00:00 1
3ed082535e053c9bb632b47a370161c9 0 0 2582912 0 0
3979564 0 0 0 0 9903400 0 0 0 0
2384161
3201126 B 1 BS 1 05/08/2018 09/08/2018 11/07/2018 0 2
1 P71.1 - - - None None None None E-4-10-I None None
(RINGAN) 4903800 0 0 - 0 - 0 - 0 - 0
4903800 9950412 0 5 1 2 0 BAYI NY MEYLAN E. VAN
BONE RUNTUWENE D405225 0 25 DR AULIA TANGKARI, SPA
0138R0170818V001509 0002472836027 3;JKN DR RIZKI; 5.2.2.201806040537
4 209156 1#0##0#0#0.0#2018-08-29
09:32:35#0#00:00:00#00:00:00#00:00:00 1 10e907bbac2ec2689817d0bdd6a58c73
0 0 842120 0 0 4268330 0 0 0 0
4581962 0 0 0 0 258000
3201126 B 1 BS 1 07/08/2018 09/08/2018 08/11/1974 0 1
GINJAL (SEDANG) 5784900 0 0 - 0 - 0 - 0 -
0 5784900 5686184 0 3 0 0 0 ERWAN HENDRA
RUSMAN D228271 43 15978 SRI KUNMARTINI.DR,SPPD 0138R0170818V002499
0001622060886 3;JKN DR RIZKI; 5.2.2.201806040537 4 210315
1#0##0#0#0.0#2018-08-29 09:39:44#0#22:16:00#22:16:00#00:00:00 1
50795f85918dcef2959e63d16f92b080 0 0 573641 0 0
1560800 0 0 0 0 3551743 0 0 0 0 0
3201126 B 3 BS 1 04/08/2018 09/08/2018 20/12/1998 0 2
1 O41.0;O48;O63.1;O82.0;Z37.0 74.0 - - None None None None
(RINGAN) 4986800 0 0 - 0 - 0 - 0 - 0
4986800 7863525 0 6 0 0 0 CHAERUNNISA D405159
3;JKN DR RIZKI; 5.2.2.201806040537 4 210650 1#0##0#0#0.0#2018-
08-29 09:41:05#0#00:00:00#00:00:00#00:00:00 1
ced21a7497bada3b6221fb82b3bd7718 0 3587500 1548172 0 0
2121285 0 0 0 0 555436 0 0 0 0 51132
3201126 B 2 BS 1 05/08/2018 09/08/2018 15/10/1964 0 2
2061500 0 0 - 0 - 0 - 0 - 0
2061500 6443393 0 5 0 0 0 SURATMI D388491
3;JKN DR RIZKI; 5.2.2.201806040537 4 209152 1#0##0#0#0.0#2018-
08-29 09:56:26#0#12:21:56#12:21:56#12:00:00 1
400b59e4ad49948b00e27973b815741c 0 0 334492 0 0
3136371 0 0 0 0 2972530 0 0 0 0 0
3201126 B 2 BS 1 07/08/2018 09/08/2018 31/07/2018 0 1
0 - 0 - 0 - 0 - 0 5045200 3225872
0 3 0 0 0 BAYI NY SINTA AGUSTIN D404833 0 7
RIZKI; 5.2.2.201806040537 4 210196 1#0##0#0#0.0#2018-08-29
09:58:09#0#00:00:00#00:00:00#00:00:00 1 006dca4a6e458f8470bc6c803acb746f
0 0 454068 0 0 163766 0 0 0 0
2268038 0 0 0 0 340000
3201126 B 2 BS 1 08/08/2018 09/08/2018 11/09/1973 0 1
- 0 - 0 10690500 9639866 0 2 0 0 0
CIPTANTO D405498 44 16402 SRI KUNMARTINI.DR,SPPD
0138R0170818V002982 0001134972775 3;JKN DR RIZKI; 5.2.2.201806040537
4 210654 1#0##0#0#0.0#2018-08-29
11:10:30#0#00:00:00#00:00:00#00:00:00 1 a99646c625ffa52d273b2bcee00e0f86
0 4496100 2276624 0 0 2084814 0 0 0 0
656645 0 0 0 0 125683
3201126 B 3 BS 1 08/08/2018 09/08/2018 06/04/1952 0 2
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0 2 0 0 0 SRI T KOESMIRATIH E W,HJ. D206887 66
DR RIZKI; 5.2.2.201806040537 4 210647 1#0##0#0#0.0#2018-08-29
11:52:00#0#00:00:00#00:00:00#00:00:00 1 868bf0706a97777cb9018e00144b90e2
0 0 111295 0 0 707650 0 0 0 0 375516
0 0 0 0 128000
3201126 B 1 BS 1 07/08/2018 09/08/2018 02/08/2018 23000 1
5118000 0 0 - 0 - 0 - 0 - 0
5118000 3644191 0 3 0 0 0 BY NY KHUZAIMAH
0002479676196 3;JKN DR RIZKI; 5.2.2.201806040537 4 210642
1#0##0#0#0.0#2018-08-29 13:37:27#0#17:46:14#17:46:14#00:00:00 1
f027ae1c8ef3ea1019a050a802cf3a05 0 0 513620 0 0 160666
0 0 0 0 2001905 0 0 0 0 968000
3201126 B 1 BS 1 05/08/2018 09/08/2018 21/06/1946 0 1
None B-4-14-I None None None None None None GANGGUAN SALURAN EMPEDU
LAIN-LAIN (RINGAN) 5879800 0 0 - 0 - 0 - 0
- 0 5879800 7838244 0 5 0 0 0 BAMBANG
ISTIDJAB D405254 72 26343 DR. ARU ARIADNO, SPPD 0138R0170818V001491
0000040068843 3;JKN irvan; 5.2.2.201806040537 4 209151
1#0##0#0#0.0#2018-09-04 13:46:23#0#00:00:00#00:00:00#00:00:00 1
6f2b256c1e799575a0237631f32fd1cb 0 0 968362 0 0
2426100 0 0 0 0 4443782 0 0 0 0 0
3201126 B 3 BS 1 28/07/2018 09/08/2018 18/12/1955 0 1
1 I63.9;I21.9;N18.5 99.04;39.95;38.95 - - None None None None
- 0 - 0 19332400 51570758 0 13 1 9 0
MUHAMAD NUR D384762 62 22868 DR MAYSAMIRAWATI SPS
0138R0170718V010215 0001469578083 3;JKN irvan; 5.2.2.201806040537
4 218990 1#0##0#0#0.0#2018-09-04
13:59:04#0#00:00:00#00:00:00#12:00:00 1 1783784e1c7747597d7ca7ce4ae7ea42
0 10836500 4339138 0 0 23227291 0 0 0 0
5504125 0 0 0 0 7663704
3201126 B 3 BS 1 09/08/2018 09/08/2018 05/03/1980 0 1
1 H10.5 - - - None None None None H-4-12-I None None
None None None None GANGGUAN MATA LAIN-LAIN (RINGAN) 3474500 0
0 - 0 - 0 - 0 - 0 3474500 895841
0 1 0 0 0 RODIA D364386 38 14036 DR ANGGA TOMALA
PUTRA 0138R0170818V003236 0002131998502 3;JKN ikwalni; 5.2.2.201806040537
4 212931 1#0##0#0#0.0#2018-09-06
17:08:06#0#00:00:00#00:00:00#12:00:00 1 f48e027a6bb2842f1a46d1df92aca1a0
0 0 312705 0 0 89530 0 0 0 0 365606
0 0 0 0 128000
3201126 B 2 BS 1 08/08/2018 09/08/2018 02/06/1959 0 1
1 I25.0;E11.9 88.55;36.07 - - YY02 None None None I-1-40-I
(RINGAN) 12871000 0 0 PCI 10725800 - 0 - 0 -
0 23596800 56192096 0 2 0 0 0 SUYANTO
0002260297754 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 210656
1#0##0#0#0.0#2018-11-14 14:00:08#0#00:00:00#00:00:00#00:00:00 2
6d177190b96ee7487d9c7aa3ad29a564 0 8571000 8318100 0 0
30468994 0 0 0 0 1226000 0 0 0 0
7608002
3201126 B 3 BS 1 07/08/2018 09/08/2018 17/09/2000 0 1
4 S06.5;S06.1;S82.31;R40.0 - - - None None None None
G-4-24-II None None None None None None TRAUMA KEPALA (SEDANG)
3802000 0 0 - 0 - 0 - 0 - 0
3802000 11255472 0 3 1 2 0 ANDRE MEHDI NUGRAHA
0002265969846 3;JKN irvan; 5.2.2.201806040537 4 210679
1#0##0#0#0.0#2018-11-15 11:15:11#0#00:00:00#00:00:00#00:00:00 2
c8ab03fc9c4078c8154095262f20294e 0 0 813067 0 2426000
4660935 0 0 0 0 2619000 0 0 0 736470
0
3201126 B 3 BS 1 07/08/2018 09/08/2018 17/09/2000 0 1
4 S06.5;S06.1;S82.31;R40.0 - - - None None None None
G-4-24-II None None None None None None TRAUMA KEPALA (SEDANG)
3802000 0 0 - 0 - 0 - 0 - 0
3802000 11255472 0 3 1 2 0 ANDRE MEHDI NUGRAHA
0002265969846 3;JKN Adinda; 5.2.2.201806040537 4 210679
1#0##0#0#0.0#2018-12-06 12:03:47#0#00:00:00#00:00:00#00:00:00 5
5a10c47eea970d505745e7c54bbf23ac 0 0 813067 0 2426000
4660935 0 0 0 0 2619000 0 0 0 736470
0
3201126 B 1 BS 1 09/08/2018 10/08/2018 24/09/2011 0 1
- 0 - 0 - 0 - 0 5424200 11429395 0
2 0 0 0 MUHAMMAD LUTFI D215290 6 2511 DR HUDA
HILMAN 0138R0170818V003007 0001662332073 3;JKN DR RIZKI;
5.2.2.201806040537 4 210669 1#0##0#0#0.0#2018-08-29
10:43:39#0#02:48:47#02:48:47#00:00:00 1 d61ed0a7d0b6779b8a7eac59d595cabb
0 0 1243832 0 0 2770646 0 0 0 0
7269917 0 0 0 0 145000
3201126 B 3 BS 1 07/08/2018 10/08/2018 05/10/2017 0 2
(RINGAN) 1718000 0 0 - 0 - 0 - 0 - 0
1718000 2319851 0 4 0 0 0 INDIRA WAHYUNI
0002422211859 3;JKN DR RIZKI; 5.2.2.201806040537 4 210311
1#0##0#0#0.0#2018-08-29 10:46:33#0#00:00:00#00:00:00#00:00:00 1
26b0dcebe4f80ed1bb8b2244509e1f98 0 0 207620 0 0 798965
0 0 0 0 1143266 0 0 0 0 170000
3201126 B 2 BS 1 08/08/2018 10/08/2018 31/05/2016 0 1
2061500 0 0 - 0 - 0 - 0 - 0
2061500 1665385 0 3 0 0 0 CHRISTOPHER GEORGE TOE
0002218446516 3;JKN DR RIZKI; 5.2.2.201806040537 4 210660
1#0##0#0#0.0#2018-08-29 10:47:35#0#23:11:50#23:11:50#12:00:00 1
b5916a7481eacb8c74c79838799e8eff 0 0 238535 0 0 281900
0 0 0 0 1144950 0 0 0 0 0
3201126 B 2 BS 1 06/08/2018 10/08/2018 05/11/2015 0 2
6093000 0 0 - 0 - 0 - 0 - 0
6093000 5509447 0 5 0 0 0 SAFIYA CASYA AZZAHRA
