Nas Register 2020

UMUR
UMUM/ BPJS/
NO. NAMA PESERTA NO RM ALAMAT
L P BANSOS
1 SAYID ALBIAN HIDAYAH 11 BL 02 27 70 BPJS TEBAO

2 AFIFAH ULYA RAHMAN 8 BL 03 12 97 UMUM TN.BEAK
3 AHMAD ILHAM 1 02 12 76 BPJS LEONG
4 AHMAD SULTAN 1 03 16 55 BPJS JERANGOAN
5 AINAYA AILA HARTANTI 2 03 11 93 UMUM BT.KUTA
6 AINUN 11 BL 03 10 87 UMUM KR.KEBON
7 AKMALUDIN 24 03 15 00 BPJS PESORONGAN JUNGKUG
8 ANISA AZKIA 8 03 13 28 BPJS LEKONG SIWAQ
9 AQ.RENO/PURNA WIRAHMAN 50 03 14 87 BPJS PAOK GADING
10 ARDIANA RIZKIANI 9 01 91 89 BPJS SELAT
11 AWALUDIN 10 03 15 54 UMUM TATAR
12 BQ.ZAINATUN 2 03 10 93 BPJS JERINGO
13 BURHANUDIN 51 03 16 22 BPJS SENTELUK LAUQ
14 DIDIK DWI JAYADI 22 00 68 64 BPJS LEMBUAK MEKAR INDAH
15 DINALIP 66 02 23 870 BPJS TIBU PILING
16 DINALIP 66 02 23 87 BPJS TIBU PILING
17 FEBRIAN ANGGARA 3 00 32 67 UMUM LEMBUAK
18 GAZLAN AL GIFARI 1 03 17 72 BPJS MEJETI
19 GINO AFTARIAWAN 10 BL 03 09 78 BANSOS BUQ- BUQ
20 H.M JALALUDIN 37 03 17 15 UMUM BUKIT TINGGIH
21 H.M.TURMUZI 69 03 11 89 UMUMN KERU
22 HAPSAH 60 03 15 99 UMU M TN.BEAK
23 HASANUDIN 59 03 14 08 BPJS TN.BEAK
24 HJ.HAYANUN 52 03 14 76 BPJS KURIPAN
25 HJ.NURHASANAH 42 02 55 49 BPJS DUMAN DASAN
26 I GEDE PERANG 62 03 06 68 BPJS KB.KUNING
27 I KOMANG SELAT 68 03 15 29 BPJS SURANADI
28 I NENGAH PURNAWE 38 03 12 30 BPJS AWANG MADIA
29 I NYOMAN SERENG 48 03 16 74 UMUM MONTONG LISUNG
30 IQ.PURNI 60 03 18 90 UMUM LEMBAH SUREN
31 JUAN ISNANDAR 19 03 14 74 BPJS BAGIK NUNGGAL
32 JUMISAH 65 03 16 07 UMUM KUMBI
33 KARSIJIL 51 00 06 55 BPJS BT.KUTA
34 L.M.DENI 27 03 18 65 BANSOS BUQ- BUQ
35 M.ADHA 6 BL 03 17 44 UMUM MEDAS
36 M.ARYA WAHYUDI 7 00 42 54 UMUM TN.BEAK
37 M.HANIP ARRASID 3 03 16 97 UMUM BUKIT TINGGIH
38 M.ILHAM 18 03 16 62 BPJS DS.GRIA
39 M.RAMDAN 20 03 17 28 UMUM KURIPAN
40 M.RAMDAN 20 03 17 28 UMUM KURIPAN
41 M.YOGI ALPIAN 2 03 14 91 UMUM SISIK
42 MARWI 54 03 17 20 BPJS SINTUNG
43 MAULANA RIZKI 13 03 17 27 BPJS JELATENG
44 MIRTE 61 03 15 74 BPJS PENGONONG
45 MUKLIS EFENDI 6 01 27 42 BPJS BT.KANTAR
46 MUNASIH 69 01 55 38 BPJS TN.TEPONG
47 MUNAWARNI 45 03 17 92 BPJS BAGIK NUNGGAL
48 NAHRI 40 02 97 94 BPJS MERCE
49 NENGAH PANDI ARYA 10 03 12 93 UMUM KUANG MAYUNG
50 NI NENGAH TANI 25 03 12 32 UMUM AWANG MADIA
51 NUR HAYATI 25 03 16 08 UMUM SURANADI UTARA
52 NURSI DARMAWAN 19 03 16 35 BPJS KALIMANTING
53 PATMAWATI 40 01 96 81 BPJS SURANADI
54 RAMDAN KHOLIK 1 01 84 09 UMUM NYIUR LEMBANG
55 RESTI SASMITA 27 03 16 30 BPJS GONDAWARI
56 RISQIA RATNAYANTI 35 03 12 92 BPJS LEMBUAK
57 ROBI SUKRIADI 6 03 16 28 UMUM PETELUAN INDAH
58 RUKIMAH 41 03 17 95 BPJS SISIK
59 RUMANIS 72 03 12 44 UMUM GEGELANG
60 RUSNIATI 33 03 15 06 BPJS JELATENG
61 SAHARI 50 03 11 46 UMUM RANJOK TIMUR
62 SAHUDIN 50 03 14 99 BPJS BUKIT TINGGIH
63 SALMIAH 76 00 30 29 BPJS TN.TEPONG
64 SAPIAH 28 03 13 34 UMUM MERCE
65 SARILAH 57 03 15 62 BPJS PEMEPEK
66 SARIPAH 77 02 72 24 BPJS TEBAO
67 SARIPUDIN 25 03 10 76 BPJS MEDAIN TIMUR
68 SEDIH 89 03 12 86 BPJS ORONG DALEM
69 SINERAH 70 02 95 59 BPJS EYAT KANDEL
70 SITI NURHASANAH 45 03 17 63 UMUM LEMBAH SEMPAGE
71 SITI ROYANI 18 03 16 34 BPJS ORONG DALEM
72 SOPATIN ROSLIANA 27 03 18 44 BPJS KALI RANGET
73 SOPIAH 27 03 14 69 BANSOS LEMBAH SEMPAGE
74 SUHAENIAH 36 03 16 61 BPJS BUKIT TINGGIH
75 SULTAN ARKANA 3 02 50 00 UMUM GONTORAN
76 SUPRIADI 14 03 17 65 BPJS ORONG UTARA
77 YATI 29 03 14 82 UMUM RUMBUK.LINGSAR
78 YUSUF 45 01 33 78 UMUM TEMAS
79 ZAKIYAH 47 03 15 98 BPJS TN.BEAK
80 ZULKARNAEN 25 03 15 31 BPJS KR.BAYAN
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
DIAGNOSA MASUK KELUAR
KODE SPESIALIS
I II III TGL JAM TGL JAM
A PNEUMONIA BERAT 18/1/2020 7.04 24/1/2020 11.45

A EFILEPSI 7/1/2020 1.38 8/1/2020 11.55
A PNEMONIA BERAT 9/1/2020 13.4 13/1/2020 11.45
A FARINGITIS AKUT 21/1/2020 12.37 23/1/2020 11.45
A PROLONG FEBRIS 3/1/2020 11.09 6/12/2020 11.45
A BP.BERAT 29/12/2019 0.35 1/1/2020 12.44
D POST.DEBRIDEMEN VULNY AMPUTASI 14/1/2020 21.4 16/1/2020 14
A SUSP.MASSA PARUN DD/TB .PARU 8/1/2020 10.35 10/1/2020 10.3
B SNAKE BITE 14/1/2020 11.58 15/1/2020 11.45
A PNEUMONIA BERAT EFILEPSI 31/12/19 11.39 3/1/2020 17
D ASMA ITERMITEN 16/1/2020 18.56 18/1/2020 11.45
A KDK 29/12/2019 18.33 4/1/2020 11.45
B POST.HERNIATOMY 20/1/2020 13.47 21/1/2020 11.4
D DHF GR I 29/1/2020 12.26 31/1/2020 11.45
D PPOK 25/1/2020 27/1/2020 11.45
D PPOK 25/1/2020 19.07 27/1/2020 11.45
A LEOKUSITOSIS 23/1/2020 26/1/2020 11.45
A DIARE AKUT 25/1/2020 11.11 28/1/2020 11.45
A GIZI BURUK 23/12/2019 13.23 2/1/2020 11.45
D MALARIA FALCIPARUM 22/1/2020 24/1/2020 11.45
D PNEUMONIA BERAT PPOK EKSERBASI AKUT 3/1/2020 10.09 3/1/2020 16.4
D DHF GRI 18/1/2020 22.51 20/1/2020 11.45
D TETANUS +GAGAL NAFAS 18/1/2020 21.06 19/1/2020 2.05
D PPOK EKSERBASI AKUT 14/1/2020 11.32 16/1/2020 11.45
D DEMEM TYPOID 23/1/2020 24/1/2020 11.45
D PPOK EKSERBASI AKUT 2/1/2020 21.07 5/1/2020 11.45
D ASMA EKSERBASI AKUT 16/1/2020 07 56 18/1/2020 11.45
D FEBRIS H-3 EC MALARIA FALCIPARUM 4/1/2020 13.4 5/1/2020 11.45
D MALARIA FALCIPARUM 22/1/2020 0.45 23/1/2020 14.35
D DHF GR II 30/1/2020 13.56 31/1/2020 11.45
D TB.PARU 16/1/2020 0.49 18/1/2020 11.45
D MELENA EC GASTRISTIS 19/1/2020 18.48 22/1/2020 11.45
D CHF FC II 20/1/2020 12.1 22/1/2020 11.45
D DHF GR I 29/1/2020 10.19 31/1/2020 11.45
A DHF GR I 24/1/2020 9.41 27/1/2020 11.45
A PNEUMONIA BERAT 26/12/2019 12.08 1/1/2020 11.45
A MALARIA FALCIPARUM 22/1/2020 12.19 30/1/2020 11.45
D DHF GR I 21/1/2020 16.56 23/1/2020 11.45
D DHF GR I 23/1/2020 14.4 27/1/2020 11.45
D DHF GR I 23/1/2020 14.4 27/1/2020 11.45
A TYPOID FEVER 14/1/2020 15.44 17/1/2020 11.45
D ASMA BRONCIALE 23/1/2020 26/1/2020 11.45
D DHF GR II 23/1/2020 25/1/2020 11.45
A EFILEPSI 2/1/2020 19.4 4/1/2020 11.45
D DHF GR I 21/1/2020 2.38 22/1/2020 11.45
D TB PARU 26/1/2020 23.54 28/1/2020 11.45
D ISKEMIK 13/1/2020 21.48 15/1/2020 11.45
A TYPOID FEVER 6/1/2020 16.52 10/1/2020 11.45
D MALARIA FALCIPARUM 4/1/2020 15.25 6/1/2020
D DHF GR I 19/1/2020 19.02 23/1/2020 11.45
D DHF GR I 21/1/2020 10.32 23/1/2020 11.45
D DHF GR II 12/1/2020 16.09 15/1/2020 11.45
A TB.PARU ( putus obat) 21/1/2020 11.19 23/1/2020 11.45
D DEMEM TYPOID 22/1/2020 25/1/2020 11.45
D DEMAM TYPOID 6/1/2020 13.5 9/1/2020 11.45
A HEPATITIS A 20/1/2020 11.09 22/1/2020 11.45
D DHF GR I 26/1/2020 21.27 28/1/2020 11.45
D HIPOGLEKEMIA 5/1/2020 16.06 7/1/2020 11.45
D 15/1/2020 11.39 15/1/2020 22.05
D PNEUMONIA BERAT TB.PARU 1/1/2020 16.32 2/1/2020 12.3
D SIROSIS HEPETIS 14/1/2020 21.15 15/1/2020 11.45
D TB.PARU 5/1/2020 13.02 7/1/2020 11.45
D CHOLESTATIK 8/1/2020 11.45 11/1/2020 11.45
D DHF GR II 16/1/2020 1.23 19/1/2020 11.45
D ANEMIA BERAT 28/1/2020 10.14 31/1/2020 11.45
B POST.EXSISI STT THORAK 13/1/2020 18.19 14/1/2020 14.45
D PENURUNAN KESADARAN 6/1/2020 12.25 8/1/2020 11.45
D AMEBIASIS OLD STROK 3/1/2020 23.11 5/1/2020 11.45
D DEMEM TYPOID DHF GR I 26/1/2020 17.59 28/1/2020 11.45
D DHF GR II 20/1/2020 15.53 23/1/2020 11.45
D DHF GR I 28/1/2020 12.02 30/1/2020 11.45
D PNEUMONIA + SEPSIS 13/1/2020 22.24 16/1/2020 11.45
A OBS.VOMITING 4/1/2020 18.02 5/1/2020 11.45
D DHF GR II 24/1/2020 22.31 27/1/2020 11.45
D GERD 8/1/2020 0.07 9/1/2020 11.45
D DHF GR I 18/1/2020 21.5 20/1/2020 11.45
B SHOULDER POSTEMOR 20/1/2020 17.28 21/1/2020 11.45
STATUS BAYAR STATUS KELUAR ALAMAT PASIEN
JML. HARI
KET
RAWAT UMUM BPJS LAIN2 SEMBUH RUJUK PP KABUR MENINGGAL DW LW LWK BARU LAMA
7 1 1 1
2 1 1 1
5 1 1 1
3 1 1 1
4 1 1 1
4 1 1 1
3 1 1 1
3 1 1 RSUP 1
2 1 1 1
4 1 1 RS.P3 1
3 1 1 1
7 1 1 1
2 1 1
3 1 1 1
3 1 1 1
3 1 1 1
4 1 1 1
4 1 1 1
11 1 1 1
3 1 1 1
1 1 k-24j 1
3 1 1 1
2 1 1 1
3 1 1 1
2 1 1 1
4 1 1 1
3 1 1 1
2 1 1 1
2 1 1 1
2 1 1 1
3 1 1 1
4 1 1 1
3 1 1 1
3 1 1 1
4 1 1 1
7 1 1 1
9 1 1 1
3 1 1 1
5 1 1 1
5 1 1 1
4 1 1 1
4 1 1 1
3 1 1 1
4 1 1 1
3 1 1 1
2 1 1 1
3 1 1 1
3 1 1 1
5 1 1 1
3 1 1 1
5 1 1 1
3 1 1 1
4 1 1 1
3 1 1 1
4 1 1 1
4 1 1 1
3 1 1 1
3 1 1 1
3 1 1 1
1 1 1 RSUP 1
2 1 1 1
2 1 1 1
3 1 1 1
4 1 1
4 1 1 1
4 1 1 1
2 1 1 1
3 1 1 RSUP 1
3 1 1 1
3 1 1 1
3 1 1 1
3 1 1 1
4 1 1 1
3 1 1 1
2 1 1 1
3 1 1 1
2 1 1 1
2 1 1 1
3 1 1 1
2 1 1 1
273 29 48 3 68 4 4 3
UMUR
UMUM/ BPJS/ KODE
NO. NAMA PESERTA NO RM BANSOS ALAMAT SPESIALIS
L P
1 HISBULLAH 18 03 18 18 UMUM SEMBUNG TIMUR D

