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LAPORAN OBAT SESUAI DENGAN FORMULARIUM JANUARI 2019

No No RM Nama Umur Jenis Tgl Tgl Keluar Dokter Diagnosa Tindakan SESUAI FORNAS KETERANGAN

Kelamin Masuk

dr. Irene
ALDIANO R. A
03.31.74
MASCARENHAS 6 L 14-01-2019 . 21-01-2019 . Lokananta, Typhoid fever
1 Sp.BA
AGNES YOSEFINA TO
2 03.32.75
WEA 23 P 17-01-2019 . 20-01-2019 . dr Nina SpPD Typhoid fever
THERESIA N. I.
3 03.32.69
SERANG 52 P 17-01-2019 . 20-01-2019 . dr Nina SpPD Typhoid fever
SHOBIKHULIATUL
4 02.99.00
J.JUANDA 31 P 15-01-2019 . 18-01-2019 . dr Nina SpPD Other viral enteritis
PETRONELA
5 03.28.70
MALELAK 54 P 02-01-2019 . 06-01-2019 . dr Nina SpPD Other viral enteritis
Diarrhoea and
Dr.Tjahyo
gastroenteritis of
02.76.45 BY.OCE.Y.N.BOYMAU 0 P 14-01-2019 . 16-01-2019 . Suryanto, SpA.
presumed infectious
MBiomed
6 origin
Diarrhoea and
dr. Simplicia
gastroenteritis of
02.75.92 NYIMAS ALESHA 2 P 12-01-2019 . 15-01-2019 . Maria
presumed infectious
Anggrahini,Sp.A
7 origin
Diarrhoea and
DEWA GEDE R. P. dr.Frans gastroenteritis of
02.51.29
TANGEB 1 L 24-01-2019 . 29-01-2019 . Taolin,Sp.A presumed infectious
8 origin
Diarrhoea and
KHAIRINA NUR dr.Frans gastroenteritis of
03.34.27
MALAIKA 1 P 24-01-2019 . 26-01-2019 . Taolin,Sp.A presumed infectious
9 origin
Diarrhoea and
PIRLO MEDISAL dr.Frans gastroenteritis of
02.62.60
PAHA TULU 4 L 08-01-2019 . 11-01-2019 . Taolin,Sp.A presumed infectious
10 origin
Diarrhoea and
SILVHA LEONA dr.Frans gastroenteritis of
03.31.24
MBATU 1 P 12-01-2019 . 15-01-2019 . Taolin,Sp.A presumed infectious
11 origin
Diarrhoea and
gastroenteritis of
03.32.91 YUSRI BOIMAU NOPE 52 P 18-01-2019 . 19-01-2019 . dr Nina SpPD
presumed infectious
12 origin

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Diarrhoea and
MARIA JOVELYN dr.Frans gastroenteritis of
03.30.82
THEI 0 P 10-01-2019 . 15-01-2019 . Taolin,Sp.A presumed infectious
13 origin
Diarrhoea and
dr. Iren David, gastroenteritis of
02.43.79 PETRA JR. LIFU 1 L 12-01-2019 . 15-01-2019 . Sp.A presumed infectious
14 origin
Diarrhoea and
Dr.Tjahyo
gastroenteritis of
03.31.65 BRADEN MULIK 1 L 13-01-2019 . 15-01-2019 . Suryanto, SpA.
presumed infectious
MBiomed
15 origin
Diarrhoea and
Dr.Tjahyo
gastroenteritis of
02.91.52 PERI QUEEN HANING 0 P 01-01-2019 . 04-01-2019 . Suryanto, SpA.
presumed infectious
MBiomed
16 origin
Diarrhoea and
dr. Irene
GISELA ISTERINA gastroenteritis of
03.34.63
MANAFE 6 P 25-01-2019 . 29-01-2019 . Lokananta,
presumed infectious
Sp.BA
17 origin
Diarrhoea and
dr. Irene
gastroenteritis of
02.46.50 BY. DARNI LOPO 0 P 16-01-2019 . 22-01-2019 . Lokananta,
presumed infectious
Sp.BA
18 origin
JUNIATI LIBERTY Bacterial infection,
19
02.24.21
HINA SAIK 29 P 16-01-2019 . 18-01-2019 . dr Nina SpPD
unspecified
dr. Simplicia
JIBRIL REINHARD Dengue fever
03.33.16
LEDOH 2 L 19-01-2019 . 21-01-2019 . Maria
[classical dengue]
20 Anggrahini,Sp.A
dr. Simplicia
RICHIE NAZARENO Dengue fever
03.33.28
ABOR 9 L 19-01-2019 . 26-01-2019 . Maria
[classical dengue]
21 Anggrahini,Sp.A
dr.Frans Dengue fever
22
01.90.52 JULIO C.H. DHALU 4 L 22-01-2019 . 27-01-2019 . Taolin,Sp.A [classical dengue]
I DEWA AYU ARI
dr. Iren David, Dengue fever
03.31.45 MALIKA A. 5 P 12-01-2019 . 15-01-2019 . Sp.A [classical dengue]
23 PEMAYUN
KATHARINA DE dr. Iren David, Dengue fever
24
01.89.16
ORNAY 3 P 13-01-2019 . 16-01-2019 . Sp.A [classical dengue]
Dr.Tjahyo
RAIFA ISHANA Dengue fever
03.31.49
QUEENARA 2 P 12-01-2019 . 14-01-2019 . Suryanto, SpA.
[classical dengue]
25 MBiomed
Dr.Tjahyo
KRESNHA Dengue fever
02.10.16
A.SANJAYA 5 L 08-01-2019 . 11-01-2019 . Suryanto, SpA.
[classical dengue]
26 MBiomed
dr.Frans Dengue
27 03.34.76 YAWINDI Y PAIDJO 12 P 26-01-2019 . 30-01-2019 . Taolin,Sp.A haemorrhagic fever

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


DESMERALDA EMELI dr.Frans Dengue
28 03.34.15
ENA BLEGUR 3 P 23-01-2019 . 30-01-2019 . Taolin,Sp.A haemorrhagic fever
FILGINO M.A.NUBAN dr.Frans Dengue
29 03.29.74
JR 4 L 07-01-2019 . 13-01-2019 . Taolin,Sp.A haemorrhagic fever
GAMALIEL
dr.Frans Dengue
02.61.06 PHILIOSCAR 0 L 20-01-2019 . 28-01-2019 . Taolin,Sp.A haemorrhagic fever
30 MESSAKH
AN.JOHAN TRISTAN dr.Frans Dengue
31 01.06.42
ABOR 4 L 19-01-2019 . 26-01-2019 . Taolin,Sp.A haemorrhagic fever
MEIVINDA dr.Frans Dengue
32 03.32.41
G.ANDARA PUTRI 11 P 16-01-2019 . 22-01-2019 . Taolin,Sp.A haemorrhagic fever
Dr.Tjahyo
VIKTORIA P. P. Dengue
03.33.88
UMADATO 5 P 22-01-2019 . 27-01-2019 . Suryanto, SpA.
haemorrhagic fever
33 MBiomed
Dr.Tjahyo
AHMAD NAJIH AL. Dengue
03.34.51
ANWAR 9 L 25-01-2019 . 28-01-2019 . Suryanto, SpA.
haemorrhagic fever
34 MBiomed
Dr.Tjahyo
GIANNO LOUIS Dengue
03.29.46
MARIO MITANG 2 L 08-01-2019 . 12-01-2019 . Suryanto, SpA.
haemorrhagic fever
35 MBiomed
Dr.Tjahyo
Dengue
03.28.79 ALENDRA 6 L 03-01-2019 . 06-01-2019 . Suryanto, SpA.
haemorrhagic fever
36 MBiomed
dr. Irene
QUEENZY Dengue
02.82.08
ALFANSYAH 4 P 01-01-2019 . 07-01-2019 . Lokananta,
haemorrhagic fever
37 Sp.BA
ANJELINA DELFINA Dengue
38 03.31.20
A JANGGUR 17 P 11-01-2019 . 14-01-2019 . dr Nina SpPD
haemorrhagic fever
I GUSTI AYU P. dr.Frans Dengue
39 03.28.45
PRASANTHI 3 P 31-12-2018 . 09-01-2019 . Taolin,Sp.A haemorrhagic fever
AN. WILLIAMS dr.Frans Dengue
40 00.97.53
D.AKSEL KENDJAM 9 L 07-01-2019 . 12-01-2019 . Taolin,Sp.A haemorrhagic fever
AN. MARIA
dr.Frans Dengue
00.88.84 CORDELIA E. 4 P 07-01-2019 . 12-01-2019 . Taolin,Sp.A haemorrhagic fever
41 KENDJAM
ALIF MUSDALIN dr. Iren David, Dengue
42 03.30.65
DOLU 6 L 09-01-2019 . 13-01-2019 . Sp.A haemorrhagic fever
dr. Iren David, Dengue
43 03.18.67 NOFRIANTI BATAN 0 P 12-01-2019 . 16-01-2019 . Sp.A haemorrhagic fever
YOLANDA JESSLYNE dr. Iren David, Dengue
44 03.34.57
LINGGA 10 P 25-01-2019 . 29-01-2019 . Sp.A haemorrhagic fever
AZKA ALGIBRAN
dr.Frans Dengue
03.29.58 BRAWIJAYA 3 L 06-01-2019 . 12-01-2019 . Taolin,Sp.A haemorrhagic fever
45 SETIAWAN
VALLERIA
dr.Frans Dengue
03.32.36 ALEXANDRA 5 P 15-01-2019 . 23-01-2019 . Taolin,Sp.A haemorrhagic fever
46 NAKMOFA
BELVA IRINA dr.Frans Dengue
47 02.96.70
JACINDA 7 P 16-01-2019 . 23-01-2019 . Taolin,Sp.A haemorrhagic fever

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


I GUSTI KETUT D dr.Frans Dengue
48 03.28.53
KURNIASANTI 5 P 01-01-2019 . 11-01-2019 . Taolin,Sp.A haemorrhagic fever
FIENTJE ROHI B. dr.Frans Dengue
49 03.04.37
THOME 72 P 05-01-2019 . 08-01-2019 . Taolin,Sp.A haemorrhagic fever
AYUNDA HASANAH dr.Frans Dengue
50 03.28.11
PUTRI NURYATI 2 L 29-12-2018 . 05-01-2019 . Taolin,Sp.A haemorrhagic fever
dr. Simplicia
pper respiratory
02.76.48 BY.IRA PATOLA 0 L 20-01-2019 . 25-01-2019 . Maria
infections (J00-J06)
51 Anggrahini,Sp.A
IZACH LOUPATTY dr.Frans Varicella with other
52
01.18.01
PIGAWAHI 4 L 15-01-2019 . 23-01-2019 . Taolin,Sp.A complications
Dr.Tjahyo
Measles without
03.35.18 NEMESIUS B.R.MAU 0 L 28-01-2019 . 31-01-2019 . Suryanto, SpA.
complication
53 MBiomed
AUDREY B. Y. dr.Frans Viral infection,
54 00.33.53
DJERAHU 3 P 20-01-2019 . 28-01-2019 . Taolin,Sp.A unspecified
GEOFREY
dr.Frans Viral infection,
02.49.78 M.ADDYSON 6 L 26-01-2019 . 31-01-2019 . Taolin,Sp.A unspecified
55 NGGESU
AYUANDHIRA
dr.Frans Viral infection,
02.33.50 POETRY PAULIN 4 P 26-01-2019 . 31-01-2019 . Taolin,Sp.A unspecified
56 LAKAPU
MIKI A.K.PAYONG dr.Frans Viral infection,
57 03.35.43
TEFNAI 3 L 28-01-2019 . 31-01-2019 . Taolin,Sp.A unspecified
BARRATAMA dr.Frans Viral infection,
58 03.33.32
DINUSA HYUGA 1 L 22-01-2019 . 25-01-2019 . Taolin,Sp.A unspecified
AN.RAYSHA dr.Frans Viral infection,
59 00.54.28
N.Q.BALUKH 3 P 06-01-2019 . 09-01-2019 . Taolin,Sp.A unspecified
dr.Frans Viral infection,
60 01.96.72 MARIA A.P.N DJENDO 1 P 04-01-2019 . 07-01-2019 . Taolin,Sp.A unspecified
DWICILD DELANO dr.Frans Viral infection,
61 02.68.51
NEONANE 0 L 07-01-2019 . 11-01-2019 . Taolin,Sp.A unspecified
dr.Frans Viral infection,
62 00.20.48 KARIN M. AGAMA 3 P 07-01-2019 . 12-01-2019 . Taolin,Sp.A unspecified
GEORGIUS J. dr. Iren David, Viral infection,
63 02.65.84
DJEMALU 2 L 13-01-2019 . 16-01-2019 . Sp.A unspecified
HANA HUMAIRAH dr.Frans Viral infection,
64 01.66.84
AHMAD 2 P 24-01-2019 . 27-01-2019 . Taolin,Sp.A unspecified
dr.Frans Viral infection,
65 00.42.21 GEVRIL HURU 7 L 25-01-2019 . 27-01-2019 . Taolin,Sp.A unspecified
LEONNEL TIMOTHY dr.Frans Viral infection,
66 03.33.70
KAPIORU 3 L 21-01-2019 . 24-01-2019 . Taolin,Sp.A unspecified
INDAH FITHROTUL dr.Frans Viral infection,
67 00.05.97
MUBAROK 5 P 08-01-2019 . 15-01-2019 . Taolin,Sp.A unspecified
AN. YULITHA D. M dr.Frans Viral infection,
68 01.35.40
LIFU 6 P 08-01-2019 . 15-01-2019 . Taolin,Sp.A unspecified
dr.Frans Viral infection,
69 01.44.80 AERILYN B.V. ZINA 3 P 11-01-2019 . 15-01-2019 . Taolin,Sp.A unspecified

