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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA STATUS PRB PROLANIS
PULANG

1 31-05-2019 111210020519P000694 0000519010007 MUDIYONO L PBI (APBN) Gastritis, unspecified Berobat Jalan

2 31-05-2019 111210020519P000813 0000519232048 SARTINAH P PBI (APBN) Contraceptive Berobat Jalan


management, unspecified
3 31-05-2019 111210020519P000814 0000519322059 SULIYAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
4 31-05-2019 111210020519P000748 0000520128786 RINI ASTUTI P PBI (APBN) False labour, unspecified Sembuh

5 31-05-2019 111210020519P000710 0000520268455 AFRI SURURUDIN L PBI (APBN) Vertigo of central origin Berobat Jalan

6 31-05-2019 111210020519P000701 0000520381203 IMING P PBI (APBN) Fever, unspecified Berobat Jalan

7 31-05-2019 111210020519P000703 0000520576288 PASEM SASTRODIYOSO P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
8 31-05-2019 111210020519P000699 0000520737524 ARIF HIDAYAT L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

9 31-05-2019 111210020519P000720 0000520918119 BADRIYAH P PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
10 31-05-2019 111210020519P000716 0000521050847 SOFIAN S L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
11 31-05-2019 111210020519P000700 0000521163617 FAISAL CANDRA L PBI (APBN) Impacted cerumen Berobat Jalan

12 31-05-2019 111210020519P000815 0000614491931 TRISNAWATI P PBI (APBN) Contraceptive Berobat Jalan


management, unspecified
13 31-05-2019 111210020519P000705 0001015212993 DULAH MUKTI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
14 31-05-2019 111210020519P000721 0001439519826 NINGRUM SARI P PBI (APBD) Prolonged pregnancy Rujuk Lanjut

15 31-05-2019 111210020519P000707 0001461704793 SUDASRI DARYATI P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

16 31-05-2019 111210020519P000816 0001627899366 ROHANAH P PEGAWAI SWASTA Contraceptive Berobat Jalan


management, unspecified
17 31-05-2019 111210020519P000698 0001842171197 HOMSIAH P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

18 31-05-2019 111210020519P000693 0002009262159 KHOMSATUN P PBI (APBN) Non-insulin-dependent Berobat Jalan


diabetes mellitus without
complications
19 31-05-2019 111210020519P000719 0002038377058 MUSTOPO L PBI (APBD) Fever, unspecified Berobat Jalan

20 31-05-2019 111210020519P000706 0002073545087 RISKI PURWASIS L PEGAWAI SWASTA Unspecified renal colic Rujuk Lanjut

21 31-05-2019 111210020519P000713 0002125678825 MUHAMMAD ALIF FADLAN L PBI (APBN) Fever, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

22 31-05-2019 111210020519P000749 0002227546721 NURHAYATI P PEKERJA MANDIRI False labour, unspecified Sembuh

23 31-05-2019 111210020519P000704 0002228055491 KHALID AKBAR nURLANGIT L PBI (APBN) Tuberculous peripheral Berobat Jalan
lymphadenopathy
24 31-05-2019 111210020519P000702 0002436979252 ARSIH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan Diabetes Mellitus Diabetes
[common cold] Mellitus
25 31-05-2019 111210020519P000697 0002453853971 MACHFUDZ L PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

26 31-05-2019 111210020519P000696 0002465733071 SUHERMAN L PEKERJA MANDIRI Follow-up care involving Berobat Jalan
removal of fracture plate
and other internal fixation
device
27 31-05-2019 111210020519P000715 0002472688989 AKAR QOSHIFUSSYARIF L PEKERJA MANDIRI Scabies Berobat Jalan

28 31-05-2019 111210020519P000709 0002484111969 ROSSA YUNIARTA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
29 31-05-2019 111210020519P000718 0002504756171 UNTUNG RIZAL FAJRI L PBI (APBN) Mania with psychotic Berobat Jalan
symptoms
30 31-05-2019 111210020519P000695 0002504761694 ISATAJIB HUSNI L PBI (APBN) Gastritis, unspecified Berobat Jalan

31 31-05-2019 111210020519P000708 0002600683312 FAYSAL CHAIRUL ANAM L PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
32 31-05-2019 111210020519P000711 0002626024307 MIFTAHUL JANNAH P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
33 31-05-2019 111210020519P000717 0002629111116 WAGIYEM P PBI (APBN) Allergic contact dermatitis Berobat Jalan

34 31-05-2019 111210020519P000714 0002634772151 MUNGINATUL IQROM L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
35 31-05-2019 111210020519P000746 0002634778416 WAHYUNI P PBI (APBN) False labour, unspecified Sembuh

36 31-05-2019 111210020519P000712 0002648664382 KASTIYEM P PBI (APBN) Gonarthrosis [arthrosis of Berobat Jalan
knee]
37 31-05-2019 111210020519P000747 0002760695548 SUMINI P PEKERJA MANDIRI False labour, unspecified Sembuh

38 31-05-2019 111210020519P000817 0002763617051 SITI MALIAH P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
39 30-05-2019 111210020519P000691 0000198391454 FARSIAWATI P PNS DAERAH Corpus luteum cyst Rujuk Lanjut

40 30-05-2019 111210020519P000812 0000520501667 IRMAWATI P PBI (APBN) Contraceptive Berobat Jalan


management, unspecified
41 30-05-2019 111210020519P000692 0002175927906 SITI FATIMAH P PBI (APBN) Prolonged pregnancy Rujuk Lanjut

42 29-05-2019 111210020519P000680 0000517234162 SULASTRI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

43 29-05-2019 111210020519P000689 0000519235817 TUGIMAN L PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
44 29-05-2019 111210020519P000809 0000519490451 NURHAYATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
45 29-05-2019 111210020519P000810 0000520091651 MUTOHAROH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
46 29-05-2019 111210020519P000670 0000520153391 SAODAH P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
breast, unspecified
47 29-05-2019 111210020519P000675 0000520184621 INDAH CAHYATI P PBI (APBN) Other forms of stomatitis Berobat Jalan

48 29-05-2019 111210020519P000683 0000520240522 MUHYATUN P PBI (APBN) Tinea cruris Berobat Jalan

49 29-05-2019 111210020519P000676 0000520326516 SANDIARJA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
50 29-05-2019 111210020519P000744 0000520501667 IRMAWATI P PBI (APBN) False labour, unspecified Sembuh

51 29-05-2019 111210020519P000688 0000520809658 TITIN NURHAYATI P PBI (APBN) Vasomotor and allergic Berobat Jalan
rhinitis
52 29-05-2019 111210020519P000653 0000520848955 SURATMAN L PBI (APBN) Ocular pain Rujuk Lanjut

53 29-05-2019 111210020519P000681 0000520879544 SULIYANI P PBI (APBN) Tinea cruris Berobat Jalan

54 29-05-2019 111210020519P000684 0000520891648 NURSIDIK L PBI (APBN) Headache Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
55 29-05-2019 111210020519P000678 0000521268838 ERNA NOVIANTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
56 29-05-2019 111210020519P000811 0000521540144 WASIAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
57 29-05-2019 111210020519P000674 0001097173912 ABDUL ROHMAN WAHYU L ANGGOTA POLRI Conjunctivitis, unspecified Berobat Jalan
SAPUTRA
58 29-05-2019 111210020519P000666 0001308467147 munfi'ah P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast, unspecified
59 29-05-2019 111210020519P000808 0001631487778 UJI HASANAH P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
60 29-05-2019 111210020519P000687 0002039874491 ARIF MAULANA L PBI (APBD) Other forms of stomatitis Berobat Jalan

61 29-05-2019 111210020519P000807 0002142392152 KHOMSATUN CHASANAH P PEGAWAI SWASTA Contraceptive Berobat Jalan
management, unspecified
62 29-05-2019 111210020519P000690 0002226758264 SITI AFALIN P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
63 29-05-2019 111210020519P000682 0002625169476 WILLY WILDIYANTO L PEKERJA MANDIRI Headache Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

64 29-05-2019 111210020519P000685 0002633541039 WATINAH P PBI (APBN) Haemoptysis Berobat Jalan

65 29-05-2019 111210020519P000679 0002636916401 ANGGIT PRASETIYO L PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
66 29-05-2019 111210020519P000677 0002648663109 TOPIK ROSIDIN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
67 29-05-2019 111210020519P000686 0002648663831 SURATI P PBI (APBN) Vertigo of central origin Berobat Jalan

68 29-05-2019 111210020519P000745 0002763617051 SITI MALIAH P PEKERJA MANDIRI False labour, unspecified Sembuh

69 28-05-2019 111210020519P000849 0000518990591 ANI WINARTI P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
70 28-05-2019 111210020519P000877 0000519002155 MUHTAR L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
71 28-05-2019 111210020519P000827 0000519117478 FATIMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
72 28-05-2019 111210020519P000672 0000519457803 KUSMIATI P PBI (APBN) Tuberculous peripheral Berobat Jalan
lymphadenopathy
73 28-05-2019 111210020519P000638 0000519534854 SAMINEM P PBI (APBN) Myalgia Berobat Jalan

74 28-05-2019 111210020519P000879 0000519592871 ROLIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
75 28-05-2019 111210020519P000669 0000519793839 TURSINAH P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
76 28-05-2019 111210020519P000873 0000519930753 WASINAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
77 28-05-2019 111210020519P000634 0000519931214 DASTIM L PBI (APBN) Myalgia Berobat Jalan

78 28-05-2019 111210020519P000826 0000519953332 SURATMI P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
79 28-05-2019 111210020519P000837 0000520021214 TUSINI P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
80 28-05-2019 111210020519P000625 0000520046651 TRI BASKORO L PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

81 28-05-2019 111210020519P000870 0000520052949 AHMAD KUSMADI L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
82 28-05-2019 111210020519P000825 0000520119933 MULASIH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
83 28-05-2019 111210020519P000805 0000520135536 SANIAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
84 28-05-2019 111210020519P000867 0000520193428 RASIKEM P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
85 28-05-2019 111210020519P000872 0000520201146 TARIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Hipertensi Mellitus
complications Hipertensi
86 28-05-2019 111210020519P000844 0000520357048 KAMSIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
87 28-05-2019 111210020519P000835 0000520383475 INDARTO L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications Hipertensi
88 28-05-2019 111210020519P000644 0000520465702 SODALI L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
89 28-05-2019 111210020519P000871 0000520471438 TURMIASIH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Hipertensi Mellitus
complications Hipertensi
90 28-05-2019 111210020519P000859 0000520612277 KUSMIYATI P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
91 28-05-2019 111210020519P000629 0000520672083 SULIYAH P PBI (APBN) Blighted ovum and Rujuk Lanjut
nonhydatidiform mole
92 28-05-2019 111210020519P000830 0000520678721 KASINAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
93 28-05-2019 111210020519P000640 0000520776292 AHYAR ALFARIZI L PBI (APBN) Fever, unspecified Berobat Jalan

94 28-05-2019 111210020519P000865 0000520788857 NGAISAH P PBI (APBN) Non-insulin-dependent Berobat Jalan


diabetes mellitus without
complications
95 28-05-2019 111210020519P000652 0000520863028 SUHARDI L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
96 28-05-2019 111210020519P000818 0000520880826 NURUL FAIZAH P PBI (APBN) Abdominal pregnancy Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

97 28-05-2019 111210020519P000632 0000520883212 PONO SISWO HARJONO L PBI (APBN) Myalgia Berobat Jalan

98 28-05-2019 111210020519P000651 0000520884448 TURSINAH P PBI (APBN) Myalgia Berobat Jalan

99 28-05-2019 111210020519P000834 0000520891648 NURSIDIK L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
100 28-05-2019 111210020519P000840 0000520891964 DAISAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
101 28-05-2019 111210020519P000627 0000520906353 ABDUL ROKHMAN L PBI (APBN) Urinary calculus, Rujuk Lanjut
unspecified
102 28-05-2019 111210020519P000876 0000520999277 SIKEM P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
103 28-05-2019 111210020519P000648 0000521116648 PANDU AJI PANGSETU L PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
104 28-05-2019 111210020519P000864 0000521128001 KASIDAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
105 28-05-2019 111210020519P000633 0000521133333 NADIA NAILA SIFA P PBI (APBN) Scabies Berobat Jalan

106 28-05-2019 111210020519P000853 0000521410083 SOBIROH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
107 28-05-2019 111210020519P000878 0000521411253 ALFIAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
108 28-05-2019 111210020519P000836 0001015220057 SITI MUSRINGAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
109 28-05-2019 111210020519P000671 0001084312956 RUSTAM L PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
110 28-05-2019 111210020519P000869 0001084672719 SAMIRAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
111 28-05-2019 111210020519P000742 0001289187156 MARSIH DIAN MELIANA P PEGAWAI SWASTA False labour, unspecified Sembuh

112 28-05-2019 111210020519P000819 0001308471243 SUGIARTI P PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

113 28-05-2019 111210020519P000860 0001314919664 ROSIHUN L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
114 28-05-2019 111210020519P000875 0001314919776 SUPARMI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
115 28-05-2019 111210020519P000861 0001317823378 SUHARTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
116 28-05-2019 111210020519P000646 0001427200907 SUDIHARJO L PEKERJA MANDIRI Gonarthrosis [arthrosis of Berobat Jalan
knee]
117 28-05-2019 111210020519P000833 0001473590171 PAINAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Hipertensi Mellitus
complications
118 28-05-2019 111210020519P000743 0001631487778 UJI HASANAH P PEKERJA MANDIRI False labour, unspecified Sembuh