2 SILKA RARA HARINI 8 03 18 17 BPJS KRMAT LAUQ D
3 EMA SURYA NINGSIH 17 03 18 53 BPJS PENIMBUING TIMUR D
4 MARENUN 67 00 73 61 BPJS KALIMANTING D
5 HARUN JULIANDA 16 01 88 31 BPJS DS,TERENG D
6 I GUSTI BAGUS 31 03 18 52 BPJS SANGIANG D
7 I PUTU EKA 03 18 51 BPJS LILIR BARAT D
8 I KETUT WANTI 41 02 72 98 BPJS PENIJOAN D
1 RUMISAH 72 01 75 61 BPJS TN.BEAK D
10 H.IHSAN 74 03 19 25 BPJS LANGKO DAYE D
11 AQ.SAYUNI 60 03 18 57 UMUM KEBON NYIUH D
12 M.KHAIRIL 1 03 19 49 UMUM PUNIKAN A
1 M.IHSAN 4 00 13 17 UMUM BT.ASAK A
14 LAEDIA ANGGINA 10 02 18 45 BPJS TELAGE NGEMBENG A
15 AZIRA FITRIANA 8 01 36 19 BPJS LEMBUAK KEBON A
1 KAMARUDIN 58 02 71 75 BPJS TIBU PILING D
17 NOVIANI SAFARA 4 03 19 23 UMUM MEJETI DAYE A
18 ZAHRATUL ZITA 11 03 17 89 BPJS BT.KUTA LENTING A
19 HARIANTINI 27 03 19 66 BANSOS BUQ-BUQ D
20 RUSMIATI 37 03 19 85 BPJS MERCE TIMUR D
21 SISNA SUHAERIAH 20 03 20 05 BPJS REPOK PANCOR D
22 INDI 37 02 10 22 BPJS AMPENAN D
23 PERDI AGUS MARIADI 14 03 20 36 UMUM SANGIANG D
24 ANISSA SYAGALI 2 03 20 56 BPJS PONDOK BUAK A
25 RIANTI 66 02 31 02 BPJS KERU D
26 ANISSA SYAGALI 39 03 20 33 BPJS KURIPAN D
27 IQ.JUMISAH 73 03 21 19 UMUM BUQ-BUQ D
28 LIONI IZAMI 11 BL 03 20 88 BPJS GERIA UTARA A
29 M.FAUZI IHSAN 10 03 20 35 BPJS GERUNG A
30 ANEKA PUTRI 14 03 21 03 UMUM SERPAKEK D
31 RANGGA ARYA PRADINATA 4 02 59 86 UMUM TIBU PILING A
32 ZAHRAWATI 38 03 20 90 UMUM SURANADI D
33 M.IMAM PATHUL.H 7 BL 03 11 28 UMUM TN,TEPONG A
34 NURDIAH 76 03 20 46 BANSOS BAGEK NUNGGAL D
35 DULASIH 70 03 21 70 UMUM TN.BEAK BARAT D
36 AQ.NAH 57 03 21 44 UMUM BEREMBENG BARAT D
37 NAHRUN 60 03 21 22 BPJS KR.SIDEMEN D
38 KADEK 48 03 21 38 BANSOS NYIUR BAYE GAWAH D
39 I GUSTI WAYAN JATRA 18 03 21 06 BPJS SANGIANG D
40 HIDAYANTI 17 03 21 72 BANSOS MURPEJI D
41 AMRINA ROSADA 5 BL 03 21 58 UMUM MAMBALAN A
42 ULUL AZMI 11 03 21 60 BANSOS PEMBUWUN A
43 RINO TAMRIN 15 03 21 59 BPJS DS.GRIA D
44 MULIADI 38 03 21 52 BPJS ORONG DALEM D
45 SAHDI 26 03 21 10 BPJS KALI ANGET D
46 L.SUHARTAWAN 36 03 22 76 BPJS LILIR D
47 AL IMRATUL FATONI 14 03 23 21 UMUM GRIYA UTARA D
48 M.SADRI 37 03 22 46 BPJS LANGKO DAYE D
49 RENDI SAPUTRA 11 03 22 78 BPJS ORONG UTARA A
50 I MADE SATIA RADITA 4 02 04 12 BPJS PEMUNUT A
51 M.ARSA RAMADAN 2 00 79 27 BPJS BT.KANTAR A
52 APRIANTO 24 03 22 79 BPJS RANJOK BARU A
53 M.RIZAL 7 03 22 94 UMUM LANGKO A
54 M.RAFAEL 1 03 22 82 BPJS BEBIE DAYE A
55 I KM.PUTRA 25 03 22 95 BPJS EYAT KANDEL D
56 MARIYAM 44 03 23 16 BPJS TN.TEPONG D
57 JISAN HALIM 3 03 23 59 BPJS KETIREK D
58 NI NYOMAN ARNIK 43 03 22 60 BPJS MONTANG D
59 BY.NY. SAMINI/IRAWAN 7 BL 03 23 24 BPJS ORONG A
60 BY.NY. USMIATI 3BL 02 92 99 BPJS PEMANGKET A
61 SUHARNI 37 03 23 62 BPJS KR.BAYAN D
62 MUMA ZAHRA 5 03 23 60 UMUM LEMBAR A
63 DIAZ NURAMDANI 11 03 23 45 BPJS TEBAO A
64 USNAWATI 35 03 23 68 BPJS KEBON BELEK D
65 RENITA 26 03 24 44 BANSOS JERINGO LIMBUNGAN D
66 ARETA SABIRA HARUM 1 BL 03 23 27 BPJS MADAK BELEQ- SEKOTONG A
67 NIA KALISYA 3 BL 03 21 94 BANSOS KR.BAYAN A
68 INARA ZAHIRA SUHA 1 03 24 73 BPJS LANGKO DAYE A
69 ASKA DIRGA 5 BL 03 24 22 UMUM MEREMBU A
70 FIKRI HIDAYATULLAH 12 03 25 01 BPJS KERU A
71 HERNI MULIANA 12 03 24 84 UMUM SAMBIK BARU A
72 ANTI ANDRIANI 24 03 25 59 UMUM DS.TELAGE D
73 NI WAYAN PURNAMI 9 03 25 02 BPJS MONTONG GALUR A
74 M.YAZIZ BILAL 3 03 24 90 UMUM BUQ-BUQ A
75 ARDIPE 79 03 25 61 UMUM MONTANG D
76 ALFINA RIZKIKA AULIA 9 00 75 12 BPJS TN.BEAK DAYE A
77 AHMAD SATRIAWAN 4BL 03 24 37 BPJS JERANGOAN A
78 FENDRA SUSETA 28 03 25 53 BPJS JERANGOAN D
79 DENI WIRANDA 6 02 95 54 BPJS KR.ANYAR A
80 KENZI ARGA PRADUTA 1 01 66 53 BPJS AIK AMPAT A
81 ADITIA RAHMAN 12 03 25 51 BPJS SANGIANG A
82 AGUS IRAWAN 12 03 26 04 UMUM JERANGOAN A
83 NI PUTU NAGIATA 1 03 26 20 BPJS SURANADI SELATAN A
84 ROHANA 27 03 25 20 UMUM JABON SISIK D
85 ARISA NAFISA SEREN 2 02 35 80 BPJS DUMAN A
86 MURNIATI 40 03 25 97 BPJS LEMBAH SEMPAGE D
87 RAENAH 64 03 26 12 UMUM SINTUNG D
DIAGNOSA MASUK KELUAR STATUS BAYAR
JML. HARI
I II III TGL JAM TGL JAM RAWAT UMUM BPJS
DHF GR II 27/2/2020 11.14 1/2/2020 11.45 6 1