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


AN. TRAVIS RATU dr.Frans Histoplasmosis,
70 01.35.87
HERE 5 L 19-01-2019 . 24-01-2019 . Taolin,Sp.A unspecified
MELSYA TRIVENA dr. Kt. Agus Leiomyoma of
71
03.21.81
SINLAE 38 P 15-01-2019 . 16-01-2019 . Sunatha, SpOG uterus, unspecified
MIOMECTOMI

SARAH TEOSA dr. Kt. Agus Leiomyoma of


72
03.29.62
NENOHAI SAE 46 P 06-01-2019 . 07-01-2019 . Sunatha, SpOG uterus, unspecified
Anaemia,
73 03.34.77 AMELIA RAGA ROPA 67 P 26-01-2019 . 28-01-2019 . dr Nina SpPD
unspecified
Other specified
MARIANA JOSEFINA diabetes mellitus
03.31.15
ULY 45 P 11-01-2019 . 13-01-2019 . dr Nina SpPD
with other specified
74 complications
Other specified
diabetes mellitus
02.55.01 CHRISTINAWATI 58 P 16-01-2019 . 18-01-2019 . dr Nina SpPD
with unspecified
75 complications
Other specified
diabetes mellitus
03.30.34 MERY THEI 57 P 19-01-2019 . 21-01-2019 . dr Nina SpPD
with unspecified
76 complications
Other specified
FRANSISKA MUKU diabetes mellitus
03.30.61
JAWA 53 P 09-01-2019 . 11-01-2019 . dr Nina SpPD
without
77 complications
DOROTEA WENY Hypo-osmolality
78
03.29.95
DOKO 65 P 07-01-2019 . 08-01-2019 . dr Nina SpPD
and hyponatraemia
dr.D.A.P. Shinta
Paranoid
03.26.42 FRENGKI NEONG 18 L 18-01-2019 . 21-01-2019 . Widari,Sp.KJ,
schizophrenia
79 MARS
dr.D.A.P. Shinta
Paranoid
02.72.11 PEMI MUTI 46 P 29-01-2019 . 31-01-2019 . Widari,Sp.KJ,
schizophrenia
80 MARS
Severe depressive
dr.D.A.P. Shinta
episode without
02.79.46 CHALIDA K ALDIN 31 P 16-01-2019 . 18-01-2019 . Widari,Sp.KJ,
psychotic
MARS
81 symptoms
Severe depressive
dr.D.A.P. Shinta
episode without
00.82.21 VONY UN CHANDRA 55 P 25-01-2019 . 28-01-2019 . Widari,Sp.KJ,
psychotic
MARS
82 symptoms
Severe depressive
dr.D.A.P. Shinta
HENDERINA episode with
03.29.88
AKUNUT 73 P 08-01-2019 . 11-01-2019 . Widari,Sp.KJ,
psychotic
MARS
83 symptoms
MUHAMAD NAUFAL dr.Frans Epilepsy,
84 03.35.30
ASRIL 7 L 28-01-2019 . 31-01-2019 . Taolin,Sp.A unspecified

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Essential (primary)
85
03.24.90 LIDIA MANAFE 61 P 01-01-2019 . 05-01-2019 . dr Nina SpPD
hypertension
FILMIN YULIANA GA- Essential (primary)
86
02.36.68
DAIK 66 P 17-01-2019 . 21-01-2019 . dr Nina SpPD
hypertension
87 01.56.91 LILI MAAKH 45 P 09-01-2019 . 11-01-2019 . dr Nina SpPD Unstable angina
88 03.28.43 YORPAH ALLE 26 P 31-12-2018 . 02-01-2019 . dr Nina SpPD Unstable angina
dr. Simplicia Acute
BY.YUNNITRI PUTRI
02.58.33
MODOK 0 L 19-01-2019 . 21-01-2019 . Maria nasopharyngitis
89 Anggrahini,Sp.A [common cold]
Acute
dr.Frans
00.03.35 AN ALFI INAYATI 3 P 20-01-2019 . 23-01-2019 . Taolin,Sp.A
nasopharyngitis
90 [common cold]
Acute
dr.Frans
03.34.87 SERGINO L.R.S.RITAN 10 L 26-01-2019 . 30-01-2019 . Taolin,Sp.A
nasopharyngitis
91 [common cold]
Acute
AZARYA ATMAJA dr.Frans
03.32.84
PINGAK 3 L 18-01-2019 . 21-01-2019 . Taolin,Sp.A
nasopharyngitis
92 [common cold]
Acute
AISYAH dr.Frans
02.65.12
RAMADHANIA ASRIL 1 P 24-01-2019 . 31-01-2019 . Taolin,Sp.A
nasopharyngitis
93 [common cold]
Acute
BY.EMERENSIANA dr.Frans
02.86.66
AEK 0 L 22-01-2019 . 26-01-2019 . Taolin,Sp.A
nasopharyngitis
94 [common cold]
Acute
EVERESTCLAY dr. Andree
03.29.51
JEMMA KYM MESAH 7 P 05-01-2019 . 12-01-2019 . Hartanto.SpOG
nasopharyngitis
95 [common cold]
Acute
KENDRIKS dr.Frans
03.30.70
TALAHATU 1 L 10-01-2019 . 17-01-2019 . Taolin,Sp.A
nasopharyngitis
96 [common cold]
MARIA Acute
dr. Iren David,
01.94.85 QUEENEZHYA TIANA 2 P 20-01-2019 . 22-01-2019 . Sp.A
nasopharyngitis
97 WERA [common cold]
Dr.Tjahyo Acute
TIARA DOMINIQUE
03.29.65
KASE 2 P 06-01-2019 . 08-01-2019 . Suryanto, SpA. nasopharyngitis
98 MBiomed [common cold]
Dr.Tjahyo Acute
01.51.20 SAHRA AQILA 2 P 17-01-2019 . 18-01-2019 . Suryanto, SpA. nasopharyngitis
99 MBiomed [common cold]
Dr.Tjahyo Acute
SHIRAATHAL M
03.32.70
DJAFAR 7 L 17-01-2019 . 18-01-2019 . Suryanto, SpA. nasopharyngitis
100 MBiomed [common cold]
Dr.Tjahyo Acute
AN.GIOVANNI
00.19.05
ROSARIO M.MITANG 6 L 08-01-2019 . 12-01-2019 . Suryanto, SpA. nasopharyngitis
101 MBiomed [common cold]

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Acute
FLORA MARIA dr.Frans
03.31.22
AMARAL 0 P 11-01-2019 . 19-01-2019 . Taolin,Sp.A
nasopharyngitis
102 [common cold]
IVANNA Acute
dr.Frans
01.34.78 D.SHARAPOVA 5 P 15-01-2019 . 17-01-2019 . Taolin,Sp.A
nasopharyngitis
103 NAITILI [common cold]
Acute
THAMARISCA dr.Frans
03.28.86
KAMEO 7 P 03-01-2019 . 07-01-2019 . Taolin,Sp.A
nasopharyngitis
104 [common cold]
Acute
GUNA ANANTA dr.Frans
00.30.13
GOTAMA 3 L 04-01-2019 . 07-01-2019 . Taolin,Sp.A
nasopharyngitis
105 [common cold]
Acute
AZKA ALFERO E. dr.Frans
03.29.21
FANGGIDAE 2 L 04-01-2019 . 09-01-2019 . Taolin,Sp.A
nasopharyngitis
106 [common cold]
Acute
SIDNEY IMANUEL dr.Frans
01.94.21
PADAMA 2 L 09-01-2019 . 14-01-2019 . Taolin,Sp.A
nasopharyngitis
107 [common cold]
Acute
AISYAH KEMALA dr.Frans
03.33.94
DEWI 6 P 22-01-2019 . 23-01-2019 . Taolin,Sp.A
nasopharyngitis
108 [common cold]
Acute
BELINDA A. Q dr.Frans
01.64.22
FANGIDAE 2 P 24-01-2019 . 27-01-2019 . Taolin,Sp.A
nasopharyngitis
109 [common cold]
Acute
dr.Frans
01.94.77 RIVAVEL G. MBURA 3 L 18-01-2019 . 22-01-2019 . Taolin,Sp.A
nasopharyngitis
110 [common cold]
Acute
LAURENSIANA dr.Frans
03.34.44
YORHIJ DANGGUR 8 P 24-01-2019 . 30-01-2019 . Taolin,Sp.A
nasopharyngitis
111 [common cold]
Acute
ADE NAZARIO dr.Frans
02.67.91
CHORNEL LASSA 0 L 21-01-2019 . 28-01-2019 . Taolin,Sp.A
nasopharyngitis
112 [common cold]
Acute
CLARA K. P. dr.Frans
03.32.50
NEPARASSI 1 P 16-01-2019 . 20-01-2019 . Taolin,Sp.A
nasopharyngitis
113 [common cold]
AN. EAGLECLEAVER dr.Frans Acute pharyngitis,
114
00.84.74
XANDER IAN MESAH 5 L 06-01-2019 . 12-01-2019 . Taolin,Sp.A unspecified
Other acute upper
WILLIAM R. dr.Frans respiratory
02.23.43
THIMOTY BENU 1 L 21-01-2019 . 25-01-2019 . Taolin,Sp.A infections of
115 multiple sites
Other acute upper
SABILA AFSHEEN dr. Iren David, respiratory
01.99.68
MAYESHA 3 P 31-12-2018 . 04-01-2019 . Sp.A infections of
116 multiple sites