0002208243172 3;JKN DR RIZKI; 5.2.2.201806040537 4 209768
1#0##0#0#0.0#2018-08-29 10:49:09#0#00:00:00#00:00:00#00:00:00 1
726932db69a03760519221f9b260f136 0 0 443231 0 0
2154785 0 0 0 0 2911431 0 0 0 0 0
3201126 B 3 BS 1 07/08/2018 10/08/2018 16/05/2017 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 2132531 0 4 0 0 0 AIRI RINJANI
D405422 1 448 DR RASTRA, SPA 0138R0170818V002148
0002231023814 3;JKN DR RIZKI; 5.2.2.201806040537 4 210013
1#0##0#0#0.0#2018-08-29 10:50:01#0#11:10:31#11:10:31#00:00:00 1
46ffccff2681bc6295c5ce816425e980 0 0 207620 0 0 707400
0 0 0 0 1217511 0 0 0 0 0
3201126 B 3 BS 1 09/08/2018 10/08/2018 06/03/1958 0 1
1 E16.2;E11.9;E87.5;A49.9 - - - None None None None E-4-
0 - 0 4894400 1372139 0 2 0 0 0
DARIM .HD D405587 60 22071 SRI KUNMARTINI.DR,SPPD
0138R0170818V003005 0001461760929 3;JKN DR RIZKI; 5.2.2.201806040537
4 210667 1#0##0#0#0.0#2018-08-29
10:52:34#0#00:00:00#00:00:00#00:00:00 1 aad55cbf890f7a7bd88661edaadd04ee
0 0 368243 0 0 362130 0 0 0 0 641766
0 0 0 0 0
3201126 B 1 BS 1 08/08/2018 10/08/2018 10/04/1979 0 1
- 0 12472300 13644986 0 3 0 0 0 RISKI
PARULIAN D405545 39 14365 SRI KUNMARTINI.DR,SPPD 0138R0170818V002991
0002065332846 3;JKN DR RIZKI; 5.2.2.201806040537 4 210662
1#0##0#0#0.0#2018-08-29 10:54:23#0#23:13:02#23:13:02#00:00:00 1
ea79b3061cefd54128b420534555d230 0 7159200 2647238 0 0
2786007 0 0 0 0 918663 0 0 0 0 133878
3201126 B 1 BS 1 07/08/2018 10/08/2018 10/06/1999 0 2
1 A01.0;K30;G43.9 - - - None None None None A-4-14-I
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 4051719 0 4 0 0 0 BUNZU
PRADENIA CHANDRA D405464 19 6998 DR BETTY DWI L, SPPD
0138R0170818V003395 0001719256072 3;JKN DR RIZKI; 5.2.2.201806040537
4 211016 1#0##0#0#0.0#2018-08-29
10:58:33#0#00:00:00#00:00:00#00:00:00 1 411cbf0ff1e830e7d3751821d408a7fe
0 0 302498 0 0 679655 0 0 0 0
3069566 0 0 0 0 0
3201126 B 3 BS 1 06/08/2018 10/08/2018 03/02/1958 0 1
1 S32.00;G82.2 - - - None None None None M-4-17-II
(SEDANG) 5157800 0 0 - 0 - 0 - 0 - 0
5157800 2900641 0 5 0 0 0 SAPRI D397624 60
22099 DR HARDI PRANATA SPS 0138R0170818V001546 0001222886474 3;JKN
DR RIZKI; 5.2.2.201806040537 4 209360 1#0##0#0#0.0#2018-08-29
11:06:17#0#09:36:21#09:36:21#00:00:00 1 9b763f0f8f0f7b501097f7144703c9e3
0 0 570202 0 0 799677 0 0 0 0
1530762 0 0 0 0 0
3201126 B 1 BS 1 07/08/2018 10/08/2018 24/03/1956 0 1
0 0 - 0 - 0 - 0 - 0 4615000
3594547 0 4 0 0 0 FAREL SIMARMATA d402382 62
DR RIZKI; 5.2.2.201806040537 4 210316 1#0##0#0#0.0#2018-08-29
11:07:34#0#00:00:00#00:00:00#00:00:00 1 9da0872737f6c1003991d2b38653d673
0 0 345275 0 0 645115 0 0 0 0
2604157 0 0 0 0 0
3201126 B 2 BS 1 06/08/2018 10/08/2018 21/05/1968 0 2
0 0 - 0 - 0 - 0 - 0 9917100
13900524 0 5 0 0 0 INDRA PURWANINGSIH D403856
50 18339 DR AFRA FONDA SPOG 0138R0170818V001904 0002080585271
3;JKN DR RIZKI; 5.2.2.201806040537 4 209785 1#0##0#0#0.0#2018-
08-29 11:12:01#0#00:00:00#00:00:00#00:00:00 1
f714951477517412313c45b6d3901d4f 0 5478200 3623156 0 0
3377533 0 0 0 0 935380 0 0 0 0 486255
3201126 B 2 BS 1 09/08/2018 10/08/2018 31/12/1952 0 2
- 0 10690500 15822253 0 2 0 0 0 SRI
HARTIDJAH D395438 65 23962 SRI KUNMARTINI.DR,SPPD 0138R0170818V003357
0000166686221 3;JKN DR RIZKI; 5.2.2.201806040537 4 210989
1#0##0#0#0.0#2018-08-29 11:13:28#0#15:27:30#15:27:30#00:00:00 1
e455d6a365663687d780a1faa245758e 0 4439100 2276624 0 0
7965076 0 0 0 0 1061101 0 0 0 0 80352
3201126 B 1 BS 1 08/08/2018 10/08/2018 03/05/2018 0 2
2405100 0 0 - 0 - 0 - 0 - 0
2405100 3128710 0 3 0 0 0 CLN BY NY AUZIA TANIA
UTAMI D405542 0 97 DR KHARNINA, SPA 0138R0170818V002973
0002455843858 3;JKN DR RIZKI; 5.2.2.201806040537 4 211579
1#1#vvip#3#723610#0.0#2018-08-29 11:23:11#0#00:00:00#00:00:00#00:00:00 1
5b7ff7f105d0bd37baebc32d3f1ce342 0 0 53000 0 0 289028
0 0 0 0 2786682 0 0 0 0 0
3201126 B 3 BS 1 07/08/2018 10/08/2018 13/03/1973 0 2
1 K83.0;C22.9;J90;R18 - - - None None None None B-4-
(BERAT) 6563200 0 0 - 0 - 0 - 0 - 0
6563200 5252559 0 4 0 0 0 NERI D404926 45
3;JKN DR RIZKI; 5.2.2.201806040537 4 209798 1#0##0#0#0.0#2018-
08-29 11:24:47#0#00:00:00#00:00:00#00:00:00 1
c82ca81b25d2933f24c76d32b9f211a0 0 0 493964 0 0
3318970 0 0 0 0 1439625 0 0 0 0 0
3201126 B 3 BS 1 03/08/2018 10/08/2018 01/06/1952 0 1
1 N18.5;I50.0;E16.2;J22 89.52;87.44 - - None None None None
- 0 4132100 21633861 0 8 1 4 0 SATAR TN
0000511411612 3;JKN DR RIZKI; 5.2.2.201806040537 4 208992
1#0##0#0#0.0#2018-08-29 11:28:10#0#16:45:48#16:45:48#00:00:00 1
74df02a9087d0ba3f232d0f035a3d2cf 0 0 351242 0 0
8597244 0 0 0 0 8913375 0 0 0 0
3772000
3201126 B 2 BS 1 08/08/2018 10/08/2018 04/10/1975 0 1
- 0 51950600 56120321 0 3 0 0 0 TOMMY WIJAYA
0002296960661 3;JKN DR RIZKI; 5.2.2.201806040537 4 210652
1#0##0#0#0.0#2018-08-29 11:31:43#0#00:00:00#00:00:00#00:00:00 1
fb1c0c09f5cd01ab4e291460cea12dd0 0 9004000 8244960 0 0
30076361 0 0 0 0 1226000 0 0 0 0
7569000
3201126 B 3 BS 1 07/08/2018 10/08/2018 01/02/1942 0 1
0 0 - 0 - 0 - 0 - 0 4144700
2288419 0 4 0 0 0 SAMAD D334279 76 27946 DR
5.2.2.201806040537 4 210317 1#0##0#0#0.0#2018-08-29
11:32:55#0#23:11:20#23:11:20#00:00:00 2 fab912e2d05e63915a18b9f42c1da139
0 0 573219 0 0 750490 0 0 0 0 964710
0 0 0 0 0
3201126 B 2 BS 1 07/08/2018 10/08/2018 15/06/1949 0 2
1 I13.2;A49.9;E11.9 - - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 4290800
3634954 0 4 0 0 0 KASEM D400582 69 25255 SRI
5.2.2.201806040537 4 210109 1#0##0#0#0.0#2018-08-29
11:36:16#0#14:05:14#14:05:14#00:00:00 1 a3681a5d17cf57c72d5af73d98bd71ec
0 0 709388 0 0 641765 0 0 0 0
2283801 0 0 0 0 0
3201126 B 3 BS 1 08/08/2018 10/08/2018 30/06/1997 0 2
1452800 0 0 - 0 - 0 - 0 - 0
1452800 1201505 0 3 0 0 0 NURUL ZHAHRO
0000512917525 3;JKN DR RIZKI; 5.2.2.201806040537 4 210547
1#0##0#0#0.0#2018-08-29 11:36:46#0#12:39:15#12:39:15#00:00:00 1
892e32b1f07c61486f46db636348db19 0 0 183752 0 0 124150
0 0 0 0 893603 0 0 0 0 0
3201126 B 1 BS 1 08/08/2018 10/08/2018 05/05/1953 0 1
1 I50.0;I25.0;J45.9 89.52 - - None None None None I-4-12-I
0 0 - 0 - 0 - 0 - 0 5005900
5963750 0 3 0 0 0 SYAMSUDIN D370559 65 23836
DR RIZKI; 5.2.2.201806040537 4 210320 1#0##0#0#0.0#2018-08-29
11:39:52#0#00:00:00#00:00:00#00:00:00 1 986fd961553b0c76fb2bf1d977fb6f9e
0 0 1056843 0 0 2147755 0 0 0 0
2759152 0 0 0 0 0
3201126 B 1 BS 1 08/08/2018 10/08/2018 19/05/1967 0 1
1 I95.9;D62;A49.9 99.04 - - None None None None I-4-24-II
(SEDANG) 9013300 0 0 - 0 - 0 - 0 - 0
9013300 10994809 0 3 0 0 0 DEDE RUSTANDY
0002206052943 3;JKN DR RIZKI; 5.2.2.201806040537 4 210322
1#0##0#0#0.0#2018-08-29 11:41:49#0#00:00:00#00:00:00#00:00:00 1
dd6c1e099ddd9596e8199cf8e41ec928 0 0 954330 0 0
5422192 0 0 0 0 3272287 0 0 0 0
1346000
3201126 B 2 BS 1 07/08/2018 10/08/2018 29/06/1994 0 2
LAIN-LAIN (RINGAN) 2722500 0 0 - 0 - 0 - 0
- 0 2722500 3051062 0 4 0 0 0 ASRI SIFA
FAUZIA D405471 24 8805 DR BETTY DWI L, SPPD 0138R0170818V002493
0002249964099 3;JKN DR RIZKI; 5.2.2.201806040537 4 210310
1#0##0#0#0.0#2018-08-29 11:42:37#0#00:00:00#00:00:00#00:00:00 1
b67d0e358e019de4f4aa2092844cd576 0 0 298025 0 0 714935
0 0 0 0 2038102 0 0 0 0 0
3201126 B 3 BS 1 08/08/2018 10/08/2018 03/07/1981 0 2