KOLESTISTUTIS 27/2/2020 13.36 1/2/2020 11.45 6 1
DHF GR I 28/2/2020 14.45 1/2/2020 11.45 5 1
ADHF 30/1/2020 5.33 1/2/2020 11.45 3 1
DHF GR I 28/1/2020 11.54 1/2/2020 11.45 5 1
DHF GR II 28/1/2020 15.46 1/2/2020 11.45 5 1
DHF GR I 28/2/2020 11.45 1/2/2020 11.45 5 1
DM TYPE II 30/1/2020 10.4 2/2/2020 4 1
ANEMIA SEDANG 1/2/2020 12.11 3/2/2020 3 1
BSK 1/2/12020 10 4/2/2020 11.45 4 1
PPOK 3/2/2020 6.56 4/2/2020 11.45 2 1
KDK 2/2/2020 11.43 4/2/2020 11.45 3 1
KDS 1/2/2020 13.34 4/2/2020 11.45 4 1
DHF GR I 2/2/2020 13.46 4/2/2020 11.45 3 1
ASMA INTERMITEN 31/1/2020 9.19 4/2/2020 11.45 5 1
MELENA EC.TROMBOSITOPENIA 4/2/2020 10.43 4/2/2020 1 1
ISK 1/2/2020 12.52 5/2/2020 11.45 5 1
PROLONG JAUNDICE 1/2/2020 11.36 5/2/2020 11.45 5 1
DEMAM TYPOID 2/2/2020 02 .01 5/2/2020 14.5 4
ANEMIA BERAT 3/2/2020 13.33 5/2/2020 3 1
VAGINAL BLEEDING 4/2/2020 12.31 7/2/2020 4 1
ANEMIA BERAT 4/2/2020 12.23 7/2/2020 4 1
DHF GR I 5/2/2020 14.37 8/2/2020 11.45 4 1
SEPSIS 6/2/2020 12.14 8/2/2020 11.45 3 1
ADEMA PARU 5/2/2020 18.16 8/2/2020 11.45 4 1
DHF GR I 5/2/2020 13.18 8/2/2020 11.45 4 1
CARDIAK ARREST 8/2/2020 21.32 9/2/2020 2.45 2 1
ANEMIA BERAT 7/2/2020 17.44 9/2/2020 3 1
DHF GR II 5/2/2020 15.09 9//2/2020 5 1
ASMA BRONCIALE 8/2/2020 11.39 10/2/2020 11.45 3 1
DEMAM TYPOID 6/2/2020 10.16 10/2/2020 11.45 5 1
DHF 7/2/2020 18.54 10/2/2020 11.45 4 1
MORBILI 5/2/2020 12.44 10/2/2020 11.45 6 1
PNEMONIA BERAT 5/2/2020 0.21 11/2/2020 11.45 6
KISTA HEPAR 10/2/2020 19.58 12/2/2020 12 3 1
CHOLESISTIS AKUT 10/2/2020 8.31 13/2/2020 11.45 4 1
ANEMIA BERAT 9/2/2020 1.19 13/2/2020 11.45 5 1
ANEMIA BERAT 9/2/2020 22.03 13/2/2020 11.45 5
DHF GR I 8/2/2020 12.49 13/2/2020 11.45 6 1
DHF GR I 10/2/2020 21.43 13/2/2020 11.45 4
PNEMONIA BERAT 10/2/2020 12.33 13/2/2020 11.45 4 1
DEMAM TYPOID 10/2/2020 15.54 13/2/2020 11.45 4
DHF GR I 10/2/2020 15.3 14/2/2020 11.45 5 1
DHF GR II 10/2/2020 11.21 14/2/2020 11.45 5 1
DEMAM TYPOID 10/2/2020 12.08 14/2/2020 11.45 5 1
DEMAM TYPOID 14/2/2020 11.24 16/2/2020 11.45 3 1
MALARIA FALCIPARUM 15/2/2020 15.07 17/2/2020 11.45 3 1
DHF GR I 13/2/2020 11.02 17/2/2020 11.45 5 1
DHF GR III 14/2/2020 12.46 17/2/2020 11.45 4 1
DENGUE FEVER 14/2/2020 22.12 17/2/2020 11.45 4 1
PNEMONIA 15/2/2020 11.31 17/2/2020 11.45 3 1
DHF GR II 14/2/2020 12.42 18/2/2020 11.45 5 1
DENGUE FEVER 14/2/2020 22.21 18/2/2020 11.45 5 1
DEMEM TYPOID 14/2/2020 17.04 18/2/2020 11.45 5 1
DHF GR I 14/2/2020 22.15 18/2/2020 5 1
DHF GR I 15/2/2020 13.2 19/2/2020 11.45 5 1
DEMAM TYPOID 17/2/2020 13.45 19/2/2020 11.45 3 1
DHF GR I 13/2/2020 20.23 19/2/2020 1
DHF 15/2/2020 19.55 19/2/2020 11.45 5 1
GIZI BURUK TIPE MARASMU 13/2/2020 10.48 19/2/2020 7 1
DHF GR I 17/2/2020 14.15 20/2/2020 11.45 4 1
DHF 17/2/2020 15.05 20/2/2020 11.45 4 1
DHF 18/2/2020 11 20/2020 11.45 3 1
DHF GR I 17/2/2020 17.55 21/2/2020 11.45 5 1
DHF GR I 20/2/2020 17.47 22/2/2020 11.45 3
PNEUMONIA BERAT 15/2/2020 22.35 22/2/2020 11.45 8 1
PNEUMONIA BERAT 11/2/2020 14.39 22/2/2020 11.45 12
21/2/2020 16.39 23/2/2020 11.45 3 1
PNEUMONIA BERAT 19/2/2020 22.34 23/2/2020 5 1
DHF GR II 22/2/2020 21.18 24/2/2020 11.45 3 1
SUSPEK PJR 22/2/2020 11.23 24/2/2020 12.45 3 1
DEMAM TYPOID 24/2/2020 20.1 25/2/2020 11.45 2 1
DEMAM DENGUE 22/2/2020 22.48 25/2/2020 11.45 4 1
IMPERTIGO 22/2/2020 45.56 25/2/2020 11.45 4 1
SEPSIS SYOK 24/2/2020 20.29 25/2/2020 10.5 2 1
FARINGITIS AKUT 24/2/2020 11.35 26/2/2020 12.45 3 1
PNEUMONIA BERAT 20/2/2020 13.41 26/2/2020 12.45 7 1
PNEUMONIA 24/2/2020 16.54 27/2/2020 11.45 4 1
GLOMENILONEPHRITIS AKUT 21/2/2020 10.48 27/2/2020 11.45 7 1
DEHIDRASI RINGAN SEDANG 25/2/2020 10.51 27/2/2020 11.45 3 1
DEMAM TYPOID 24/2020 13.39 27/2/2020 11.45 4 1
DEMAM DENGUE 26/2/2020 14.01 27/2/2020 11.45 2 1
SEPSIS 27/2/2020 11.03 27/2020 1 1
DHF GR I 23/2/2020 18.04 28/2/2020 11.45 6 1
PNEUMONIA BERAT 25/2/2020 11.49 28/2/2020 12.25 4 1
CHOLESTITIS JOUNDLE ET CAUSA 26/2/2020 11.45 28/2/2020 11.45 3 1
CHF FC III 26/2/2020 23.31 29/2/2020 11.45 4 1
363 25 55
KET
LAIN2 SEMBUH RUJUK PP KABUR MENINGGAL DW LW LWK BARU LAMA
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 RS.KOTA 1
1 1
1 1
1 1 1
1 RSUP 1
1 RS.KOTA 1
1 1
1 1
1 1
1 1
1 1
1 1
1 RS.KOTA 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1
1 RSUP 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 RSUP 1
1 1
1 1
1 1
1 1
7 74 6 5 2 69 18
UMUR
UMUM/ BPJS/
L P BANSOS
1 MUTHIANI 17 03 26 60 BPJS KR.BAYAN