119 28-05-2019 111210020519P000650 0001633752134 MINO MIRANTO L PEKERJA MANDIRI Myalgia Berobat Jalan

120 28-05-2019 111210020519P000850 0001700513932 PARIYEM P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
121 28-05-2019 111210020519P000831 0001700515045 AMINAH P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
122 28-05-2019 111210020519P000821 0001718361551 SARIYEM P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus
diabetes mellitus without
complications
123 28-05-2019 111210020519P000845 0001734459164 ELI PURWANTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
124 28-05-2019 111210020519P000846 0001734459208 PENTI FAJRIYANTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
125 28-05-2019 111210020519P000856 0001812660794 yasih P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
126 28-05-2019 111210020519P000624 0001859875852 YATNO L PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
127 28-05-2019 111210020519P000839 0002009246016 WATIEM P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

128 28-05-2019 111210020519P000848 0002009246376 SUDARTI P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
129 28-05-2019 111210020519P000874 0002009262565 SAINEM P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Hipertensi Mellitus
complications Hipertensi
130 28-05-2019 111210020519P000761 0002051949723 DARYATI P PBI (APBD) Other and unspecified Berobat Jalan
convulsions
131 28-05-2019 111210020519P000866 0002090362915 UDIYONO L PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
132 28-05-2019 111210020519P000858 0002102155841 Sutini P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
SWASTA diabetes mellitus without Mellitus
complications
133 28-05-2019 111210020519P000851 0002128484362 KARWITA P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
134 28-05-2019 111210020519P000824 0002175856378 TOYIBAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
135 28-05-2019 111210020519P000642 0002188267975 HEDIANA SUBAGIO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
136 28-05-2019 111210020519P000643 0002234111365 MUHAMMAD FA'IZ ABDILLAH L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
137 28-05-2019 111210020519P000863 0002234887727 FAUZAN L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
138 28-05-2019 111210020519P000857 0002250503291 SUATMI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
139 28-05-2019 111210020519P000855 0002264978081 TRIYONO L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
140 28-05-2019 111210020519P000854 0002265248812 SIJEM P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
141 28-05-2019 111210020519P000852 0002267674661 JUMINAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Hipertensi Mellitus
complications Hipertensi
142 28-05-2019 111210020519P000647 0002269062652 DASIYEM P PEKERJA MANDIRI Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

143 28-05-2019 111210020519P000838 0002272269014 SALIM TOFIK L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
144 28-05-2019 111210020519P000841 0002285620209 HJ DIANA MARYANI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
145 28-05-2019 111210020519P000842 0002296989101 SUDARTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications Hipertensi
146 28-05-2019 111210020519P000832 0002298999352 PARIYAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
147 28-05-2019 111210020519P000820 0002310367915 SUMINAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
148 28-05-2019 111210020519P000847 0002324710585 JULIYATI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
149 28-05-2019 111210020519P000862 0002436979252 ARSIH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
150 28-05-2019 111210020519P000868 0002437322771 ENDANG SOEPRIYANTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
151 28-05-2019 111210020519P000843 0002446198525 MUSRINGAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
152 28-05-2019 111210020519P000828 0002449266535 SARTINEM P PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
153 28-05-2019 111210020519P000829 0002456832148 SUNARYO JADI L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus without Mellitus
complications
154 28-05-2019 111210020519P000635 0002468398116 SEPNA AVILIA P PEKERJA MANDIRI Ulcerative colitis, Berobat Jalan
unspecified
155 28-05-2019 111210020519P000822 0002501059836 SUKINAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
156 28-05-2019 111210020519P000641 0002504752266 DESI ANDRIYANTI P PBI (APBN) Headache Berobat Jalan

157 28-05-2019 111210020519P000673 0002504756171 UNTUNG RIZAL FAJRI L PBI (APBN) Mania with psychotic Rujuk Lanjut
symptoms
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

158 28-05-2019 111210020519P000626 0002576979009 SADIKEM P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
complications
159 28-05-2019 111210020519P000639 0002601977117 REGITA ISNA HAYATUN NUFUS P PBI (APBN) Fever, unspecified Berobat Jalan

160 28-05-2019 111210020519P000637 0002611394774 JIHAN ANDRIAN L PEKERJA MANDIRI Conjunctivitis, unspecified Berobat Jalan

161 28-05-2019 111210020519P000631 0002625808353 SLAMET L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
162 28-05-2019 111210020519P000806 0002625808432 NUR MANISEM P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
163 28-05-2019 111210020519P000630 0002629111465 RIHANA NUR W P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

164 28-05-2019 111210020519P000645 0002633643527 SITI MUALIFAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
165 28-05-2019 111210020519P000823 0002637961277 MARDI SISWOYO L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
166 28-05-2019 111210020519P000649 0002639092105 ENI HARTATI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
167 28-05-2019 111210020519P000636 0002639119702 SUMIARJO RADIMUN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
168 28-05-2019 111210020519P000628 0002640119321 HILMAN FAUZI L PBI (APBN) Recurrent and persistent Rujuk Lanjut
haematuria, unspecified
169 28-05-2019 111210020519P000654 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
170 27-05-2019 111210020519P000581 0000519120617 TOTO SARTO L PBI (APBN) Follow-up care involving Rujuk Lanjut
removal of fracture plate
and other internal fixation
device
171 27-05-2019 111210020519P000617 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
172 27-05-2019 111210020519P000609 0000519506381 LAELATUL MUNAWAROH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
173 27-05-2019 111210020519P000667 0000519574577 SUSILAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
174 27-05-2019 111210020519P000804 0000519828502 NASIMAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
175 27-05-2019 111210020519P000580 0000520192192 AMAD SUTRISNO L PBI (APBN) Schizoaffective disorder, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

176 27-05-2019 111210020519P000579 0000520192405 GENDRO WARSITO L PBI (APBN) Paranoid schizophrenia Rujuk Lanjut

177 27-05-2019 111210020519P000664 0000520238428 KAMISAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan Diabetes Mellitus Diabetes
[common cold] Mellitus
178 27-05-2019 111210020519P000605 0000520275025 SAMIRUN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
179 27-05-2019 111210020519P000603 0000520275418 ROMYATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
180 27-05-2019 111210020519P000604 0000520275982 SAMIR JASTIN AGUSTINo L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
181 27-05-2019 111210020519P000660 0000520277117 TURIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
182 27-05-2019 111210020519P000655 0000520318394 WAGINEM P PBI (APBN) Gastritis, unspecified Berobat Jalan

183 27-05-2019 111210020519P000656 0000520319439 TISAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
184 27-05-2019 111210020519P000658 0000520323748 JAMIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
185 27-05-2019 111210020519P000582 0000520462798 ADE JARKASIH L PBI (APBN) Attention to surgical Rujuk Lanjut
dressings and sutures
186 27-05-2019 111210020519P000668 0000520724384 RATINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
187 27-05-2019 111210020519P000663 0000520744522 SUNARTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
188 27-05-2019 111210020519P000662 0000520823643 SATINEM P PBI (APBN) Myalgia Berobat Jalan

189 27-05-2019 111210020519P000613 0000521297458 PARIYAH P PBI (APBN) Gastritis, unspecified Berobat Jalan Hipertensi Hipertensi

190 27-05-2019 111210020519P000619 0000521456073 NGADINAH P PBI (APBN) Fever, unspecified Berobat Jalan

191 27-05-2019 111210020519P000616 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
192 27-05-2019 111210020519P000665 0001015223264 SUDARMAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
193 27-05-2019 111210020519P000614 0001770083706 MOHAMAD WAHYUDIN L PEGAWAI SWASTA Fever, unspecified Berobat Jalan

194 27-05-2019 111210020519P000606 0001913892524 ATHAR MAHALI L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
195 27-05-2019 111210020519P000622 0001968202754 AGUNG TRI PRASETYO L PEGAWAI SWASTA Fever, unspecified Berobat Jalan

196 27-05-2019 111210020519P000610 0002039429136 MAD LASIMAN L PBI (APBD) Gastritis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

197 27-05-2019 111210020519P000620 0002175926141 ISNA MARYANI P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
198 27-05-2019 111210020519P000611 0002198298249 NGATIMAN L PEKERJA MANDIRI Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
199 27-05-2019 111210020519P000657 0002265248812 SIJEM P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
200 27-05-2019 111210020519P000615 0002272269014 SALIM TOFIK L PEKERJA MANDIRI Predominantly allergic Berobat Jalan Diabetes Mellitus Diabetes
asthma Mellitus
201 27-05-2019 111210020519P000623 0002276349726 TUSIAH P PEKERJA MANDIRI Endometrial glandular Rujuk Lanjut
hyperplasia
202 27-05-2019 111210020519P000612 0002295951963 warisem P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

203 27-05-2019 111210020519P000621 0002470534389 JAMINGAH P PEKERJA MANDIRI Myalgia Berobat Jalan

204 27-05-2019 111210020519P000602 0002485174454 RADYSTA SETIAWAN L PEKERJA MANDIRI Scabies Berobat Jalan

205 27-05-2019 111210020519P000659 0002504759207 SUSIYANTI P PBI (APBN) Headache Berobat Jalan

206 27-05-2019 111210020519P000618 0002576641702 DEWI INA ROTUL RISDA P PBI (APBD) Fever, unspecified Berobat Jalan

207 27-05-2019 111210020519P000608 0002576833108 TURSINI P PBI (APBD) Myalgia Berobat Jalan

208 27-05-2019 111210020519P000661 0002646400061 SUMIRAH HARYANTI P PBI (APBN) Headache Berobat Jalan

209 26-05-2019 111210020519P000803 0000520446633 FEBRIYANTI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
210 26-05-2019 111210020519P000740 0001775412448 FEBRY DAMAYANTI P PEGAWAI SWASTA False labour, unspecified Sembuh

211 26-05-2019 111210020519P000760 0002218427008 VINA RIANA P PEKERJA MANDIRI Delayed and secondary Berobat Jalan
postpartum haemorrhage
212 26-05-2019 111210020519P000741 0002632472886 ARIYATI P PBI (APBN) False labour, unspecified Sembuh

213 26-05-2019 111210020519P000802 0002750720376 KUNDARTI P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
214 25-05-2019 111210020519P000739 0000438465104 SITI ROHMATUN P PBI (APBN) False labour, unspecified Sembuh

215 25-05-2019 111210020519P000597 0000518678965 LASINEM P PBI (APBN) Myalgia Berobat Jalan

216 25-05-2019 111210020519P000592 0000520361155 TOHARI L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

217 25-05-2019 111210020519P000591 0000520431884 FATIMAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
218 25-05-2019 111210020519P000596 0000520446554 SITI ROFINGAH P PBI (APBN) Gastritis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

219 25-05-2019 111210020519P000738 0000520446633 FEBRIYANTI P PBI (APBN) False labour, unspecified Sembuh

220 25-05-2019 111210020519P000585 0000520471113 KHAERIYAH P PBI (APBN) Fever, unspecified Berobat Jalan

221 25-05-2019 111210020519P000590 0000520507045 MAHPUROH P PBI (APBN) Myalgia Berobat Jalan

222 25-05-2019 111210020519P000593 0000520621176 SOLIKHUDIN L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

223 25-05-2019 111210020519P000594 0000520621749 UMI SOLIHAH P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

224 25-05-2019 111210020519P000586 0000521091742 AHMAD MUKSIN L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

225 25-05-2019 111210020519P000589 0000521093092 ARIF SETIAWAN L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

226 25-05-2019 111210020519P000600 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
227 25-05-2019 111210020519P000598 0002009261215 SUTINAH P PBI (APBN) Gastritis, unspecified Berobat Jalan

228 25-05-2019 111210020519P000584 0002199800441 YUSUF SUGITO RAHARJO L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
229 25-05-2019 111210020519P000583 0002214391779 SUFIYAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
230 25-05-2019 111210020519P000587 0002453853971 MACHFUDZ L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
231 25-05-2019 111210020519P000588 0002492792853 mad sumeri L PEKERJA MANDIRI Congestive heart failure Berobat Jalan

232 25-05-2019 111210020519P000595 0002611978075 sakiyah P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
233 25-05-2019 111210020519P000607 0002633643617 NASRUN L PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
234 25-05-2019 111210020519P000599 0002635686731 MADSUKARTO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
235 25-05-2019 111210020519P000737 0002750720376 KUNDARTI P PEKERJA MANDIRI False labour, unspecified Sembuh

236 25-05-2019 111210020519P000601 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
237 24-05-2019 111210020519P000575 0000520330509 TRI WIYONO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
238 24-05-2019 111210020519P000576 0000520539614 SITI MUNIROH P PBI (APBN) Pulpitis Berobat Jalan

239 24-05-2019 111210020519P000569 0000520757381 RUMIATI P PBI (APBN) Headache Berobat Jalan

240 24-05-2019 111210020519P000573 0000520901987 TURYATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

241 24-05-2019 111210020519P000577 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
242 24-05-2019 111210020519P000564 0001859875852 YATNO L PEKERJA MANDIRI Background retinopathy Rujuk Lanjut
and retinal vascular
changes
243 24-05-2019 111210020519P000568 0002038377058 MUSTOPO L PBI (APBD) Fever, unspecified Berobat Jalan