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Other acute upper
PRICILYA KIMORA dr. Iren David, respiratory
02.43.81
NDUN 4 P 30-12-2018 . 02-01-2019 . Sp.A infections of
117 multiple sites
Other acute upper
Dr.Tjahyo
GWYNETH J.KIDO respiratory
03.35.10
DENA 6 P 27-01-2019 . 29-01-2019 . Suryanto, SpA.
infections of
MBiomed
118 multiple sites
Other acute upper
Dr.Tjahyo
AZZAM NURADY respiratory
03.01.20
RADHYSA 3 L 06-01-2019 . 08-01-2019 . Suryanto, SpA.
infections of
MBiomed
119 multiple sites
Other acute upper
respiratory
03.30.55 LEONI TEFI 16 P 09-01-2019 . 10-01-2019 . dr Nina SpPD
infections of
120 multiple sites
Other acute upper
ELISABETH respiratory
03.33.38
IDELFONSA SONBAI 19 P 21-01-2019 . 23-01-2019 . dr Nina SpPD
infections of
121 multiple sites
dr.Frans Bronchopneumonia,
122
03.32.53 AULIA IZZATUNNISA 1 P 24-01-2019 . 30-01-2019 . Taolin,Sp.A unspecified
dr.Frans Acute bronchitis,
123
00.45.40 RISKA ELZIRA LELIS 3 P 23-01-2019 . 29-01-2019 . Taolin,Sp.A unspecified
SADIRA NUR A. dr.Frans Asthma,
124 03.33.99
SUPARMAN 4 P 22-01-2019 . 27-01-2019 . Taolin,Sp.A unspecified
SHALOM GRACIA M. dr.Frans Asthma,
125 03.33.66
SONBAI 5 P 21-01-2019 . 28-01-2019 . Taolin,Sp.A unspecified
YESTIANA RAHEL Asthma,
126 00.87.77
MANU 48 P 30-12-2018 . 02-01-2019 . dr Nina SpPD
unspecified
dr. Irene
02.33.73 NOBRIANTO MISSA 9 L 15-01-2019 . 17-01-2019 . Lokananta, Dyspepsia
127 Sp.BA
YOHANA TASYA
128 03.30.93
BEDA 17 P 11-01-2019 . 13-01-2019 . dr Nina SpPD Dyspepsia

129 03.34.96 HELENA SURYA 19 P 26-01-2019 . 29-01-2019 . dr Nina SpPD Dyspepsia


130 03.34.93 MARIA J.S. SAQUERA 49 P 27-01-2019 . 29-01-2019 . dr Nina SpPD Dyspepsia
ZUWINDA HANDARI
131 03.34.82
RAHMIYATI 28 P 26-01-2019 . 30-01-2019 . dr Nina SpPD Dyspepsia

132 03.33.95 HELENA TUATI 58 P 26-01-2019 . 28-01-2019 . dr Nina SpPD Dyspepsia


133 03.33.26 INGGRID T. MAHA 32 P 19-01-2019 . 21-01-2019 . dr Nina SpPD Dyspepsia
dr. Ahmad Other specified
03.32.21 DORTJE BENU 46 P 20-01-2019 . 21-01-2019 . Hendra diseases of
134 Yuniarsa, Sp.B appendix

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Unspecified
dr. Irene
abdominal hernia
03.29.81 ONISIMUS SKAU 0 L 07-01-2019 . 07-01-2019 . Lokananta,
without obstruction
Sp.BA
135 or gangrene
Local infection of
dr. Ahmad
skin and
03.30.33 ANTHONETA KORE 46 P 08-01-2019 . 10-01-2019 . Hendra
subcutaneous
Tindakan Bedah
Yuniarsa, Sp.B
136 tissue, unspecified
SUSANA MARIANA
137 03.03.36
DUKA DJUMA 30 P 08-01-2019 . 10-01-2019 . dr Nina SpPD Pain in joint
Dr.Tjahyo Unspecified
MAGDALENA RINA
03.28.27
SERAN 5 P 30-12-2018 . 05-01-2019 . Suryanto, SpA. nephritic syndrome,
138 MBiomed other
Unspecified
RAMADHANI DWI dr.Frans
02.13.45
AYUNI IDRIS 4 P 06-01-2019 . 17-01-2019 . Taolin,Sp.A
nephritic syndrome,
139 unspecified
Urinary tract
VERONIKA YULIANA
03.31.18
MEO DOLE 17 P 11-01-2019 . 14-01-2019 . dr Nina SpPD infection, site not
140 specified
Urinary tract
YOVENTA INA DONI
03.31.21
LD 17 P 11-01-2019 . 14-01-2019 . dr Nina SpPD infection, site not
141 specified
Disorder of urinary
142
03.34.08 NI PUTU DENIADI 40 P 23-01-2019 . 25-01-2019 . dr Nina SpPD
system, unspecified
dr. Ahmad
Fibroadenosis of
03.32.76 SALOMI LAKBANU 62 P 17-01-2019 . 18-01-2019 . Hendra
breast
143 Yuniarsa, Sp.B
Incisi Bartolin
NAEMA K.H.GORANG dr. Kt. Agus Abscess of
01.54.13
MAU,SP 41 P 31-12-2018 . 02-01-2019 . Sunatha, SpOG Bartholin's gland
Abces +
144 Anastesi
Extrepasi Kista
dr. Andree Abscess of
03.31.33 ELISABETH BESSI 26 P 12-01-2019 . 14-01-2019 . Hartanto.SpOG Bartholin's gland
Bartolin +
145 Anastesi
Other and
ANACI AMNAHAS dr. Andree
03.30.47
NENOTAELA 46 P 09-01-2019 . 12-01-2019 . Hartanto.SpOG
unspecified ovarian LAPARATOMI
146 cysts
dr.D.A.A.Shanti Polyp of cervix Biopsi +
147
03.27.87 ARISANCE LAY PA 40 L 10-01-2019 . 11-01-2019 . Widyasari,SpOG uteri Anastesi
Endometrial
dr. Andree Curetage +
03.29.38 NOVALINDA SELEKY 41 P 05-01-2019 . 06-01-2019 . Hartanto.SpOG
glandular
Anastesi
148 hyperplasia
Erosion and
dr.D.A.A.Shanti Curetage +
03.27.87 ARISANCE LAY PA 40 L 05-01-2019 . 07-01-2019 . Widyasari,SpOG
ectropion of cervix
Anastesi
149 uteri

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Excessive and
STEVANIA ESTRINA dr.D.A.A.Shanti frequent Curetage +
03.34.02
Y. NGEFAK 39 P 30-01-2019 . 31-01-2019 . Widyasari,SpOG menstruation with Anastesi
150 regular cycle
Excessive and
dr. Kt. Agus frequent Curetage +
00.95.93 ROSANTI J.MESAH 38 P 15-01-2019 . 16-01-2019 . Sunatha, SpOG menstruation with Anastesi
151 irregular cycle
Abnormal uterine
NY.OKTOVIANA dr.D.A.A.Shanti and vaginal Curetage +
00.43.32
MAIKAMANG 38 P 29-01-2019 . 30-01-2019 . Widyasari,SpOG bleeding, Anastesi
152 unspecified
Blighted ovum and
dr.D.A.A.Shanti Curetage +
00.91.33 LIMAS JUNIATI 40 P 22-01-2019 . 23-01-2019 . Widyasari,SpOG
nonhydatidiform
Anastesi
153 mole
Blighted ovum and
MARTHADINA Y. Y. dr.D.A.A.Shanti Curetage +
03.35.66
TAOSU 45 P 30-01-2019 . 31-01-2019 . Widyasari,SpOG
nonhydatidiform
Anastesi
154 mole
Blighted ovum and
dr. Kt. Agus Curetage +
03.34.10 RISKA PUSPITA SARI 30 P 23-01-2019 . 24-01-2019 . Sunatha, SpOG
nonhydatidiform
Anastesi
155 mole
Blighted ovum and
FICTORIDA A.N dr. Kt. Agus Curetage +
03.00.38
MANOE 42 P 12-01-2019 . 13-01-2019 . Sunatha, SpOG
nonhydatidiform
Anastesi
156 mole
Blighted ovum and
dr. Kt. Agus Curetage Mola
03.28.75 MEFI KIKHAU 19 P 02-01-2019 . 03-01-2019 . Sunatha, SpOG
nonhydatidiform
+ Anastesi
157 mole
Blighted ovum and
ROHMADITA dr. Andree Curetage +
00.61.54
W.KHASANAH 26 P 08-01-2019 . 10-01-2019 . Hartanto.SpOG
nonhydatidiform
Anastesi
158 mole
Unspecified
abortion,
dr.D.A.A.Shanti Curetage +
03.33.87 NORLINDA TAHIK 26 P 22-01-2019 . 23-01-2019 . Widyasari,SpOG
incomplete,
Anastesi
complicated by
159 genital tract and
Unspecified
abortion,
dr.D.A.A.Shanti Curetage +
03.27.03 RUTNI HENI PAUT 31 P 10-01-2019 . 11-01-2019 . Widyasari,SpOG
incomplete, with
Anastesi
other and
160 unspecified
Unspecified
abortion,
SARLINDA ADRIANI dr.D.A.A.Shanti Curetage +
01.81.05
KISEK 43 P 14-01-2019 . 15-01-2019 . Widyasari,SpOG
incomplete, with
Anastesi
other and
161 unspecified

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Unspecified
abortion,
DEWITA dr.D.A.A.Shanti Curetage +
03.31.53
DAMAYANTI SINAGA 28 P 13-01-2019 . 14-01-2019 . Widyasari,SpOG
incomplete, with
Anastesi
other and
162 unspecified
Unspecified
abortion,
GINA LIANA dr.D.A.A.Shanti Curetage +
03.34.43
THOMAS 31 P 24-01-2019 . 26-01-2019 . Widyasari,SpOG
incomplete, with
Anastesi
other and
163 unspecified
Unspecified
abortion,
ATRI SURYANI TEFA dr.D.A.A.Shanti Curetage +
03.34.36
APLUGI 30 P 24-01-2019 . 25-01-2019 . Widyasari,SpOG
incomplete, with
Anastesi
other and
164 unspecified
Unspecified
abortion,
dr. Kt. Agus Curetage +
03.19.27 GASTIANA ISLIKO 41 P 17-01-2019 . 19-01-2019 . Sunatha, SpOG
incomplete, with
Anastesi
other and
165 unspecified
Unspecified
abortion,
dr. Andree Curetage +
02.83.95 AFLIANA LAY 26 P 24-01-2019 . 25-01-2019 . Hartanto.SpOG
incomplete, with
Anastesi
other and
166 unspecified
Unspecified
abortion,
dr. Andree Curetage +
03.25.76 ANASTASIA KEDANG 31 P 09-01-2019 . 10-01-2019 . Hartanto.SpOG
incomplete, with
Anastesi
other and
167 unspecified
dr.Dewa Putu
Moderate pre-
03.32.73 YOHANA NABUASA 27 P 18-01-2019 . 19-01-2019 . Sahadewa,
eclampsia
168 SpOG(K)
DEASYANI BARCE dr.D.A.A.Shanti Moderate pre-
169
03.15.42
MANDALA 37 P 16-01-2019 . 18-01-2019 . Widyasari,SpOG eclampsia
Sectio Cesarea

dr.D.A.A.Shanti Severe pre-


170
03.29.99 LIDIA LAMBANAUNG 41 P 07-01-2019 . 10-01-2019 . Widyasari,SpOG eclampsia
Sectio Cesarea
Unspecified
dr.D.A.A.Shanti
03.29.49 YANE DETHAN 35 P 05-01-2019 . 07-01-2019 . Widyasari,SpOG
maternal Sectio Cesarea
171 hypertension
Unspecified
dr.D.A.A.Shanti
03.32.00 ELDA PATOLA 17 P 14-01-2019 . 17-01-2019 . Widyasari,SpOG
maternal Sectio Cesarea
172 hypertension
Unspecified
PRISKILA ELISABETH dr.D.A.A.Shanti
03.25.65
FONI 29 P 19-01-2019 . 21-01-2019 . Widyasari,SpOG
maternal
173 hypertension