2 ACE 59 03 23 96 BPJS TATAR DAYE
3 LANE SARI 41 03 26 32 BPJS TEBAO
4 EJAN FERDIANSYAH 4 03 26 65 UMUM MEDAIN BARAT
5 SAHRUL AINI 45 03 26 57 BPJS KR.BAYAN
6 IQ ILUK 65 03 26 43 UMUM MBUNG PAS
7 M.BILLI ROSAT 14 03 26 81 BANSOS TELAGE NGEMBENG
8 NAULA YUSRIA 1 03 26 31 UMUM MEJETI OTAK DESE
9 I KOMANG JUNIATANE 5 03 27 37 BPJS MEKAR SARI
10 KAMARIAH 52 01 80 37 BPJS BT.RIMPANG
11 M.SODIKIN 14 03 27 33 BPJS SANDONGAN
12 DIKA MUTTAQI 2 03 27 53 UMUM PRINGGARATA
13 NI MADE DWI FEBRI 11 03 27 32 BPJS SURANADI
14 M.RADITIA 1 03 27 68 UMUM SINTUNG
15 SALMAN AL FARIZI 11 BL 03 27 81 BPJS DS.TERENG
16 LAILA LASIOPA 15 03 27 36 BPJS SEDAYU
17 M.RIDHO 9 03 27 86 BPJS LANGKO LAUQ
18 MISKAH 38 03 27 35 BPJS PENIMBUNG
19 ABDUL AZIZ 30 03 27 69 UMUM BUQ-BUQ
20 ALYA JASMITA 7 03 28 06 UMUM KURIPAN
21 M.AMRILLAH 5 BL 03 28 31 UMUM PESANTEK
22 RAFA ELTANU 10 BL 02 55 39 UMUM AIK NYET
23 SAKIRA 2 03 28 48 UMUM MEJETI
24 NIZAR ALFIAN HADI 4 BL 03 27 83 BPJS JABON UTARA
25 JIRHAM JUNDALLAH 2 BL 03 27 11 UMUM MONTOR
26 ALIA ANDRIANA 2 02 00 58 UMUM BT.ASAK
27 MUTIARA ZAHRA 1 03 00 98 UMUM KARANG MAS
28 IWAN 30 03 29 34 UMUM PRESAK
29 I GUSTI AYU KETUT 21 03 28 38 UMUM TAMAN BALI
30 GUSTI AYU PRADITA 8 BL 03 29 41 UMUM SURANADI BARAT
31 AFIFA ULYA RAHMAN 10 BL 03 12 97 UMUM TN.BEAK
32 MURNI 40 03 29 14 UMUM SEDAU TIMUR
33 I KETUT WARDITA 19 03 29 62 UMUM MOKEH
34 NURDAN 63 03 29 28 BPJS LANGKO LAUQ
35 AHMAD SAHRIL 20 03 29 26 BPJS SURANADI UTARA
36 INTAN WIDIASWARI 13 03 29 47 BPJS TELAGE NGEMBENG
37 SULMAYADI 30 03 29 19 BANSOS KR.BAYAN
38 NURMULIATI 29 03 29 75 UMUM PEMENGKET
39 NYOMAN WIDIA 26 03 29 07 UMUM PENINJOAN
40 SAFA ALFATUN NISA 6 BL 02 80 90 UMUM KALI ANGET
41 SELVINA 1 02 80 54 UMUM KR.TEMU
42 PAIDA ANAILA 5 00 97 30 UMUM TELAGE NGEMBENG
43 IBATATUN 29 03 29 53 BANSOS KR.BAYAN BARAT
44 MINATI 28 03 29 69 UMUM MUHAJIRIN
45 H.SUDIRMAN 67 02 68 24 BPJS SISIK TIMUR
46 IQ.RIADI 59 03 29 78 BANSOS LONGSERAN BARAT
47 TOMI HACANDRA 2 01 48 62 BPJS BT.ASAK
48 FATI FATMAWATI 6 03 30 03 UMUM DS.PUSPALAYA
49 YULFA AISILA 1 03 30 02 BPJS LANGKI DAYE
50 I WAYAN BUDIARTHA 17 03 30 30 BPJS SIGERONGAN
51 SELEHE 65 03 30 36 BPJS BUQ-BUQ
52 NURAMIN/MURTINI 63 00 05 77 BPJS SANDONGAN TIMUR
53 NURAINI AISYAH 32 03 30 56 BPJS JELOJOK
54 I KOMANG AGUS JUNIARTHA 22 03 30 00 BPJS GONDAWARI
55 IQ.AMENAH 49 03 30 47 BPJS KURIPAN
56 SUMINAH 26 03 30 35 UMUM KR.BAYAN
57 ALAYA ABSIN MAERA 7 BL 03 30 64 UMUM KEBON NYIUH
58 CITRA PUTRI 5 BL 02 60 23 BPJS MEJETI LAUQ
59 QIARA ZULFIANI AZAHRA 7 BL 03 00 17 UMUM TEBAO
60 KETUT PUTRA ASTAWE 26 03 31 01 BPJS GONDAWARI
61 IDUL ADHA 55 03 30 06 BPJS LEMBUAK
62 GHITA JULIANA DWI PUTRI 2 00 86 89 BPJS BREMBENG BARAT
63 PUTRI AZALIA 5 BL 02 85 81 UMUM PENANGKE
64 M.RAFIADI 9 00 07 66 BPJS BT.KUTA
65 I NYOMAN SUPARTA 32 03 31 76 UMUM EYAT KANDEL
66 M.RIZALDI 14 03 31 49 BANSOS MUHAJIRIN
67 AZZAM FARHAN 10 03 31 52 BPJS KR.BAYAN
1 M.FADLAN 2 03 32 17 UMUM SANDIK BAWAQ
69 SUPRIADI 13 03 31 87 UMUM BT.LAYAR
70 ADRIAN RAMADAN SYAH 10 BL 02 48 41 BPJS SIGERONGAN
71 IQ DERUN 64 03 31 11 BPJS SEMBUNG
72 NI KADEK KARIANI 54 03 31 55 BPJS KR.MEJETI
73 HARTRINI 31 03 32 12 BPJS SEMBUNG
74 HABIBURRAHMAN 21 03 32 54 BPJS LONGSERAN BARAT
75 SARIMAH 53 03 32 34 BPJS KERAMAT JAYA
76 RIAN HIDAYAT 29 03 08 85 BPJS BUQ-BUQ
77 RUMANIS 72 03 12 44 BPJS GEGELANG
78 SUHAELAN 19 03 31 91 UMUM JURANG SATE
79 AHMAD MADANI 12 03 32 96 BPJS MURPEJI
80 HAERIAH 49 02 24 25 BPJS MUHAJIRIN
81 AMIN WAPIK 18 02 62 84 UMUM PRESAK
82 NI MADE KARTINI 25 03 33 16 UMUM LILIR
83 ADITYA DIBA SULAIMAN 11 03 32 30 BPJS MUHAJIRIN
84 VIRA FAUZANA 7 03 32 23 BANSOS SEDAU
85 ABDUL ZALIL 6 03 30 14 BANSOS BT.KUTA SELATAN
86 NAHWAN 42 03 33 56 BPJS SINTUNG BARAT
87 SITI BADRIAH 42 01 46 64 BPJS KEMBANG KUNING
88 HASAN 34 03 32 50 BPJS KURIPAN
89 M.BENI IBRAHIMOVIC 10 03 33 15 BPJS LINGSAR
90 IBNU WARDANI 20 03 33 18 BPJS MEDAIN BARAT
91 USNIATUN ALAWIAYAH 21 03 33 78 BPJS BENGKEL
92 BQ.TITIK 27 03 33 37 UMUM PEMEPEK
93 KAFFA RIFAN PRAYUDA 4 BL 03 24 65 BPJS MUJAHIRIN
94 BILAL ZAIDAN HAQ 3 BL 03 32 68 BPJS MEJELI
95 ALFAN YUDI ANGGARA 3 BL 03 33 44 UMUM PADE MARE
96 NAYRA AQILA NASIFA 4 BL 03 30 78 UMUM ARJANGKE
97 MASNAH 39 03 33 17 BPJS KURIPAN
98 ARUMI NAZALIA 2 03 34 38 UMUM KR.BAYAN
99 ANISA SAPUTRI 3 BL 03 32 22 BPJS LEONG
100 KENZI ARGA PRADUTA 1 01 66 53 BPJS AIK AMPAT
101 SAHRI 64 03 06 34 BPJS TN.BEAK
102 NUR ASTUTI 16 03 31 94 BPJS LEKONG SIWAQ
103 SEHAN 73 03 33 20 BPJS MEJELI
104 MUNAHAR 42 03 33 51 UMUM EYAT BINTANG
105 HERIAWAN 32 03 33 74 UMUM MEDAS
106 NI NENGAH SURIANI 30 03 34 86 UMUM AWANG MADIA
107 KAMAHARIANI 38 03 34 24 BPJS KURIPAN
108 SADANI 33 03 35 37 UMUM GURIPAK
109 JATUM 51 03 35 95 UMUM SEKOTONG
110 RAKNAH 45 03 35 74 UMUM PESANTEK
111 QIARA ZULFIANI AZAHRA 7 BL 03 00 17 BPJS TEBAO
KODE JML. HARI
SPESIALIS I II III TGL JAM TGL JAM RAWAT UMUM
D DHF GR I 28/2/2020 11.53 1/3/2020 11.45 3

D CHOLELITISIS AKUT 27/2/2020 20.51 1/3/2020 11.45 4
D CHOLELITISIS AKUT 28/2/2020 7.51 1/3/2020 11.45 3
D FEBRIS H-8 EC DHF 28/2/2020 18.18 1/3/2020 11.45 3 1
D DHF GR II 28/2/2020 11.58 2/3/2020 11.45 4
D ANEMIA SEDANG 27/2/2020 11.45 2/3/2020 12.45 5 1
D DHF GR I 29/2/2020 13.3 3/3/2020 11.45 4
A DISENTRI 27/2/2020 13.15 3/3/2020 12.45 6 1
A DEMAM DENGUE 2/3/2020 14.24 4/3/2020 11.45 3
D DM TYPE II 2/3/2020 17.16 5/3/2020 11.45 4
D DHF GR I 2/3/2020 13.22 5/3/2020 11.45 4
A KDK 3/3/2020 10.4 5/3/2020 11.45 3 1
A DHFF GR I 2/3/2020 11.52 5/3/2020 11.45 4
A LOW INTAKE 3/3/2020 12.37 6/3/2020 11.45 4 1
A KDK 4/3/2020 10.39 6/3/2020 11.45 3
D ANEMIA BERAT 2/3/2020 13.48 6/3/2020 11.45 5
A LOW INTAKE 4/3/2020 13.22 6/3/2020 11.45 3
D DHF GR I 2/3/2020 14.05 7/3/2020 11.45 6
D DHF GR I 3/3/2020 15.26 7/3/2020 11.45 5 1
A DEMAM DENGUE 5/3/2020 13.54 7/3/2020 12.45 3 1
A PNEUMONIA BERAT 6/3/2020 13.04 7/3/2020 12.45 2 1
A DEMAM TYPOID 6/3/2020 23.13 9/3/2020 11.45 4 1
A PNEUMONIA BERAT 4/3/2020 11.04 9/3/2020 11.45 6
A LOW INTAKE 7/3/2020 9.11 9/3/2020 11 3 1
D DEMAM TYPOID 9/3/2020 20.13 10/3/2020 11 2 1
D DHF GR I 6/3/20200 18.38 10/3/1010 11 5 1
A DIARE AKUT DEHIDRASI RINGAN SEDANG 10/3/2020 10.32 11/3/2020 12 2 1
A PNEUMONIA BERAT 8/3/2020 22.53 11/3/2020 4 1
D PNEUMONIA BERAT 9/3/2020 12.55 12/3/2020 4 1
D MALARIA FALCIPARUM 10/3/2020 16.45 12/3/2020 3 1
D DEHIDRASI BERAT 9/3/2020 19.08 12/3/2020 4
D DHF GR II 9/3/2020 18.2 12/3/2020 4
D DHF GR I 10/3/2020 10.37 12/3/2020 3
D DHF GR I 9/3/2020 13.03 12/3/2020 4
D DHF GR I 10/3/2020 21.37 12/3/2020 3 1
D DHF GR I 9/3/2020 11.01 13/3/2020 5 1
A DEMAM DENGUE 10/3/2020 10.56 13/3/2020 4 1
D DHF GR I 10/3/2020 11.22 13/3/2020 4
D DHF GR I 10/3/2020 20.12 13/3/2020 4 1
D EFUSI FLEURA 13/3/2020 12.49 14/3/2020 2
D PNEUMONIA BERAT 10/3/2020 8.18 14/3/2020 5
A DIARE AKUT DEHIDRASI RINGAN SEDANG 9/3/2020 20.02 14/3/2020 6
A DEMAM DENGUE 11/3/2020 15.12 14/3/2020 4 1
A HIPERPIREKSIA 11/3/2020 16.36 14/3/2020 4
D DHF GR II 12/3/2020 14.51 15/3/2020 4
D DHF GR I 12/3/2020 18.56 15/3/2020 4
D PPOK 13/3/2020 12.36 16/3/2020 4
D ACUTE CORONAY SYNDROM 13/3/2020 12.11 16/3/2020 4
D DHF GR I 11/3/2020 13.31 16/3/2020 6
D DHF GR I 12/3/2020 23.2 16/3/2020 5
D DHF GR II 12/3/2020 17.54 16/3/2020 5 1
A FARINGITIS AKUT 12/3/2020 12.36 16/3/2020 5
D GEA 14/3/2020 0.06 17/3/2020 4
D DHF GR I 12/3/2020 17.41 17/3/2020 6
A PNEUMONIA BERAT 12/3/2020 22.33 17/3/2020 6
A LOW INTAKE 14/3/2020 11.29 18/3/2020 5
D DHF GR I 17/3/2020 11.57 18/3/2020 2 1
D DHF GR I 16/3/2020 15.15 19/3/2020 4
A EPILEPSI 16/3/2020 167.21 19/3/2020 4
A KDK 18/3/2020 15.5 20/3/2020 3 1
A DHF GR I 17/3/2020 17.28 20/3/2020 4 1
D DHF GR II 15/3/2020 15.19 20/3/2020 6
D DHF GR I 16/3/2020 18.06 20/3/2020 5
D DHF GR II 18/3/2020 15.19 20/3/2020 3
D DHF GR I 19/3/2020 12.26 21/3/2020 3
D EDEMA PARU 19/3/2020 03 .53 21/3/2020 3
D LIMPALENIS TB/LIMPARU 12/3/2020 14.47 21/3/2020 10
D DM TYPE II 21/3/2020 3.45 22/3/2020 2
D DHF GR I 17/3/2020 18.36 22/3/2020 6 1
A DHF 20/3/2020 15.53 23/3/2020 4
D ASMA BRONKIOLITIS 20/3/2020 18.451 23/3/2020 4
D DHF GR I 18/3/2020 7.42 23/3/2020 6 1
D DHF GR I 21/3/2020 12.05 23/3/2020 3 1
A DEMAM DENGUE 18/3/2020 23.04 23/3/2020 6
A DHF GR IV 18/3/2020 19.51 23/3/2020 6
A HEPATITIS A 19/3/2020 11 23/3/2020 5
D DHF GR I 23/3/2020 1.4 23/3/2020 1
D DM TYPE II 21/3/2020 12.41 24/3/2020 4
D DHF GR I 19/3/2020 10.37 24/3/2020 6
A TYPOID FEVER 21/3/2020 12.06 24/3/2020 4
D DHF GR I 21/3/2020 14.19 25/3/2020 5
D DHF GR I 23/3/2020 13.11 25/3/2020 3
D DHF GR I 22/3/2020 10.19 25/3/2020 4
D DHF GR I 24/3/2020 17.03 26/3/2020 3
A DEMAM TYPOID 25/3/2020 13.22 26/3/2020 2 1
A ANEMIA FISIOLOGIS 18/3/2020 21.57 26/3/2020 9
A IMPERTIGO GULOSA 25/3/2020 14.48 26/3/2020 2
D ANEMIA SEDANG 24/3/2020 10.32 26/3/2020 3
D DEMAM TYPOID 23/3/2020 20.51 26/3/2020 4
D DHF GR I 21/3/2020 16.55 27/3/2020 7
D PDP COVID 19 22/3/2020 9.07 27/3/2020 6 1
D PDP COVID 19 26/3/2020 9.07 28/3/2020 3 1
D ISK 26/3/2020 16.37 28/3/2020 3 1
A DM TYPE II 24/3/20202 19.34 28/3/2020 5
D MALARIA FALCIPARUM 28/3/2020 16.06 30/3/2020 3 1
D PDP COVID 19 31/3/2020 6.31 31/3/2020 2 1
D DENGUE FEVER 30/3/2020 11.19 31/3/2020 2 1
A SUSP.PJB 29/3/2020 23.13 31/3/2020 3
470 45
KET
BPJS LAIN2 SEMBUH RUJUK PP KABUR MENINGGAL DW LW LWK BARU LAMA
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 RSUP 1
1 1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 RSUP 1
1 1 1
1 1
1 1 1
1 1 1
1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 RSUP 1
1 1
1 1 1
1 1
1 1
1 1
1 1 RSUP 1
59 7 102 4 5 84 27
UMUR
UMUM/ BPJS/
L P BANSOS
1 JUMHURI AZHAR 30 03 35 43 BPJS BERTAIS