244 24-05-2019 111210020519P000574 0002038950685 AHMAD MUSTOFA L PBI (APBD) Myalgia Berobat Jalan

245 24-05-2019 111210020519P000799 0002051988052 SITI MARHAMAH P PBI (APBD) Contraceptive Berobat Jalan
management, unspecified
246 24-05-2019 111210020519P000571 0002125678599 NAUFAL RIJAL FAIQ L PBI (APBN) Fever, unspecified Berobat Jalan

247 24-05-2019 111210020519P000578 0002226758264 SITI AFALIN P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
248 24-05-2019 111210020519P000563 0002377382398 NUR FAIZAH LINGASIROH P PEKERJA MANDIRI Excessive and frequent Rujuk Lanjut
menstruation with regular
cycle
249 24-05-2019 111210020519P000572 0002437046785 SUKARDI RASIKUN L PEKERJA MANDIRI Hyperplasia of prostate Berobat Jalan

250 24-05-2019 111210020519P000565 0002632449969 AMINAH P PBI (APBN) Otalgia Berobat Jalan

251 24-05-2019 111210020519P000567 0002636904273 JEMU HADI WALUYO L PBI (APBN) Urticaria, unspecified Berobat Jalan

252 24-05-2019 111210020519P000566 0002636904295 ASIH P PBI (APBN) Headache Berobat Jalan

253 24-05-2019 111210020519P000801 0002639082014 SRI RAHMAWATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
254 24-05-2019 111210020519P000800 0002756426848 KATIRAH P PEKERJA MANDIRI Insertion of (intrauterine) Berobat Jalan
contraceptive device
255 24-05-2019 111210020519P000570 0002758721422 SATIWEN P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
256 23-05-2019 111210020519P000553 0000519629477 DASIWEN P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
257 23-05-2019 111210020519P000562 0000520178411 DZIYA MAY NAFIIS P PBI (APBN) Other hearing loss Berobat Jalan

258 23-05-2019 111210020519P000547 0000520299279 YONI WIDADI L PBI (APBN) Scar conditions and Rujuk Lanjut
fibrosis of skin
259 23-05-2019 111210020519P000561 0000520385231 JUMANTORO DFRAYOGA L PBI (APBN) Attention to surgical Berobat Jalan
WINARTO dressings and sutures
260 23-05-2019 111210020519P000552 0000520465296 SUGINAH P PBI (APBN) Gastritis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

261 23-05-2019 111210020519P000548 0000520591026 SATIRAH P PBI (APBN) Congestive heart failure Rujuk Lanjut

262 23-05-2019 111210020519P000554 0000520885675 AMINAH P PBI (APBN) Otitis media, unspecified Berobat Jalan

263 23-05-2019 111210020519P000555 0000521317124 HOLIPAH P PBI (APBN) Headache Berobat Jalan

264 23-05-2019 111210020519P000559 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
265 23-05-2019 111210020519P000797 0001015220114 MARYATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
266 23-05-2019 111210020519P000557 0001915142229 AMELIA RAHMA DENITA P PBI (APBN) Dental caries Berobat Jalan

267 23-05-2019 111210020519P000560 0002129893154 SUTIJAH P PBI (APBN) Gastritis, unspecified Berobat Jalan

268 23-05-2019 111210020519P000551 0002234487475 SARTINI P PEKERJA MANDIRI Myalgia Berobat Jalan

269 23-05-2019 111210020519P000558 0002504759319 AKMAL UBAIDILLAH L PBI (APBN) Fever, unspecified Berobat Jalan

270 23-05-2019 111210020519P000798 0002517242769 AAN ANISA P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
271 23-05-2019 111210020519P000556 0002630300927 BADRIYAH P PBI (APBN) Keratitis Berobat Jalan

272 23-05-2019 111210020519P000549 0002630392503 KUSWANTO L PBI (APBN) Chronic renal failure, Rujuk Lanjut
unspecified
273 23-05-2019 111210020519P000550 0002634778405 RASINAH P PBI (APBN) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
complications
274 22-05-2019 111210020519P000521 0000081303197 GONO L PENERIMA PENSIUN Other and unspecified Rujuk Lanjut
PNS right bundle-branch block
275 22-05-2019 111210020519P000534 0000519504838 SUGENG JOKO SANTOSO L PBI (APBN) Gonarthrosis [arthrosis of Berobat Jalan
knee]
276 22-05-2019 111210020519P000525 0000519798352 MARSIYEM P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

277 22-05-2019 111210020519P000531 0000519937209 SUGIWATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
278 22-05-2019 111210020519P000526 0000520080502 SUTARJO SIMIN L PBI (APBN) Gastritis, unspecified Berobat Jalan

279 22-05-2019 111210020519P000539 0000520111282 SITI FATIMAH P PBI (APBN) Headache Berobat Jalan

280 22-05-2019 111210020519P000796 0000520321307 MARIYAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
281 22-05-2019 111210020519P000527 0000520455745 DAVID PUJIONO L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

282 22-05-2019 111210020519P000545 0000520462798 ADE JARKASIH L PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
283 22-05-2019 111210020519P000533 0000520515459 JASIYEM P PBI (APBN) Headache Berobat Jalan

284 22-05-2019 111210020519P000523 0000520603694 MUSLIHAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
285 22-05-2019 111210020519P000536 0000520603852 ZULAEHAH NINGSIH P PBI (APBN) Urticaria, unspecified Berobat Jalan

286 22-05-2019 111210020519P000524 0000520604616 NISA LUTFIYANA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
287 22-05-2019 111210020519P000519 0000520918119 BADRIYAH P PBI (APBN) Attention to surgical Rujuk Lanjut
dressings and sutures
288 22-05-2019 111210020519P000544 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
289 22-05-2019 111210020519P000735 0001015220114 MARYATI P PBI (APBN) False labour, unspecified Sembuh

290 22-05-2019 111210020519P000532 0001280179359 RAHMAT BASUKI L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
291 22-05-2019 111210020519P000537 0001435997992 samini P PEKERJA MANDIRI Conjunctivitis, unspecified Berobat Jalan

292 22-05-2019 111210020519P000518 0001812660794 yasih P PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut Diabetes Mellitus Diabetes
unspecified Mellitus
293 22-05-2019 111210020519P000541 0002009269405 TRI ASTUTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
294 22-05-2019 111210020519P000530 0002009270968 UMIYATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
295 22-05-2019 111210020519P000535 0002009270979 DWI AFFIT DINATA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
296 22-05-2019 111210020519P000540 0002039429856 DWI YULIANTI P PBI (APBD) Myalgia Berobat Jalan

297 22-05-2019 111210020519P000520 0002039470942 TUKIYAH P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
complications
298 22-05-2019 111210020519P000542 0002125678127 ZAINI IKHFAN MAULANA L PBI (APBN) Fever, unspecified Berobat Jalan

299 22-05-2019 111210020519P000528 0002128483923 MANISEM P PBI (APBN) Vertigo of central origin Berobat Jalan

300 22-05-2019 111210020519P000546 0002226758264 SITI AFALIN P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
301 22-05-2019 111210020519P000522 0002326574158 ITA SUCIATI P PEKERJA MANDIRI Follow-up care involving Rujuk Lanjut
removal of fracture plate
and other internal fixation
device
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

302 22-05-2019 111210020519P000529 0002436809152 MARSIDI L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
303 22-05-2019 111210020519P000736 0002517242769 AAN ANISA P PEKERJA MANDIRI False labour, unspecified Sembuh

304 22-05-2019 111210020519P000543 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
305 22-05-2019 111210020519P000538 0002758721422 SATIWEN P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
complications
306 21-05-2019 111210020519P000509 0000518692061 TUKIRAH P PBI (APBN) Myalgia Berobat Jalan

307 21-05-2019 111210020519P000511 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
308 21-05-2019 111210020519P000507 0000520165416 JAMIAH P PBI (APBN) Vertigo of central origin Berobat Jalan

309 21-05-2019 111210020519P000495 0000520326516 SANDIARJA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
310 21-05-2019 111210020519P000506 0000520329205 MAD SUPARDI SUPARNO L PBI (APBN) Gastritis, unspecified Berobat Jalan

311 21-05-2019 111210020519P000496 0000520439668 SITI NURAZIZAH P PBI (APBN) Fever, unspecified Berobat Jalan

312 21-05-2019 111210020519P000493 0000520628152 SITI FATIMAH P PBI (APBN) Hypertensive heart Rujuk Lanjut
disease with (congestive)
heart failure
313 21-05-2019 111210020519P000508 0000520692129 SUWARTINI P PBI (APBN) Fever, unspecified Berobat Jalan

314 21-05-2019 111210020519P000516 0000520812685 MISWAN L PBI (APBN) Spondylosis, unspecified Rujuk Lanjut

315 21-05-2019 111210020519P000513 0000520841957 SITI KOMARIYAH P PBI (APBN) Headache Berobat Jalan

316 21-05-2019 111210020519P000500 0000520917783 SATINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
317 21-05-2019 111210020519P000512 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
318 21-05-2019 111210020519P000497 0001084698843 PARIYEM P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

319 21-05-2019 111210020519P000498 0001647286738 EVI NOVITASARI P PEKERJA MANDIRI Maternal care for Rujuk Lanjut
disproportion, unspecified
320 21-05-2019 111210020519P000502 0002009255433 KOLISOH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

321 21-05-2019 111210020519P000504 0002210745249 KASIYEM P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes Mellitus
diabetes mellitus without
complications
322 21-05-2019 111210020519P000503 0002447211969 ANISA TIASARI P PEKERJA MANDIRI Unspecified haemorrhoids Berobat Jalan
without complication

323 21-05-2019 111210020519P000515 0002479352354 MULYADI L PEKERJA MANDIRI Headache Berobat Jalan

324 21-05-2019 111210020519P000494 0002620174893 AHMAD MUKRI L PEKERJA MANDIRI Leprosy, unspecified Rujuk Lanjut

325 21-05-2019 111210020519P000501 0002630392503 KUSWANTO L PBI (APBN) Congestive heart failure Berobat Jalan

326 21-05-2019 111210020519P000510 0002634778631 WASINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
327 21-05-2019 111210020519P000514 0002635685278 ARYATI P PBI (APBN) Headache Berobat Jalan

328 21-05-2019 111210020519P000505 0002635686268 MANISAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
329 21-05-2019 111210020519P000517 0002740031651 ETI P PEKERJA MANDIRI Maternal care for Rujuk Lanjut
malpresentation of fetus,
unspecified
330 21-05-2019 111210020519P000499 0002756014659 SUNARDI MADSUKARDI L PEKERJA MANDIRI Low back pain Berobat Jalan Hipertensi

331 20-05-2019 111210020519P000488 0000519475083 BERKAH ARDIANSYAH L PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
332 20-05-2019 111210020519P000458 0000519484724 JAGAT MUKTI L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
333 20-05-2019 111210020519P000492 0000519938335 ARIS ILHAM SAPUTRA L PBI (APBN) Tuberculous peripheral Berobat Jalan
lymphadenopathy
334 20-05-2019 111210020519P000476 0000519984257 ROBBY MUZAKY L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
335 20-05-2019 111210020519P000481 0000520053175 ENDANG FAJRI NINGSIH P PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
336 20-05-2019 111210020519P000475 0000520136032 SANGIDAH P PBI (APBN) Low back pain Berobat Jalan

337 20-05-2019 111210020519P000759 0000520192394 SITI ZULEHA P PBI (APBN) Other single delivery by Berobat Jalan
caesarean section
338 20-05-2019 111210020519P000462 0000520205253 TITIM P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

339 20-05-2019 111210020519P000455 0000520205253 TITIM P PBI (APBN) Other rheumatoid arthritis Rujuk Lanjut

340 20-05-2019 111210020519P000474 0000520218358 MADIKSAN PAIMUN L PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

341 20-05-2019 111210020519P000450 0000520225514 TUMIYATI P PBI (APBN) Other current Rujuk Lanjut
complications following
acute myocardial infarction

342 20-05-2019 111210020519P000478 0000520226379 MANISAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
343 20-05-2019 111210020519P000484 0000520256373 AHMAD FARKHAN L PBI (APBN) Unspecified haemorrhoids Berobat Jalan
without complication

344 20-05-2019 111210020519P000483 0000520256665 SITI TOYIBAH P PBI (APBN) Pterygium Berobat Jalan

345 20-05-2019 111210020519P000793 0000520265125 SURIPAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
346 20-05-2019 111210020519P000449 0000520298177 SUMARTI P PBI (APBN) Other specified Rujuk Lanjut
pregnancy-related
conditions
347 20-05-2019 111210020519P000480 0000520365756 ROSIYAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

348 20-05-2019 111210020519P000490 0000520385231 JUMANTORO DFRAYOGA L PBI (APBN) Attention to surgical Berobat Jalan
WINARTO dressings and sutures
349 20-05-2019 111210020519P000452 0000520550245 MEI INDRIYANI WIDIYASARI P PBI (APBN) Other specified anaemias Rujuk Lanjut

350 20-05-2019 111210020519P000477 0000520553373 SOIM MUAZIZ L PBI (APBN) Myalgia Berobat Jalan

351 20-05-2019 111210020519P000463 0000520724384 RATINAH P PBI (APBN) Headache Berobat Jalan