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Unspecified
FENISIANA dr.D.A.A.Shanti
03.32.37
CLAUDINA E. TABUN 18 P 15-01-2019 . 17-01-2019 . Widyasari,SpOG
maternal Sectio Cesarea
174 hypertension
Unspecified
MARIA N.PEHEN dr. Kt. Agus
03.31.25
BISING 39 P 12-01-2019 . 15-01-2019 . Sunatha, SpOG
maternal Sectio Cesarea
175 hypertension
dr.D.A.A.Shanti
176 03.28.96 RISMA 24 P 15-01-2019 . 16-01-2019 . Widyasari,SpOG
Threatened abortion
dr.D.A.A.Shanti
177 03.32.98 KETSIA S.P.M. LANOE 33 P 18-01-2019 . 19-01-2019 . Widyasari,SpOG
Threatened abortion
MALINDA RADJA dr. Andree
178 03.29.52
PONO 29 P 05-01-2019 . 09-01-2019 . Hartanto.SpOG
Threatened abortion
dr.Dewa Putu
HARTININGSIH Mild hyperemesis
03.35.01
PELLOKILA 29 P 27-01-2019 . 28-01-2019 . Sahadewa,
gravidarum
179 SpOG(K)
dr.Dewa Putu
Mild hyperemesis
03.29.43 ADRIANA I. SAEFATU 26 P 05-01-2019 . 07-01-2019 . Sahadewa,
gravidarum
180 SpOG(K)
dr.D.A.A.Shanti Mild hyperemesis
181
02.24.18 SALOMI UMBU DETA 37 P 03-01-2019 . 07-01-2019 . Widyasari,SpOG gravidarum
dr.D.A.A.Shanti Mild hyperemesis
182
03.30.78 HELENA DA COSTA 26 P 10-01-2019 . 11-01-2019 . Widyasari,SpOG gravidarum
METI DELFIANA dr. Andree Mild hyperemesis
183
03.30.87
NATONIS 28 P 10-01-2019 . 12-01-2019 . Hartanto.SpOG gravidarum
ADELFIA METO dr. Kt. Agus Mild hyperemesis
184
00.11.31
TARIGAN 32 P 02-01-2019 . 03-01-2019 . Sunatha, SpOG gravidarum
CHRISTY M. dr.D.A.A.Shanti Mild hyperemesis
185
03.32.07
AMTARAN 27 P 14-01-2019 . 16-01-2019 . Widyasari,SpOG gravidarum
ANGELINA PRISCILA dr.D.A.A.Shanti Mild hyperemesis
186
03.35.91
RADJA PADJI 20 P 30-01-2019 . 31-01-2019 . Widyasari,SpOG gravidarum
ADELFIA METO dr. Kt. Agus Mild hyperemesis
187
00.11.31
TARIGAN 32 P 14-01-2019 . 16-01-2019 . Sunatha, SpOG gravidarum
MARIA BERNADETE dr. Kt. Agus Mild hyperemesis
188
01.63.76
B.SEBAN 30 P 19-01-2019 . 21-01-2019 . Sunatha, SpOG gravidarum
ADELFIA METO dr. Kt. Agus Mild hyperemesis
189
00.11.31
TARIGAN 32 P 07-01-2019 . 09-01-2019 . Sunatha, SpOG gravidarum
dr.D.A.A.Shanti Mild hyperemesis
190
02.81.43 FAJAR OKTA UNDARI 34 P 17-01-2019 . 19-01-2019 . Widyasari,SpOG gravidarum
Infections of the
NY. MARIA MARICE
00.99.10
NOMESEO 38 P 03-01-2019 . 05-01-2019 . dr Nina SpPD genital tract in
191 pregnancy
dr.Dewa Putu
Maternal care for
02.89.78 SEPTIANA A TELLA 29 P 21-01-2019 . 24-01-2019 . Sahadewa,
breech presentation
Sectio Cesarea
192 SpOG(K)
dr. Kt. Agus Maternal care for
193
03.34.97 APRILI YANTI ANO 22 P 26-01-2019 . 29-01-2019 . Sunatha, SpOG breech presentation
Sectio Cesarea

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


dr.Dewa Putu Maternal care for
DEBYSANDRA
02.50.22
BALANG 38 P 22-01-2019 . 24-01-2019 . Sahadewa, transverse and Sectio Cesarea
194 SpOG(K) oblique lie
Maternal care for
DIAN ADRIANA dr.D.A.A.Shanti
03.07.82
TAKALAPETA - LOMI 37 P 19-01-2019 . 21-01-2019 . Widyasari,SpOG
transverse and Sectio Cesarea
195 oblique lie
Maternal care for
dr. Andree
02.79.41 DEWI HARYANTI 40 P 23-01-2019 . 27-01-2019 . Hartanto.SpOG
transverse and Sectio Cesarea
196 oblique lie
Maternal care for
dr. Andree
03.06.13 NURLIANA FAFO 36 P 05-01-2019 . 07-01-2019 . Hartanto.SpOG
transverse and Sectio Cesarea
197 oblique lie
Maternal care for
NURSHANY M. dr. Andree
03.09.02
ZACHARIAS 32 P 19-01-2019 . 21-01-2019 . Hartanto.SpOG
transverse and Sectio Cesarea
198 oblique lie
Maternal care for
DORA YULIANA dr. Andree
03.31.91
NDOLU 39 P 19-01-2019 . 21-01-2019 . Hartanto.SpOG
transverse and Sectio Cesarea
199 oblique lie
Maternal care for
YULI FITRIANI dr. Kt. Agus
03.35.28
MANSULA 37 P 28-01-2019 . 30-01-2019 . Sunatha, SpOG
transverse and Sectio Cesarea
200 oblique lie
Maternal care for
dr. Kt. Agus
02.42.50 HAMSINAH MANSUR 37 P 04-01-2019 . 06-01-2019 . Sunatha, SpOG
transverse and Sectio Cesarea
201 oblique lie
Maternal care for
dr. Kt. Agus
02.96.77 YASINTA O. DJAWA 34 P 03-01-2019 . 05-01-2019 . Sunatha, SpOG
transverse and Sectio Cesarea
202 oblique lie
Maternal care for
PATRICIA WALANDA dr. Kt. Agus
03.28.83
WOWOR 24 P 03-01-2019 . 06-01-2019 . Sunatha, SpOG
transverse and Sectio Cesarea
203 oblique lie
Maternal care for
YULIANA ABUK dr.D.A.A.Shanti
03.29.89
HULER SERAN 35 P 07-01-2019 . 09-01-2019 . Widyasari,SpOG
transverse and Sectio Cesarea
204 oblique lie
Maternal care for
dr.D.A.A.Shanti
03.07.42 MARIA SAETBAN 21 P 20-01-2019 . 22-01-2019 . Widyasari,SpOG
transverse and Sectio Cesarea
205 oblique lie
Maternal care for
dr.D.A.A.Shanti
03.16.93 PETRONELA OLLA 36 P 28-01-2019 . 30-01-2019 . Widyasari,SpOG
transverse and Sectio Cesarea
206 oblique lie
Maternal care for
dr.D.A.A.Shanti
03.21.93 DORINCE LOPO 40 P 18-01-2019 . 21-01-2019 . Widyasari,SpOG
transverse and Sectio Cesarea
207 oblique lie
NY. TOHIROTUL Maternal care for
dr.D.A.A.Shanti
01.23.11 HIDAYATI OLLA 38 P 26-01-2019 . 28-01-2019 . Widyasari,SpOG
transverse and Sectio Cesarea
208 PELU oblique lie
WIDA RESKI dr. Kt. Agus Maternal care for
209
03.25.57
PASORONGG 29 P 23-01-2019 . 25-01-2019 . Sunatha, SpOG high head at term
Sectio Cesarea

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


dr. Kt. Agus Maternal care for
210
03.22.81 NOFI K FAHIK 24 P 02-01-2019 . 04-01-2019 . Sunatha, SpOG high head at term
Sectio Cesarea
Maternal care for
dr.D.A.A.Shanti disproportion due to
03.35.00 SUSIANA SOLET 24 P 27-01-2019 . 29-01-2019 . Widyasari,SpOG inlet contraction of
Sectio Cesarea
211 pelvis
Maternal care for
dr.D.A.A.Shanti disproportion due to
03.21.10 MARLIN NIUFLAPU 26 P 26-01-2019 . 28-01-2019 . Widyasari,SpOG inlet contraction of
Sectio Cesarea
212 pelvis
Maternal care for
dr.D.A.A.Shanti disproportion due to
03.09.18 SERLY M. PE LEDE 33 P 20-01-2019 . 22-01-2019 . Widyasari,SpOG inlet contraction of
Sectio Cesarea
213 pelvis
Maternal care for
dr. Kt. Agus disproportion due to
03.09.27 NI LUH SUPADMI 28 P 15-01-2019 . 18-01-2019 . Sunatha, SpOG inlet contraction of
Sectio Cesarea
214 pelvis
Maternal care for
dr. Kt. Agus disproportion due to
03.28.89 RELIN MERTINI NAU 28 P 03-01-2019 . 06-01-2019 . Sunatha, SpOG inlet contraction of
Sectio Cesarea
215 pelvis
Maternal care for
dr. Kt. Agus disproportion due to
03.23.03 ETNI TRIFENA IBU 28 P 30-12-2018 . 02-01-2019 . Sunatha, SpOG inlet contraction of
Sectio Cesarea
216 pelvis
Maternal care for
PAULINA YUNITA dr. Kt. Agus disproportion due to
03.24.05
CEUNFIN 21 P 30-12-2018 . 02-01-2019 . Sunatha, SpOG inlet contraction of
Sectio Cesarea
217 pelvis
Maternal care due
dr. Andree
03.30.16 ADELINA SASI 36 P 15-01-2019 . 17-01-2019 . Hartanto.SpOG
to uterine scar from Sectio Cesarea
218 previous surgery
Maternal care due
JEANNETTE L. dr. Andree
03.28.81
FANGGIE 29 P 05-01-2019 . 08-01-2019 . Hartanto.SpOG
to uterine scar from Sectio Cesarea
219 previous surgery
Maternal care due
dr. Kt. Agus
00.41.96 NORCE TANESIB 25 P 31-12-2018 . 02-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
220 previous surgery
Maternal care due
dr. Kt. Agus
03.17.81 FEBY URNIANI LAU 34 P 29-12-2018 . 01-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
221 previous surgery
Maternal care due
YANTI MARIANA dr. Kt. Agus
03.19.81
KEBA 35 P 02-01-2019 . 04-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
222 previous surgery
Maternal care due
dr. Kt. Agus
03.28.60 ECI TAROCI RONDO 32 P 01-01-2019 . 04-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
223 previous surgery

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Maternal care due
dr. Kt. Agus
03.28.56 YUNITA NESI 29 P 01-01-2019 . 03-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
224 previous surgery
Maternal care due
dr. Andree
01.35.35 NY.NONI NOVITA UN 36 P 06-01-2019 . 10-01-2019 . Hartanto.SpOG
to uterine scar from Sectio Cesarea
225 previous surgery
Maternal care due
NY. PUTU WISMA dr. Kt. Agus
00.14.70
NINGSIH 29 P 15-01-2019 . 17-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
226 previous surgery
Maternal care due
MARIA SUSANTHY dr. Kt. Agus
02.47.59
RIA 26 P 18-01-2019 . 21-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
227 previous surgery
Maternal care due
dr. Kt. Agus
03.33.65 FITRI RAHMADINI 27 P 21-01-2019 . 24-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
228 previous surgery
Maternal care due
dr. Kt. Agus
00.48.42 NY.ASMI DASI 32 P 10-01-2019 . 12-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
229 previous surgery
YOSEPHINA Maternal care due
dr. Kt. Agus
03.28.51 MARGARETHA T D 36 P 01-01-2019 . 03-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
230 WEA previous surgery
Maternal care due
dr. Kt. Agus
03.28.88 WINDRA W. MANAFE 29 P 03-01-2019 . 05-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
231 previous surgery
Maternal care due
dr.D.A.A.Shanti
03.11.56 YUBLINA LALUS 29 P 12-01-2019 . 15-01-2019 . Widyasari,SpOG
to uterine scar from Sectio Cesarea
232 previous surgery
Maternal care due
NY. ZETLIN MOLA dr.D.A.A.Shanti
01.16.23
KORE 33 P 17-01-2019 . 21-01-2019 . Widyasari,SpOG
to uterine scar from Sectio Cesarea
233 previous surgery
Maternal care due
NY. IVONEE C. T dr.D.A.A.Shanti
00.51.42
WANGGE 34 P 20-01-2019 . 22-01-2019 . Widyasari,SpOG
to uterine scar from Sectio Cesarea
234 previous surgery
Maternal care due
NY. SUSANA L. dr.D.A.A.Shanti
00.25.54
ANIMAU 37 P 06-01-2019 . 08-01-2019 . Widyasari,SpOG
to uterine scar from Sectio Cesarea
235 previous surgery
Maternal care due
dr. Kt. Agus
02.10.85 CHRISTIN R. DILLAK 36 P 15-01-2019 . 18-01-2019 . Sunatha, SpOG
to uterine scar from Sectio Cesarea
236 previous surgery
dr.D.A.A.Shanti Maternal care for
237
03.10.62 MARSALINA DJAMI 26 P 19-01-2019 . 21-01-2019 . Widyasari,SpOG intrauterine death
Sectio Cesarea

dr.D.A.A.Shanti Maternal care for


238
03.33.84 LENI TUPU 34 P 23-01-2019 . 25-01-2019 . Widyasari,SpOG intrauterine death
Sectio Cesarea