2 KADEK NAENAULIN 1 03 35 35 UMUM PEMUNUT
3 ROHANIAH 42 03 34 75 BPJS KR.BAYAN
4 SLAMET SUBAGIO 40 03 35 99 UMUM GOLONG
5 ANDI SAPUTRA 19 03 35 08 UMUM DUMAN INDAH
6 AHMAD ZAENUL RAMLI 20 03 36 47 BPJS GEGELANG
7 I NENGAH RANE 17 03 35 84 UMUM MONTANG GALUR
8 NAZRAH 35 03 35 64 UMUM LANGKO DAYE
9 KADEK WIDYA 8 03 35 55 UMUM PRESAK
10 NI WY.ANGGI SAPUTRA 11 03 35 75 UMUM SURANADI SELATAN
11 M.ZAPRAN AL FATIH 9 BL 03 36 34 UMUM MENJELI INDAH
12 ASROBI ABDIHI 9 03 35 69 BPJS SALUT
13 JUPRIADI 30 03 36 11 BPJS LANGKO
14 SUTRIMIN 42 03 36 07 UMUM KR.BAYAN
15 NI NOMAN AYU ASTINI 23 02 45 65 BPJS EYAT KANDEL
16 M.THORIK 1 03 36 65 UMUM REPOK TEMAS
17 SUARNI 53 03 36 43 BPJS LINGSAR TIMUR
18 M.IRSAD 23 00 22 43 BPJS TELAGE NGEMBENG
19 RAUDATUL ZANAH 6 03 36 42 BPJS MERCE BARAT
20 ALUNA AMARA 1 BL 03 23 43 BPJS KEMBANG KUNING
21 ABDUL RAHMAN 32 03 36 94 UMUM JATI MEKAR
22 ATRIKA RAHMA YANTI 19 02 12 69 BPJS SELAT BARAT
23 WIRA YUDHA PRATAMA 13 03 36 95 BPJS TELAGE NGEMBENG
24 M.GALIH CAHYO 8 03 36 51 BPJS TN.TEPONG
25 LATIPATUN NAJWA 5 03 35 92 UMUM MERCE
26 MURDI 61 03 32 38 UMUM TELAGE NGEMBENG
27 MAULANA HASBI 1 03 35 63 BPJS LONGSERAN
28 IRWANSYAH 10 03 36 61 BPJS SELAT
29 RABIATUL ADAWIYAH 6 03 37 99 UMUM BEREMI
30 SOFIATUN AZZARA 1 03 37 73 BANSOS MUHAJIRIN
31 M.NABIL ARNAWA 5 03 37 74 BANSOS BT.KUTA
32 ELMA IZORA 2 BL 03 23 52 UMUM MEJETI
33 MUSLIHAN 24 03 37 46 BPJS KR.TALIWANG
34 ERNI SETIAWATI 46 00 09 85 BPJS BT.KUTA
35 ERNI 50 03 38 39 UMUM REPOK ATAS
36 IRAWAN HAWARI 39 03 37 44 BPJS TN.TEPONG
37 HARIS 20 03 38 66 UMUM KERU
38 ARIMUDIN 73 01 72 28 BPJS SELAT BARAT
39 NYOMAN YUDA 10 BL 03 37 23 BANSOS KEMBANG KUNING
40 ELDOTA IQRAMAR 7 03 38 18 UMUM LINGSAR PERMAI
41 JENENG WATAKIA 10 03 38 15 UMUM DUMAN
42 BQ.NALA 8 BL 03 36 98 BANSOS DS.TERENG
43 MELI 9 BL 03 14 43 UMUM SURANADI UTARA
44 NAZMIN 11 BL 03 38 10 UMUM SURANADI
45 IBRAHIM AZRAGI 1 03 38 49 UMUM SINTUNG
46 NASERAH 41 03 38 50 UMUM MURPEJI
47 SURYA EDI 49 01 80 04 UMUM PRESAK SELATAN
48 NAZIR ILHAM 25 03 38 87 UMUM PONDOK BUAK
49 AHMAD NIZAR 1 032 93 74 UMUM SEMBUNG BARAT
50 SINTIA LESTARI 2 03 38 92 UMUM PRESAK TIMUR
51 ADIPA DANIA KANZA 1 02 51 79 UMUM TN.BEAK DASAN
52 DIO ALFATAN 1 03 39 18 UMUM MURBAYE GAWAH
53 ASTIAH 84 033905 BPJS TANAK TEPONG
54 IQ. RENE 81 018885 UMUM BATU KUMBUNG
55 WASHAMUDIN 44 033771 BPJS DARMASABA DASAN
56 MUSLIMIN 31 033931 BPJS PERESAK
57 ZAINUDIN ZOHRI 48 033997 UMUM DUSUN ONOR LINGSAR
58 MURSAH 56 033942 BPJS TEBAO
59 SARDIANTO 34 033938 UMUM PIDADA PRINGGARATA
60 SALMIAH 44 033957 BPJS TATAR NYURLEMBANG
61 BUDIYANTO 68 033979 BANSOS DUMAN LINGSAR
62 MUHAMMAD RAFIF 5BL 033972 UMUM KARANG DUNTAL GERIMAX
63 H.USMAN 70 034031 UMUM EMBUNG PAS
64 IQ. MUNAAH 80 028536 UMUM JURANG MALANG
65 I NENGAH DWI PUSPA 37 033996 BPJS DUSUN ENDUT
66 BQ. SILFI KAMILA 1 033966 UMUM DUSUN PIDADA
67 RIDHO ARIF RAHMAN 7 034012 UMUM MUHAJIRIN UTARA
68 MASIRAH. IQ 60 032439 UMUM GEGELANG DESE
69 MUHAIMI 23 034068 UMUM GEGELANG DESE
70 KEMUN 59 014341 BPJS TANAK TEPONG
71 NI MADE WIDARI 10 034066 BPJS DUMAN DASAAN
72 NOVIA ISNANI 24 34072 BPJS LONGSERAN BARAT
73 SAKDIAH 63 034096 UMUM PESORONGAN JUKUNG
74 UTAMA ASKANDRIA 53 009654 BPJS MONTONG TANGAR
75 TINARSIH 57 034115 UMUM NYURLEMBANG
76 WARDIMAN 31 034086 BPJS PAOK GADING
77 AMSAH 49 034176 BPJS GEGELANG
78 EZA PRAMUDITA 27 034185 BPJS MEJETI LAUK
79 JALIMAH 72 034133 BPJS JURANG MEKAR
80 NENGAH CENIK 22 034119 UMUM MONTONG LISUNG
81 I NENGAH SELACAR 56 034075 BPJS EAT KANDEL
82 GILANG RAMADAN 15 034192 UMUM MEDUGUL
83 MUKMIN 57 034169 BPJS CEKING
84 M. FARHAN AL KAISI 2 BLN 034125 UMUM MEJETI OTAK DESE
85 SITI ROHIMA ASSYFA 1 023790 UMUM JERANGOAN
86 ZAHRA RIZQINA H 7 034197 BPJS BUG -BUG
87 MURAIS 68 034183 BPJS GEGUTU REBAN
88 AMIRILLAH 30 03 42 66 BPJS MUHAJIRIN
89 ADIBA DEVARA PUTRI 4 BL 03 11 05 BPJS KR.DUNTAL
90 MUSDAH 44 03 42 19 UMUM SELAT TIMUR
91 ARSYADIL SYABANI 9 03 41 87 BPJS SANDONGAN
92 NADIRA MAYSA SOLEHA 1 03 42 45 BPJS NYIUR BAYE GAWAH
DIAGNOSA MASUK KELUAR
KODE JML. HARI
SPESIALIS I II III TGL JAM TGL JAM RAWAT
D DHF GR I 28/3/2020 22.36 1/4/2020 11.45 5