1 N18.5;I50.0;J18.0;D63.8;E11.9 39.27;99.04 - - None None None
0 - 0 - 0 19332400 11209663 0 3 0 0
0 LINAH MARLINAH D405534 37 13550 SRI KUNMARTINI.DR,SPPD
0138R0170818V002931 0001270614791 3;JKN DR RIZKI; 5.2.2.201806040537
4 210643 1#0##0#0#0.0#2018-08-29
11:44:33#0#00:00:00#00:00:00#00:00:00 1 42df36b5bf19376160ee3e8da0ba5d69
0 3525300 4074139 0 0 2734296 0 0 0 0
759342 0 0 0 0 116586
3201126 B 3 BS 1 09/08/2018 10/08/2018 04/05/1960 0 1
DIALISIS (RINGAN) 4340500 0 0 - 0 - 0 - 0 -
0 4340500 8689473 0 2 0 0 0 TRI MULYONO
0138R0170818V003432 0001381870337 3;JKN DR RIZKI; 5.2.2.201806040537
4 211230 1#0##0#0#0.0#2018-08-29
11:47:15#0#10:43:13#10:43:13#00:00:00 1 ed7a2ee185f9b2b9deb38c2bb974308c
0 3062500 921100 0 0 4031051 0 0 0 0
594470 0 0 0 0 80352
3201126 B 3 BS 1 09/08/2018 10/08/2018 13/06/1964 0 1
- 0 8908800 9410970 0 2 0 0 0 YUNUS HARI
SAPTONO D405593 54 19780 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170818V003284 0001461154825 3;JKN DR RIZKI; 5.2.2.201806040537
4 210906 1#0##0#0#0.0#2018-08-29
14:10:32#0#13:50:03#13:50:03#00:00:00 1 8496f505ff9f15992d3e3d72b74e170b
0 3438800 1853030 0 0 3390352 0 0 0 0
641671 0 0 0 0 87117
3201126 B 1 BS 1 07/08/2018 10/08/2018 03/12/1989 0 2
0 - 0 - 0 - 0 - 0 6981500 22626993
0 4 0 0 0 AMANDARA VENTRINA D274316 28 10474 ENDANG
TRI KURNIADEWI DR SPOG 0138R0170818V002500 0001374117704 3;JKN TANTIYO
S;16137 5.2.2.201806040537 4 210314 1#1#vvip#4#15645493#0.0#2018-
08-30 12:03:38#1#00:00:00#00:00:00#00:00:00 1
dacd6af621913a46e6780bd002be3072 0 8613234 8407961 0
1378000 3954970 0 0 0 0 0 0 0 0 272828
0
3201126 B 2 BS 1 07/08/2018 10/08/2018 28/08/1988 0 2
0 - 0 - 0 - 0 - 0 5984100 20882941
0 4 0 0 0 SURAEDAH D102705 29 10936 DR FERRI
SABARUDDIN SPOG 0138R0170818V002491 0001315550823 3;JKN irene;
5.2.2.201806040537 4 210308 1#1#vvip#4#14898841#0.0#2018-08-30
15:35:50#1#00:00:00#00:00:00#00:00:00 4 15b8e3cec54f9b868181b20a5034c26c
0 0 7346920 0 1200000 5442285 0 0 0 0
6688170 0 0 0 205566 0
3201126 B 1 BS 1 02/08/2018 10/08/2018 22/02/1954 0 1
1 I82.8;L03.9 88.67;39.50 - - None None None None I-1-20-I
(RINGAN) 21509500 0 0 - 0 - 0 - 0 - 0
21509500 45372630 0 9 0 0 0 THAMRIN D405016
DR RIZKI; 5.2.2.201806040537 4 208774 1#0##0#0#0.0#2018-08-30
15:47:47#0#22:40:49#22:40:49#00:00:00 1 3dd022ed44ce4efb081b1746437e828c
0 9283000 4569995 0 0 27566735 0 0 0 0
1577900 0 0 0 0 2375000
3201126 B 1 BS 1 09/08/2018 10/08/2018 13/04/1951 0 2
1 I61.5;J81;I11.0;J18.0;E11.9 87.03;87.44;99.60;88.72 - - None
None None None G-4-13-III None None None None None None PERDARAHAN
INTRA KRANIAL BUKAN TRAUMATIK (BERAT) 8556600 0 0 - 0 -
0 - 0 - 0 8556600 6249184 0 2 1 0
0 MATHILDA SIREGAR D037568 67 24590 DR HARDI PRANATA SPS
0138R0170818V003441 0002058186633 3;JKN irvan; 5.2.2.201806040537
4 211027 1#0##0#0#0.0#2018-09-04
10:02:08#0#23:44:04#23:44:04#00:00:00 2 30db6b645bfcb56beb3f823f3708d0f8
0 0 1115567 0 0 2715892 0 0 0 0
1659725 0 0 0 0 758000
3201126 B 1 BS 1 09/08/2018 10/08/2018 16/08/1967 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 10786043 0 2 0 0 0 MARGONO
0138R0170818V003287 0001644199075 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 210911 1#0##0#0#0.0#2018-10-10
09:24:20#0#13:52:38#13:52:38#00:00:00 1 9b7c23513cbb409a8fa26cbc31270718
0 0 1263953 0 6468200 2253261 0 0 0 0
705629 0 0 0 95000 0
3201126 B 3 BS 1 27/07/2018 10/08/2018 09/02/1957 0 1
1 I21.1;N18.5;J18.9;R57.2;D63.8 38.95;39.95;99.04 - - None None
- 0 - 0 - 0 19332400 72156489 0 15 1
4 0 ISMAIRIN D402869 61 22448 DR BAMBANG DWIPUTRA SPJP
0138R0170718V009969 0001386302859 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206347 1#0##0#0#0.0#2018-10-10
09:50:25#0#00:00:00#00:00:00#00:00:00 2 63f4cf8217835e48c9fb6e9c9f36dfd7
0 15535500 4368466 0 0 40303360 0 0 0 0
4347875 0 0 0 0 7601288
3201126 B 3 BS 1 08/08/2018 10/08/2018 22/03/1995 0 2
0 - 0 - 0 - 0 - 0 2168300 2318002
0 3 0 0 0 DINDA VIRO NULAILA D279763 23 8540
S;16137 5.2.2.201806040537 4 210562 1#0##0#0#0.0#2018-10-10
09:57:32#0#13:59:17#13:59:17#00:00:00 1 a81845a0863c21eb0fcaa3dcd6315397
0 0 248147 0 0 1085210 0 0 0 0 807000
0 0 0 177645 0
3201126 B 2 BS 1 08/08/2018 10/08/2018 07/08/1953 0 2
0 - 0 - 0 - 0 1821000 3825984 0 3
0 0 0 IDA FARIDA NY D143498 65 23742 DR MAYSAMIRAWATI
5.2.2.201806040537 4 210641 1#0##0#0#0.0#2018-10-10
10:01:51#0#17:35:35#17:35:35#00:00:00 1 bcf61f7a630d823a35fcb615d29d1591
0 0 216890 0 0 2025296 0 0 0 0
1307500 0 0 0 276298 0
3201126 B 1 BS 1 10/08/2018 11/08/2018 06/02/1966 0 2
1 M70.58;M65.98 80.76;83.5 - - None None None None M-1-
50-I None None None None None None PROSEDUR JARINGAN LUNAK (RINGAN)
7464200 0 0 - 0 - 0 - 0 - 0
7464200 11781699 0 2 0 0 0 RINI INDAH WULANDARI
d315636 52 19178 DR RAY HENDRY, SPOT 0138R0170818V003632
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1#0##0#0#0.0#2018-08-29 13:36:30#0#11:03:15#11:03:15#12:00:00 1
a99f9c0b6c460c918c2a684f57fb61fd 0 0 2089976 0 0
1917358 0 0 0 0 7705365 0 0 0 0 69000
3201126 B 3 BS 1 10/08/2018 11/08/2018 25/02/2012 0 2
0 - 0 - 0 - 0 - 0 3900700 6593049
0 2 0 0 0 INKA FEBIOLA MAULIDA D395855 6 2358
DR RISMAN S, SPTHT 0138R0170818V003451 0002096609916 3;JKN DR
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13:40:43#0#00:00:00#00:00:00#00:00:00 1 f721ebe4cb9900a081d3a0a4f08f8a72
0 0 1145196 0 0 1704502 0 0 0 0
3600321 0 0 0 0 143030
3201126 B 3 BS 1 10/08/2018 11/08/2018 07/03/1955 0 2
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 12311211 0 2 0 0 0 ROHAYAH NY
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4 211283 1#0##0#0#0.0#2018-08-29
13:43:55#0#11:15:13#11:15:13#00:00:00 1 17ee8516c6a0519c7826a85cc30b7aec
0 3062500 921100 0 0 7354501 0 0 0 0
881406 0 0 0 0 91704
3201126 B 3 BS 1 10/08/2018 11/08/2018 28/10/1949 0 1
- 0 8908800 8042070 0 2 0 0 0 MADI
0002236914371 3;JKN DR RIZKI; 5.2.2.201806040537 4 211581
1#0##0#0#0.0#2018-08-29 15:23:15#0#00:00:00#00:00:00#00:00:00 1
6dd4d3416113678bbdc9f55a4c15e55b 0 3618800 1906030 0 0
1831295 0 0 0 0 602117 0 0 0 0 83828
3201126 B 1 BS 1 09/08/2018 11/08/2018 04/06/1953 0 1
- 0 12472300 16952743 0 3 0 0 0 ANDA
RUSKANDA D288907 65 23807 SRI KUNMARTINI.DR,SPPD 0138R0170818V002996
0002375510062 3;JKN DR RIZKI; 5.2.2.201806040537 4 210663
1#0##0#0#0.0#2018-08-29 15:25:01#0#00:00:00#00:00:00#00:00:00 1
13e672688d5cef2e275a44fcf96a9de4 0 6587000 2647238 0 0
5545686 0 0 0 0 1994433 0 0 0 0 178386
3201126 B 3 BS 1 10/08/2018 11/08/2018 23/02/1979 0 1
(RINGAN) 4340500 0 0 - 0 - 0 - 0 - 0
4340500 12008018 0 2 0 0 0 TRI GIARTO D405669
0001209774903 3;JKN DR RIZKI; 5.2.2.201806040537 4 211306
1#0##0#0#0.0#2018-08-29 15:40:05#0#11:27:40#11:27:40#00:00:00 1
bad05a287926a2f4ebf58440dfbd9f4e 0 3062500 921100 0 0
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3201126 B 3 BS 1 11/08/2018 11/08/2018 01/07/1964 0 2
4 N18.5;R40.2 89.52;99.60 - - None None None None N-4-10-II
GINJAL (SEDANG) 4132100 0 0 - 0 - 0 - 0 -
0 4132100 3259230 0 1 0 0 0 SUNANI
0000508741413 3;JKN DR RIZKI; 5.2.2.201806040537 4 211661