352 20-05-2019 111210020519P000469 0000520939642 MARIYAH P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

353 20-05-2019 111210020519P000794 0000521018133 SUPINAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
354 20-05-2019 111210020519P000486 0000521132973 SOLIAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
355 20-05-2019 111210020519P000466 0000521240771 MARYATUN P PBI (APBN) Headache Berobat Jalan

356 20-05-2019 111210020519P000461 0000521388584 RISTA CAHYANINGSIH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
357 20-05-2019 111210020519P000795 0000653395601 ROHMINI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
358 20-05-2019 111210020519P000489 0001084639724 ROKHIMAH P PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
359 20-05-2019 111210020519P000459 0001450724523 MAHARANI WILUJENG SAFITRI P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

360 20-05-2019 111210020519P000471 0001798321724 muhammad kholilur rohman L PEGAWAI SWASTA Urticaria, unspecified Berobat Jalan

361 20-05-2019 111210020519P000472 0001812660794 yasih P PEKERJA MANDIRI Low back pain Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
362 20-05-2019 111210020519P000454 0001842170894 WAGIYO L PEKERJA MANDIRI Schizophrenia Rujuk Lanjut

363 20-05-2019 111210020519P000485 0001842171197 HOMSIAH P PEKERJA MANDIRI Urticaria, unspecified Berobat Jalan

364 20-05-2019 111210020519P000482 0002038975762 SRI HARTATI P PBI (APBD) Unspecified haemorrhoids Berobat Jalan
without complication

365 20-05-2019 111210020519P000479 0002043864112 siti asih P PEKERJA MANDIRI Myalgia Berobat Jalan

366 20-05-2019 111210020519P000465 0002084596266 KISEM P PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
367 20-05-2019 111210020519P000460 0002128232518 NASIROTUN IMROH P PBI (APBN) Headache Berobat Jalan

368 20-05-2019 111210020519P000491 0002224164036 WASRI P PEKERJA MANDIRI Congestive heart failure Berobat Jalan

369 20-05-2019 111210020519P000464 0002265248812 SIJEM P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
370 20-05-2019 111210020519P000792 0002291718969 SUTINAH P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
371 20-05-2019 111210020519P000467 0002377382398 NUR FAIZAH LINGASIROH P PEKERJA MANDIRI Myalgia Berobat Jalan

372 20-05-2019 111210020519P000453 0002436351085 WAGIMIN L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,
unspecified
373 20-05-2019 111210020519P000470 0002611394469 WAGIRAH P PEKERJA MANDIRI Lichen simplex chronicus Berobat Jalan

374 20-05-2019 111210020519P000473 0002630301129 JUARIYAH P PBI (APBN) Vertigo of central origin Berobat Jalan

375 20-05-2019 111210020519P000451 0002635705269 RITA LESTARI L PBI (APBN) Maternal care for Rujuk Lanjut
intrauterine death
376 20-05-2019 111210020519P000487 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
377 20-05-2019 111210020519P000468 0002756115854 YULIS SARIROH P PEGAWAI SWASTA Chest pain, unspecified Berobat Jalan

378 18-05-2019 111210020519P000456 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
379 18-05-2019 111210020519P000787 0000519465969 IMAS AISAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
380 18-05-2019 111210020519P000446 0000520139935 SITI NANGIMAH P PBI (APBN) Tinea corporis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

381 18-05-2019 111210020519P000439 0000520152096 MARSINAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

382 18-05-2019 111210020519P000442 0000520252176 NATHAN YUSUF AL KHAFI L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
383 18-05-2019 111210020519P000434 0000520476748 ABDUL MALIK L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
384 18-05-2019 111210020519P000790 0000520621749 UMI SOLIHAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
385 18-05-2019 111210020519P000788 0000520889951 PUPUT ARTA P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
386 18-05-2019 111210020519P000789 0000520905835 RUSTI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
387 18-05-2019 111210020519P000437 0000521298764 AMMAR SYAFIQ L PBI (APBN) Nausea and vomiting Berobat Jalan

388 18-05-2019 111210020519P000734 0000653395601 ROHMINI P PBI (APBN) False labour, unspecified Sembuh

389 18-05-2019 111210020519P000457 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
390 18-05-2019 111210020519P000438 0002176014857 SRI DARNINGSIH P PBI (APBN) Nausea and vomiting Berobat Jalan

391 18-05-2019 111210020519P000443 0002310367915 SUMINAH P PEKERJA MANDIRI Diabetic cataract Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
392 18-05-2019 111210020519P000432 0002314260472 imam baehaqi L PEKERJA MANDIRI Dyspepsia Rujuk Lanjut

393 18-05-2019 111210020519P000441 0002467612023 WAHYUDI NUGROHO L PEGAWAI SWASTA Headache Berobat Jalan

394 18-05-2019 111210020519P000433 0002487033988 TUKINEM P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast, unspecified
395 18-05-2019 111210020519P000435 0002504752086 MICHELLE FUTIHATUN P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan
NAJIHAH
396 18-05-2019 111210020519P000444 0002635705719 MISIATUN P PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
397 18-05-2019 111210020519P000436 0002639092667 ADMINAH P PBI (APBN) Gastritis, unspecified Berobat Jalan

398 18-05-2019 111210020519P000440 0002737461699 HADMIYATUN P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

399 18-05-2019 111210020519P000445 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
400 17-05-2019 111210020519P000733 0000519465969 IMAS AISAH P PBI (APBN) False labour, unspecified Sembuh
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

401 17-05-2019 111210020519P000419 0000519669268 WAGIMIN L PBI (APBN) Gastritis, unspecified Berobat Jalan

402 17-05-2019 111210020519P000416 0000520246539 MUNGINAH P PBI (APBN) Fever, unspecified Berobat Jalan

403 17-05-2019 111210020519P000428 0000520268411 MARIYAH P PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
404 17-05-2019 111210020519P000427 0000520381203 IMING P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
405 17-05-2019 111210020519P000424 0000520570686 ABDUL SYUKUR L PBI (APBN) Unspecified renal colic Berobat Jalan

406 17-05-2019 111210020519P000413 0000520769676 TOHIYEM P PBI (APBN) Intra-abdominal and pelvic Rujuk Lanjut
swelling, mass and lump

407 17-05-2019 111210020519P000786 0000521116492 TUMIYATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
408 17-05-2019 111210020519P000422 0000529944816 IMAM PAMUJI L PBI (APBN) Typhoid fever Berobat Jalan

409 17-05-2019 111210020519P000431 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
410 17-05-2019 111210020519P000415 0001475773312 IMAM GHOJALI L PEKERJA MANDIRI Headache Berobat Jalan

411 17-05-2019 111210020519P000429 0001475774965 NURHAYATI P PEKERJA MANDIRI Headache Berobat Jalan

412 17-05-2019 111210020519P000418 0002009244993 JUMIRAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
413 17-05-2019 111210020519P000417 0002125678127 ZAINI IKHFAN MAULANA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
414 17-05-2019 111210020519P000426 0002175854545 ENDANG HARTONO L PBI (APBN) Fever, unspecified Berobat Jalan

415 17-05-2019 111210020519P000421 0002175854556 DARSIH P PBI (APBN) Myalgia Berobat Jalan

416 17-05-2019 111210020519P000420 0002334331732 RAFIQIH FERDIANSYAH L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
417 17-05-2019 111210020519P000414 0002443635562 PIYU RAHMA ARDIANTO L PEKERJA MANDIRI Contusion of elbow Rujuk Lanjut

418 17-05-2019 111210020519P000425 0002458307812 MASO ILYAS L PEKERJA MANDIRI Paraesthesia of skin Berobat Jalan

419 17-05-2019 111210020519P000423 0002504755258 BUDIANTO L PBI (APBN) Gastritis, unspecified Berobat Jalan

420 17-05-2019 111210020519P000430 0002519863841 PARIYAH P PEKERJA MANDIRI Single delivery by Berobat Jalan
caesarean section
421 16-05-2019 111210020519P000397 0000081286569 KARSINAH P PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
422 16-05-2019 111210020519P000410 0000081495808 PARINAH P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

423 16-05-2019 111210020519P000381 0000518678965 LASINEM P PBI (APBN) Senile cataract, Rujuk Lanjut
unspecified
424 16-05-2019 111210020519P000394 0000519365946 KHALIMI L PBI (APBN) Gastritis, unspecified Berobat Jalan

425 16-05-2019 111210020519P000411 0000519574577 SUSILAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
426 16-05-2019 111210020519P000390 0000520296344 SUYATIN P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
427 16-05-2019 111210020519P000391 0000520297277 RICKO NANDA SAPUTRA L PBI (APBN) Scabies Berobat Jalan

428 16-05-2019 111210020519P000407 0000520323748 JAMIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
429 16-05-2019 111210020519P000783 0000520379875 SRI SULASTRI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
430 16-05-2019 111210020519P000402 0000520385231 JUMANTORO DFRAYOGA L PBI (APBN) Attention to surgical Berobat Jalan
WINARTO dressings and sutures
431 16-05-2019 111210020519P000393 0000520395502 HADIS L PBI (APBN) Low back pain Berobat Jalan

432 16-05-2019 111210020519P000405 0000520456004 MUTMAINAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
433 16-05-2019 111210020519P000785 0000520554442 KASITEM P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
434 16-05-2019 111210020519P000409 0000520724384 RATINAH P PBI (APBN) Headache Berobat Jalan

435 16-05-2019 111210020519P000380 0000520764276 NGADIRAH P PBI (APBN) Strabismus, unspecified Rujuk Lanjut

436 16-05-2019 111210020519P000412 0000520823643 SATINEM P PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
437 16-05-2019 111210020519P000406 0000520830887 MAHMUDAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
438 16-05-2019 111210020519P000385 0000520973616 SITI AISYAH P PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
439 16-05-2019 111210020519P000408 0000521025153 SARIMI P PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
440 16-05-2019 111210020519P000782 0000521063144 WINASIH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
441 16-05-2019 111210020519P000395 0000521093136 ALVI KURNIAWAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

442 16-05-2019 111210020519P000404 0000521230331 DOLAH NGASMAN L PBI (APBN) Headache Berobat Jalan

443 16-05-2019 111210020519P000392 0001084613231 WAGINEM P PBI (APBN) Myalgia Berobat Jalan

444 16-05-2019 111210020519P000399 0001633752134 MINO MIRANTO L PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
445 16-05-2019 111210020519P000386 0001876319199 MANISEM P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan Hipertensi Hipertensi

446 16-05-2019 111210020519P000398 0002050581464 MITA YUNITA P PEKERJA MANDIRI Calculus in urethra Berobat Jalan

447 16-05-2019 111210020519P000400 0002051990717 ISKANDAR L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
448 16-05-2019 111210020519P000383 0002073742345 LESI RETNOSARI P PEKERJA MANDIRI Maternal care due to Rujuk Lanjut
uterine scar from previous
surgery
449 16-05-2019 111210020519P000382 0002432172497 UMI KULSUM EP P PEGAWAI SWASTA Seronegative rheumatoid Rujuk Lanjut
arthritis, unspecified site
450 16-05-2019 111210020519P000388 0002464275993 ALFIAH P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

451 16-05-2019 111210020519P000784 0002630336938 RIYATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
452 16-05-2019 111210020519P000396 0002634208132 SATI MARYAMAH P PBI (APBN) Pterygium Berobat Jalan

453 16-05-2019 111210020519P000384 0002635058698 SITI MARIYAH P PBI (APBN) Other disorders of Rujuk Lanjut
conjunctiva
454 16-05-2019 111210020519P000403 0002636929269 CHANDRA FADHILAH L PBI (APBN) Predominantly allergic Berobat Jalan
RABBAANI asthma
455 16-05-2019 111210020519P000387 0002640118869 TUGINI P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

456 16-05-2019 111210020519P000389 0002646399576 TIARA MAULIDA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

457 16-05-2019 111210020519P000401 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
458 15-05-2019 111210020519P000369 0000081366636 SURBANI L PENERIMA PENSIUN Diarrhoea and Berobat Jalan Diabetes Mellitus Diabetes
PNS gastroenteritis of Mellitus
presumed infectious origin

459 15-05-2019 111210020519P000370 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
460 15-05-2019 111210020519P000364 0000519588448 MASIYAM L PBI (APBN) Fever, unspecified Berobat Jalan

461 15-05-2019 111210020519P000778 0000519749403 SITI ROHATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

462 15-05-2019 111210020519P000377 0000519908523 risna dewi P PBI (APBN) Mastoiditis, unspecified Berobat Jalan

463 15-05-2019 111210020519P000780 0000519983469 MANIRAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
464 15-05-2019 111210020519P000779 0000520215175 JARIYAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
465 15-05-2019 111210020519P000352 0000520268938 NASIYEM SITI NURKHASANAH P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
breast, unspecified
466 15-05-2019 111210020519P000731 0000520379875 SRI SULASTRI P PBI (APBN) False labour, unspecified Sembuh

467 15-05-2019 111210020519P000359 0000520414132 DARIMUN DARMUDI L PBI (APBN) Follow-up care involving Rujuk Lanjut
removal of fracture plate
and other internal fixation
device
468 15-05-2019 111210020519P000781 0000520462629 PURWATININGSIH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
469 15-05-2019 111210020519P000373 0000520493152 MADSUWARDI L PBI (APBN) Senile cataract, Berobat Jalan
unspecified
470 15-05-2019 111210020519P000367 0000520528004 SAPUTRIANA P PBI (APBN) Threatened abortion Rujuk Lanjut

