Kantor Cabang : TASIKMALAYA - 1009

FKTP : SAMARANG - 10240601

NO TANGGAL NO KUNJUNGAN NO KARTU

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NAMA PESERTA SE JENIS PESERTA DIAGNOSA
X
RESTU PRADINA L PBI (APBN) Unilateral or unspecified inguinal
hernia, without

ERAT P PBI (APBD) Cerebral infarction, unspecified

ADIN L PEKERJA MANDIRI Fracture of lower end of tibia,

closed
PIA MAYASARI P PNS DAERAH Benign lipomatous neoplasm

RESTU PRADINA L PBI (APBN) Unilateral or unspecified inguinal

NURAFNI PUTRI AZZAHRA
BISRI ADNAN,BA
WAFIQ FAWAWAZ HASAN
P PBI (APBN)
L PENERIMA PENSIUN PNS
L PNS DAERAH
hernia, without
Diarrhoea and gastroenteritis of
presumed infectious origin
Other disorders of peripheral
nervous system
Necrosis of pulp

hj. titi rukmini P PEKERJA MANDIRI Other malignant neoplasms of skin

RANI SRI WAHYUNI P PBI (APBN) Respiratory tuberculosis,

bacteriologically and
ade paridah P PEKERJA MANDIRI Epilepsy

DEWI MELASARI P PEGAWAI PEMERINTAH Pre-eclampsia, unspecified

DENGAN PERJANJIAN

INA MARLINA P PEKERJA MANDIRI Other and unspecified abdominal

pain
IWAN MASRIAWAN L PENERIMA PENSIUN PNS Chronic ischaemic heart disease

YUYUN L PBI (APBN) Respiratory tuberculosis,

bacteriologically and
NENI P PBI (APBN) Premature rupture of membranes,
unspecified
ASIPAH P PBI (APBN) Malignant neoplasm of skin,
unspecified

DEDEH P PBI (APBN) Gonarthrosis [arthrosis of knee]

RANI SRI WAHYUNI P PBI (APBN) Tuberculosis of lung, confirmed

histologically
AHMAD SANUSI L PBI (APBN) Follow-up care involving removal
of fracture plate and other internal
fixation

muhammad alvy yusuf L PBI (APBN) Bronchopneumonia, unspecified

ADA L PBI (APBN) Congestive heart failure

muhammad chandra tegar aldriansah L PEKERJA MANDIRI Cerebral infarction, unspecified

IRPAN L PBI (APBN) Congestive heart failure

IHAH SOLIHAH P PBI (APBN) Premature rupture of membranes

IJANG L PBI (APBN) Calculus of ureter

LINA L PBI (APBN) Necrosis of pulp
UYUM P PBI (APBN) Congestive heart failure
HJ. MIMI RUKMINI P PEKERJA MANDIRI Ulcer of lower limb, not elsewhere
classified
muchamad rezki L PEKERJA MANDIRI Epilepsy, unspecified
AAM AMINAH P PNS PUSAT Enlarged lymph nodes, unspecified

SITI SALAMAH P PBI (APBN) Severe pre-eclampsia

TRESA AGMI P PBI (APBN) Vitiligo
N DEWI NURAENI P PBI (APBN) Maternal care for breech
presentation
NURZAMAN L PBI (APBN) Loss of teeth due to accident,
extraction or
YULIANTI P PBI (APBN) Other chest pain
AGUS RAMDANI L PBI (APBD) Fever, unspecified
PIAH SOPIAH P PBI (APBD) Other benign neoplasm of
connective and other soft
NENI P PBI (APBN) Stroke, not specified as
haemorrhage or infarction
WAWAN RACHADIAN,S.PD L PENERIMA PENSIUN PNS Dyspepsia
DIANA ANUGRAH P PBI (APBN) Unspecified diabetes mellitus

ENDANG RAHMAT L PBI (APBN) Unspecified diabetes mellitus

HADIDAH P PBI (APBN) Maternal care for intrauterine

death
JONI kusnadi L PBI (APBN) Congestive heart failure
RIZKI ILHAM PAUJI L PBI (APBN) Unspecified injury of head
ZAHWA SEPTIANI KHOERUNNISA P PBI (APBN) Necrosis of pulp
RIKA P PBI (APBN) Abscess of Bartholin's gland

RANI ROHAENI P PBI (APBN) Pre-eclampsia, unspecified

lilis rodiah P PEKERJA MANDIRI Dental caries, unspecified
ai asiyah P PEKERJA MANDIRI Uterovaginal prolapse, unspecified

EUIS AISYAH P PEKERJA MANDIRI Sequelae of cerebrovascular

disease
SITI NURHAYATI P PBI (APBN) Other vascular syndromes of brain
in cerebrovascular

YULIANTI P PBI (APBN) Gastro-oesophageal reflux disease

hj. titi rukmini P PEKERJA MANDIRI Malignant neoplasm of skin,

unspecified
TITIN SUPRIATIN P PBI (APBN) Long labour, unspecified
MUHAMMAD ZULFAN HABIBURROHMAN L PBI (APBN) Tuberculosis of lung, confirmed by
culture only
ADE BUSRO NADA L PENERIMA PENSIUN PNS Heart failure
IWAN MASRIAWAN L PENERIMA PENSIUN PNS Chronic ischaemic heart disease

KANIA SAPITRI P PBI (APBN) Other specified anaemias

AI KARMINI P PBI (APBN) Ectopic pregnancy, unspecified

RINDU MIRANTI P PBI (APBN) Unspecified abortion, incomplete,

without
O.HIDAYAT L PBI (APBN) Pleural effusion, not elsewhere
classified
RIKA RAHAYU P PEGAWAI SWASTA Acute tonsillitis, unspecified
HAIKAL R L PBI (APBN) Benign neoplasm of middle ear
and respiratory
N. HANIFAH L PBI (APBN) Heart failure
AZKA AHMAD HANAFI L PEKERJA MANDIRI Epilepsy, unspecified
ANGGUN NOVIA ELISA L PEKERJA MANDIRI Acute tonsillitis, unspecified

DEDE SUNARSIH P PNS DAERAH Anxiety disorder, unspecified

EUIS KARTIKA P PEGAWAI SWASTA Disruption of caesarean section

wound
AISAH P PEKERJA MANDIRI Nontoxic single thyroid nodule

NUNUNG NURHAYATI P PEKERJA MANDIRI Hypertensive heart disease without

RIDA SAHATI DARIAH P PEGAWAI SWASTA Antenatal screening, unspecified

s. mimih P PENERIMA PENSIUN PNS Unspecified diabetes mellitus

AISAH P PEKERJA MANDIRI Nontoxic single thyroid nodule

SYARIFAH P PBI (APBN) Umbilical hernia

imam L PBI (APBN) Epilepsy
ATIK MARYATI P PBI (APBN) Fracture of unspecified body
region
HAMZAH L PBI (APBN) Hyperplasia of prostate
INA MARLINA P PEKERJA MANDIRI Malignant neoplasm of ovary

TINI P PBI (APBN) Other anaemias

SITI MARYAM P PBI (APBN) Chest pain, unspecified
EMA MARLINA P PBI (APBN) Disease of Bartholin's gland,
unspecified
AI KARMINI P PBI (APBN) Spontaneous abortion, incomplete,
without
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