1#0##0#0#0.0#2018-08-29 15:50:49#0#10:13:19#10:13:19#00:00:00 3
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2405767 0 0 0 0 502221 0 0 0 0 0
3201126 B 1 BS 1 01/08/2018 11/08/2018 03/03/1997 0 1
1 J93.1;J98.1;A16.1 34.91;87.49;90.59 - - None None None None
J-4-20-II None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK
(SEDANG) 9001900 0 0 - 0 - 0 - 0 - 0
9001900 22647436 0 11 0 0 0 BINSAR PARULIAN
ARITONANG D404880 21 7821 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170818V000401 0002201145917 3;JKN DR RIZKI; 5.2.2.201806040537
4 208257 1#0##0#0#0.0#2018-08-30
10:52:28#0#17:54:01#17:54:01#00:00:00 1 cd44b62151e3e9db06cfab2773f41153
0 11769500 2403475 0 0 7062766 0 0 0 0
1226000 0 0 0 0 185695
3201126 B 1 BS 1 08/08/2018 11/08/2018 12/04/1979 0 2
0 - 0 - 0 - 0 - 0 6981500 19553209
0 4 0 0 0 DIAN EKAWATI E087990 39 14363 DR
5.2.2.201806040537 4 210649 1#1#vvip#4#12571709#0.0#2018-08-30
11:42:40#1#00:00:00#00:00:00#00:00:00 1 69ee9f327571f7d15d78e3b3d942adec
0 0 7207600 0 0 4016245 0 0 0 0
6706170 0 0 0 1623194 0
3201126 B 2 BS 1 09/08/2018 11/08/2018 10/03/1959 0 2
9351000 0 0 - 0 - 0 - 0 - 0
9351000 8980688 0 3 0 0 0 MARHAYA D404781
3;JKN DR RIZKI; 5.2.2.201806040537 4 210671 1#0##0#0#0.0#2018-
08-30 16:04:30#0#00:00:00#00:00:00#00:00:00 1
47a367b150ea18c2baf0f9d3f3f723ac 0 4854100 1154272 0 0
2289794 0 0 0 0 613522 0 0 0 0 69000
3201126 B 1 BS 1 09/08/2018 11/08/2018 05/02/1969 0 1
1 T82.4;I13.1 87.49;39.27;39.95;89.52 - - None None None None
- 0 - 0 12472300 13528607 0 3 0 0 0
M YUNUS D395655 49 18082 DR DEDY PRATAMA SPBV
0138R0170818V003173 0001457654657 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 210796 1#0##0#0#0.0#2018-09-03
17:35:21#0#10:09:50#10:09:50#00:00:00 1 115ac8bb29da4690b86841820e812cc1
0 7159200 2619183 0 0 1396377 0 0 0 0
2264241 0 0 0 0 89606
3201126 B 3 BS 1 09/08/2018 11/08/2018 01/12/1957 0 1
1 I13.1;T82.4;I11.0 90.59;89.52;39.59;39.95;99.21 - - None None
None None I-1-20-III None None None None None None PROSEDUR SISTIM
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MURTOWO D389563 60 22166 DR IRFIANSYAH LESMANA DR SPBTKV
0138R0170818V003009 0000511824982 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 210670 1#0##0#0#0.0#2018-09-03
18:10:54#0#00:00:00#00:00:00#12:00:00 1 af1268bf244ab35c77572790f17d40cb
0 5219300 6019202 0 0 4112291 0 0 0 0
2355251 0 224119 0 0 0
3201126 B 2 BS 1 09/08/2018 11/08/2018 27/06/1998 0 1
None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN (RINGAN)
18436700 0 0 - 0 - 0 - 0 - 0
18436700 12625321 0 3 0 0 0 RUSDIAN D405475
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 210994
1#0##0#0#0.0#2018-09-03 19:37:18#0#00:00:00#00:00:00#00:00:00 2
763eb97a4414844d44888bde01a3a433 0 5326100 5215276 0 95000
1162989 0 0 0 0 0 0 0 0 825956 0
3201126 B 2 BS 1 29/07/2018 11/08/2018 06/07/1955 0 1
1 D69.6;D64.9;B50.9;Q44.6;E87.1;E87.6;E88.0 90.59;89.52;88.76 - -
None None None None D-4-11-II None None None None None None
GANGGUAN PEMBEKUAN DARAH (SEDANG) 8717800 0 0 - 0 -
0 - 0 - 0 8717800 12997332 0 14 0 0
0 DAMIRI D404633 63 23034 DR ARU, SPPD
0138R0170718V010401 0001338865817 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 206660 1#0##0#0#0.0#2018-09-03
19:40:56#0#09:22:13#09:22:13#00:00:00 2 d19c4d820cd0a78736ad8f4b877490cd
0 0 706832 0 0 4831207 0 0 0 0
7459293 0 0 0 0 0
3201126 B 2 BS 1 10/08/2018 11/08/2018 17/05/1985 0 2
1 K80.2;B17.9;A01.0;K76.0 88.76 - - None None None None B-4-
(BERAT) 7875800 0 0 - 0 - 0 - 0 - 0
7875800 2891019 0 2 0 0 0 TITI ANDRIYAH
0001262519763 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211204
1#0##0#0#0.0#2018-09-03 19:44:14#0#10:29:05#10:29:05#12:00:00 3
bf63639076ceb9f95049d4a392e7e261 0 0 429362 0 0
1236525 0 0 0 0 1225132 0 0 0 0 0
3201126 B 1 BS 1 08/08/2018 11/08/2018 31/07/1985 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 21896280 0 4 0 0 0 NOVA ZULIYANTI
0001634916183 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 210655
1#0##0#0#0.0#2018-09-03 19:45:10#0#00:00:00#00:00:00#00:00:00 3
24925111b78db714fe2af0f679485949 0 8671000 8811200 0 0
2882914 0 0 0 0 1308600 0 0 0 0 222566
3201126 B 1 BS 1 08/08/2018 11/08/2018 22/07/1989 0 2
6981500 0 0 - 0 - 0 - 0 - 0
6981500 22810581 0 4 0 0 0 YESHY IKE NURYA DEWI
b209449 29 10609 DR NINING H, SPOG 0138R0170818V002595
0001642731669 3;JKN irvan; 5.2.2.201806040537 4 210331
15#0##0#0#0.0#2018-09-04 09:37:19#0#07:52:41#07:52:41#00:00:00 1
eff5d817cffbcebda6259472cc684d35 0 9686000 8748200 0 0
2845215 0 0 0 0 1308600 0 0 0 0 222566
3201126 B 3 BS 1 09/08/2018 11/08/2018 26/02/1968 0 1
1 K30;I10;R10.4 88.76 - - None None None None K-4-18-I
(RINGAN) 1452800 0 0 - 0 - 0 - 0 - 0
1452800 2513135 0 3 0 0 0 MARWAN D405566
3;JKN irvan; 5.2.2.201806040537 4 210664 5#0##0#0#0.0#2018-
09-04 09:46:50#0#00:00:00#00:00:00#00:00:00 1
a36dd4089caee4596bca19c72dd960cf 0 0 360584 0 0
1173140 0 0 0 0 979411 0 0 0 0 0
3201126 B 1 BS 1 09/08/2018 11/08/2018 13/08/1953 0 1
1 I13.1;A49.9;J18.0 87.49;90.59;89.52 - - None None None None
- 0 8508800 3866365 0 3 0 0 0 ENANG KOMARA
D317681 64 23737 DR ARU, SPPD 0138R0170818V003399
0001744707881 3;JKN irvan; 5.2.2.201806040537 4 211017
11#0##0#0#0.0#2018-09-04 09:51:38#0#00:00:00#00:00:00#00:00:00 1
bab6f451b49c00b8ade4ec47a56fb282 0 0 470546 0 0 773879
0 0 0 0 2621940 0 0 0 0 0
3201126 B 2 BS 1 09/08/2018 11/08/2018 21/08/2017 0 1
1 A09.9 93.94;87.44 - - None None None None K-4-17-I None
(RINGAN) 2061500 0 0 - 0 - 0 - 0 - 0
2061500 4448180 0 3 0 0 0 RAFI HILAL MAULANA
0002278028158 3;JKN irvan; 5.2.2.201806040537 4 210665
6#0##0#0#0.0#2018-09-04 10:12:27#0#00:00:00#00:00:00#00:00:00 1
be0e9aaf63cc7d6f1a71c63cd9d26911 0 0 840941 0 0
1605237 0 0 0 0 1832002 0 0 0 0 170000
3201126 B 1 BS 1 07/08/2018 11/08/2018 31/07/1986 0 2
1 O60.1;O46.9;O99.0;Z37.5;O82.0 99.04;74.0 - - None None None
None O-6-10-III None None None None None None OPERASI PEMBEDAHAN
CAESAR (BERAT) 12674100 0 0 - 0 - 0 - 0 -
0 12674100 17630799 0 5 0 0 0 LUKLUK MAWADDAH
D279611 32 11695 DR MARLY, SPOG 0138R0170818V002165
0000203619464 3;JKN irvan; 5.2.2.201806040537 4 210078
24#0##0#0#0.0#2018-09-04 10:24:00#0#11:54:52#11:54:52#00:00:00 2
8aa1a5f2724e78a00782a401ef4d7562 0 7641900 3369939 0 0
5172585 0 0 0 0 1194417 0 0 0 0 251958
3201126 B 2 BS 1 09/08/2018 11/08/2018 12/06/2015 0 1
(RINGAN) 2722500 0 0 - 0 - 0 - 0 - 0
2722500 2366011 0 3 0 0 0 HASBI AGUNG PUTRA
0002200284505 3;JKN irvan; 5.2.2.201806040537 4 210668
7#0##0#0#0.0#2018-09-04 10:27:19#0#00:00:00#00:00:00#00:00:00 1
b313da9e7d8a752c98387768eea77d56 0 0 298025 0 0 372200
0 0 0 0 1695786 0 0 0 0 0
3201126 B 2 BS 1 07/08/2018 11/08/2018 23/05/1974 0 1
0 0 - 0 - 0 - 0 - 0 4426600
7845358 0 5 0 0 0 RAHMAT SUBHI D405466 44
irvan; 5.2.2.201806040537 4 210541 25#0##0#0#0.0#2018-09-04
10:34:30#0#11:55:57#11:55:57#00:00:00 1 ce220800c35f62bbbaa78fcc66a2a0c8
0 0 504394 0 0 4168650 0 0 0 0
2856748 0 0 0 0 315566
3201126 B 2 BS 1 07/08/2018 11/08/2018 10/03/1956 0 2
1 E16.2;E11.6;E87.6 87.44 - - None None None None E-4-10-II