471 15-05-2019 111210020519P000372 0000520529264 NURUL TAMYIZ L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

472 15-05-2019 111210020519P000375 0000520564048 EKO WARISNO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
473 15-05-2019 111210020519P000365 0000520650549 FEBRIANSYAH L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
474 15-05-2019 111210020519P000368 0000520702435 ENING SALIMAH P PBI (APBN) Low back pain Berobat Jalan

475 15-05-2019 111210020519P000732 0000521063144 WINASIH P PBI (APBN) False labour, unspecified Sembuh

476 15-05-2019 111210020519P000362 0000521269503 YOGA STIAWAN L PBI (APBN) Gastritis, unspecified Berobat Jalan

477 15-05-2019 111210020519P000363 0000521286129 JAENAH P PBI (APBN) Fever, unspecified Berobat Jalan

478 15-05-2019 111210020519P000374 0000521762286 JEMIAH P PBI (APBN) Fever, unspecified Berobat Jalan

479 15-05-2019 111210020519P000379 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
480 15-05-2019 111210020519P000366 0001015220891 INGANATUROFIQOH P PBI (APBN) Headache Berobat Jalan Hipertensi Hipertensi

481 15-05-2019 111210020519P000371 0001015223264 SUDARMAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
482 15-05-2019 111210020519P000360 0001084836598 SIMAN AL BASOIR L PBI (APBN) Keratitis Rujuk Lanjut

483 15-05-2019 111210020519P000361 0001200346582 M KHUMEDULOH NGIRFAN L PEGAWAI SWASTA Scabies Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

484 15-05-2019 111210020519P000353 0002420930766 SAPURAH P PBI (APBD) Low back pain Rujuk Lanjut

485 15-05-2019 111210020519P000354 0002625791218 SUKADI L PEKERJA MANDIRI Urinary calculus, Rujuk Lanjut
unspecified
486 15-05-2019 111210020519P000378 0002632471839 BRILIAN ISNA BAIDURI P PBI (APBN) Pulpitis Berobat Jalan

487 15-05-2019 111210020519P000376 0002632472695 KHAIRUL AFANDI L PBI (APBN) Predominantly allergic Berobat Jalan
asthma
488 14-05-2019 111210020519P000350 0000519779215 UMARUDIN L PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
489 14-05-2019 111210020519P000348 0000519793839 TURSINAH P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
490 14-05-2019 111210020519P000289 0000519881725 BEJA KARTAMIARJA L PBI (APBN) Hyperplasia of prostate Rujuk Lanjut

491 14-05-2019 111210020519P000336 0000520139935 SITI NANGIMAH P PBI (APBN) Tinea corporis Berobat Jalan

492 14-05-2019 111210020519P000346 0000520248295 WARNI P PBI (APBN) Gastritis, unspecified Berobat Jalan

493 14-05-2019 111210020519P000335 0000520248554 NGADIRAN L PBI (APBN) Chronic obstructive Berobat Jalan
pulmonary disease,
unspecified
494 14-05-2019 111210020519P000337 0000520248982 SUKINAH P PBI (APBN) Myalgia Berobat Jalan

495 14-05-2019 111210020519P000294 0000520349591 KHOTIMAH P PBI (APBN) Gestational Rujuk Lanjut
[pregnancy-induced]
hypertension without
significant proteinuria
496 14-05-2019 111210020519P000296 0000520478109 MUNJIAH P PBI (APBN) Haemoptysis Rujuk Lanjut

497 14-05-2019 111210020519P000332 0000520493927 NURI SANGADAH P PBI (APBN) Headache Berobat Jalan

498 14-05-2019 111210020519P000351 0000520529264 NURUL TAMYIZ L PBI (APBN) Headache Berobat Jalan

499 14-05-2019 111210020519P000334 0000520561326 SIPON L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
500 14-05-2019 111210020519P000291 0000520602322 LISA OCTAVIANI P PBI (APBN) Thalassaemia, unspecified Rujuk Lanjut

501 14-05-2019 111210020519P000292 0000520602805 AYU AMELYA LESTARI P PBI (APBN) Thalassaemia, unspecified Rujuk Lanjut

502 14-05-2019 111210020519P000300 0000520786192 UMI ROFINGAH P PBI (APBN) Attention to surgical Rujuk Lanjut
dressings and sutures
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

503 14-05-2019 111210020519P000349 0000520921866 SATIMAH P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
504 14-05-2019 111210020519P000343 0000520939642 MARIYAH P PBI (APBN) Entropion and trichiasis of Berobat Jalan
eyelid
505 14-05-2019 111210020519P000290 0000521250366 DANANG EDI PURNOMO L PBI (APBN) Thalassaemia, unspecified Rujuk Lanjut

506 14-05-2019 111210020519P000293 0000521909853 SALAMUDIN L PBI (APBN) Headache Rujuk Lanjut

507 14-05-2019 111210020519P000299 0001722156592 LELA HAIRUNNISA MELIJA P PEKERJA MANDIRI Gestational Rujuk Lanjut
[pregnancy-induced]
hypertension without
significant proteinuria
508 14-05-2019 111210020519P000347 0001900689985 SITI FATIMAH P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

509 14-05-2019 111210020519P000331 0001913892884 ATIKA ZAHRA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
510 14-05-2019 111210020519P000295 0002009244712 ERNA SUSANTI P PBI (APBN) Predominantly allergic Rujuk Lanjut
asthma
511 14-05-2019 111210020519P000338 0002009270676 AHMAD FAIZAL L PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
512 14-05-2019 111210020519P000344 0002009273387 ASTUTI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

513 14-05-2019 111210020519P000341 0002167379436 SANIYAH P PBI (APBD) Gastritis, unspecified Berobat Jalan

514 14-05-2019 111210020519P000340 0002450452151 FITRI NURUL FAIDAH P PEKERJA MANDIRI Headache Berobat Jalan

515 14-05-2019 111210020519P000777 0002517490247 RUSMINAH P PEKERJA MANDIRI Contraceptive Berobat Jalan
management, unspecified
516 14-05-2019 111210020519P000333 0002629065126 SELLY MARLINA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

517 14-05-2019 111210020519P000345 0002629120926 NGADIKIN ADJI SAPUTRA L PBI (APBN) Dental caries Berobat Jalan

518 14-05-2019 111210020519P000297 0002634771374 NURSIDIK L PBI (APBN) Cystitis Rujuk Lanjut

519 14-05-2019 111210020519P000342 0002634771385 RATINAH P PBI (APBN) Urticaria, unspecified Berobat Jalan

520 14-05-2019 111210020519P000339 0002640230054 WARSIH P PBI (APBN) Vertigo of central origin Berobat Jalan

521 14-05-2019 111210020519P000298 0002742029111 TUBANGIYAH P PEKERJA MANDIRI Excessive bleeding in the Rujuk Lanjut
premenopausal period
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

522 13-05-2019 111210020519P000313 0000518688325 MIMBARIYATUN P PBI (APBN) Fever, unspecified Berobat Jalan

523 13-05-2019 111210020519P000324 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
524 13-05-2019 111210020519P000318 0000519558636 BERTA SALSA BILA P PBI (APBN) Fever, unspecified Berobat Jalan

525 13-05-2019 111210020519P000322 0000519669268 WAGIMIN L PBI (APBN) Gastritis, unspecified Berobat Jalan

526 13-05-2019 111210020519P000314 0000519693377 SURIP P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
527 13-05-2019 111210020519P000286 0000520041565 NGADIYAH P PBI (APBN) Gastritis, unspecified Berobat Jalan

528 13-05-2019 111210020519P000312 0000520091414 MOHAMAD FIDIN L PBI (APBN) Calculus in urethra Berobat Jalan

529 13-05-2019 111210020519P000287 0000520112957 NUR ENDAH OCTAVIANA P PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
530 13-05-2019 111210020519P000303 0000520239003 KUSMIATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
531 13-05-2019 111210020519P000307 0000520239699 MUNJIRIN L PBI (APBN) Tinea cruris Berobat Jalan

532 13-05-2019 111210020519P000253 0000520280932 MADSUPANDI TUGIYO L PBI (APBN) Left ventricular failure Rujuk Lanjut

533 13-05-2019 111210020519P000321 0000520326516 SANDIARJA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
534 13-05-2019 111210020519P000304 0000520411656 WARTINI P PBI (APBN) Fever, unspecified Berobat Jalan

535 13-05-2019 111210020519P000329 0000520470044 SATIYAH P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

536 13-05-2019 111210020519P000776 0000520470044 SATIYAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
537 13-05-2019 111210020519P000316 0000520520185 TUTI RAHAYU P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
538 13-05-2019 111210020519P000308 0000520536508 AKSIN TANAL P PBI (APBN) Unspecified renal colic Berobat Jalan

539 13-05-2019 111210020519P000358 0000520563205 WATINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
540 13-05-2019 111210020519P000310 0000520589709 NINDA AMELIA L PBI (APBN) Varicella without Berobat Jalan
complication
541 13-05-2019 111210020519P000309 0000520594031 JESI MALIK P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

542 13-05-2019 111210020519P000284 0000520624721 SITI MUYASIROH P PBI (APBN) Gastritis, unspecified Berobat Jalan

543 13-05-2019 111210020519P000356 0000520701208 SATIYAH P PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
544 13-05-2019 111210020519P000762 0000520738176 PONIRAH P PBI (APBN) Aplastic anaemia, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

545 13-05-2019 111210020519P000355 0000520744522 SUNARTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
546 13-05-2019 111210020519P000251 0000520802651 LANGENSIH P PBI (APBN) Congestive heart failure Rujuk Lanjut

547 13-05-2019 111210020519P000357 0000520841261 PARTI DARMIASTUTI P PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
548 13-05-2019 111210020519P000320 0000520917298 SUJAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
549 13-05-2019 111210020519P000758 0000520918119 BADRIYAH P PBI (APBN) Acute appendicitis, other Berobat Jalan
and unspecified
550 13-05-2019 111210020519P000323 0000520930719 MARSINI P PBI (APBN) Other forms of stomatitis Berobat Jalan

551 13-05-2019 111210020519P000305 0000520970657 FATIMAH P PBI (APBN) Disorder of refraction, Berobat Jalan
unspecified
552 13-05-2019 111210020519P000245 0000520979466 TASWAN SUTARDI L PBI (APBN) Other forms of stomatitis Rujuk Lanjut

553 13-05-2019 111210020519P000246 0000520982414 SUDIRO L PBI (APBN) Subarachnoid Rujuk Lanjut
haemorrhage, unspecified
554 13-05-2019 111210020519P000247 0000520983009 MUNIRAH P PBI (APBN) Hypertensive heart Rujuk Lanjut
disease with (congestive)
heart failure
555 13-05-2019 111210020519P000327 0000521262639 PONIRIN L PBI (APBN) Headache Berobat Jalan

556 13-05-2019 111210020519P000288 0000521315807 PONIMAN L PBI (APBN) Predominantly allergic Berobat Jalan
asthma
557 13-05-2019 111210020519P000775 0000521518094 EKA P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
558 13-05-2019 111210020519P000330 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
559 13-05-2019 111210020519P000252 0001428807374 abu salim L PEKERJA MANDIRI Atherosclerotic heart Rujuk Lanjut
disease
560 13-05-2019 111210020519P000244 0001718361538 BAHRUN SARWANI L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

561 13-05-2019 111210020519P000302 0002039877415 suwito L PBI (APBD) Gastritis, unspecified Berobat Jalan

562 13-05-2019 111210020519P000301 0002039878012 akbar dwi satria L PBI (APBD) Predominantly allergic Berobat Jalan
asthma
563 13-05-2019 111210020519P000311 0002125677914 ALDI RAHMAT N L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
564 13-05-2019 111210020519P000306 0002125679297 ALIA WIJAYA P PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
565 13-05-2019 111210020519P000326 0002129377397 SHOLIYATUN P PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

566 13-05-2019 111210020519P000285 0002175928391 RIKO SALISNO L PBI (APBN) Gastritis, unspecified Berobat Jalan

567 13-05-2019 111210020519P000328 0002450452151 FITRI NURUL FAIDAH P PEKERJA MANDIRI Headache Berobat Jalan

568 13-05-2019 111210020519P000250 0002450452217 HANIF AL ATSARI L PEKERJA MANDIRI Other orthopaedic Rujuk Lanjut
follow-up care
569 13-05-2019 111210020519P000249 0002628113951 WALUYO L PBI (APBN) Corneal ulcer Rujuk Lanjut

570 13-05-2019 111210020519P000319 0002629111858 MARWIYAH P PBI (APBN) Gastritis, unspecified Berobat Jalan

571 13-05-2019 111210020519P000315 0002633540613 AHMAD WAHYU TURMUZI L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

572 13-05-2019 111210020519P000248 0002634798069 KANAN L PBI (APBN) Localized swelling, mass Rujuk Lanjut
and lump, neck
573 13-05-2019 111210020519P000317 0002639092149 SITI KHOTIMI P PBI (APBN) Headache Berobat Jalan