D STT PEBRA KEPALA 28/3/2020 18.09 1/4/2020 5
D DHF GR I 31/3/2020 10.56 2/4/2020 3
D DHF GR I 28/3/2020 11.44 2/4/2020 6
D TB.PARU KASUS BARU 1/4/2020 2.02 2/4/2020 2
D DHF GR I 30/3/2020 17.34 2/4/2020 4
D GUM BLEEDING 31/3/2020 11.03 2/4/2020 3
A DEMAM TYPOID 29/3/2020 12.3 2/4/2020 5
A DHF GR I 30/3/2020 11.45 2/4/2020 4
A DIARE AKUT DEHIDRASI R/S 1/4/2020 11 2/4/2020 2
A DEMAM TYPOID 30/3/2020 10.45 2/4/2020 4
D DEMAM TYPOID 31/3/2020 13.37 3//4/2020 4
D ANEMIA SEDANG 31/3/2020 13.3 3/4/2020 5
B APENDIK KRONIS 31/3/2020 17.57 3/4/2020 4
A DEMAM TYPOID 2/4/2020 17.57 3/4/2020 2
B SNAKE BITE 1/4/2020 21.11 3/4/2020 3
B APENDIK TOMY 31/3/2020 0.5 3/4/2020 4
A ISPA 1/4/2020 18 4/4/2020 4
D DHF GR I 3/4/2020 14.01 6/4/2020 4
D DEMAM TYPOID 4/4/2020 13.39 6/4/2020 3
A DHF GR I 3/4/2020 15.23 6/4/2020 4
A DHF GR I 3/4/2020 9.4 6/4/2020 4
A DEMAM TYPOID 3/4/2020 11.04 6/4/2020 4
D TB.PARU 5/4/2020 10.23 7/4/2020 3
A DEMAM TYPOID 5/4/2020 14.38 7/4/2020 3
A DSS 7/4/2020 13.06 8/4/2020 2
A DEMAM TYPOID 6/4/2020 14.29 8/4/2020 3
A DEMAM TYPOID 6/4/2020 19.29 8/4/2020 3
D DHF GR I 5/4/2020 16.32 10/4/2020 6
B POST LAPORATOMY 8/4/2020 12.14 10/4/2020 3
D GUM BLEEDING 9/4/2020 10.53 11/4/2020 3
D DHF GR I 7/4/2020 11.55 11/4/2020 5
D DHF GR I 10/4/2020 15.16 11/4/2020 2
D ANEMIA BERAT 8/4/2020 21.16 11/4/2020 4
A KDK 4/4/2020 15.53 11/4/2020 8
A DEMAM DENGUE 9/4/2020 10.28 11/4/2020 3
A DHF GR I 8/4/2020 11.35 11/4/2020 4
A DEMAM DENGUE 9/4/2020 17.49 12/4/2020 4
D DHF GR II 9/4/2020 18.04 13/4/2020 5
D PNEUMONIA BERAT 10/4/2020 1.3 13/4/2020 4
D DHF GR II 11/4/2020 11.35 13/4/2020 3
A TYPOID FEVER 11/4/2020 15.54 14/4/2020 4
A PNEUMONIA KOMUNITY 9/4/2020 12.37 14/4/2020 6
A DIARE AKUT DEHIDRASI R/S 13/4/2020 10.16 14/4/2020 2
D TB PARU 12/4/2020 15:34 15/4/2020 3
D SEFSIS 15/4/2020 13:45 15/4/2020
B HIL DEXTRA REPOMBILIS 12/4/2020 19:00 15/4/2020 4
D DHF GR I 13/4/2020 17:00 16/4/2020 4
D DM TIPE II 16/4/2020 18:35 17/4/2020 2
B ABSESPOSONAL 14/4/2020 14:00 17/4/2020 4
D DHF GR II 13/4/2020 22:30 18/4/2020 6
D DHF GR II 14/4/2020 21:00 18/4/2020 5
D 14/4/2020 21:00 18/4/2020 5
D PNEUMONIA BERAT PDP 15/4/2020 13:00 19/4/2020 5
D 18/4/2020 13:00 20/4/2020 3
D CHF FE III CC CAD 17/4/2020 20/4/2020 4
D DHF GR I 16/4/2020 16:00 20/4/2020 5
A PNEOMONI KOMONITAS PDP 15/4/2020 10:30 20/4/2020 6
A DHF 17/4/2020 10:00 20/4/2020 4
D HIPOGLIKEMI 19/4/2020 18:00 21/4/2020 3
D DHF GR I 20/4/2020 13:30 22/4/2020 3
D MILENA ET CAUCA GASTOPATINSAID 19/4/2020 22:00 22/4/2020 4
A DHF 20/4/2020 22/4/2020 3
D DEMAM TIFOID 20/4/2020 13:30 23/4/2020 4
D MILENA ET CAUSA GASTRITIS EVOSVY 21/4/2020 13:00 23/4/2020 3
D DHF GR II 19/4/2020 19:12 23/4/2020 5
D DHF GR I 22/4/2020 12:30 24/4/2020 3
B MASSA /TUMOR SCROTUM 21/4/2020 13:30 24/4/2020 4
D TB PARU 25/4/2020 1:00 26/4/2020 2
B COLITIS 25/4/2020 12:00 26/4/2020 2
B GANGRENDISIASE II PEDIS 23/4/2020 13:00 26/4/2020 4
D DHF GR I 22/4/2020 26/4/2020 5
D DHF GR I 20/4/2020 13:00 26/4/2020 6
D DEMAM TYPOID 25/4/2020 16:00 27/4/2020 3
D DEMAM TYPOID 24/4/2020 16:52 27/4/2020 4
A PDP 23/4/2020 27/4/2020 5
A PDP 26/4/2020 23:00 27/4/2020 2
A TYPOID FEVER 25/4/2020 1:25 28/4/2020 4
D TB PARU 27/4/2020 28/4/2020 2
D DHF GR I 24/4/2020 11:31 29/4/2020 6
A PDP 22/4/2020 3:50 29/4/2020 6
B SNAKE BITE 27/4/2020 13:12 29/4/2020 3
B HEMANGROMA MANDIBULAR 28/4/2020 12:14 30/4/29020 3
A DIARE AKUT DEHIDRASI R/S 28/4/2020 13:55 30/4/2020 3
370
KET
UMUM BPJS LAIN2 SEMBUH RUJUK PP KABUR MENINGGAL DW LW LWK BARU LAMA
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 KOTA
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 RSUP
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 RISA
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 RSUP
1 1
1 1
1 1
1 1
1 1
1 1
1 1
41 42 9 82 4 5 1
UMUR UMUM/ BPJS/ KODE
NO. NAMA PESERTA NO RM BANSOS ALAMAT SPESIALIS
L P
1 MULTAZAM 29 03 42 76 BPJS SIGERONGAN B

2 AHMAD SAGIR 47 03 38 57 UMUM DS.GRIA D
3 ONI SOPIANINGSIH 16 03 42 74 BPJS LEMBAH SEMPAGE D
4 PARDI 23 03 43 17 UMUM KUMBI D
5 MUZAKIR 26 03 42 68 BPJS REPOK PANCOR D
6 AHMAD DISAERI 8 BL 03 42 59 UMUM MANDOK-TN.BEAK A
7 SAMAUL AL GOZI 10 BL 02 86 15 UMUM GEGELANG DESE A
8 MAWARNI 31 03 42 95 UMUM KEBUN SIRIH D
9 RODI ANJAS MARIADI 21 03 43 37 BPJS KEMBANG KUNING D
10 M.REFANDRI SETYA 21 00 63 28 BPJS MONTONG TANGAR D
11 IMANUEL FIKRI 16 03 43 36 BPJS DS.KETAPANG B
12 DESFITA AJWA 2 03 43 69 BPJS DS.TERENG A
13 REMBUNI 49 03 41 71 BPJS PRESAK TIMUR B
14 HJ.RAUDATUL JANNAH 70 03 43 14 BPJS TN.BEAK TIMUR B
15 SUNIMAN 40 03 43 68 UMUM KR.BAYAN B
16 ABDUL SAHID 18 03 43 39 UMUM MEJETI D
17 UNIK 33 03 43 62 BPJS DS.MEJETI D
18 SENI 47 03 44 08 UMUM NYIUR BAYE D
19 AZMI MUMTAZ 5 BL 03 01 65 UMUM TN.BEAK DASAN A
20 NURSIBAH 39 03 41 55 UMUM DUMAN D
21 ASMAUN 41 03 41 54 UMUM DS.GILI GEDE/SEKOTONG D
22 ROSIDI'IN 30 03 41 29 UMUM EMBUNG PAS BARAT D
23 ADELIA FARANISA 10 BL 02 64 14 UMUM TN.BEAK DASAN A
24 ZIRA AYU NINGSIH 28 HR 03 43 72 UMUM KEBON NYIUH A
25 LATIFA ALIVIA FAQIALA 1 02 69 25 UMUM LEMBAH MUNTE A
26 MINARIM 59 03 43 49 BPJS DS.TERENG D
27 BQ.IRNAWATI 27 00 44 51 BPJS MEDAEN D
28 L.ARYA BAYADI 54 03 37 43 UMUM MEDAS-LOTENG D
29 AQ IT 03 44 49 UMUM EMBUNG PAS D
30 MUNASEH 49 03 43 94 BANSOS BEREMBENG BARAT D
31 EZA PARAMUDITA 27 03 41 85 BPJS MEJETI TENGAK B
32 ISKAN JAUHARI 37 034464 UMUM LEMBUAK NARMADA D
33 WARDI 33 034459 BPJS KARANG ANYAR D
34 AZKIYA FARZANA 2 '034459 UMUM LONGSERAN BARAT A
35 HAIKAL FATAN P 1 034390 UMUM BEREMBENG TIMUR A
36 SOFIA ANANDA 1 BLN 034481 UMUM RUMBUK A
37 SAHDI 36 034446 BPJS JURANG MALANG B
38 AHMAD DANU ABADI 1 034495 BPJS MEDAIN BARAT A
39 JIHAN TALITA ULFA 1 034497 BANSOS MAMBALAN A
40 I KETUT WIDAYANA 30 034524 BANSOS AWANG MADYA D
41 NI NENGAH SUKERNI 49 025711 BPJS EAT KANDEL D
42 NAIZAR PADYA RAHMAN 1 034501 BPJS BATU KUTA A
43 RAHADI 42 028732 BPJS TELAGA NGEMBENG DASAN D
44 ALYA AUDIA RAISA 1 034512 BANSOS REPOK ATAS A
45 I GEDE SANARIA 16 034594 BPJS BATU MEKAR D
46 ANISDA PEBRIANA 6 034589 BANSOS BAGIK NUNGGAL A
47 TIRTAWAN 56 034620 UMUM PERABA LINGSAR D
48 NI WAYAN LACUR 39 034591 BPJS MONTONG GALUH D
49 NURMINAH 61 018177 UMUM SESAOT D
50 SUCI HERNAWATI 28 034629 BANSOS REPOK PANCOR D
51 NURUDIN 68 034645 BPJS GEGELANG LAUK B
52 IQ. MIAH 62 000246 BPJS LEMBUAK NARMADA B
DIAGNOSA MASUK KELUAR JML. HARI STATUS BAYAR
I II III TGL JAM TGL JAM RAWAT UMUM
SNAKE BITE 29/4/2020 22.42 2/5/2020 11.45 4