0 - 0 5873300 8894392 0 5 1 1 0 AISAH
D405403 62 22795 DR ARU, SPPD 0138R0170818V002087
0001881584357 3;JKN irvan; 5.2.2.201806040537 4 209843
16#0##0#0#0.0#2018-09-04 10:47:21#0#09:03:25#09:03:25#00:00:00 1
d8146bc56a7f23b55a740e6e7d3855eb 0 0 581597 0 0
3705919 0 0 0 0 3500876 0 0 0 0
1106000
3201126 B 1 BS 1 08/08/2018 11/08/2018 29/04/1944 0 1
1 M13.94;I10;E11.9;I63.9 - - - None None None None M-4-
18-III None None None None None None PENYAKIT TULANG DAN SENDI LAIN-LAIN
(BERAT) 7081000 0 0 - 0 - 0 - 0 - 0
7081000 5120710 0 4 0 0 0 C. YUDHO ISWORO SURYO. K
0002061862593 3;JKN irvan; 5.2.2.201806040537 4 210648
1#0##0#0#0.0#2018-09-04 10:56:45#0#00:00:00#00:00:00#00:00:00 1
87fcfcde78e8174c74c3c4bdc9b63e40 0 0 464020 0 0
1517190 0 0 0 0 3139500 0 0 0 0 0
3201126 B 1 BS 1 09/08/2018 11/08/2018 29/05/2003 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 3185636 0 3 0 0 0 MUHAMMAD IHSAN
0002436668335 3;JKN irvan; 5.2.2.201806040537 4 210979
29#0##0#0#0.0#2018-09-04 12:00:05#0#15:11:41#15:11:41#00:00:00 1
a98c7d8fe7960eadaa352546ab315179 0 0 316331 0 0 291899
0 0 0 0 2577406 0 0 0 0 0
3201126 B 3 BS 1 10/08/2018 11/08/2018 10/06/1995 0 1
1 Z53.9;J34.2;S02.20 - - - None None None None Z-4-
12-II None None None None None None FAKTOR-FAKTOR YANG MEMPENGARUHI STATUS
0 - 0 3938000 979484 0 2 0 0 0 ADY
DARMAWAN D152335 23 8462 DR. INDAH TRISNAWATY SP.THT
0138R0170818V003936 0002251531822 3;JKN irvan; 5.2.2.201806040537
4 211594 31#0##0#0#0.0#2018-09-04
12:07:55#0#20:50:29#20:50:29#00:00:00 1 b36d2c76b37307cc724b1318037e205d
0 0 332073 0 0 31333 0 0 0 0 616078
0 0 0 0 0
3201126 B 2 BS 1 09/08/2018 11/08/2018 13/07/1967 0 1
- 0 3584400 4633149 0 3 0 0 0 KOHARUDIN
0001204431941 3;JKN irvan; 5.2.2.201806040537 4 211019
12#0##0#0#0.0#2018-09-04 13:15:14#0#00:00:00#00:00:00#00:00:00 1
79163498c4d432ca992b6124b6864c2b 0 0 375596 0 1515000
2413450 0 0 0 0 329103 0 0 0 0 0
3201126 B 2 BS 1 01/08/2018 11/08/2018 07/09/1968 0 1
0 - 0 8291400 23037844 0 11 1 6 0 MUHSAN
0001131466724 3;JKN irvan; 5.2.2.201806040537 4 208270
1#0##0#0#0.0#2018-09-04 13:34:08#0#22:35:01#22:35:01#00:00:00 1
3ff23f26e6bb0ff801e0cddf4e70ad30 0 0 3105393 0 0
9520451 0 0 0 0 7380000 0 0 0 0
3032000
3201126 B 3 BS 1 11/08/2018 11/08/2018 11/09/1964 0 2
1 B16.9;N18.5;I11.9;E87.2;K74.6;R18 90.59;89.52 - - None None
None None B-4-13-II None None None None None None GANGGUAN HATI
LAIN-LAIN (SEDANG) 4897800 0 0 - 0 - 0 - 0
- 0 4897800 1900919 0 1 0 0 0 MUJI ASTUTI
0000197192103 3;JKN ikwalni; 5.2.2.201806040537 4 211615
1#0##0#0#0.0#2018-09-06 16:40:31#0#00:00:00#00:00:00#00:00:00 1
932d5ddc14b6a2a61f7895c812672e87 0 0 244890 0 0 621670
0 0 0 0 413359 0 0 0 0 621000
3201126 B 1 BS 1 11/08/2018 11/08/2018 19/08/2016 0 1
- 0 - 0 - 0 - 0 3718200 6458917 0
1 0 0 0 MUHAMMAD ALWI D391309 1 722 DR RASTRA,
5.2.2.201806040537 4 211973 1#0##0#0#0.0#2018-10-10
09:04:20#0#00:00:00#00:00:00#12:00:00 1 dae9a38bd6ed87b72127a20e1aeeac71
0 0 387637 0 454546 1201734 0 0 0 0
3905000 0 0 0 510000 0
3201126 B 1 BS 1 09/08/2018 11/08/2018 25/07/1982 0 2
(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 3656516 0 3 0 0 0 FITRIYAH D263936
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211020
1#0##0#0#0.0#2018-10-10 10:08:21#0#00:00:00#00:00:00#00:00:00 1
02a3964d99573f176fc9818e7317506c 0 0 399995 0 0 648310
0 0 0 0 2608211 0 0 0 0 0
3201126 B 3 BS 1 10/08/2018 11/08/2018 26/03/1992 0 2
4986800 0 0 - 0 - 0 - 0 - 0
4986800 7580362 0 2 0 0 0 NURHAYANIH D405651
26 9633 DR DENNY DHANARDONO, SPOG 0138R0170818V003445
0001305413436 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211028
1#0##0#0#0.0#2018-11-14 13:56:37#0#00:00:00#00:00:00#00:00:00 3
025f29e2c8a49fcb465d77e3e37fea92 0 3605500 1602040 0 0
1624715 0 0 0 0 542912 0 0 205195 0
0
3201126 B 3 BS 1 06/08/2018 11/08/2018 01/03/1958 0 1
1 J91;I50.0 34.91 - - None None None None J-4-20-II None
6429900 0 0 - 0 - 0 - 0 - 0
6429900 4904377 0 6 0 0 0 SAIFUL D387312
0001014240396 3;JKN Adinda; 5.2.2.201806040537 4 209576
1#0##0#0#0.0#2018-12-06 10:08:20#0#13:01:23#13:01:23#12:00:00 3
538df1b4b46116fc04b9da7c03d5b7e5 0 0 1631910 0 0
1718620 0 0 0 0 1135847 0 0 0 0 418000
3201126 B 2 BS 1 06/08/2018 11/08/2018 21/02/1958 0 2
0 0 - 0 - 0 - 0 - 0 10406400
15089768 0 6 0 0 0 ASNAWATI D391199 60 22081
DR ARU, SPPD 0138R0170818V001773 0002074469231 3;JKN Adinda;
5.2.2.201806040537 4 209577 1#0##0#0#0.0#2018-12-06
10:09:14#0#13:14:24#13:14:24#12:00:00 4 a3fdac240de848baa6b174e06750106d
0 6639100 3207107 0 0 3692645 0 0 0 0
1365081 0 0 0 0 185835
3201126 B 3 BS 1 08/08/2018 12/08/2018 04/08/1959 0 1
1 I63.9;G81.9;I11.0 87.03;87.49;90.59;89.52 - - None None None
- 0 - 0 8672200 3542618 0 5 0 0 0
RACHMAT S TN D405497 59 21554 DR NURUL KOMARI SPS
0138R0170818V002814 0001743663846 3;JKN DR RIZKI; 5.2.2.201806040537
4 210599 1#0##0#0#0.0#2018-08-29
13:21:22#0#15:01:43#15:01:43#00:00:00 1 ab653761ec6efa90e6732f90ba8d40bf
0 0 833498 0 0 1136360 0 0 0 0
1572760 0 0 0 0 0
3201126 B 1 BS 1 08/08/2018 12/08/2018 11/05/2016 0 2
2925900 0 0 - 0 - 0 - 0 - 0
2925900 4762079 0 5 0 0 0 AFIQAH NAHDA LATHIFAH
0002057869844 3;JKN DR RIZKI; 5.2.2.201806040537 4 210646
1#0##0#0#0.0#2018-08-29 13:24:59#0#18:57:11#18:57:11#00:00:00 1
c9d5b8f56a30733f0cb4b00a2f0cd15e 0 0 316331 0 0 548710
0 0 0 0 3897038 0 0 0 0 0
3201126 B 1 BS 1 09/08/2018 12/08/2018 05/06/1944 0 1
0 0 - 0 - 0 - 0 - 0 5164300
5417856 0 4 0 0 0 SUBAGYO SUBROTO D405631 74
3;JKN DR RIZKI; 5.2.2.201806040537 4 211023 1#0##0#0#0.0#2018-
08-29 13:34:13#0#00:00:00#00:00:00#00:00:00 1
1fe137a379c4fb9d55fa3d740335f83e 0 0 333467 0 0
1925450 0 0 0 0 3158939 0 0 0 0 0
3201126 B 2 BS 1 08/08/2018 12/08/2018 03/04/1972 0 2
8447200 0 0 - 0 - 0 - 0 - 0
8447200 13454625 0 5 0 0 0 AAS D396115 46
3;JKN DR RIZKI; 5.2.2.201806040537 4 210653 1#0##0#0#0.0#2018-
08-29 13:35:34#0#00:00:00#00:00:00#00:00:00 1
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3579206 0 0 0 0 906209 0 0 0 0 337066
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1#0##0#0#0.0#2018-08-29 14:08:12#0#07:48:46#07:48:46#00:00:00 1
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17320000
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4426600 0 0 - 0 - 0 - 0 - 0
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3201126 B 3 BS 1 10/08/2018 12/08/2018 25/08/1984 0 2
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None None None None None TUMOR SISTEM REPRODUKSI WANITA (SEDANG)
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3201126 B 2 BS 1 10/08/2018 12/08/2018 14/03/1973 0 1
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0001303037774 3;JKN DR RIZKI; 5.2.2.201806040537 4 211589
1#0##0#0#0.0#2018-08-29 15:07:52#0#00:00:00#00:00:00#00:00:00 2
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2069000
3201126 B 2 BS 1 11/08/2018 12/08/2018 23/04/1958 0 1
1 I20.0;I25.0;K30;Q24.5;I05.9 88.55 - - None None None None
I-1-15-II None None None None None None KATETERISASI JANTUNG (SEDANG)
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2069000