574 13-05-2019 111210020519P000325 0002756014659 SUNARDI MADSUKARDI L PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
575 12-05-2019 111210020519P000774 0000520931417 SITI NUR KHOYIMAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
576 12-05-2019 111210020519P000242 0001519911393 NOVI ROSIANA P PEGAWAI BUMN Prolonged pregnancy Rujuk Lanjut

577 12-05-2019 111210020519P000757 0002009261417 FITRIANI P PBI (APBN) Obstructed labour due to Berobat Jalan
breech presentation
578 12-05-2019 111210020519P000243 0002636929484 TASIMI P PBI (APBN) Retention of urine Rujuk Lanjut

579 11-05-2019 111210020519P000268 0000519858808 ALAM FIRMANSYAH P PBI (APBN) Predominantly allergic Berobat Jalan
asthma
580 11-05-2019 111210020519P000275 0000520021214 TUSINI P PBI (APBN) Acute nasopharyngitis Berobat Jalan Diabetes Mellitus Diabetes
[common cold] Mellitus
581 11-05-2019 111210020519P000272 0000520152096 MARSINAH P PBI (APBN) Vertigo of central origin Berobat Jalan

582 11-05-2019 111210020519P000264 0000520292182 ASDI KASNADI L PBI (APBN) Otitis media, unspecified Berobat Jalan Hipertensi Hipertensi

583 11-05-2019 111210020519P000279 0000520357048 KAMSIYAH P PBI (APBN) Urticaria, unspecified Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
584 11-05-2019 111210020519P000276 0000520502578 UMI MAUWAH P PBI (APBN) Headache Berobat Jalan

585 11-05-2019 111210020519P000255 0000520533101 USWATUN HASANAH P PBI (APBN) Tinea corporis Berobat Jalan

586 11-05-2019 111210020519P000260 0000520582331 QORIATULATIFAH L PBI (APBN) Fever, unspecified Berobat Jalan

587 11-05-2019 111210020519P000258 0000520596999 HERAWATI JUNINTYAS P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
588 11-05-2019 111210020519P000266 0000520768697 SAKINAH P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

589 11-05-2019 111210020519P000256 0000520788857 NGAISAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
590 11-05-2019 111210020519P000270 0000520812685 MISWAN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
591 11-05-2019 111210020519P000277 0000520824341 SISKA ARIYANTI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

592 11-05-2019 111210020519P000262 0000521296211 JEMAKUN EKO AHMADI L PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
593 11-05-2019 111210020519P000282 0001015214725 SARTIYAH P PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
594 11-05-2019 111210020519P000278 0001015223062 MUKHLISON L PBI (APBN) Pterygium Berobat Jalan

595 11-05-2019 111210020519P000273 0001085029132 MUSIRAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
596 11-05-2019 111210020519P000240 0001314919776 SUPARMI P PEKERJA MANDIRI Dystonia, unspecified Rujuk Lanjut Diabetes Mellitus Diabetes
Mellitus
597 11-05-2019 111210020519P000254 0001633752134 MINO MIRANTO L PEKERJA MANDIRI Myalgia Berobat Jalan

598 11-05-2019 111210020519P000261 0001700515045 AMINAH P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
599 11-05-2019 111210020519P000257 0002038965917 SUYUD L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
600 11-05-2019 111210020519P000773 0002093021739 KARSEM P PBI (APBD) Contraceptive Berobat Jalan
management, unspecified
601 11-05-2019 111210020519P000263 0002102155841 Sutini P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
SWASTA diabetes mellitus without Mellitus
complications
602 11-05-2019 111210020519P000259 0002125678127 ZAINI IKHFAN MAULANA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
603 11-05-2019 111210020519P000241 0002210745249 KASIYEM P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
complications
604 11-05-2019 111210020519P000755 0002218427008 VINA RIANA P PEKERJA MANDIRI Obstructed labour due to Berobat Jalan
breech presentation
605 11-05-2019 111210020519P000280 0002250503291 SUATMI P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
606 11-05-2019 111210020519P000267 0002262748792 NGASIMUN L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

607 11-05-2019 111210020519P000238 0002423490208 kasinah P PEKERJA MANDIRI Fracture of other and Rujuk Lanjut
unspecified parts of
lumbar spine and pelvis
608 11-05-2019 111210020519P000283 0002424121839 SARTINEM P PEKERJA MANDIRI Hypertensive heart Berobat Jalan
disease without
(congestive) heart failure
609 11-05-2019 111210020519P000281 0002437040968 SARJONO L PEKERJA MANDIRI Cutaneous abscess, Berobat Jalan Diabetes Mellitus Diabetes
furuncle and carbuncle, Mellitus
unspecified
610 11-05-2019 111210020519P000239 0002476774618 TURIMIN MADSUWITO L PEKERJA MANDIRI Urinary calculus, Rujuk Lanjut
unspecified
611 11-05-2019 111210020519P000269 0002479352354 MULYADI L PEKERJA MANDIRI Low back pain Berobat Jalan

612 11-05-2019 111210020519P000265 0002479352782 LASIKEM P PEKERJA MANDIRI Low back pain Berobat Jalan

613 11-05-2019 111210020519P000271 0002629069727 OZIL FANWAS AFLAH L PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

614 11-05-2019 111210020519P000274 0002637960783 NGADIYAH P PBI (APBN) Gonarthrosis, unspecified Berobat Jalan

615 10-05-2019 111210020519P000228 0000519010659 MARSINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
616 10-05-2019 111210020519P000236 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
617 10-05-2019 111210020519P000219 0000519776302 MUSLIMAH P PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut

618 10-05-2019 111210020519P000223 0000519793839 TURSINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
619 10-05-2019 111210020519P000225 0000519858009 RASMINI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
620 10-05-2019 111210020519P000222 0000519959439 PAINAH P PBI (APBN) Headache Berobat Jalan

621 10-05-2019 111210020519P000235 0000520178411 DZIYA MAY NAFIIS P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
622 10-05-2019 111210020519P000217 0000520269399 UMI AMANAH P PBI (APBN) Localized swelling, mass Rujuk Lanjut
and lump, trunk
623 10-05-2019 111210020519P000231 0000520280932 MADSUPANDI TUGIYO L PBI (APBN) Gastritis, unspecified Berobat Jalan

624 10-05-2019 111210020519P000756 0000520385231 JUMANTORO DFRAYOGA L PBI (APBN) Acute appendicitis, other Berobat Jalan
WINARTO and unspecified
625 10-05-2019 111210020519P000214 0000520576288 PASEM SASTRODIYOSO P PBI (APBN) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

626 10-05-2019 111210020519P000229 0000520891648 NURSIDIK L PBI (APBN) Acute nasopharyngitis Berobat Jalan Diabetes Mellitus Diabetes
[common cold] Mellitus
627 10-05-2019 111210020519P000218 0000521139341 KASINAH P PBI (APBN) Thyrotoxicosis, Rujuk Lanjut
unspecified
628 10-05-2019 111210020519P000227 0000521287841 NURUL HUDA L PBI (APBN) Other forms of stomatitis Berobat Jalan

629 10-05-2019 111210020519P000216 0001461274468 ATI MUNAWAROH P PEKERJA MANDIRI Schizoaffective disorder, Rujuk Lanjut
manic type
630 10-05-2019 111210020519P000224 0001676703622 RESMIATI P PEGAWAI SWASTA Conjunctivitis, unspecified Berobat Jalan

631 10-05-2019 111210020519P000237 0001977061061 MAULANA ARIEF L PBI (APBN) Headache Berobat Jalan
RAHMANDANU
632 10-05-2019 111210020519P000221 0002009254138 TUMBRAS P PBI (APBN) Gastritis, unspecified Berobat Jalan

633 10-05-2019 111210020519P000220 0002009254408 ANGGI RIZALI L PBI (APBN) Gastritis, unspecified Berobat Jalan

634 10-05-2019 111210020519P000226 0002295951219 JUANDA L PEKERJA MANDIRI Chronic obstructive Berobat Jalan
pulmonary disease,
unspecified
635 10-05-2019 111210020519P000230 0002436979252 ARSIH P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
636 10-05-2019 111210020519P000234 0002456832148 SUNARYO JADI L PEKERJA MANDIRI Attention to surgical Berobat Jalan Diabetes
dressings and sutures Mellitus
637 10-05-2019 111210020519P000215 0002492792199 JASMI P PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
638 10-05-2019 111210020519P000232 0002637961547 KEMEN P PBI (APBN) Gastritis, unspecified Berobat Jalan

639 10-05-2019 111210020519P000233 0002637966284 SUGIARTI P PBI (APBN) Irritant contact dermatitis Berobat Jalan

640 09-05-2019 111210020519P000208 0000518735428 KATEM P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
641 09-05-2019 111210020519P000209 0000519592871 ROLIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
642 09-05-2019 111210020519P000202 0000520038347 SANMIARJA NGADIMAN L PBI (APBN) Headache Berobat Jalan

643 09-05-2019 111210020519P000772 0000520133793 MAR'ATUS SA'DIYAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
644 09-05-2019 111210020519P000206 0000520185914 SAWIYEM P PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
645 09-05-2019 111210020519P000188 0000520214984 RAHMAT L PBI (APBN) Myalgia Berobat Jalan

646 09-05-2019 111210020519P000200 0000520507078 WIWI P PBI (APBN) Gastritis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

647 09-05-2019 111210020519P000207 0000520563205 WATINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
648 09-05-2019 111210020519P000212 0000520708239 ANITA SARI P PBI (APBN) Fever, unspecified Berobat Jalan

649 09-05-2019 111210020519P000193 0000520711345 ALI SODIK L PBI (APBN) Myalgia Berobat Jalan

650 09-05-2019 111210020519P000213 0000520724384 RATINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
651 09-05-2019 111210020519P000211 0000521381981 SARTI P PBI (APBN) Headache Berobat Jalan

652 09-05-2019 111210020519P000187 0000521478999 SUTINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
653 09-05-2019 111210020519P000192 0000521481508 DEWI ROSIMA P PBI (APBN) Headache Berobat Jalan

654 09-05-2019 111210020519P000205 0001015214725 SARTIYAH P PBI (APBN) Other specified diabetes Berobat Jalan Diabetes Mellitus Diabetes
mellitus with peripheral Mellitus
circulatory complications
655 09-05-2019 111210020519P000730 0001015225817 PARYATUN P PBI (APBN) False labour, unspecified Sembuh

656 09-05-2019 111210020519P000183 0001647286738 EVI NOVITASARI P PEKERJA MANDIRI Maternal care due to Rujuk Lanjut
uterine scar from previous
surgery
657 09-05-2019 111210020519P000190 0002009242721 ALI MASKUR L PBI (APBN) Constipation Berobat Jalan

658 09-05-2019 111210020519P000184 0002009261237 SUMARNI P PBI (APBN) Headache Rujuk Lanjut

659 09-05-2019 111210020519P000181 0002009261417 FITRIANI P PBI (APBN) Maternal care for Rujuk Lanjut
malpresentation of fetus,
unspecified
660 09-05-2019 111210020519P000199 0002048666916 ENDANG ROHMAN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
661 09-05-2019 111210020519P000180 0002048667581 SUTINEM P PEKERJA MANDIRI Low back pain Rujuk Lanjut

662 09-05-2019 111210020519P000201 0002090362915 UDIYONO L PBI (APBD) Gastritis, unspecified Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
663 09-05-2019 111210020519P000198 0002090362959 LASIYEM P PBI (APBD) Vertigo of central origin Berobat Jalan

664 09-05-2019 111210020519P000185 0002120711275 MUJIYANTI P PBI (APBN) Congestive heart failure Rujuk Lanjut

665 09-05-2019 111210020519P000203 0002228055491 KHALID AKBAR nURLANGIT L PBI (APBN) Tuberculous peripheral Berobat Jalan
lymphadenopathy
666 09-05-2019 111210020519P000754 0002283780273 MUSLIMIN L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

667 09-05-2019 111210020519P000189 0002436809152 MARSIDI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

668 09-05-2019 111210020519P000197 0002487653943 TURIYAH P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

669 09-05-2019 111210020519P000196 0002487655923 PUTRI KHAERUNISA P PEKERJA MANDIRI Pain localized to other Berobat Jalan
parts of lower abdomen
670 09-05-2019 111210020519P000194 0002635058698 SITI MARIYAH P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

671 09-05-2019 111210020519P000195 0002637966036 SARPIN SUNANDAR L PBI (APBN) Predominantly allergic Berobat Jalan
asthma
672 09-05-2019 111210020519P000210 0002646400061 SUMIRAH HARYANTI P PBI (APBN) Gastritis, unspecified Berobat Jalan

673 09-05-2019 111210020519P000182 0002739110804 FATHAN rENDIANSYAH L PEKERJA MANDIRI Subdural haemorrhage Rujuk Lanjut
PRATAMA (acute) (nontraumatic)
674 09-05-2019 111210020519P000204 0002754704564 ROBINEM P PEKERJA MANDIRI Attention to surgical Berobat Jalan
dressings and sutures
675 09-05-2019 111210020519P000186 0002756114526 SOFIYANA TRI RAHAYU P PEKERJA MANDIRI Epilepsy, unspecified Rujuk Lanjut

676 09-05-2019 111210020519P000191 0002758721422 SATIWEN P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

677 08-05-2019 111210020519P000152 0000518739535 KOSIDAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
678 08-05-2019 111210020519P000159 0000519557477 TASIYEM P PBI (APBN) Myalgia Berobat Jalan