DESI WEMILIA dr. Kt. Agus Maternal care for


239
03.28.94
BOIMAU 29 P 03-01-2019 . 04-01-2019 . Sunatha, SpOG intrauterine death
Sectio Cesarea

HABRITA KORE dr. Kt. Agus Maternal care for


240
03.29.47
TUDU 26 P 05-01-2019 . 08-01-2019 . Sunatha, SpOG intrauterine death
Partus Normal

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


NENGSI ROSITA dr. Kt. Agus Maternal care for
241
03.28.59
KARLAU 32 P 01-01-2019 . 03-01-2019 . Sunatha, SpOG intrauterine death
MARIA ERMILINDA dr.D.A.A.Shanti
242
03.31.34
FUNAN 35 P 12-01-2019 . 14-01-2019 . Widyasari,SpOG
Oligohydramnios Sectio Cesarea

dr. Kt. Agus


243
03.24.22 ETIK AMBARWATI 29 P 31-12-2018 . 02-01-2019 . Sunatha, SpOG
Oligohydramnios Sectio Cesarea
Premature rupture
dr. Kt. Agus of membranes,
03.32.85 KUNISAH 26 P 18-01-2019 . 21-01-2019 . Sunatha, SpOG onset of labour after
Sectio Cesarea
244 24 hours
Premature rupture
dr. Kt. Agus of membranes,
03.10.26 KRISTIANI KORE 30 P 26-01-2019 . 28-01-2019 . Sunatha, SpOG onset of labour after
Sectio Cesarea
245 24 hours
Premature rupture
RATNANDYA PUTRI dr.D.A.A.Shanti of membranes,
02.03.82
LUTHFITA 24 P 07-01-2019 . 10-01-2019 . Widyasari,SpOG labour delayed by
246 therapy
Premature rupture
MARIA SUSANTHY dr. Kt. Agus of membranes,
02.47.59
RIA 26 P 08-01-2019 . 10-01-2019 . Sunatha, SpOG labour delayed by
247 therapy
dr.Dewa Putu Premature rupture
CHRISTIN
02.98.41
P.M.RAJAGUKGUK 25 P 03-01-2019 . 06-01-2019 . Sahadewa, of membranes, Sectio Cesarea
248 SpOG(K) unspecified
Premature rupture
ENA WASTI dr.D.A.A.Shanti
03.30.67
AMTIRAN 22 P 09-01-2019 . 11-01-2019 . Widyasari,SpOG
of membranes, Sectio Cesarea
249 unspecified
Premature rupture
dr.D.A.A.Shanti
03.35.55 ELNI TEUF 28 P 29-01-2019 . 31-01-2019 . Widyasari,SpOG
of membranes, Sectio Cesarea
250 unspecified
Premature rupture
YULITE SINA dr. Kt. Agus
03.32.62
YOHANIS 40 P 17-01-2019 . 19-01-2019 . Sunatha, SpOG
of membranes, Sectio Cesarea
251 unspecified
Premature rupture
dr. Kt. Agus
03.27.46 YURLINCE TAGEL 21 P 01-01-2019 . 02-01-2019 . Sunatha, SpOG
of membranes, Partus Normal
252 unspecified
dr. Laurens Premature rupture
ROSINA RIBKA
03.29.73
TAKAIN 42 P 07-01-2019 . 11-01-2019 . David Paulus. of membranes, Sectio Cesarea
253 SpOG(K) unspecified
dr. Andree Placenta praevia
254
03.07.49 EVA SUPRIANINGSIH 29 P 08-01-2019 . 11-01-2019 . Hartanto.SpOG with haemorrhage
Sectio Cesarea

dr. Andree Other antepartum


255
03.33.22 IRNA MASTINI MISA 25 P 19-01-2019 . 21-01-2019 . Hartanto.SpOG haemorrhage

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Antepartum
MAGDA M. DASINTA dr. Kt. Agus
03.28.80
HUMA 39 P 03-01-2019 . 06-01-2019 . Sunatha, SpOG
haemorrhage, Sectio Cesarea
256 unspecified
Antepartum
YOHANA FRANSISKA dr.D.A.A.Shanti
03.24.94
WOLOR 35 P 28-01-2019 . 31-01-2019 . Widyasari,SpOG
haemorrhage, Sectio Cesarea
257 unspecified
MARIA GABRIELA dr.D.A.A.Shanti Other failed
258
03.23.59
TUTO 29 P 05-01-2019 . 07-01-2019 . Widyasari,SpOG induction of labour
Sectio Cesarea

dr.D.A.A.Shanti Failed induction of


259
03.07.56 MARLIN SELAK 25 P 20-01-2019 . 23-01-2019 . Widyasari,SpOG labour, unspecified
Sectio Cesarea

dr.D.A.A.Shanti Other abnormalities Partus Patologi


03.23.11 SEMI KOLMATE 36 P 04-01-2019 . 07-01-2019 . Widyasari,SpOG of forces of labour (Vacum)
260
ARLINCE S.
dr.D.A.A.Shanti Other abnormalities Partus Patologi
01.71.21 WABANG- 36 P 07-01-2019 . 09-01-2019 . Widyasari,SpOG of forces of labour (Vacum)
261 BILISTOLEN

dr.D.A.A.Shanti Other abnormalities Partus Patologi


01.60.02 FELIKSIA DIATI 28 P 24-01-2019 . 25-01-2019 . Widyasari,SpOG of forces of labour (Vacum)
262
dr. Andree Prolonged first
263
03.30.10 AURELIA ENSALITA 21 P 07-01-2019 . 10-01-2019 . Hartanto.SpOG stage (of labour)
Sectio Cesarea

MARIA MERLINDA dr. Andree Prolonged first


264
03.20.76
DHITU 23 P 12-01-2019 . 15-01-2019 . Hartanto.SpOG stage (of labour)
Sectio Cesarea
Obstructed labour
dr. Kt. Agus
03.31.47 MERYANA DOKO 36 P 12-01-2019 . 14-01-2019 . Sunatha, SpOG
due to unusually Sectio Cesarea
265 large fetus
Labour and delivery
dr.D.A.A.Shanti complicated by
03.31.66 NORLINA PITAY 24 P 13-01-2019 . 15-01-2019 . Widyasari,SpOG fetal stress,
Sectio Cesarea
266 unspecified
Labour and delivery
dr.D.A.A.Shanti complicated by
03.31.67 YAKOBA SONBAI 33 P 14-01-2019 . 15-01-2019 . Widyasari,SpOG fetal stress,
Sectio Cesarea
267 unspecified
Labour and delivery
DORTIA ESNAINA dr.D.A.A.Shanti complicated by Partus Patologi
03.21.40
SMAUT 34 P 04-01-2019 . 07-01-2019 . Widyasari,SpOG fetal stress, (Vacum)
268 unspecified
Labour and delivery
dr.D.A.A.Shanti complicated by
03.33.73 YUSARMI ATAUPAH 19 P 22-01-2019 . 24-01-2019 . Widyasari,SpOG fetal stress,
Sectio Cesarea
269 unspecified

SETIAR ROHANI dr.D.A.A.Shanti Labour and delivery


03.35.08
NINGSIH 43 P 27-01-2019 . 29-01-2019 . Widyasari,SpOG complicated by
Sectio Cesarea
270

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


fetal stress,
unspecified

Labour and delivery


dr.D.A.A.Shanti complicated by
03.35.17 ANCE MISSA 32 P 28-01-2019 . 30-01-2019 . Widyasari,SpOG fetal stress,
Sectio Cesarea
271 unspecified
Labour and delivery
LUSIA ROSWITA dr.D.A.A.Shanti complicated by
03.29.70
TAPATAB 26 P 06-01-2019 . 12-01-2019 . Widyasari,SpOG fetal stress,
Sectio Cesarea
272 unspecified

Labour and delivery


NY. MARIA Sectio Casarea
dr. Kt. Agus complicated by
01.24.68 YOLANDA IVONEY 27 P 10-01-2019 . 12-01-2019 . Sunatha, SpOG fetal stress,
+ Simple Suture
LANUS of Tuba Fallopi
unspecified
273
Labour and delivery
ASRIYANI DIMU dr. Andree complicated by
03.32.08
LUDJI 33 P 14-01-2019 . 16-01-2019 . Hartanto.SpOG fetal stress,
Sectio Cesarea
274 unspecified
Labour and delivery
dr. Andree complicated by
03.33.44 NELCI ATOLO MAMO 45 P 21-01-2019 . 23-01-2019 . Hartanto.SpOG fetal stress,
Sectio Cesarea
275 unspecified
Perineal laceration
dr.D.A.A.Shanti Repair
03.31.02 ADONIA KIKHAU 27 P 13-01-2019 . 15-01-2019 . Widyasari,SpOG
during delivery,
Perineum gr IV
276 unspecified
HUTARI PUTRI dr.D.A.A.Shanti Spontaneous vertex
277 03.12.93
LEODIMA 21 P 17-01-2019 . 26-01-2019 . Widyasari,SpOG delivery
Incisi Abces
Other single
dr.D.A.A.Shanti
03.04.97 MENCI MANAO 31 P 10-01-2019 . 11-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
278 delivery
Other single
dr.D.A.A.Shanti
03.31.04 MERCI TAMONOB 23 P 11-01-2019 . 13-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
279 delivery
Other single
dr.D.A.A.Shanti
01.78.17 MARIA SOLU LANI 37 P 14-01-2019 . 15-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
280 delivery
Other single
YUNITRI RAMBU dr.D.A.A.Shanti
03.31.03
DADA 30 P 22-01-2019 . 23-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
281 delivery
Other single
dr.D.A.A.Shanti
03.26.85 MARIA TEFA 31 P 09-01-2019 . 10-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
282 delivery

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Other single
ARANCI APRIDA dr.D.A.A.Shanti
02.44.21
NDUN 38 P 20-01-2019 . 22-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
283 delivery
Other single
YUYUN OLIVIA dr. Andree
03.24.46
MANDALA 20 P 19-01-2019 . 21-01-2019 . Hartanto.SpOG
spontaneous Partus Normal
284 delivery
Other single
FALENTINA BHALU dr. Andree
02.14.35
LEO 23 P 18-01-2019 . 19-01-2019 . Hartanto.SpOG
spontaneous Partus Normal
285 delivery
Other single
dr. Andree
03.34.33 ROSITA A.BAI 15 P 24-01-2019 . 25-01-2019 . Hartanto.SpOG
spontaneous Partus Normal
286 delivery
Other single
JANNE VICTORIA dr. Andree
03.33.69
BENU 19 P 21-01-2019 . 23-01-2019 . Hartanto.SpOG
spontaneous Partus Normal
287 delivery
ADRIANA Other single
dr. Andree
03.33.45 HENDERINA 33 P 21-01-2019 . 22-01-2019 . Hartanto.SpOG
spontaneous Partus Normal
288 SAEKETU delivery
Other single
dr. Andree
03.33.00 NADINE NANGA 19 P 18-01-2019 . 19-01-2019 . Hartanto.SpOG
spontaneous Partus Normal
289 delivery
Other single
dr. Kt. Agus
03.31.26 ANJANI C.W.GIRI 27 P 12-01-2019 . 13-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
290 delivery
Other single
MONIKA AGUSTINA dr. Kt. Agus
03.21.15
V. BAUNSELE 30 P 05-01-2019 . 07-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
291 delivery
Other single
dr. Kt. Agus Partus Patologi
03.27.52 SRI LESTARI 27 P 09-01-2019 . 11-01-2019 . Sunatha, SpOG
spontaneous
(Induksi)
292 delivery
Other single
MARIANA S. dr. Kt. Agus
03.28.49
TAPOONA 25 P 01-01-2019 . 02-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
293 delivery
Other single
ADELIA HANDAYANI dr. Kt. Agus
03.28.46
SIDIN 19 P 31-12-2018 . 02-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
294 delivery
Other single
MARIA ALFIANI dr. Kt. Agus
03.28.67
NAHAS 21 P 02-01-2019 . 03-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
295 delivery
Other single
WELSIN TRIYANA dr.D.A.A.Shanti
03.31.28
HOTAN 21 P 14-01-2019 . 16-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
296 delivery
Other single
SANTRI LAIDAT dr.D.A.A.Shanti
03.34.52
BELLEH 28 P 25-01-2019 . 26-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
297 delivery