3201126 B 2 BS 1 11/08/2018 12/08/2018 27/05/1964 0 1
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15:12:08#0#00:00:00#00:00:00#00:00:00 1 09c8fcd028a0d8fd1f132b439e95b7ca
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3201126 B 2 BS 1 10/08/2018 12/08/2018 12/02/2006 0 1
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0001308847083 3;JKN DR RIZKI; 5.2.2.201806040537 4 211590
1#0##0#0#0.0#2018-08-29 15:26:19#0#00:00:00#00:00:00#00:00:00 1
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1068099 0 0 0 0 668107 0 0 0 0 69000
3201126 B 2 BS 1 10/08/2018 12/08/2018 24/10/1974 0 1
14653000 0 0 - 0 - 0 - 0 - 0
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0001134968049 3;JKN DR RIZKI; 5.2.2.201806040537 4 211592
1#0##0#0#0.0#2018-08-29 15:28:12#0#00:00:00#00:00:00#00:00:00 1
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4397000 0 0 0 0 1002457 0 0 0 0
2069000
3201126 B 2 BS 1 10/08/2018 12/08/2018 28/12/1956 0 1
1 I25.0;E11.9;I11.0 88.55 - - None None None None I-1-15-III
0 0 - 0 - 0 - 0 - 0 14653000
12492625 0 3 0 0 0 ABDULLAH D306279 61 22505
DR RIZKI; 5.2.2.201806040537 4 211587 1#0##0#0#0.0#2018-08-29
15:29:06#0#00:00:00#00:00:00#12:00:00 1 7337f99e393b3be35c9a4f99f57275f4
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1#0##0#0#0.0#2018-08-29 15:35:01#0#00:00:00#00:00:00#00:00:00 3
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1#0##0#0#0.0#2018-08-29 15:46:26#0#10:59:00#10:59:00#00:00:00 1
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1 A01.0;A91;N39.0 - - - None None None None A-4-14-III
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1#0##0#0#0.0#2018-08-29 15:51:51#0#12:11:02#12:11:02#00:00:00 2
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3201126 B 1 BS 1 07/08/2018 12/08/2018 14/05/2002 0 2
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(SEDANG) 3855500 0 0 - 0 - 0 - 0 - 0
3855500 7098515 0 6 0 0 0 SALSABILA MEISYAR
0001260544847 3;JKN DR RIZKI; 5.2.2.201806040537 4 210318
1#0##0#0#0.0#2018-08-29 15:57:00#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 3 BS 1 12/08/2018 12/08/2018 01/08/1978 0 2
1718000 0 0 - 0 - 0 - 0 - 0
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0001325896749 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211779
1#0##0#0#0.0#2018-09-03 15:43:22#0#12:12:52#12:12:52#00:00:00 1
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1#0##0#0#0.0#2018-09-03 17:43:32#0#09:28:32#09:28:32#12:00:00 1
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1#0##0#0#0.0#2018-09-03 17:55:22#0#00:00:00#00:00:00#12:00:00 1
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3201126 B 3 BS 1 11/08/2018 12/08/2018 26/01/1981 0 1
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1#0##0#0#0.0#2018-09-03 18:43:39#0#11:18:14#11:18:14#00:00:00 2
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2905309 0 0 0 0 663660 0 0 0 0 69000
3201126 B 3 BS 1 11/08/2018 12/08/2018 21/04/1978 0 1
1 I72.8;I74.2;N18.5;D63.8 99.04;38.53 - - None None None None
I-1-17-III None None None None None None LIGASI DAN STRIPPING PEMBULUH
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1#0##0#0#0.0#2018-09-03 19:00:37#0#10:22:25#10:22:25#00:00:00 2
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1509000 0 0 0 0 669723 0 0 0 0 0
3201126 B 2 BS 1 07/08/2018 12/08/2018 24/03/1994 0 2
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5.2.2.201806040537 4 210546 1#0##0#0#0.0#2018-10-10
09:11:45#0#12:30:55#12:30:55#00:00:00 1 090275745ff5934706d522c15f83f77d
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5981600 0 0 0 95000 0
3201126 B 1 BS 1 11/08/2018 12/08/2018 08/06/1992 0 1
INTERNAL (RINGAN) 6041900 0 0 - 0 - 0 - 0 -
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1#0##0#0#0.0#2018-10-10 09:20:06#0#00:00:00#00:00:00#00:00:00 1
aaac84d9e2eb84a15be3500a49b44717 0 9763300 2244732 0 0
612078 0 0 0 0 898878 0 0 0 221000
0
3201126 B 1 BS 1 09/08/2018 12/08/2018 09/07/2006 0 1
2925900 0 0 - 0 - 0 - 0 - 0
2925900 6459778 0 4 0 0 0 ALTHAF ZHAFRAN ALGHIFARU
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1#1#vvip#2#3533878#0.0#2018-10-10 09:47:32#0#00:00:00#00:00:00#00:00:00
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385347 0 0 0 0 5100000 0 0 0 460602
0
3201126 B 1 BS 1 04/08/2018 12/08/2018 05/06/1954 0 1
1 I11.0;N19;I21.2;I61.9 87.03;87.44 - - None None None None
6963100 0 0 - 0 - 0 - 0 - 0
6963100 25504369 0 9 1 3 0 SYAPRI MA`RUF
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1#0##0#0#0.0#2018-12-06 10:10:29#0#00:00:00#00:00:00#00:00:00 3
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9682319 0 0 0 0 8992000 0 0 0 0
5544000
3201126 B 1 BS 1 11/08/2018 12/08/2018 09/10/1948 0 1
DIALISIS (RINGAN) 6076700 0 0 - 0 - 0 - 0 -
0 6076700 11780994 0 2 0 0 0 SUWATRIL
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1#0##0#0#0.0#2018-12-06 10:11:21#0#08:27:17#08:27:17#00:00:00 4
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1952615 0 0 0 0 796719 0 0 0 0 69000
3201126 B 1 BS 1 12/08/2018 13/08/2018 18/02/1983 0 1
(SEDANG) 5784900 0 0 - 0 - 0 - 0 - 0
5784900 4757902 0 2 0 0 0 ARIF BUDIANSYAH TN
d382848 35 12959 DR ARU, SPPD 0138R0170818V004145
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1#0##0#0#0.0#2018-08-29 17:45:09#0#20:31:21#20:31:21#00:00:00 1
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1965400 0 0 0 0 1216500 0 0 0 1146640
0
3201126 B 3 BS 1 09/08/2018 13/08/2018 07/07/1952 0 1
1 I21.3;J18.0;R57.0;N18.5 93.94 - - None None None None I-4-
10401900 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-08-29 17:49:03#0#07:47:43#07:47:43#00:00:00 1
8ed4444a97413d426b1183c711be52c4 0 0 989169 0 0
6815100 0 0 0 0 3145000 0 0 2409000 965899
0
3201126 B 3 BS 1 12/08/2018 13/08/2018 01/12/1968 0 2
1 N18.5;E14.9;A49.9;I11.9;T82.4 38.95 - - None None None None
- 0 - 0 19332400 11844877 0 2 0 0 0
NANI RUSMIAH D405597 49 18151 DR IRFIANSYAH LESMANA DR SPBTKV
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18:14:27#0#10:11:47#10:11:47#00:00:00 1 435d8cf2c41244d4c9038839e9d8186e
0 0 939370 0 0 6901984 0 0 0 0
3062500 0 0 80352 860671 0
3201126 B 2 BS 1 12/08/2018 13/08/2018 10/04/1974 0 1
DIALISIS (SEDANG) 10690500 0 0 - 0 - 0 - 0 -
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0138R0170818V004113 0001139615346 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 211777 1#0##0#0#0.0#2018-08-29
18:31:07#0#11:08:31#11:08:31#00:00:00 1 02d7e475f752ea899a4ccdcb50545218
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0 0 0 0 1067783 0
3201126 B 3 BS 1 13/08/2018 13/08/2018 16/08/1971 0 2
- 0 - 0 - 0 - 0 2216400 2242678 0
5.2.2.201806040537 4 212071 1#0##0#0#0.0#2018-08-29
18:55:50#0#00:00:00#00:00:00#00:00:00 1 d31078476c626ff78f81f92d37707e68
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19:00:07#0#00:00:00#00:00:00#00:00:00 1 938a232c7670b6bb1df0802aeb0bd09a
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3201126 B 2 BS 1 12/08/2018 13/08/2018 29/09/1973 0 1
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ISMAIL HATRASH D405870 44 16388 DR. ARU ARIADNO, SPPD