679 08-05-2019 111210020519P000177 0000519558636 BERTA SALSA BILA P PBI (APBN) Fever, unspecified Berobat Jalan

680 08-05-2019 111210020519P000151 0000519715923 SANMIYADI L PBI (APBN) Low back pain Berobat Jalan

681 08-05-2019 111210020519P000729 0000520133793 MAR'ATUS SA'DIYAH P PBI (APBN) False labour, unspecified Sembuh

682 08-05-2019 111210020519P000147 0000520309282 DARSINI P PBI (APBN) Gonarthrosis [arthrosis of Berobat Jalan
knee]
683 08-05-2019 111210020519P000171 0000520451559 FADIA APRILYANI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
684 08-05-2019 111210020519P000157 0000520468931 SUTARMI P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

685 08-05-2019 111210020519P000172 0000520471113 KHAERIYAH P PBI (APBN) Myalgia Berobat Jalan

686 08-05-2019 111210020519P000158 0000520527071 KARTIJEM P PBI (APBN) Myalgia Berobat Jalan

687 08-05-2019 111210020519P000771 0000520578224 TURSINI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
688 08-05-2019 111210020519P000118 0000520628152 SITI FATIMAH P PBI (APBN) Female genital prolapse, Rujuk Lanjut
unspecified
689 08-05-2019 111210020519P000156 0000520734295 MUTMAINAH P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

690 08-05-2019 111210020519P000154 0000520788857 NGAISAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
691 08-05-2019 111210020519P000125 0000520892717 SUYITNO L PBI (APBN) Urinary calculus, Rujuk Lanjut
unspecified
692 08-05-2019 111210020519P000165 0000520921866 SATIMAH P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
693 08-05-2019 111210020519P000170 0000520975023 TEGUH LINGGAR PRASETYO L PBI (APBN) Dermatitis herpetiformis Berobat Jalan

694 08-05-2019 111210020519P000162 0000520979466 TASWAN SUTARDI L PBI (APBN) Other forms of stomatitis Berobat Jalan

695 08-05-2019 111210020519P000168 0000521377031 TAUFIK HARYANTO L PBI (APBN) Corneal ulcer Berobat Jalan

696 08-05-2019 111210020519P000160 0001015213768 SUKIRMAN L PBI (APBN) Chest pain, unspecified Berobat Jalan

697 08-05-2019 111210020519P000153 0001015217987 KARSINAH P PBI (APBN) Vertigo of central origin Berobat Jalan

698 08-05-2019 111210020519P000149 0001015221273 SUMARNO L PBI (APBN) Dyspepsia Berobat Jalan

699 08-05-2019 111210020519P000130 0001181050288 SUPRIYATI P PEGAWAI SWASTA Residual schizophrenia Rujuk Lanjut

700 08-05-2019 111210020519P000175 0001842170894 WAGIYO L PEKERJA MANDIRI Myalgia Berobat Jalan

701 08-05-2019 111210020519P000174 0001842171197 HOMSIAH P PEKERJA MANDIRI Urticaria, unspecified Berobat Jalan

702 08-05-2019 111210020519P000179 0001977061061 MAULANA ARIEF L PBI (APBN) Fever, unspecified Berobat Jalan
RAHMANDANU
703 08-05-2019 111210020519P000173 0002009274085 SATIYEM P PBI (APBN) Headache Berobat Jalan

704 08-05-2019 111210020519P000155 0002175926141 ISNA MARYANI P PBI (APBN) Conjunctivitis, unspecified Berobat Jalan

705 08-05-2019 111210020519P000163 0002188268155 KAILA RAHMA SAPUTRI P PBI (APBN) Impetigo Berobat Jalan

706 08-05-2019 111210020519P000176 0002377382398 NUR FAIZAH LINGASIROH P PEKERJA MANDIRI Headache Berobat Jalan

707 08-05-2019 111210020519P000178 0002443336615 MOHAMAD NUR AFIF L PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

708 08-05-2019 111210020519P000166 0002449117822 DARYONO L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

709 08-05-2019 111210020519P000164 0002449118013 SAVIKA AMERIA SOFIA P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

710 08-05-2019 111210020519P000161 0002458072596 TUGIYONO L PEKERJA MANDIRI Headache Berobat Jalan

711 08-05-2019 111210020519P000148 0002504757339 ANANDA WIJI UTRI ASTUTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
712 08-05-2019 111210020519P000117 0002625994776 SUROSO L PEKERJA MANDIRI Chest pain, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

713 08-05-2019 111210020519P000150 0002629064968 AMSIYAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
714 08-05-2019 111210020519P000169 0002636930226 SAINI P PBI (APBN) Myalgia Berobat Jalan

715 08-05-2019 111210020519P000167 0002639120084 DHIMAS ARYA PRASETYO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
716 07-05-2019 111210020519P000145 0000080798758 YUNINGSIH P PNS DAERAH Headache Berobat Jalan

717 07-05-2019 111210020519P000138 0000518738635 VITA LISTIANI P PBI (APBN) Calculus in urethra Berobat Jalan

718 07-05-2019 111210020519P000143 0000519195519 VERI IRAWAN L PBI (APBN) Attention to surgical Berobat Jalan Diabetes Mellitus Diabetes
dressings and sutures Mellitus
719 07-05-2019 111210020519P000144 0000519570235 MOHAMMAD ZAKIYA ADNAN L PBI (APBN) Attention to surgical Berobat Jalan
dressings and sutures
720 07-05-2019 111210020519P000770 0000519843486 TURMI HAYATUN P PBI (APBN) Insertion of (intrauterine) Berobat Jalan
contraceptive device
721 07-05-2019 111210020519P000119 0000520011112 SAKIMAN AHMAD SAHRO L PBI (APBN) Gastritis, unspecified Berobat Jalan

722 07-05-2019 111210020519P000115 0000520166608 SURYATI P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
723 07-05-2019 111210020519P000114 0000520235493 DWI ERNAETUN P PBI (APBN) Localized swelling, mass Rujuk Lanjut
and lump, neck
724 07-05-2019 111210020519P000128 0000520364079 BESARI L PBI (APBN) Myalgia Berobat Jalan

725 07-05-2019 111210020519P000133 0000520392284 SUDARMI P PBI (APBN) Dengue haemorrhagic Berobat Jalan
fever
726 07-05-2019 111210020519P000109 0000520828885 AJI NUR CAHYA L PBI (APBN) Gastrointestinal Rujuk Lanjut
haemorrhage, unspecified
727 07-05-2019 111210020519P000141 0000520857639 NYARINGUN L PBI (APBN) Fever, unspecified Berobat Jalan

728 07-05-2019 111210020519P000120 0000520998502 ULQIYA KHUMAIROH P PBI (APBN) Acute gingivitis Berobat Jalan

729 07-05-2019 111210020519P000129 0000521151838 IHSAN ALI SYAHBANA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
730 07-05-2019 111210020519P000123 0001015212993 DULAH MUKTI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
731 07-05-2019 111210020519P000146 0001015214725 SARTIYAH P PBI (APBN) Other specified diabetes Berobat Jalan Diabetes Mellitus Diabetes
mellitus with peripheral Mellitus
circulatory complications
732 07-05-2019 111210020519P000791 0001015216255 MUNAWAROH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
733 07-05-2019 111210020519P000135 0001084613231 WAGINEM P PBI (APBN) Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

734 07-05-2019 111210020519P000111 0001084714053 MUDIARJO L PBI (APBN) Respiratory tuberculosis Rujuk Lanjut
unspecified, confirmed
bacteriologically and
histologically
735 07-05-2019 111210020519P000124 0001873701235 DASIYAH P PEKERJA MANDIRI Gonarthrosis [arthrosis of Berobat Jalan
knee]
736 07-05-2019 111210020519P000136 0002009253554 KOMIATI P PBI (APBN) Vertigo of central origin Berobat Jalan

737 07-05-2019 111210020519P000137 0002120712085 UMI MASMIYATUN P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
738 07-05-2019 111210020519P000140 0002176014565 SUNTARI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
739 07-05-2019 111210020519P000127 0002209189836 DEWI PUTRI PURWATI P PBI (APBD) Scabies Berobat Jalan

740 07-05-2019 111210020519P000131 0002211415885 ETI MULDIYATI P PBI (APBD) Unspecified chronic Berobat Jalan
bronchitis
741 07-05-2019 111210020519P000142 0002221673319 PUTRI NABILLA FITRIANI P PEKERJA MANDIRI Unspecified renal colic Berobat Jalan

742 07-05-2019 111210020519P000121 0002295948249 WATIMAH P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

743 07-05-2019 111210020519P000116 0002295951219 JUANDA L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,
unspecified
744 07-05-2019 111210020519P000113 0002308805673 NIDEM P PEKERJA MANDIRI Intra-abdominal and pelvic Rujuk Lanjut
swelling, mass and lump

745 07-05-2019 111210020519P000122 0002425817103 MOH. NAJIB MUBAROK L PEGAWAI PEMERINTAH Acute nasopharyngitis Berobat Jalan
DENGAN PERJANJIAN [common cold]
KERJA
746 07-05-2019 111210020519P000728 0002433438549 IIN TOHIROH P PEGAWAI SWASTA False labour, unspecified Sembuh

747 07-05-2019 111210020519P000139 0002617106905 SAMINI P PEKERJA MANDIRI Scabies Berobat Jalan

748 07-05-2019 111210020519P000112 0002620174893 AHMAD MUKRI L PEKERJA MANDIRI Leprosy, unspecified Rujuk Lanjut

749 07-05-2019 111210020519P000132 0002636904273 JEMU HADI WALUYO L PBI (APBN) Psoriasis, unspecified Berobat Jalan

750 07-05-2019 111210020519P000134 0002640147658 WASMI SUMIARUM P PBI (APBN) Paraesthesia of skin Berobat Jalan

751 07-05-2019 111210020519P000126 0002640230054 WARSIH P PBI (APBN) Vertigo of central origin Berobat Jalan

752 07-05-2019 111210020519P000110 0002648666248 SUTARMI P PBI (APBN) Senile cataract, Rujuk Lanjut
unspecified
753 06-05-2019 111210020519P000097 0000518678965 LASINEM P PBI (APBN) Myalgia Berobat Jalan

754 06-05-2019 111210020519P000093 0000518684038 UMI TARBIYATUSSOLIHAH P PBI (APBN) Gastritis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

755 06-05-2019 111210020519P000104 0000518687087 DEDE AZIFATU ZULFA P PBI (APBN) Gastritis, unspecified Berobat Jalan

756 06-05-2019 111210020519P000076 0000519878316 TOLIB L PBI (APBN) Tuberculosis of lung, Rujuk Lanjut
confirmed by unspecified
means
757 06-05-2019 111210020519P000092 0000519981715 SARINAH P PBI (APBN) Headache Berobat Jalan

758 06-05-2019 111210020519P000091 0000520054852 PRIHATINI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
759 06-05-2019 111210020519P000101 0000520215175 JARIYAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
760 06-05-2019 111210020519P000103 0000520280932 MADSUPANDI TUGIYO L PBI (APBN) Chronic obstructive Berobat Jalan
pulmonary disease,
unspecified
761 06-05-2019 111210020519P000094 0000520424234 SRI WAHYUNI P PBI (APBN) Fever, unspecified Berobat Jalan

762 06-05-2019 111210020519P000072 0000520502297 MUSRIFAH P PBI (APBN) Idiopathic Rujuk Lanjut
thrombocytopenic purpura
763 06-05-2019 111210020519P000106 0000520563205 WATINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
764 06-05-2019 111210020519P000096 0000520769665 TRI WIJIYANTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
765 06-05-2019 111210020519P000078 0000520786192 UMI ROFINGAH P PBI (APBN) Threatened abortion Rujuk Lanjut

766 06-05-2019 111210020519P000105 0000520958518 KARTI P PBI (APBN) Headache Berobat Jalan

767 06-05-2019 111210020519P000108 0000521043366 SUWANDI L PBI (APBN) Headache Berobat Jalan

768 06-05-2019 111210020519P000100 0000521158397 SAIKEM P PBI (APBN) Fever, unspecified Berobat Jalan

769 06-05-2019 111210020519P000090 0000521608105 MARYATUN P PBI (APBN) Gastritis, unspecified Berobat Jalan

770 06-05-2019 111210020519P000099 0001015221251 RINAH P PBI (APBN) Myalgia Berobat Jalan

771 06-05-2019 111210020519P000107 0001015223253 WASIYEM P PBI (APBN) Gastritis, unspecified Berobat Jalan

772 06-05-2019 111210020519P000727 0001314054461 RITA SETYA WARDHANI P PEGAWAI SWASTA False labour, unspecified Sembuh

773 06-05-2019 111210020519P000073 0001422677204 MUDAKIR L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut Diabetes Mellitus Diabetes
diabetes mellitus without Mellitus
complications
774 06-05-2019 111210020519P000753 0002051949723 DARYATI P PBI (APBD) Prolonged first stage (of Berobat Jalan
labour)
775 06-05-2019 111210020519P000079 0002504755574 EKA SUSI TAMAYASI P PBI (APBN) Myopia Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