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Other single
dr. Kt. Agus
03.32.18 EVI HELAN SEPTORY 34 P 15-01-2019 . 16-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
298 delivery
Other single
KAROLINA MALA dr. Kt. Agus
03.32.20
RATU BAI 22 P 15-01-2019 . 16-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
299 delivery
Other single
YOVITA KENYO dr. Kt. Agus
03.23.91
WIDIASTUTI 25 P 26-01-2019 . 28-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
300 delivery
Other single
dr. Kt. Agus
03.35.42 NAIMA ARKIAN 28 P 28-01-2019 . 30-01-2019 . Sunatha, SpOG
spontaneous Partus Normal
301 delivery
Other single
FENTI MARIANA dr.D.A.A.Shanti Pemeriksaan
03.31.09
KONIS 18 P 11-01-2019 . 12-01-2019 . Widyasari,SpOG
spontaneous
Ginekologi
302 delivery
Other single
dr.D.A.A.Shanti
03.29.91 ISMIYATI SUWONO 29 P 12-01-2019 . 14-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
303 delivery
Other single
dr.D.A.A.Shanti Partus Patologi
03.12.62 WELMINCE NARA 35 P 29-01-2019 . 31-01-2019 . Widyasari,SpOG
spontaneous
(Induksi)
304 delivery
Other single
PRISKA YUNITA dr.D.A.A.Shanti
03.34.66
TALEKI 20 P 26-01-2019 . 26-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
305 delivery
Other single
dr.D.A.A.Shanti Partus Patologi
03.34.61 NAOMI RIANA WATY 23 P 25-01-2019 . 28-01-2019 . Widyasari,SpOG
spontaneous
(Induksi)
306 delivery
Other single
YOSMINA ADELHET dr.D.A.A.Shanti
03.25.81
HAOFBENU 36 P 22-01-2019 . 24-01-2019 . Widyasari,SpOG
spontaneous Partus Normal
307 delivery
Other single
APLONIA YOHANA dr.D.A.A.Shanti
03.30.46
BOLLA 39 P 09-01-2019 . 11-01-2019 . Widyasari,SpOG
delivery by Sectio Cesarea
308 caesarean section
Other single
dr. Kt. Agus
03.26.10 SELVI YAHYA 32 P 05-01-2019 . 07-01-2019 . Sunatha, SpOG
delivery by Sectio Cesarea
309 caesarean section
Other single
TESALONIKA dr. Andree
01.27.40
TRIPUJA HANING 30 P 11-01-2019 . 13-01-2019 . Hartanto.SpOG
delivery by Sectio Cesarea
310 caesarean section
Other single
dr. Andree
03.30.18 YAKOMINA ADONIS 30 P 08-01-2019 . 09-01-2019 . Hartanto.SpOG
delivery by Sectio Cesarea
311 caesarean section
Infection of
dr.D.A.A.Shanti
01.55.36 YERI MARLENI ADU 31 P 08-01-2019 . 09-01-2019 . Widyasari,SpOG
obstetric surgical
312 wound

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Infection of
dr.D.A.A.Shanti Repair
03.12.99 MARTHA MANIT 25 P 25-01-2019 . 27-01-2019 . Widyasari,SpOG
obstetric surgical
Perineum gr IV
313 wound
Infection of HEACTING
YUYUN OLIVIA dr. Andree
03.24.46
MANDALA 20 P 24-01-2019 . 25-01-2019 . Hartanto.SpOG
obstetric surgical PERINIUM +
314 wound ANASTESI
Infection of HEACTING
dr. Andree
03.30.08 MARTHA SOLUKH 38 P 17-01-2019 . 18-01-2019 . Hartanto.SpOG
obstetric surgical PERINIUM +
315 wound ANASTESI

Disruption of Tindakan
ROSINA RIBKA dr.D.A.A.Shanti
03.29.73
TAKAIN 43 P 19-01-2019 . 21-01-2019 . Widyasari,SpOG
caesarean section Debridement +
wound Anastesi OK
316
Disruption of HEACTING
dr.D.A.A.Shanti
03.26.85 MARIA TEFA 31 P 14-01-2019 . 15-01-2019 . Widyasari,SpOG
perineal obstetric PERINIUM +
317 wound ANASTESI
Disruption of HEACTING
dr.D.A.A.Shanti
03.17.05 DELTIDE DHEPA 32 P 04-01-2019 . 05-01-2019 . Widyasari,SpOG
perineal obstetric PERINIUM +
318 wound ANASTESI
Diseases of the
respiratory system
MARIA ROSINA
02.03.62
DALLA 31 P 25-01-2019 . 29-01-2019 . dr Nina SpPD complicating
pregnancy,
319 childbirth
Diseases of the
digestive system
dr.D.A.A.Shanti
03.27.75 NURAINI DJAILANI 26 P 22-01-2019 . 23-01-2019 . Widyasari,SpOG
complicating
pregnancy,
320 childbirth and
Diseases of the
digestive system
dr. Andree
03.29.16 RAHAYU SAFITRI 33 P 04-01-2019 . 05-01-2019 . Hartanto.SpOG
complicating
pregnancy,
321 childbirth and
Diseases of the skin
dr. Ahmad
MEYDINI CAROLINA and subcutaneous
00.42.49
DALLY 24 P 28-01-2019 . 30-01-2019 . Hendra
tissue complicating
Tindakan Bedah
Yuniarsa, Sp.B
322 pregnancy,
Other specified
diseases and
NY. RATIH LUISA dr.D.A.A.Shanti
00.43.17
YULIAN. OTTO 31 P 11-01-2019 . 12-01-2019 . Widyasari,SpOG
conditions
complicating
323 pregnancy,

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Other specified
diseases and
CHITRA MONALISA dr.D.A.A.Shanti
03.31.61
FUNAY 25 P 13-01-2019 . 17-01-2019 . Widyasari,SpOG
conditions
complicating
324 pregnancy,
Other specified
diseases and
LUSIA ROSWITA dr.D.A.A.Shanti
03.29.70
TAPATAB 26 P 18-01-2019 . 21-01-2019 . Widyasari,SpOG
conditions
complicating
325 pregnancy,
Fetus and newborn
Dr.Tjahyo
affected by delivery
03.34.23 BY FELIKSIA DIATI 0 L 24-01-2019 . 25-01-2019 . Suryanto, SpA.
by vacuum
MBiomed
326 extractor [ventouse]
dr. Simplicia Fetus and newborn
03.33.41 BY.SERLY M.PE LEDE 0 L 20-01-2019 . 23-01-2019 . Maria affected by
327 Anggrahini,Sp.A caesarean delivery
dr. Simplicia Fetus and newborn
BY. IVONNE C.T
03.33.42
WANGGE 0 P 20-01-2019 . 22-01-2019 . Maria affected by
328 Anggrahini,Sp.A caesarean delivery
dr. Simplicia Fetus and newborn
03.31.57 BY.MERYANA DOKO 0 L 12-01-2019 . 14-01-2019 . Maria affected by
329 Anggrahini,Sp.A caesarean delivery
dr. Simplicia Fetus and newborn
BY.MARIA
03.31.58
ERMELINDA FUNAN 0 L 13-01-2019 . 14-01-2019 . Maria affected by
330 Anggrahini,Sp.A caesarean delivery
dr. Simplicia Fetus and newborn
BY.DORA YULIANA
03.33.30
NDOLU 0 L 19-01-2019 . 21-01-2019 . Maria affected by
331 Anggrahini,Sp.A caesarean delivery
dr. Simplicia Fetus and newborn
BY NURSHANY M.
03.33.36
ZACHARIAZ 0 P 20-01-2019 . 21-01-2019 . Maria affected by
332 Anggrahini,Sp.A caesarean delivery
dr. Irene Fetus and newborn
BY. ETIK
03.28.44
AMBARWATI 0 L 31-12-2018 . 02-01-2019 . Lokananta, affected by
333 Sp.BA caesarean delivery
dr. Irene Fetus and newborn
03.29.45 BY. SELVI YAHYA 0 L 05-01-2019 . 07-01-2019 . Lokananta, affected by
334 Sp.BA caesarean delivery
dr. Irene Fetus and newborn
BY. YANTI MARIANA
03.28.71
KEBA 0 L 02-01-2019 . 04-01-2019 . Lokananta, affected by
335 Sp.BA caesarean delivery
Dr.Tjahyo Fetus and newborn
03.28.62 BY. YUNITA NESI 0 P 02-01-2019 . 03-01-2019 . Suryanto, SpA. affected by
336 MBiomed caesarean delivery
Dr.Tjahyo Fetus and newborn
BY. YOSEPHINA M. T.
03.28.58
D. WEA 0 L 01-01-2019 . 03-01-2019 . Suryanto, SpA. affected by
337 MBiomed caesarean delivery

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Dr.Tjahyo Fetus and newborn
BY. ETNI TRIVENA
03.28.28
IBU 0 P 30-12-2018 . 02-01-2019 . Suryanto, SpA. affected by
338 MBiomed caesarean delivery
Dr.Tjahyo Fetus and newborn
BY. WINDRA W.
03.28.95
MANAFE 0 L 03-01-2019 . 05-01-2019 . Suryanto, SpA. affected by
339 MBiomed caesarean delivery
dr. Irene Fetus and newborn
BY.YULI FITRIANI
03.35.35
MANSULA 0 L 28-01-2019 . 30-01-2019 . Lokananta, affected by
340 Sp.BA caesarean delivery
dr. Irene Fetus and newborn
BY. JEANNETTE L.
03.29.54
FANGGIE 0 P 06-01-2019 . 08-01-2019 . Lokananta, affected by
341 Sp.BA caesarean delivery
Fetus and newborn
dr. Iren David,
03.35.25 BY ANCE MISSA 0 L 28-01-2019 . 31-01-2019 . Sp.A
affected by
342 caesarean delivery
Dr.Tjahyo Fetus and newborn
BY.ZETLIN MOLA
03.32.87
KORE 01 0 L 18-01-2019 . 21-01-2019 . Suryanto, SpA. affected by
343 MBiomed caesarean delivery
Dr.Tjahyo Fetus and newborn
BY.ZETLIN MOLA
03.32.88
KORE 02 0 L 18-01-2019 . 21-01-2019 . Suryanto, SpA. affected by
344 MBiomed caesarean delivery
Dr.Tjahyo Fetus and newborn
BY.DEBYSANDRA
03.33.91
BALANG 0 L 22-01-2019 . 24-01-2019 . Suryanto, SpA. affected by
345 MBiomed caesarean delivery
Dr.Tjahyo Fetus and newborn
BY. WELMINCE
03.35.71
NARA 0 P 29-01-2019 . 31-01-2019 . Suryanto, SpA. affected by
346 MBiomed caesarean delivery
Dr.Tjahyo Fetus and newborn
03.32.27 BY. ADELINA SASI 0 L 15-01-2019 . 17-01-2019 . Suryanto, SpA. affected by
347 MBiomed caesarean delivery
Fetus and newborn
BY.TOHIROTUL dr.Frans
03.34.83
H.OLLA PELU 0 L 26-01-2019 . 28-01-2019 . Taolin,Sp.A
affected by
348 caesarean delivery
Fetus and newborn
dr.Frans
03.31.56 BY. MARIA M. DHITU 0 P 12-01-2019 . 15-01-2019 . Taolin,Sp.A
affected by
349 caesarean delivery
Fetus and newborn
BY MARIA DOE dr.Frans
03.33.09
MUGA 0 L 19-01-2019 . 21-01-2019 . Taolin,Sp.A
affected by
350 caesarean delivery
Fetus and newborn
dr.Frans
03.30.14 BY. NONI NOVITA UN 0 P 08-01-2019 . 10-01-2019 . Taolin,Sp.A
affected by
351 caesarean delivery
Fetus and newborn
BY. AURELIA dr. Iren David,
03.30.27
ENSALITA 0 P 08-01-2019 . 10-01-2019 . Sp.A
affected by
352 caesarean delivery
Fetus and newborn
BY MARIA dr. Iren David,
03.33.14
SUSANTHY RIA 0 L 19-01-2019 . 22-01-2019 . Sp.A
affected by
353 caesarean delivery