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19:02:47#0#00:00:00#00:00:00#00:00:00 1 84bde35d799d4afa2b079df2de2beba3
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1#0##0#0#0.0#2018-08-29 19:06:19#0#08:52:46#08:52:46#00:00:00 1
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0138R0170818V004165 0002063562041 3;JKN TANTIYO S;16137
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19:14:20#0#00:00:00#00:00:00#12:00:00 1 de42aa1b2202670a3bd4bb8ac6bfd57b
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4024100 0 0 0 34500 0
3201126 B 1 BS 1 08/08/2018 13/08/2018 11/03/2015 0 1
2925900 0 0 - 0 - 0 - 0 - 0
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1#1#vvip#6#6529365#0.0#2018-09-03 17:37:37#0#00:00:00#00:00:00#00:00:00
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1575867 0 0 0 0 7025569 0 0 0 0 340000
3201126 B 1 BS 1 10/08/2018 13/08/2018 06/11/1942 0 1
1 A49.9;Z59.4 - - - None None None None A-4-14-I None
(RINGAN) 3176200 0 0 - 0 - 0 - 0 - 0
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1#0##0#0#0.0#2018-09-03 17:40:17#0#07:36:14#07:36:14#00:00:00 1
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1 G37.3;E87.8;J39.0 - - - None None None None G-4-12-II
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1#0##0#0#0.0#2018-09-03 17:41:31#0#14:19:03#14:19:03#00:00:00 1
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0002234821803 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211580
1#0##0#0#0.0#2018-09-03 17:44:31#0#00:00:00#00:00:00#00:00:00 1
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1802138 0 0 0 0 2124371 0 0 0 0 0
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5784900 4553593 0 2 0 0 0 ROSIYATI D384812
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 212265
1#0##0#0#0.0#2018-09-03 17:45:34#0#19:22:48#19:22:48#12:00:00 1
1a00c17a4f0a8f9a22f0c4d83bd93ceb 0 0 424889 0 0
1778930 0 0 0 0 2349774 0 0 0 0 0
3201126 B 1 BS 1 10/08/2018 13/08/2018 05/12/1943 0 2
1 A01.0;N18.1;R63.0;R54 - - - None None None None A-4-
LAIN-LAIN (RINGAN) 3176200 0 0 - 0 - 0 - 0
- 0 3176200 5112097 0 4 0 0 0 NURHAYATI
0000016560527 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211367
1#0##0#0#0.0#2018-09-03 17:48:34#0#13:57:43#13:57:43#00:00:00 1
6bc1e5120d65147c9ad8ab0b60fab8be 0 0 338858 0 0
1257405 0 0 0 0 3515834 0 0 0 0 0
3201126 B 1 BS 1 11/08/2018 13/08/2018 21/04/1970 0 2
1 K29.1;K92.1;D63.8 99.04;90.59;89.52;45.16 - - None None None
None K-4-11-II None None None None None None GASTRITIS & ULKUS
PEPTIKUM (SEDANG) 4615000 0 0 - 0 - 0 - 0 -
0 4615000 16106486 0 3 0 0 0 FERTINY B.
SIMATUPANG D405740 48 17644 DR ARU, SPPD 0138R0170818V003955
0000041236986 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211610
1#1#vvip#3#11491486#0.0#2018-09-03 17:51:32#0#00:00:00#00:00:00#00:00:00
1 1dc7d295f8e17839d97b122c0903c445 0 0 2395112 0 0
6146929 0 0 0 0 5747195 0 0 0 0
1817250
3201126 B 3 BS 1 11/08/2018 13/08/2018 10/08/1991 0 1
1 I13.1;I51.7;D63.8 38.95;99.04;90.59;89.52 - - None None None
0 - 0 - 0 8908800 10936976 0 3 0 0
0 AGUS TONO D405759 27 9863 DR. ARU ARIADNO, SPPD
0138R0170818V004060 0002476252462 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 211746 1#0##0#0#0.0#2018-09-03
17:56:41#0#00:00:00#00:00:00#00:00:00 1 2c933ed6aa2789cd32e7718a6f9b4872
0 0 1906028 0 0 5014445 0 0 0 0
3947503 0 0 0 0 69000
3201126 B 1 BS 1 11/08/2018 13/08/2018 07/10/2016 0 2
- 0 - 0 - 0 - 0 3718200 3446532 0
3 0 0 0 VANIA CARISSA QURROTA'AYUN D355611 1 673
DR SUPROHAITA SPA(K) 0138R0170818V003987 0002088992531 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 211622 1#0##0#0#0.0#2018-
09-03 17:57:43#0#07:53:01#07:53:01#00:00:00 1
b2c6728ac2981e67a4b48a19ee01c747 0 0 387638 0 0 464420
0 0 0 0 2594474 0 0 0 0 0
3201126 B 2 BS 1 06/08/2018 13/08/2018 25/02/1955 0 1
1 J90;J18.8 87.49;93.94;89.52 - - None None None None J-4-
20-III None None None None None None PLEURAL EFUSI DAN PNEUMOTORAK
(BERAT) 9325200 0 0 - 0 - 0 - 0 - 0
9325200 12908491 0 8 0 0 0 MININ D405326 63
3;JKN TANTIYO S;16137 5.2.2.201806040537 4 209683
1#0##0#0#0.0#2018-09-03 17:59:18#0#00:00:00#00:00:00#00:00:00 1
e0372427d5914787565675a7a82a388c 0 0 1918040 0 0
6079970 0 0 0 0 4910481 0 0 0 0 0
3201126 B 1 BS 1 10/08/2018 13/08/2018 10/12/1980 0 2
1 G40.6;I63.9;G81.9 - - - None None None None G-4-22-III
None None None None None None SERANGAN KEJANG (BERAT) 5551000 0
0 - 0 - 0 - 0 - 0 5551000 4788397
0 4 0 0 0 ZULIYATIN d389964 37 13757 DR NURUL
KOMARI SPS 0138R0170818V003948 0001821841042 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 211605 1#0##0#0#0.0#2018-09-03
18:03:36#0#00:00:00#00:00:00#12:00:00 1 2df85339cb1186dba45ba1aa83c4dad1
0 0 552590 0 0 1514746 0 0 0 0
2721061 0 0 0 0 0
3201126 B 3 BS 1 11/08/2018 13/08/2018 01/05/1957 0 2
1 I48;I50.0 - - - None None None None I-4-19-II None
6111300 0 0 - 0 - 0 - 0 - 0
6111300 2469604 0 3 0 0 0 AMINAH D372721
0000512274521 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211703
1#0##0#0#0.0#2018-09-03 18:06:10#0#11:51:04#11:51:04#12:00:00 1
cb68b7cda72f0476cd4746370c603bfc 0 0 603017 0 0 883050
0 0 0 0 983537 0 0 0 0 0
3201126 B 3 BS 1 10/08/2018 13/08/2018 27/02/2018 0 2
1718000 0 0 - 0 - 0 - 0 - 0
1718000 1734481 0 4 0 0 0 MISCEL ALYA SUBA
0002434561143 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211586
1#0##0#0#0.0#2018-09-03 18:07:24#0#00:00:00#00:00:00#00:00:00 1
57e56180fd2049bbf089f8927d8c42e1 0 0 207620 0 0 421890
0 0 0 0 1104971 0 0 0 0 0
3201126 B 1 BS 1 10/08/2018 13/08/2018 10/04/1956 0 1
(BERAT) 48095600 0 0 PCI 10725800 - 0 - 0 -
0 58821400 81185692 0 4 0 0 0 BESOCHI HAREFA
0000039648464 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211355
1#0##0#0#0.0#2018-09-03 18:13:14#0#13:18:02#13:18:02#00:00:00 1
67525d67df0027da96caafc531a2840f 0 11808000 9672120 0 0
50264572 0 0 0 0 1276000 0 0 0 0
8165000
3201126 B 3 BS 1 09/08/2018 13/08/2018 10/07/1967 0 2
1 I67.4 - - - None None None None G-4-21-I None None
None None None None KOMA & STUPOR NON TRAUMA (RINGAN) 2692100 0
0 - 0 - 0 - 0 - 0 2692100 8010873
0 5 0 0 0 NOVI DIANA D405621 51 18658 DR CELLY
ANANTARIA. SPJP 0138R0170818V003412 0001260108821 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 212262 1#0##0#0#0.0#2018-09-03
19:08:49#0#17:50:19#17:50:19#00:00:00 2 226748c1f6289ea7358538d8205cd972
0 0 224603 0 0 1643194 0 0 0 0
4305076 0 0 0 0 1838000
3201126 B 1 BS 1 09/08/2018 13/08/2018 02/03/1937 0 1
1 A49.9;N39.0;J18.0;R63.0 - - - None None None None A-4-
0 - 0 4626600 5431041 0 5 0 0 0
SOETJIPTO, BA D405606 81 29745 DR BETTY 0138R0170818V003405
0000060973558 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 212259
1#0##0#0#0.0#2018-09-03 19:10:22#0#17:31:30#17:31:30#00:00:00 1
efdae93bda610e1dbc9c308d60e6c716 0 0 469394 0 0 675345
0 0 0 0 4286302 0 0 0 0 0
3201126 B 1 BS 1 04/08/2018 13/08/2018 14/11/1947 0 2
1 G91.2;I63.9;I15.9;G81.9 02.34 - - None None None None G-1-
11-III None None None None None None PROSEDUR VENTRICULAR SHUNT (BERAT)