776 06-05-2019 111210020519P000077 0002625994776 SUROSO L PEKERJA MANDIRI Respiratory tuberculosis Rujuk Lanjut
unspecified, confirmed
bacteriologically and
histologically
777 06-05-2019 111210020519P000095 0002626024307 MIFTAHUL JANNAH P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
778 06-05-2019 111210020519P000102 0002634778631 WASINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
779 06-05-2019 111210020519P000098 0002756014659 SUNARDI MADSUKARDI L PEKERJA MANDIRI Myalgia Berobat Jalan

780 05-05-2019 111210020519P000752 0000520438173 SITI ALHIKMATUN P PBI (APBN) Single delivery by Berobat Jalan
caesarean section
781 05-05-2019 111210020519P000726 0000521439603 MARJANATUN P PBI (APBN) False labour, unspecified Sembuh

782 05-05-2019 111210020519P000769 0002009254476 SITI NURROHMAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
783 04-05-2019 111210020519P000086 0000410662056 IIS MULYATI P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
784 04-05-2019 111210020519P000767 0000519196634 DASIRAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
785 04-05-2019 111210020519P000089 0000520275418 ROMYATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
786 04-05-2019 111210020519P000080 0000520472711 ANISA RAHMANIYAH P PBI (APBN) Unspecified renal colic Berobat Jalan

787 04-05-2019 111210020519P000082 0000520472856 MUHAMAD FAIZAL AZIDKI L PBI (APBN) Pulpitis Berobat Jalan

788 04-05-2019 111210020519P000064 0000520485783 RODIYAH P PBI (APBN) Senile cataract, Rujuk Lanjut
unspecified
789 04-05-2019 111210020519P000768 0000520658076 UMIATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
790 04-05-2019 111210020519P000059 0000520697496 AHMAD FATHUR ROHMAN L PBI (APBN) Other senile cataract Rujuk Lanjut

791 04-05-2019 111210020519P000081 0000520755311 MURSIKEM P PBI (APBN) Amoebiasis Berobat Jalan

792 04-05-2019 111210020519P000083 0000521083091 TUMINI P PBI (APBN) Paraesthesia of skin Berobat Jalan

793 04-05-2019 111210020519P000084 0000521909853 SALAMUDIN L PBI (APBN) Headache Berobat Jalan

794 04-05-2019 111210020519P000075 0001084635191 SARTINAH P PBI (APBN) Fever, unspecified Berobat Jalan

795 04-05-2019 111210020519P000061 0001724189657 SITI KURNIAWATI P PEKERJA MANDIRI Predominantly allergic Rujuk Lanjut
asthma
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

796 04-05-2019 111210020519P000060 0002009243439 SUDIONO L PBI (APBN) Presence of intraocular Rujuk Lanjut Diabetes Mellitus Diabetes
lens Hipertensi Mellitus
Hipertensi
797 04-05-2019 111210020519P000085 0002009272487 NGADIMAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
798 04-05-2019 111210020519P000088 0002176095363 SAHLI L PBI (APBN) Predominantly allergic Berobat Jalan
asthma
799 04-05-2019 111210020519P000074 0002468398116 SEPNA AVILIA P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

800 04-05-2019 111210020519P000087 0002479918296 SUGENG RIYADI L PEKERJA MANDIRI Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
801 04-05-2019 111210020519P000063 0002632450004 IRA RAHAYU P PEGAWAI SWASTA Dislocation of patella Rujuk Lanjut

802 04-05-2019 111210020519P000766 0002636929484 TASIMI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
803 04-05-2019 111210020519P000062 0002756426848 KATIRAH P PEKERJA MANDIRI Diffuse cystic mastopathy Rujuk Lanjut

804 03-05-2019 111210020519P000038 0000518688516 ATIKA INDRIATUN ROHANAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
805 03-05-2019 111210020519P000045 0000519482171 ZAENAL ARIFIN L PBI (APBN) Myalgia Berobat Jalan

806 03-05-2019 111210020519P000046 0000519482351 SAWITTRI P PBI (APBN) Myalgia Berobat Jalan

807 03-05-2019 111210020519P000043 0000519793839 TURSINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
808 03-05-2019 111210020519P000047 0000519955648 ARNI WIBIANTI P PBI (APBN) Respiratory tuberculosis Berobat Jalan
unspecified, confirmed
bacteriologically and
histologically
809 03-05-2019 111210020519P000058 0000520041565 NGADIYAH P PBI (APBN) Headache Berobat Jalan

810 03-05-2019 111210020519P000015 0000520438173 SITI ALHIKMATUN P PBI (APBN) Maternal care due to Rujuk Lanjut
uterine scar from previous
surgery
811 03-05-2019 111210020519P000765 0000520471989 SITI SUWAIBAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
812 03-05-2019 111210020519P000053 0000520552113 SUGIARTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
813 03-05-2019 111210020519P000723 0000520658076 UMIATI P PBI (APBN) False labour, unspecified Sembuh
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

814 03-05-2019 111210020519P000057 0000520815194 LIA ARUM INDRI SAPUTRI P PBI (APBN) Headache Berobat Jalan

815 03-05-2019 111210020519P000041 0000520978127 SLAMET MUFADI L PBI (APBN) Predominantly allergic Berobat Jalan
asthma
816 03-05-2019 111210020519P000048 0001015221958 SUNI P PBI (APBN) Headache Berobat Jalan

817 03-05-2019 111210020519P000448 0001450723533 SELVANA RURI PARTININGSIH P PEGAWAI SWASTA False labour, unspecified Sembuh

818 03-05-2019 111210020519P000040 0001547073753 ROBBY HABLI AL - FAUZA L PEGAWAI SWASTA Predominantly allergic Berobat Jalan
asthma
819 03-05-2019 111210020519P000052 0001913891117 AMELIA PUTRI RAHMAWATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
820 03-05-2019 111210020519P000039 0001913896708 GILANG ERLANGGA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
RAMADHAN [common cold]
821 03-05-2019 111210020519P000018 0002009246376 SUDARTI P PBI (APBN) Calculus in urethra Rujuk Lanjut Diabetes Mellitus Diabetes
Mellitus
822 03-05-2019 111210020519P000725 0002009254476 SITI NURROHMAH P PBI (APBN) False labour, unspecified Sembuh

823 03-05-2019 111210020519P000044 0002039877538 suratmi P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
824 03-05-2019 111210020519P000051 0002048666916 ENDANG ROHMAN L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

825 03-05-2019 111210020519P000042 0002128232799 KARTINAH P PBI (APBN) Fever, unspecified Berobat Jalan

826 03-05-2019 111210020519P000050 0002209139774 TUMINAH P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

827 03-05-2019 111210020519P000056 0002441439167 FAHRI BAYANNURREHAN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
828 03-05-2019 111210020519P000016 0002445468118 AKHMAD RIYANTO L PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
829 03-05-2019 111210020519P000021 0002449897165 CAHYANTI P PEKERJA MANDIRI Undifferentiated Rujuk Lanjut
schizophrenia
830 03-05-2019 111210020519P000049 0002501059836 SUKINAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan Diabetes Mellitus
diabetes mellitus without
complications
831 03-05-2019 111210020519P000055 0002612386449 AZZAHRA AURELIA PUTRI P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

832 03-05-2019 111210020519P000054 0002620174893 AHMAD MUKRI L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
833 03-05-2019 111210020519P000724 0002636929484 TASIMI P PBI (APBN) False labour, unspecified Sembuh

834 02-05-2019 111210020519P000025 0000081286391 SUGIJARTO L PENERIMA PENSIUN Conjunctivitis, unspecified Berobat Jalan Hipertensi Hipertensi
PNS
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

835 02-05-2019 111210020519P000065 0000081495808 PARINAH P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
836 02-05-2019 111210020519P000010 0000519369625 HIDAYAH NUR CHLORELLA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

837 02-05-2019 111210020519P000011 0000519784143 DWIKA PUTRA ROMADONI L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
838 02-05-2019 111210020519P000019 0000519791613 NARSIH P PBI (APBN) Gastritis, unspecified Berobat Jalan

839 02-05-2019 111210020519P000008 0000519906161 KARSIYEM P PBI (APBN) Vascular dementia, Rujuk Lanjut
unspecified
840 02-05-2019 111210020519P000071 0000520101729 LEGIATI P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
841 02-05-2019 111210020519P000014 0000520220035 MUARIFIN L PBI (APBN) Scabies Berobat Jalan

842 02-05-2019 111210020519P000031 0000520332377 KARSIYEM P PBI (APBN) Congestive heart failure Berobat Jalan

843 02-05-2019 111210020519P000033 0000520333187 TEGUH MULYONO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
844 02-05-2019 111210020519P000017 0000520409529 AMINUDIN L PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
845 02-05-2019 111210020519P000447 0000520471989 SITI SUWAIBAH P PBI (APBN) False labour, unspecified Sembuh

846 02-05-2019 111210020519P000036 0000520492544 DWI KUSWORO L PBI (APBN) Traumatic amputation of Berobat Jalan
wrist and hand
847 02-05-2019 111210020519P000764 0000520526114 KASIRAH IRA P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
848 02-05-2019 111210020519P000022 0000520615675 PARIYEM P PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,
unspecified
849 02-05-2019 111210020519P000028 0000520712752 MINDRI ASTRIYANI P PBI (APBN) Scabies Berobat Jalan

850 02-05-2019 111210020519P000068 0000520724384 RATINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
851 02-05-2019 111210020519P000067 0000520823643 SATINEM P PBI (APBN) Gastritis, unspecified Berobat Jalan

852 02-05-2019 111210020519P000023 0000520864198 RODIYAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
853 02-05-2019 111210020519P000005 0000520961927 RuSWANTO L PBI (APBN) Beta thalassaemia Rujuk Lanjut

854 02-05-2019 111210020519P000034 0000520974022 HIKMATUL FITRI P PBI (APBN) Dermatitis herpetiformis Berobat Jalan

855 02-05-2019 111210020519P000035 0000520979466 TASWAN SUTARDI L PBI (APBN) Other forms of stomatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

856 02-05-2019 111210020519P000003 0001084714053 MUDIARJO L PBI (APBN) Respiratory tuberculosis Rujuk Lanjut
unspecified, confirmed
bacteriologically and
histologically
857 02-05-2019 111210020519P000029 0001812660794 yasih P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan Diabetes Mellitus Diabetes
[common cold] Mellitus
858 02-05-2019 111210020519P000013 0002039110558 AL MISBAHUL MUNIR L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
859 02-05-2019 111210020519P000066 0002039424873 TINAH YULIA NINGSIH P PBI (APBD) Dermatophytosis, Berobat Jalan
unspecified
860 02-05-2019 111210020519P000070 0002176013766 NABILA MEILANI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
861 02-05-2019 111210020519P000024 0002188267964 DEVI PARASTUTI P PBI (APBN) Fever, unspecified Berobat Jalan

862 02-05-2019 111210020519P000009 0002222627591 SODIAH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
endocervix
863 02-05-2019 111210020519P000069 0002265025149 SOATI P PEKERJA MANDIRI Dermatophytosis, Berobat Jalan
unspecified
864 02-05-2019 111210020519P000026 0002285408338 SUMIYATI P PEKERJA MANDIRI Low back pain Berobat Jalan

865 02-05-2019 111210020519P000751 0002426211641 TITI SUPRAPTI P PEGAWAI PEMERINTAH Prolonged second stage Berobat Jalan
DENGAN PERJANJIAN (of labour)
KERJA
866 02-05-2019 111210020519P000030 0002439380801 RUNO KRISTIANTI DEWI P PENERIMA PENSIUN TNI Myalgia Berobat Jalan

867 02-05-2019 111210020519P000037 0002450452217 HANIF AL ATSARI L PEKERJA MANDIRI Follow-up care involving Berobat Jalan
removal of fracture plate
and other internal fixation
device
868 02-05-2019 111210020519P000006 0002519573218 ELVIRA AQUINA P PEKERJA MANDIRI Predominantly allergic Rujuk Lanjut
asthma
869 02-05-2019 111210020519P000012 0002607363112 ZAKY DENIS ARFIANSYAH L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
870 02-05-2019 111210020519P000032 0002628130173 YUSMIATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without
complications
871 02-05-2019 111210020519P000007 0002630379172 BENGNIATI P PBI (APBN) Gonarthrosis [arthrosis of Rujuk Lanjut
knee]
872 02-05-2019 111210020519P000004 0002632313698 ABID NAILUL HAKIM L PBI (APBN) Nutritional deficiency, Rujuk Lanjut
unspecified
873 02-05-2019 111210020519P000027 0002632449969 AMINAH P PBI (APBN) Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PURWOKERTO - 1104

FKTP : Bantarsari - 11121002

874 02-05-2019 111210020519P000763 0002633643663 SAMSIYAH P PBI (APBN) Contraceptive Berobat Jalan
management, unspecified
875 02-05-2019 111210020519P000020 0002637994353 NAKEM P PBI (APBN) Gonarthrosis [arthrosis of Berobat Jalan
knee]
876 01-05-2019 111210020519P000750 0000520488235 WARSITI P PBI (APBN) Pre-existing hypertensive Berobat Jalan
disorder with
superimposed proteinuria
877 01-05-2019 111210020519P000722 0002175770992 SADIAH P PBI (APBN) False labour, unspecified Sembuh

878 01-05-2019 111210020519P000002 0002617968576 MUTHOHAROH P PEKERJA MANDIRI Other specified Rujuk Lanjut
pregnancy-related
conditions