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Fetus and newborn
BY.EVI HELAN dr. Iren David,
03.32.47
SEPTORY 0 L 16-01-2019 . 28-01-2019 . Sp.A
affected by
354 precipitate delivery
dr. Irene Fetus and newborn
03.30.95 BY SRI LESTARI 0 L 11-01-2019 . 11-01-2019 . Lokananta, affected by
355 Sp.BA precipitate delivery
dr. Irene
BY. ECI TAROCI Severe birth
03.28.65
RONDO 0 P 02-01-2019 . 07-01-2019 . Lokananta,
asphyxia
356 Sp.BA
dr. Simplicia
BY.YUYUN OLIVIA Mild and moderate
03.33.34
MANDALA 0 L 20-01-2019 . 21-01-2019 . Maria
birth asphyxia
357 Anggrahini,Sp.A
BY.MARLIN dr.Frans Mild and moderate
358
03.34.85
NIUFLAPU 0 L 26-01-2019 . 28-01-2019 . Taolin,Sp.A birth asphyxia
BY. APRILIA YANTI dr.Frans Mild and moderate
359
03.34.99
ANO 0 L 27-01-2019 . 29-01-2019 . Taolin,Sp.A birth asphyxia
dr.Frans Mild and moderate
360
03.35.02 BY SUSIANI SOLET 0 P 27-01-2019 . 29-01-2019 . Taolin,Sp.A birth asphyxia
dr.Frans Mild and moderate
361
03.35.57 BY ELNI TEUF 0 L 29-01-2019 . 31-01-2019 . Taolin,Sp.A birth asphyxia
BY ERNA LILA dr.Frans Mild and moderate
362
03.35.58
TARAMEHA 0 L 29-01-2019 . 31-01-2019 . Taolin,Sp.A birth asphyxia
BY.FALENTINA dr. Iren David, Mild and moderate
363
03.32.95
BHALU LEO 0 P 18-01-2019 . 21-01-2019 . Sp.A birth asphyxia
BY. ASRIYANI DIMU dr. Iren David, Mild and moderate
364
03.32.09
LUDJI 0 P 14-01-2019 . 17-01-2019 . Sp.A birth asphyxia
BY.PETRONELA dr. Iren David, Mild and moderate
365
03.35.37
OLLA 0 P 28-01-2019 . 31-01-2019 . Sp.A birth asphyxia
Dr.Tjahyo
BY TESALONIKA T. Mild and moderate
03.31.06
HANING 0 P 11-01-2019 . 14-01-2019 . Suryanto, SpA.
birth asphyxia
366 MBiomed
dr. Irene
BY. LIDIA Mild and moderate
03.30.13
LAMBANAUNG 0 L 08-01-2019 . 11-01-2019 . Lokananta,
birth asphyxia
367 Sp.BA
BY. MARIA dr.Frans Mild and moderate
368
03.32.49
MURTIANA ONAL 0 P 16-01-2019 . 18-01-2019 . Taolin,Sp.A birth asphyxia
dr.Frans Mild and moderate
369
03.28.76 BY. NOFI K FAHIK 0 L 02-01-2019 . 04-01-2019 . Taolin,Sp.A birth asphyxia
BY MAGDA M. D dr.Frans Mild and moderate
370
03.29.15
HUMA 0 L 04-01-2019 . 07-01-2019 . Taolin,Sp.A birth asphyxia
BY.HAMSINAH dr.Frans Mild and moderate
371
03.29.17
MANSUR 0 P 04-01-2019 . 07-01-2019 . Taolin,Sp.A birth asphyxia
BY.ROSINA RIBKA dr.Frans Mild and moderate
372
03.29.93
TAKAIN 0 P 07-01-2019 . 09-01-2019 . Taolin,Sp.A birth asphyxia

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


BY YULIANA A. H. dr.Frans Mild and moderate
373
03.30.05
SERAN 0 L 07-01-2019 . 09-01-2019 . Taolin,Sp.A birth asphyxia
BY ERNESTINA dr.Frans Mild and moderate
374
03.35.61
BAREK HADA 0 P 29-01-2019 . 31-01-2019 . Taolin,Sp.A birth asphyxia
dr.Frans Mild and moderate
375
03.34.34 BY.ROSITA A BAI 0 L 24-01-2019 . 26-01-2019 . Taolin,Sp.A birth asphyxia
BY.MARIA N.PEHEN dr.Frans Mild and moderate
376
03.31.42
BISING 0 L 12-01-2019 . 17-01-2019 . Taolin,Sp.A birth asphyxia
BY. ADRIANA
dr.Frans Mild and moderate
03.33.55 HENDERINA 0 L 21-01-2019 . 23-01-2019 . Taolin,Sp.A birth asphyxia
377 SAEKETU
dr.Frans Mild and moderate
378
03.33.61 BY. MERLIN SELAK 0 P 21-01-2019 . 23-01-2019 . Taolin,Sp.A birth asphyxia
dr.Frans Mild and moderate
379
03.33.43 BY.MARIA SAETBAN 0 P 20-01-2019 . 22-01-2019 . Taolin,Sp.A birth asphyxia
BY.EVA Respiratory distress
dr. Iren David,
03.30.64 SUPRIANINGSIH 0 P 09-01-2019 . 15-01-2019 . Sp.A
of newborn,
380 TAMONOB unspecified
Respiratory distress
BY. MARTHA dr. Iren David,
03.30.25
SOLUKH 0 L 08-01-2019 . 14-01-2019 . Sp.A
of newborn,
381 unspecified
Dr.Tjahyo Respiratory distress
03.28.52 BY.YURLINCE TAGEL 0 L 01-01-2019 . 04-01-2019 . Suryanto, SpA. of newborn,
382 MBiomed unspecified
dr. Irene Respiratory distress
BY.MELINDA
03.30.49
ANASTASIA W RATA 0 P 09-01-2019 . 14-01-2019 . Lokananta, of newborn,
383 Sp.BA unspecified
Respiratory
dr. Simplicia
condition of
03.33.39 BY. MARTHA MANIT 0 L 20-01-2019 . 23-01-2019 . Maria
newborn,
Anggrahini,Sp.A
384 unspecified
dr.Frans Neonatal jaundice,
385
03.34.34 BY.ROSITA A BAI 0 L 28-01-2019 . 30-01-2019 . Taolin,Sp.A unspecified
BY. DORTIA E. dr.Frans Neonatal jaundice,
386
03.29.39
SMAUT 0 P 09-01-2019 . 14-01-2019 . Taolin,Sp.A unspecified
BY. DORTIA E. dr.Frans Neonatal jaundice,
387
03.29.39
SMAUT 0 P 05-01-2019 . 07-01-2019 . Taolin,Sp.A unspecified
Dr.Tjahyo
BY.YASINTA O. Neonatal jaundice,
03.29.03
DJAWA 0 L 12-01-2019 . 15-01-2019 . Suryanto, SpA.
unspecified
388 MBiomed
dr. Irene
BY. CHRISTIN Neonatal jaundice,
03.32.17
DILLAK 0 L 28-01-2019 . 30-01-2019 . Lokananta,
unspecified
389 Sp.BA
dr. Irene
Neonatal jaundice,
03.27.33 BY. YERI M. ADU 0 L 07-01-2019 . 09-01-2019 . Lokananta,
unspecified
390 Sp.BA

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


dr. Irene
BY. ETIK Neonatal jaundice,
03.28.44
AMBARWATI 0 L 07-01-2019 . 10-01-2019 . Lokananta,
unspecified
391 Sp.BA
dr. Irene
BY. JEANNETTE L. Neonatal jaundice,
03.29.54
FANGGIE 0 P 09-01-2019 . 12-01-2019 . Lokananta,
unspecified
392 Sp.BA
BY. ARLINCE S. dr.Frans Convulsions of
393 03.30.11
WABANG 0 P 08-01-2019 . 15-01-2019 . Taolin,Sp.A newborn
dr. Simplicia
AN. JOSUA JULIO Nausea and
00.16.08
DJARA HADJO 7 L 20-01-2019 . 23-01-2019 . Maria
vomiting
394 Anggrahini,Sp.A
ELKANA GABRIEL dr.Frans Nausea and
395 01.42.84
SAEFATU 3 L 17-01-2019 . 19-01-2019 . Taolin,Sp.A vomiting
WILDA SETIANI dr.Frans Nausea and
396 01.90.87
NAUTANI 6 P 21-01-2019 . 23-01-2019 . Taolin,Sp.A vomiting
CHIKA EVANGELICH dr.Frans Nausea and
397 01.65.07
KOE HOEA 4 P 16-01-2019 . 18-01-2019 . Taolin,Sp.A vomiting
JYMJOSE ADRIANO dr.Frans Nausea and
398 03.31.23
FOES 1 L 11-01-2019 . 15-01-2019 . Taolin,Sp.A vomiting
I PUTU D.ARTANTYA dr.Frans Nausea and
399 03.31.27
PUTRA 7 L 12-01-2019 . 15-01-2019 . Taolin,Sp.A vomiting
KRISTIANO KUSI dr.Frans Nausea and
400 01.86.50
HUMAU 3 L 03-01-2019 . 07-01-2019 . Taolin,Sp.A vomiting
SAHRAZAD YUSRI dr. Iren David, Nausea and
401 03.34.46
MAHISA 3 P 25-01-2019 . 26-01-2019 . Sp.A vomiting
dr. Irene
DARELL GERARLDO Nausea and
01.88.13
PANDIE 2 L 01-01-2019 . 04-01-2019 . Lokananta,
vomiting
402 Sp.BA
Nausea and
403 03.11.67 ANGRE HANAS 21 P 21-01-2019 . 22-01-2019 . dr Nina SpPD
vomiting
dr.Frans
404 02.91.99 ANATTA NAYIRA 1 P 12-01-2019 . 17-01-2019 . Taolin,Sp.A
Febrile convulsions
REYNA MIKAYLA dr.Frans
405 00.46.35
SCHELLING 3 P 12-01-2019 . 17-01-2019 . Taolin,Sp.A
Febrile convulsions
dr.Frans
406 03.29.55 FARIZ ULIL ALBAB 0 L 06-01-2019 . 09-01-2019 . Taolin,Sp.A
Febrile convulsions
ELTARI A. dr.Frans
407 03.30.99
ANUGERAH JELITA 8 P 11-01-2019 . 15-01-2019 . Taolin,Sp.A
Febrile convulsions
dr.Frans
408 01.71.48 DETRI SELVIN POLLO 2 P 14-01-2019 . 17-01-2019 . Taolin,Sp.A
Febrile convulsions
NI KETUT KRISTINA dr. Iren David,
409 03.28.33
A ARIASTUTI 0 P 31-12-2018 . 02-01-2019 . Sp.A
Febrile convulsions
Dr.Tjahyo
GIBRAN LEONARDO
03.30.19
KOLLY 3 L 08-01-2019 . 11-01-2019 . Suryanto, SpA. Febrile convulsions
410 MBiomed
YANTI ARIYANI dr.D.A.A.Shanti
411
03.32.35
SINLAELOE 36 P 21-01-2019 . 22-01-2019 . Widyasari,SpOG
Sterilization MOW BPJS (B)

dr. Kt. Agus


412
03.32.68 ESRA IRWATI LEDO 34 P 17-01-2019 . 18-01-2019 . Sunatha, SpOG
Sterilization MOW BPJS (B)