50188100 0 0 - 0 - 0 - 0 - 0
50188100 54141019 0 10 0 0 0 HJ UUN NURHADA
0001258887611 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 212268
1#0##0#0#0.0#2018-09-03 19:12:03#0#19:41:59#19:41:59#00:00:00 1
d4f665aed1971936cfa34639d4f4e1bc 0 0 16306420 0 0
17959187 0 0 0 0 14245100 0 0 0 0
5630312
3201126 B 1 BS 1 10/08/2018 13/08/2018 08/01/1986 0 2
1 G40.9;Z34.9;O62.4 - - - None None None None G-4-22-I
0 0 - 0 - 0 - 0 - 0 3718200
4992707 0 4 0 0 0 NILA DWI PRATIWI D001098 32
11902 DR HARDI PRANATA SPS 0138R0170818V003931 0001907525441 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 211588 1#0##0#0#0.0#2018-
09-03 19:13:11#0#00:00:00#00:00:00#12:00:00 1
2baedb1ab6577234cb742d59f3b79976 0 0 513638 0 0
1201943 0 0 0 0 3149126 0 0 0 0 128000
3201126 B 1 BS 1 09/08/2018 13/08/2018 28/12/1981 0 1
4 E14.1;A41.9;J18.9;I50.0;R57.0 96.71 - - None None None None
- 0 40790100 29935518 0 5 1 5 0 RA.EKI
ALFURQON D337265 36 13373 DR EVA INDAHWATI SPAN 0138R0170818V003443
0001212714505 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211026
1#0##0#0#0.0#2018-09-03 19:20:52#0#00:00:00#00:00:00#12:00:00 1
bc1b2a07fd55d9a7ca650ac6685b8c70 0 0 5556713 0 0
13966505 0 0 0 0 5928300 0 0 0 0
4484000
3201126 B 1 BS 1 10/08/2018 13/08/2018 20/12/1949 0 2
SICKLE (RINGAN) 4181800 0 0 - 0 - 0 - 0 -
0 4181800 7985824 0 4 0 0 0 TITI SUHARTINI
D405703 68 25070 DR ARU, SPPD 0138R0170818V003893
0000039637438 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 212270
1#0##0#0#0.0#2018-09-03 19:23:40#0#19:54:09#19:54:09#00:00:00 1
f4d3275d117cd4c829f2f5175a653b1c 0 0 429362 0 0
4229525 0 0 0 0 3326937 0 0 0 0 0
3201126 B 2 BS 1 11/08/2018 13/08/2018 11/03/1994 0 2
0 0 - 0 - 0 - 0 - 0 5984100
10092891 0 3 0 0 0 YULIANA D378235 24 8919
TANTIYO S;16137 5.2.2.201806040537 4 211625 1#0##0#0#0.0#2018-
09-03 19:26:18#0#09:03:31#09:03:31#00:00:00 1
ce9394ed10cd2b23458dd1a2e41fea49 0 0 1867730 0 0
1671206 0 0 0 0 6310783 0 0 0 0 243172
3201126 B 3 BS 1 13/08/2018 13/08/2018 20/05/1962 0 1
1 I64;I21.1 - - - None None None None G-4-15-III None
- 0 - 0 - 0 6899800 3586803 0 1 0
0 0 M.WAHYUDIN D405896 56 20539 DR DICKI PRATAMA
0138R0170818V004172 0000511071118 3;JKN ikwalni; 5.2.2.201806040537
4 211809 1#0##0#0#0.0#2018-09-06
17:00:20#0#00:00:00#00:00:00#00:00:00 1 7a52a081c13fd386a345a09ab716355c
0 0 344990 0 260651 1832162 0 0 0 0
263000 0 0 0 886000 0
3201126 B 2 BS 1 11/08/2018 13/08/2018 15/10/1964 0 2
4 I13.0;I95.9;J80;A41.9 38.95 - - None None None None N-1-
- 0 - 0 23198900 17602249 0 3 1 2 0
SURATMI D388491 53 19658 DR. ARU ARIADNO, SPPD
0138R0170818V004021 0002222966035 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 211717 1#0##0#0#0.0#2018-10-10
08:54:16#0#12:36:22#12:36:22#12:00:00 1 d46d5c5ececbe1b6f2d0112e8e5e2874
0 0 2044300 0 1151549 11622576 0 0 0 0
2619000 0 0 0 164824 0
3201126 B 3 BS 1 12/08/2018 13/08/2018 02/02/1969 0 2
1 N18.5;I82.8 39.27 - - None None None None N-1-12-II None
DIALISIS (SEDANG) 8908800 0 0 - 0 - 0 - 0 -
0 8908800 7659230 0 2 0 0 0 ENDAH D405656
0000366695368 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211783
1#0##0#0#0.0#2018-11-03 14:10:28#0#00:00:00#00:00:00#00:00:00 2
129e8a2b95c8d1e4c363fbb03ef5d921 0 0 1853030 0 0
1771329 0 0 0 0 3438800 0 0 0 596071
0
3201126 B 3 BS 1 12/08/2018 13/08/2018 01/08/1943 0 2
1 K51.9;I84.9;N20.0;R54 45.23 - - None None None None K-4-
0 - 0 - 0 5152700 3971733 0 2 0 0
0 NASMI D404852 75 27405 DR BETTY DWI L, SPPD
0138R0170818V004096 0001014137065 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 211765 1#0##0#0#0.0#2018-11-09
15:53:26#0#00:00:00#00:00:00#00:00:00 2 140708324ed1753b0e8026a9cf7c3001
0 0 1495756 0 0 897102 0 0 0 0
1238500 0 0 54542 285833 0
3201126 B 3 BS 1 13/08/2018 13/08/2018 05/10/1968 0 2
- 0 - 0 - 0 - 0 2216400 5569238 0
1 0 0 0 MARYATI D405094 49 18209 RACHMAWATI
5.2.2.201806040537 4 212072 1#0##0#0#0.0#2018-11-09
15:54:37#0#00:00:00#00:00:00#00:00:00 3 0b323782b3bb9e20f2a0ec7eaa16b6fb
0 0 199476 0 263000 4413715 0 0 0 0
670343 0 0 0 0 22704
3201126 B 3 BS 1 13/08/2018 13/08/2018 16/11/1944 0 1
4 I95.9;A15.3;R40.2;E14.1 - - - None None None None I-4-
LAIN-LAIN (BERAT) 8139800 0 0 - 0 - 0 - 0 -
0 8139800 7383398 0 1 0 0 0 PANOSOR MARUYUAN
SIAHAAN D328815 73 26933 DR DICKI PRATAMA 0138R0170818V004291
0001261229422 3;JKN Adinda; 5.2.2.201806040537 4 213035
1#0##0#0#0.0#2018-12-06 10:12:22#0#00:00:00#00:00:00#00:00:00 3
9e9ffd1a17aeda8f0b2296504c4c918a 0 0 321905 0 0
5250467 0 0 0 0 772026 0 0 0 0
1039000
3201126 B 2 BS 1 10/08/2018 13/08/2018 10/10/1982 0 2
1 O82.9;Z37.0;O99.0 74.0;66.69;99.04 - - None None None None
W-1-20-II None None None None None None PROSEDUR PADA RAHIM & ADNEKSA
(SEDANG) 12391500 0 0 - 0 - 0 - 0 - 0
12391500 15893189 0 4 0 0 0 YATNI ARSIH D072941
35 13088 DR NOVI RESISTANTIE, SPOG 0138R0170818V003949
0001166887045 3;JKN Adinda; 5.2.2.201806040537 4 211606
1#0##0#0#0.0#2018-12-06 10:13:48#0#00:00:00#00:00:00#00:00:00 4
53456bfa5b9da447549920d3b91dd275 0 0 4089860 0 0
4361243 0 0 0 0 7240241 0 0 0 0 201845
3201126 B 2 BS 1 10/08/2018 14/08/2018 15/04/1941 0 1
1 I63.9;R25.8;I10 - - - None None None None G-4-14-II
INFARK (SEDANG) 8291400 0 0 - 0 - 0 - 0 -
0 8291400 5477326 0 5 0 0 0 TOYIB EFFENDI
0000060995845 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211596
1#0##0#0#0.0#2018-08-29 12:09:51#0#21:30:23#21:30:23#00:00:00 1
4b139cb92ab4c40aa693544fbd7685c7 0 0 799226 0 0
2273770 0 0 0 0 2020000 0 0 0 384330
0
3201126 B 1 BS 1 13/08/2018 14/08/2018 17/09/1945 0 2
1 S82.80;A49.9 78.67 - - None None None None M-1-40-I
0 - 0 6041900 15428043 0 2 0 0 0
ZAWIRNA D005849 72 26628 BENNY TUMBALEKA SPOT
0138R0170818V004371 0000061057945 3;JKN TANTIYO S;16137
5.2.2.201806040537 4 212028 1#0##0#0#0.0#2018-08-29
15:57:15#0#00:00:00#00:00:00#12:00:00 1 7cf9f2af7cf3a1424bcae6fc36a8463e
0 9763300 2316732 0 0 2167700 0 0 0 0
1035311 0 0 0 145000 0
3201126 B 1 BS 1 04/08/2018 14/08/2018 02/08/1996 0 1
1 I80.2;A15.2 99.19 - - None None None None I-4-13-II None
None None None None None THROMBOPHLEBITIS PADA PEMBULUH DARAH VENA
(SEDANG) 9096300 0 0 - 0 - 0 - 0 - 0
9096300 18866167 0 11 0 0 0 BARA D150804 22
8037 DR SUKAMTO SPPD 0138R0170818V001460 0000060792309 3;JKN
TANTIYO S;16137 5.2.2.201806040537 4 209131 1#0##0#0#0.0#2018-
08-29 16:42:47#0#19:07:49#19:07:49#00:00:00 1
b9f5f3f473c5226096a6e616b94d7f58 0 8245500 909630 0 0
7805037 0 0 0 0 1200000 0 0 0 706000
0
3201126 B 3 BS 1 11/08/2018 14/08/2018 07/01/1994 0 1
(RINGAN) 2268700 0 0 - 0 - 0 - 0 - 0
2268700 2442722 0 4 0 0 0 RAHMAT HIDAYAT
0002339240613 3;JKN TANTIYO S;16137 5.2.2.201806040537 4 211749
1#0##0#0#0.0#2018-08-29 16:45:02#0#00:00:00#00:00:00#00:00:00 1
6dfb56f7f06d579e85b010293cd7d09d 0 0 257183 0 0
1034235 0 0 0 0 965500 0 0 0 185804
0
3201126 B 1 BS 1 11/08/2018 14/08/2018 26/07/1968 0 2
1 E13.9;D64.9;I11.9;J18.0 99.04 - - None None None None E-4-
0 - 0 8768000 8591743 0 4 0 0 0
SUWARTI D405737 50 18278 DR. ARU ARIADNO, SPPD
0138R0170818V003953 0

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