PNEUMONIA COVID 19 9/4/2020 0.55 2/5/2020 1
TB PARU MILIER 29/4/2020 17.43 2/5/2020 14.15 4
INTOKSIKASI PEPTISIDA 2/5/2020 20.37 3/5/2020 2 1
DHF GR I 29/4/2020 12.33 3/5/2020 5
PNEUMONIA BERAT (PDP) 29/4/2020 9.4 3/5/2020 5 1
PNEUMONIA BERAT (PDP) 29/4/2020 9.47 3/5/2020 5 1
BRONKIOLITIS AKUT 1/5/2020 18.25 4/5/2020 11.45 4 1
DHF GR II 4/5/2020 12.25 6/5/2020 3
DHF GR I 3/5/2020 15.41 6/5/2020 4
SNAKE BITE 4/5/2020 11.39 6/5/2020 11.45 3
EPILEPSI 5/5/2020 16.57 6/5/2020 11.45 2
SNAKE BITE 24/4/2020 16.01 6/5/2020 11.45 13
DM.TYPE II 2/5/2020 18.11 6/5/2020 11.45 5
SNAKE BITE 5/5/2020 15.38 7/5/2020 11.45 3 1
DHF GR I 4/5/2020 17.35 7/5/2020 11.45 4 1
DHF GR II 5/5/2020 12.43 8/5/2020 11.45 4
ANEMIA BERAT 7/5/2020 21.02 8/5/2020 2 1
PNEUMONIA KOMUNITY(PDP) 4/5/2020 12.15 8/5/2020 5 1
PNEUMONIA COVID 19 24/4/2020 7.41 8/5/2020 13 1
PNEUMONIA COVID 19 24/4/2020 7.46 8/5/2020 13 1
PNEUMONIA COVID 19 23/4/2020 6.48 8/5/2020 12 1
PNEUMONIA KOMUNITY(PDP) 7/5/2020 11.01 9/5/2020 11.45 3 1
TB.PARU 5/5/2020 8.52 10/5/2020 11.45 6
DHF GR I 6/5/2020 4.34 10/5/2020 11.45 5
PDP COVID 19 5/4/2020 19.38 10/5/2020 1
PPOK 9/5/2020 23.34 11/5/2020 11.45 3 1
DHF GR I 6/5/2020 16.05 11/5/2020 6
APENDIK KRONIS 8/5/2020 19.51 11/5/2020 11.45 4
DHF 13/5/2020 1
DHF GR II 11/5/2020 13/5/2020 3
PDP 10/5/2020 16:10 13/5/2020 4
PDP 9/5/2020 9:47 13/5/2020 5
PDP 11/5/2020 15:56 15/5/2020 5
RUPTUR TENDON ARTIKAS DEXTA 9/5/2020 13:58 14/5/2020 6
PROLOPED FEFER EC TUBERKLOSIS ANAK 12/5/2020 10:54 15/5/2020 4
SPSY 12/5/2020 11:46 15/5/2020 4
DEMAM TYPOID 13/5/2020 15:36 17/5/2020 5
DHF GR I 13/5/2020 21:30 16/5/2020 4
PNEMONIA SEDANG ( PDP ) 12/5/2020 20:41 15/5/2020 4
DEMAM TYPOID 14/5/2020 11;39 18/5/2020 5
PNEMONIA (PDP) 13/5/2020 10:42 19/5/2020 7
DHF GR I 16/5/2020 22:57 19/5/2020 4
DHF 16/5/2020 13:06 19/5/2020 4
DHF GR II 18/5/2020 5:14 20/5/2020 3 1
ANEMIA BERAT 16/5/2020 16:54 21/5/2020 6
GEA EC BAKTREIA DISENTRI 19/5/2020 11:45 21/5/2020 3 1
DHF GR I 18/5/2020 13:58 21/5/2020 4
HERNIA IGUINALIS LATERALIS 19/5/2020 15:38 21`/5/2020 3
ABSES PEDIS 18/5/2020 11:51 21/5/2020 4
20
KET
BPJS LAIN2 SEMBUH RUJUK PP KABUR MENINGGAL DW LW LWK BARU LAMA
1 1
1 1
1
1 1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
1
1
1
1
1
1
1
1 1
1 1
1
1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1 1
1 1
1 1
23 9 46 3 2
UMUR DIAGNOSA
NO. NAMA PESERTA L P NO RM ALAMAT KODE SPI II
1 ZILFAN SAPUTRA 10 01 77 59 BT KUTA A EPILEPSI

2 RIZKIA PUTRI 17 BL 02 69 45 KALI RANGET A PNEMONIA
3 SUMAYA 11 BL 03 49 32 TN BEAK A PNEMONIA
4 SUMARNI 28 03 49 58 DARMASABA D TROMBOSITOPENI
5 RAFKA SATHIR 1 03 49 78 PEMANGKET A FEBRIS ANEMIA
6 MARINUN 65 00 73 61 KALIMANTING D ASMA
7 ALIF QIANDRA A 3 03 49 91 DS TAPEN A FEBRIS
8 H HUSNI FARHAN 5 TH 03 49 93 PEMEPEK D GEA DHF II
9 QORRI FITRI NABILA 11BL 03 49 87 PUNIKAN A ISK
10 RIZKA NANUNG Y 9 03 49 74 LEMBUAK A DHF TF
11 SAINEP NY 50 03 50 08 TN BEAK D VERTIGO
12 ZAIN RADITYA 3 03 50 22 PEMEPEK A PNEMONIA
13 DAFA HIDAYAT 10 03 50 30 MEJETI A PNEMONIA
14 MUHASAN 54 03 50 19 KEMOKEK D SEPSIS
15 SAMSUDIN 49 01 20 13 GN MALANG D DHF
16 M LUKMAN 26 03 48 29 KURIPAN B PNEMOTHORAX
17 I GST KOMANG ALIT 60 01 31 97 PETELUAN INDAH B DM DF
18 M RIDHO RIZKI 9 03 50 21 REPOK B SNAKE BITE
19 KUSNAH 70 03 50 10 TLG NGEMBENG B HERNIA POSTOP
20 RUSNI 51 02 51 42 KBN NYIUH D DISPEPSIA
21 HAIDIR KARMAVI 12 03 49 62 MEDUGUL A DHF
22 YULIANTI 43 01 91 96 BEREMBENG B D CKD
23 NANA SILVIA 2 03 50 66 BT MEKAR A PNEMONIA
24 ALANO DHIA FILARDA 1 02 86 81 PRESAK BARAT A GB ANEMIA
25 USWATUN INDAH 24 03 50 77 PERESAK D DISPEPSIA PANKREATITIS
26 I PUTU TEJA S 22 03 50 88 PENINJAUAN D DHF
27 KAUSARA ALHAMDALA 2 BLN 03 51 64 MERCE A PNEMONIA
28 ZILFAN SAPUTRA 10 01 77 59 BT KUTA A EPILEPSI
29 M ARIF 29 03 51 17 SINTUNG D DHF
30 I KM SUKARSA 29 01 29 88 KALIRANGET D DHF
31 AQ JAMIL 57 03 46 02 SEDAU D CAD
32 NURMAWE 50 03 51 37 MONTONG D TB PARURELAPS
33 RETASIH 68 03 51 05 BT ASA D GEA
34 NI MD BAYU 21 03 51 72 BUWUN SEJATI B SNAKE BITE
35 HARMIAH 49 03 51 63 SESAOT B GANGREN DM
36 EGY ALFAEZA 2 03 51 80 JELATENG A KDK
37 NI WAYAN SANTI 40 03 51 84 PENINJAUAN D DHF
38 JUITA HAKIKI 20 00 00 88 MEKAR SARI B TUMOR M POSTOP
39 AHMAD MALIK 10 BL 03 51 94 GELOGOR A PNEMONIA
40 MURTAWAN 31 03 52 38 AIKNYET B SNAKE BITE
41 I GDE PERANG 62 03 11 73 KB KUNING B HERNIA
42 AHMAD NIZAR 1 02 93 74 SEMBUNG A OF TB
43 MUNARAH 40 03 52 10 BEREMBENG B D PNEMONIA
44 IZZATUL A 28 03 51 99 MIDANG D PP
45 BY IZZATUL A 2HR 03 52 06 MIDANG A BBL
46 NI KADEK LAKSMI 22 03 52 78 PENINJAUAN D DHF
47 YADI EFENDI 29 00 28 35 KR DUNTAL D DHF
48 NY MUADDAH 24 01 94 22 EMBUNG PAS D PP
49 BY NY MUADDAH 3HR 03 52 39 EMBUNG PAS A BBL
50 RIMA YULIA 23 03 45 88 BT KANTAR D SLE SN
51 NI WAYAN SRI 32 02 68 34 LILIR D GEA ANEMI
52 I KT SUKARI 62 03 52 58 MATARAM D PNEMONIA
53 MUHNAN 49 03 57 75 DS GERIA B POST STT
54 AZZAM KHALIF PA 1..5 03 52 93 DUMAN A GEA
55 FAHRI ZAFRAN 3 TH 00 32 34 BTKUTA A RSINOFARIANEMI
56 SARIME 60 03 53 02 DARMASABA D TB PARU ANEMI
57 SADERIM 82 03 08 56 AIKNYET D PNEMONIA
58 M DEVIN MAULANA 2BL 03 42 69 DUMAN A DD
59 GILANG RAMADHAN 8 03 53 47 PRINGGARATA B REFAIR ARTERI
60 ISAH NY 48 03 53 45 GONDANG D DHF
61 KARMIN 50 01 75 93 MEKAR INDAH D PNEMONIA
62 RAISAH 50 00 51 90 KERU D PNEMONIA
63 YULIANI 48 03 28 18 BK PUNIK B DMDF ANEMI
A MASUK KELUAR STATUS BAYAR STATUS KELUAR
SEM RUJU KAB