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


Supervision of
MARIA MURTIANA dr. Andree
03.17.37
ONAL 38 P 16-01-2019 . 18-01-2019 . Hartanto.SpOG
normal first Sectio Cesarea
413 pregnancy
dr. Simplicia
BY. DIAN A. Singleton, born in
03.33.27
TAKALAPETA-LOMI 0 L 19-01-2019 . 21-01-2019 . Maria
hospital
414 Anggrahini,Sp.A
dr.Frans Singleton, born in
415 03.35.53 BY. NAIMA ARKIAN 0 P 29-01-2019 . 30-01-2019 . Taolin,Sp.A hospital
dr.Frans Singleton, born in
416 03.34.98 BY. KRISTIANI KORE 0 P 26-01-2019 . 28-01-2019 . Taolin,Sp.A hospital
BY.SEPTIANA A dr.Frans Singleton, born in
417 03.33.89
TELLA 0 P 22-01-2019 . 24-01-2019 . Taolin,Sp.A hospital
BY. SUSANA L. dr.Frans Singleton, born in
418 03.29.76
ANIMAU 0 L 07-01-2019 . 08-01-2019 . Taolin,Sp.A hospital
BY. MALISA dr.Frans Singleton, born in
419 03.35.96
TUALAKA 0 L 30-01-2019 . 31-01-2019 . Taolin,Sp.A hospital
Dr.Tjahyo
BY.PATRICIA Singleton, born in
03.29.02
WALANDA WOWOR 0 P 03-01-2019 . 06-01-2019 . Suryanto, SpA.
hospital
420 MBiomed
Dr.Tjahyo
Singleton, born in
03.29.05 BY.INDRIANI BUTAR 0 P 03-01-2019 . 06-01-2019 . Suryanto, SpA.
hospital
421 MBiomed
dr. Irene
BY.PRISKA YUNITA Singleton, born in
03.34.69
TALEKI 0 L 26-01-2019 . 26-01-2019 . Lokananta,
hospital
422 Sp.BA
dr. Irene
Singleton, born in
03.33.13 BY DORINCE LOPO 0 P 19-01-2019 . 23-01-2019 . Lokananta,
hospital
423 Sp.BA
Dr.Tjahyo
Singleton, born in
03.31.30 BY FENTI M. KONIS 0 P 12-01-2019 . 14-01-2019 . Suryanto, SpA.
hospital
424 MBiomed
Dr.Tjahyo
Singleton, born in
03.31.68 BY. NORLINA PITAY 0 P 14-01-2019 . 15-01-2019 . Suryanto, SpA.
hospital
425 MBiomed
Dr.Tjahyo
Singleton, born in
03.31.70 BY. YAKOBA SONBAI 0 L 14-01-2019 . 15-01-2019 . Suryanto, SpA.
hospital
426 MBiomed
Dr.Tjahyo
BY. MARIA SOLU Singleton, born in
03.31.76
LANI 0 P 14-01-2019 . 15-01-2019 . Suryanto, SpA.
hospital
427 MBiomed
Dr.Tjahyo
BY. ADELIA Singleton, born in
03.28.54
HANDAYANI SIDIN 0 L 01-01-2019 . 02-01-2019 . Suryanto, SpA.
hospital
428 MBiomed
Dr.Tjahyo
BY VENI TRIVENA Singleton, born in
03.28.30
LELY 0 P 30-12-2018 . 09-01-2019 . Suryanto, SpA.
hospital
429 MBiomed
Dr.Tjahyo
BY. WELSIN Singleton, born in
03.32.13
TRIYANA HOTAN 0 L 15-01-2019 . 16-01-2019 . Suryanto, SpA.
hospital
430 MBiomed
Dr.Tjahyo
Singleton, born in
03.34.22 BY LENI A. ABANAT 0 P 24-01-2019 . 25-01-2019 . Suryanto, SpA.
hospital
431 MBiomed

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


BY.YOSMINA Dr.Tjahyo
Singleton, born in
03.34.09 ADELHET 0 P 23-01-2019 . 24-01-2019 . Suryanto, SpA.
hospital
432 HAOFBENU MBiomed
Dr.Tjahyo
BY. JANNE VICTORIA Singleton, born in
03.34.06
BENU 0 P 23-01-2019 . 23-01-2019 . Suryanto, SpA.
hospital
433 MBiomed
Dr.Tjahyo
BY. YUSARMI Singleton, born in
03.33.74
ATAUPAH 0 P 22-01-2019 . 24-01-2019 . Suryanto, SpA.
hospital
434 MBiomed
Dr.Tjahyo
Singleton, born in
03.33.82 BY FITRI RAHMADINI 0 L 22-01-2019 . 24-01-2019 . Suryanto, SpA.
hospital
435 MBiomed
BY WIDA RESKI dr. Iren David, Singleton, born in
436 03.34.20
PASORONG 0 P 23-01-2019 . 25-01-2019 . Sp.A hospital
dr. Iren David, Singleton, born in
437 03.32.10 BY. ELDA PATOLA 0 L 14-01-2019 . 17-01-2019 . Sp.A hospital
BY.YOHANA dr. Iren David, Singleton, born in
438 03.35.39
FRANSISKA WOLOR 0 P 28-01-2019 . 31-01-2019 . Sp.A hospital
Dr.Tjahyo
BY. NAOMI RIANA Singleton, born in
03.34.65
WATY 0 L 26-01-2019 . 27-01-2019 . Suryanto, SpA.
hospital
439 MBiomed
Dr.Tjahyo
BY.YULITE SINA Singleton, born in
03.32.78
YOHANIS 0 L 17-01-2019 . 21-01-2019 . Suryanto, SpA.
hospital
440 MBiomed
Dr.Tjahyo
BY.SETIAR ROHANI Singleton, born in
03.35.15
NINGSIH 0 P 27-01-2019 . 29-01-2019 . Suryanto, SpA.
hospital
441 MBiomed
dr. Iren David, Singleton, born in
442 03.30.73 BY.MARIA TEFA 0 L 10-01-2019 . 10-01-2019 . Sp.A hospital
BY. KAROLINA dr. Iren David, Singleton, born in
443 03.32.26
MALA RATU BAI 0 L 15-01-2019 . 16-01-2019 . Sp.A hospital
BY. MARIA dr. Iren David, Singleton, born in
444 03.29.56
GABRIELA TUTO 0 L 06-01-2019 . 07-01-2019 . Sp.A hospital
dr. Iren David, Singleton, born in
445 03.29.53 BY. NURLIANA FAFO 0 P 06-01-2019 . 09-01-2019 . Sp.A hospital
dr. Iren David, Singleton, born in
446 03.32.52 BY. NI LUH SUPADMI 0 P 16-01-2019 . 18-01-2019 . Sp.A hospital
dr. Iren David, Singleton, born in
447 03.29.63 BY YANE DETHAN 0 P 06-01-2019 . 08-01-2019 . Sp.A hospital
BY.CHRISTIN dr. Iren David, Singleton, born in
448 03.29.19
P.M.RAJAGUKGUK 0 P 04-01-2019 . 06-01-2019 . Sp.A hospital
BY.RELIN MERTINI dr. Iren David, Singleton, born in
449 03.29.29
NAU 0 L 04-01-2019 . 06-01-2019 . Sp.A hospital
dr. Iren David, Singleton, born in
450 03.28.48 BY NORCE TANESIB 0 P 31-12-2018 . 04-01-2019 . Sp.A hospital
BY.FEBY URNIANI dr. Iren David, Singleton, born in
451 03.28.20
LAU 0 L 30-12-2018 . 02-01-2019 . Sp.A hospital
dr. Iren David, Singleton, born in
452 03.25.41 BY ANSILA BANO 0 L 15-12-2018 . 03-01-2019 . Sp.A hospital

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :


BY.MARIA ALFIANI dr. Iren David, Singleton, born in
453 03.28.73
NAHAS 0 L 02-01-2019 . 03-01-2019 . Sp.A hospital
BY. DEASYANI B. dr.Frans Singleton, born in
454 03.32.39
MANDALA 0 P 16-01-2019 . 21-01-2019 . Taolin,Sp.A hospital
BY. MARIA Y. I. dr.Frans Singleton, born in
455 03.30.89
LANUS 0 P 10-01-2019 . 12-01-2019 . Taolin,Sp.A hospital
dr.Frans Singleton, born in
456 03.30.91 BY. ASMI DASI 0 L 10-01-2019 . 12-01-2019 . Taolin,Sp.A hospital
dr.Frans Singleton, born in
457 03.30.92 BY. MENCI MANA'O 0 L 10-01-2019 . 11-01-2019 . Taolin,Sp.A hospital
BY MONIKA
dr.Frans Singleton, born in
03.29.40 AGUSTINA V. 0 L 05-01-2019 . 07-01-2019 . Taolin,Sp.A hospital
458 BAUNSELE
BY.APLONIA dr. Iren David, Singleton, born in
459 03.30.68
Y.BOLLA 0 L 09-01-2019 . 12-01-2019 . Sp.A hospital
dr.Frans Singleton, born in
460 03.34.35 BY. DEWI HARYANTI 0 P 24-01-2019 . 27-01-2019 . Taolin,Sp.A hospital
dr.Frans Singleton, born in
461 03.31.48 BY. ANJANI C.W GIRI 0 P 12-01-2019 . 13-01-2019 . Taolin,Sp.A hospital
BY.NELCI ATOLO dr.Frans Singleton, born in
462 03.33.46
MAMO 0 P 21-01-2019 . 26-01-2019 . Taolin,Sp.A hospital
BY. ARANCI APRIDA dr.Frans Singleton, born in
463 03.33.49
NDUN 0 L 21-01-2019 . 22-01-2019 . Taolin,Sp.A hospital
BY ISMIYATI dr.Frans Singleton, born in
464 03.31.32
SUWONO 0 P 12-01-2019 . 13-01-2019 . Taolin,Sp.A hospital
BY FENISIANA C. E. dr.Frans Singleton, born in
465 03.32.38
TABUN 0 L 15-01-2019 . 18-01-2019 . Taolin,Sp.A hospital
Singleton,
dr.D.A.A.Shanti
03.34.32 MARIA SUMIYANTI 35 P 24-01-2019 . 25-01-2019 . Widyasari,SpOG
unspecified as to MOW BPJS (B)
466 place of birth
dr.D.A.A.Shanti Preterm labor
467
03.29.50 LENI A ABANAT 18 P 05-01-2019 . 07-01-2019 . Widyasari,SpOG without delivery
ARSIONTRIS dr.D.A.A.Shanti Preterm labor
468
03.30.96
HERLINCE SELAN 30 P 21-01-2019 . 22-01-2019 . Widyasari,SpOG without delivery
dr.D.A.A.Shanti Preterm labor
469
03.29.50 LENI A ABANAT 18 P 24-01-2019 . 25-01-2019 . Widyasari,SpOG without delivery
Partus Normal
Dr.Tjahyo
BY YUNITRI RAMBU Singleton, born in
03.33.90
DAE 0 L 22-01-2019 . 28-01-2019 . Suryanto, SpA.
hospital
470 MBiomed
dr.D.A.A.Shanti Preterm labor
471
03.35.77 MALISA TUALAKA 33 L 30-01-2019 . 31-01-2019 . Widyasari,SpOG without delivery
Partus Normal

VALIDASI : SESUAI FORNAS : TIDAK SESUAI FORNAS :