Kantor Cabang : TAPAKTUAN - 0105

FKTP : UJUNG PADANG RASIAN - 00031001

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX

1 29-06-2018 000310010618Y000064 0000211914134 MAHALEH P

2 29-06-2018 000310010618Y000066 0000978367522 BEDON L

3 29-06-2018 000310010618Y000067 0000978379446 ZULBAIDAH P

4 29-06-2018 000310010618Y000065 0001271989214 JUNIBAR L

5 28-06-2018 000310010618Y000057 0000212825586 TAMLEKHA L

6 28-06-2018 000310010618Y000056 0001676752288 NURSIMAH P

7 28-06-2018 000310010618Y000058 0001676836708 NADILA CHAVIRA P

8 28-06-2018 000310010618Y000055 0001814296173 marwi P

9 26-06-2018 000310010618Y000033 0000212097216 DEVISTA REZA P

10 26-06-2018 000310010618Y000020 0000212795662 WARDIAH P

11 26-06-2018 000310010618Y000026 0000978365632 ALFATA L

12 26-06-2018 000310010618Y000054 0000978366216 AINAL FARIDA P

13 26-06-2018 000310010618Y000052 0001676803476 NURAIN P

14 26-06-2018 000310010618Y000072 0001899345745 ELIS SUCI RAHAYU P

15 25-06-2018 000310010618Y000007 0000004091264 RATNAWATI P

16 25-06-2018 000310010618Y000014 0000212455653 M. NASIR L

17 25-06-2018 000310010618Y000008 0000212870564 ZUBIR L

18 25-06-2018 000310010618Y000015 0000978367487 ASMADI L

19 25-06-2018 000310010618Y000013 0001270742679 JALEMAN L

Kantor Cabang : TAPAKTUAN - 0105

FKTP : UJUNG PADANG RASIAN - 00031001
20 25-06-2018 000310010618Y000009 0001427043251 HASMIDANI P

21 25-06-2018 000310010618Y000011 0001676765068 MASYITAH P

22 25-06-2018 000310010618Y000019 0001676786769 HAMDAN L

23 25-06-2018 000310010618Y000017 0001676812792 EMA SUSANTI P

 24 25-06-2018 000310010618Y000018 0001800225022 BUNGSU P

25 25-06-2018 000310010618Y000016 0001814296173 marwi P

26 25-06-2018 000310010618Y000010 0002076804966 RUSNI P

27 25-06-2018 000310010618Y000012 0002421607252 HERMIDA P

28 22-06-2018 000310010618Y000004 0001292178914 SAFATUL MAYESA P

29 22-06-2018 000310010618Y000005 0001676755809 ASRI L

30 22-06-2018 000310010618Y000006 0002424560117 HASNIDAR P

31 21-06-2018 000310010618Y000002 0000206622729 EMA YULIDA P

32 21-06-2018 000310010618Y000003 0001676794566 SURIANA P

33 21-06-2018 000310010618Y000001 0001676803476 NURAIN P

34 08-06-2018 000310010618Y000071 0000978382991 SAUWATI P

35 06-06-2018 000310010618Y000061 0000004091297 RAMAWI L

36 06-06-2018 000310010618Y000063 0000212111109 ERMA.Z P

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JENIS PESERTA DIAGNOSA STATUS PRB PROLANIS
PULANG

PBI (APBN) Congenital cataract Rujuk Vertikal

PBI (APBN) Chronic obstructive pulmonary Rujuk Vertikal

disease, unspecified

PBI (APBN) Uterovaginal prolapse, Rujuk Vertikal

unspecified
PBI (APBD) Benign neoplasm of breast Rujuk Vertikal

PBI (APBN) Cardiomegaly Rujuk Vertikal

PBI (APBD) Chronic obstructive pulmonary Rujuk Vertikal

disease, unspecified

PNS DAERAH Other strabismus Rujuk Vertikal

PBI (APBD) Benign neoplasm of ovary Rujuk Vertikal

PBI (APBN) Chronic tonsillitis Rujuk Vertikal

PBI (APBN) Epispadias Berobat Jalan

PBI (APBN) Intracranial injury Rujuk Vertikal

PBI (APBN) Myopia Rujuk Vertikal

PBI (APBD) Nontoxic multinodular goitre Rujuk Vertikal

PBI (APBD) Spontaneous vertex delivery Sembuh

PBI (APBD) Non-insulin-dependent diabetes Rujuk Vertikal

mellitus
PBI (APBN) Tuberculosis of lung, confirmed Rujuk Vertikal
by sputum microscopy with or
without culture

PBI (APBN) Chronic obstructive pulmonary Rujuk Vertikal

disease, unspecified

PNS DAERAH Schizophrenia Rujuk Vertikal

PBI (APBD) Insulin-dependent diabetes Rujuk Vertikal

mellitus

PBI (APBD) Supervision of pregnancy with Rujuk Vertikal

history of insufficient antenatal
care
PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care
PBI (APBD) Other specified intervertebral Rujuk Vertikal
disc displacement

PBI (APBD) Malignant neoplasm of Rujuk Vertikal

bronchus and lung
 PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care
PBI (APBD) Gastritis, unspecified Rujuk Vertikal

PBI (APBD) Non-insulin-dependent diabetes Rujuk Vertikal

mellitus
PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care
PBI (APBD) Thalassaemia, unspecified Rujuk Vertikal

PBI (APBD) Tuberculosis of lung, confirmed Rujuk Vertikal

by sputum microscopy with or
without culture

PBI (APBD) Tuberculosis of lung, confirmed Rujuk Vertikal

by sputum microscopy with or
without culture

PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Supervision of pregnancy with Rujuk Vertikal

history of insufficient antenatal
care

PBI (APBD) Tuberculous peripheral Rujuk Vertikal

lymphadenopathy
PBI (APBN) Spontaneous vertex delivery Sembuh

PNS DAERAH Epispadias Berobat Jalan

PBI (APBN) Epispadias Berobat Jalan

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