UMUM BPJS LAIN2 PP
BUH K UR
III TGL JAM TGL JAM JML. HARI R
PDP 2/6/2020 4/6/2020 3 1 1

PDP 2/6/2020 4/6/2020 3 1 1
PDP 3/6/2020 12/6/2020 10 1 1
6/6/2020 8/6/2020 1 1
PDP 6/6/2020 9/6/2020 1 1
6/6/2020 9/6/2020 1 1
PDP 6/6/2020 12/6/2020 1 1
7/6/2020 11/6/2020 1 1
7/6/2020 10/6/2020 1 1
6/6/2020 9/6/2020 1 1
PDP 8/6/2020 11/6/2020 1 1
PDP 8/6/2020 12/6/2020 1 1
PDP 9/6/2020 12/6/2020 1 1
8/6/2020 12/6/2020 1 1
9/6/2020 13/6/2020 1 1
PDP 2/6/2020 3/6/2020 1 1
8/6/2020 17/6/2020 1
8/6/2020 10/6/2020 1 1
9/6/2020 11/6/2020 1 1
8/6/2020 9/6/2020 1 1
10/6/2020 11/6/2020 1 1
11/6/2020 10/6/2020 1 1
PDP 11/6/2020 9/6/2020 1 1
11/6/2020 12/6/2020 1 1
PANKREATITIS 12/6/2020 16/6/2020 1 1
12/6/2020 15/6/2020 1 1
PDP 13/6/2020 19/6/2020 1 1
12/6/2020 13/6/2020 1 1
14/6/2020 16/6/2020 1 1
15/6/2020 18/6/2020 1 1
PDP 15/6/2020 16/6/2020 1 1
16/2020 17/6/2020 1 1
16/6/2020 19/6/2020 1 1
17/6/2020 19/6/2020 1 1
17/6/2020 22/6/2020 1 1
PDP 18/6/2020 22/6/2020 1 1
18/8/2020 22/6/2020 1 1
19/6/2020 21/6/2020 1 1
PDP 19/6/2020 22/6/2020 1 1
21/6/2020 27/6/2020 1 1
21/6/2020 22/6/2020 1 1
PDP 21/6/2020 26/6/2020 1 1
PDP 22/6/2020 23/6/2020 1 1
PDP 21/6/2020 22/6/2020 1 1
21/6/2020 22/6/2020 1 1
23/6/2020 26/6/2020 1 1
23/6/2020 25/6/2020 1 1
PDP 23/6/2020 24/6/2020 1 1
23/6/2020 24/6/2020 1 1
HIPOALBUMI 23/6/2020 27/6/2020 1 1
DMT2 23/6/2020 25/6/2020 1 1
PDP 24/6/2020 25/6/2020 1 1
23/2020 25/6/2020 1 1
PDP 24/6/2020 27/6/2020 1
24/6/2020 26/6/2020 1 1
25/6/2020 27/6/2020 1 1
PDP 26/6/2020 27/6/2020 1 1
26/6/2020 27/6/2020 1 1
27/6/2020 30/6/2020 1 1
27/6/2020 30/6/2020 1 1
PDP 26/6/2020 30/6/2020 1 1
PDP 29/6/2020 30/6/2020 1 1
SEPSIS 29/6/2020 30/6/2020 1 1
16 15 25 23 57 1 3 0
STATUS KELUAR KLS SPESIALIS KATE
MENI KET
PINDAH
RUANGAN
NGGA 2 1 VIP titipan kls DALAM ANAK OBGYN BEDAH 0-6 hr 7-28 hr28 hr - <1 th
L kls 3
3
KELAS L P L P L P L P L P L P L
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1 0 63 0 0 0 0 16 12 15 8 0 0 7 4 0 0 0 0 2 2
KATEGORI UMUR
28 hr - <1 th1-4 th 5-14 th 15-24 th 25-44 th 45-64 th ≥65 th
P L P L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3 8 3 4 2 2 4 6 7 9 5 5 1
UMUR DIAGNOSA
UMUM/
KODE
NO. NAMA PESERTA NO RM BPJS/ ALAMAT SPESIALIS
P BANSOS I
L
1 MERTASARI 38 03 53 77 BANSOS SEDAU D DHF

2 RAISAH 50 00 51 90 BPJS KERU B POST.STT
3 SUKIRNO 40 03 53 60 BPJS LD.BAJUR D PNEUMONIA
4 TAZIDAN 11 03 53 98 BPJS LANGKO A DF/KALITIS
5 SAINUN 70 03 54 15 UMUM KERAMAT JAYA D HT EMERJENSI
6 REZA GUSRI FADLAN 11 03 54 18 UMUM KALIMANTING A PANTOSITOPENIA
7 DARSIAH 62 03 54 33 BPJS MEDAS B POST.HEMOROID
8 CITRA HENDRI 5 02 32 21 UMUM BERTAIS A TF
9 ZULAIKA AKIFA 6 03 54 30 BPJS TELAGE WARU A TF
10 I GSTI NGURAH BPJS PEMENGKET D
11 YULIANA 25 03 54 05 UMUM MENDUGUL D DHF
12 REZI IDWANDA 10 03 54 91 BPJS SANDONGAN A kdk
13 ROHAINI 61 03 50 48 UMUM KERU D anemia sedang
14 SUMIATI 49 01 07 69 BPJS TN.BEAK D PDP PNEUMONIA
15 MINAH 70 03 55 22 BPJS LEKONG DENDEK D anemia sedang
16 SARIDAH 55 02 00 61 BPJS DARMA SABA D HDHF POST.HHD
17 NOVIA ISNAINI 24 03 40 72 BPJS LONGSERAN B POST.PARTU
18 RIMA YULIANI GUSTI 22 03 45 88 BPJS BT.KANTAR D SYOK SEPSIS
19 YUNARDI 24 03 54 97 UMUM PUNIKAN B ABSES TESTIS
20 ZAENUDIN 45 03 55 59 BPJS PENANGKE B SNAKE BITE
21 M.ADIB ZAFRAN 10 BL 03 55 60 BPJS DS.TRATAK A PNEUMONIA
22 I WAYAN ISME 48 03 55 76 BPJS AWANG MADIA B VULNUS APERTUM
23 ARJUNA 36 03 55 78 UMUM BENJERUK B VULNUS APERTUM
24 MAHMAD TAUFIK 1 03 55 75 UMUM BEREMBENG BARAT A PNEUMONIA
25 M.AZRIL RAFASYA 1 02 61 42 UMUM GONTORAN A PNEUMONIA
26 APRIL RENATA 6 03 55 97 UMUM MURBAYA A DENGUE FEVER
27 AKAM MAULANA 8 03 56 10 BPJS MONTANG A ABSES COLID EC TB
28 NYOMAN MUSTARA 58 03 56 48 BPJS KEMBANG KUNING D retensio urin
29 HENDARDI IRAWAN 21 03 56 54 BPJS MENDUGUL D DHF
30 AHMAD RAMLI 17 03 56 14 BPJS ORONG UTARA D eksisi tumor
31 RISKI YUNITA 17 03 56 72 BPJS PEMUNUT D
32 M.AFIFUDIN 25 03 56 87 UMUM GONTORAN TIMUR B SNAKE BITE
33 NURSIMAH 58 03 56 61 UMUM KR.SIDEMEN D SUSPEC PNEUMONIA
34 I NYOMAN NATAH 18 03 57 38 BPJS PEMANGKALAN B SNAKE BITE
35 IDA BAGUS ADITYA 3 02 18 66 UMUM PENINJOAN A KEJANG DEMAM KOMPLEK
36 MURSIDI 56 01 98 55 BPJS BANGKET PUNIK D anemia sedang
37 SHAFA SALSABILA PUTRI 3 02 13 56 BPJS LINGSAR TIMUR A KDK
38 SATIMAH 59 00 97 10 BPJS TEMAS D SUSPEC PNEUMONIA
39 ZAYLAN ZAKIR KHAFADI 2BL 03 44 50 BPJS MEJETI DAYE A GIZI BURUK TYPE MARASM
40 NI WAYAN SUWATI 46 00 78 40 BPJS PEMUNUT B SNAKE BITE
41 REGINA PUTRI ADABI 1 03 58 32 UMUM TN.BEAK A DIARE AKUT DEHIDRASI
42 SAHDAN 60 03 58 28 UMUM SELAKAN B SNAKE BITE
43 EVA SELVIA 1BL 03 55 21 BPJS GONTORAN DAYE A GIZI BURUK TYPE MARASM
44 RIZKI YUNITA 17 03 56 72 BPJS PEMUNUT D HEMATOEP ET CAUSA TB M
45 SINTA ROSALINA 22 03 58 68 UMUM TANAK BEAK D DISPESIA
46 FITRIA HARIANTI 29 03 58 78 UMUM MUHAJIRIN SELATAN D POST PARTU
47 NARINAH 52 03 58 73 BPJS SIDE KARYA B EKSISI TUMOR
48 OLIVIA RAMADANI 10 00 15 93 UMUM MEJELI PERTELUAN A SINDROM NEPROTIK
49 MIKAILA AISYANI 4 03 59 01 UMUM SEDAU A ISK
50 SAHWAN MAULIDI 15 03 58 87 BPJS MERCE TIMUR B APENDIK AKUT
51 BIDAYA SAKIYA MUSIDA 1 03 59 13 UMUM BT.KUTA A EPILEPSI
52 SALAM BUDIATMO 53 00 81 74 BPJS LEMBUAK MEKAR D EFUSI FLEURA SINISTRA
DIAGNOSA MASUK KELUAR STATUS BAYAR STATUS KELUAR
JML. HARI
RAWAT SEMBU RUJ KABU
II III TGL JAM TGL JAM UMUM BPJS LAIN2 PP
H UK R
29/6/2020 1/7/2020 3 1 1
29/6/2020 1/7/2020 3 1 1
PNEUMONIA PDP 28/6/2020 2/7/2020 5 1 1
DF/KALITIS 30/6/2020 4/7/2020 5 1 1
HT EMERJENSI 1/7/2020 2/7/2020 2 1 1
PANTOSITOPENIA 1/7/2020 2/7/2020 1 2 1
POST.HEMOROID 2/7/2020 4/7/2020 3 1 1
2/7/2020 6/7/2020 5 1 1
2/7/2020 7/7/2020 6 1 1
PDP 2/7/2020 4/7/2020 3 1 1
4/7/2020 7/7/2020 4 1 1
PDP 5/7/2020 13/7/2020 9 1
anemia sedang 7/7/2020 10/7/2020 4 1 1
PDP PNEUMONIA PDP 7/7/2020 19/7/2020 13 1 1
anemia sedang 7/7/2020 10/7/2020 4 1 1
HDHF POST.HHD PDP 7/7/2020 10/7/2020 4 1 1
POST.PARTU PDP 7/7/2020 10/7/2020 4 1 1
SYOK SEPSIS 8/7/2020 9/7/2020 2 1 1
ABSES TESTIS 8/7/2020 10/7/2020 3 1 1
SNAKE BITE 9/7/2020 10/7/2020 2 1 1
PNEUMONIA PDP 9/7/2020 13/7/2020 5 1 1
VULNUS APERTUM 10/7/2020 11/7/2020 2 1 1
VULNUS APERTUM 10/7/2020 12/7/2020 3 1 1
PNEUMONIA PDP 10/7/2020 15/7/2020 1 1
PNEUMONIA PDP 10/7/2020 15/7/2020 6 1 1
DENGUE FEVER 12/7/2020 15/7/2020 4 1 1
ABSES COLID EC TB 13/7/2020 18/7/2020 6 1 1
retensio urin 14/7/2020 16/7/2020 3 1 1
14/7/2020 16/7/2020 3 1 1 1
eksisi tumor 14/7/2020 16/7/2020 3 1 1
15/7/2020 17/7/2020 3 1 1
SNAKE BITE 16/7/2020 20/7/2020 5 1 1
SUSPEC PNEUMONIA PDP 17/7/2020 22/7/2020 6 1 1
SNAKE BITE 20/7/2020 22/7/2020 3 1 1
KEJANG DEMAM KOMPLEK 20/7/2020 21/7/2020 2 1 1
anemia sedang 21/7/2020 24/7/2020 4 1 1
22/7/2020 24/7/2020 3 1 1
SUSPEC PNEUMONIA PDP 23/7/2020 28/7/2020 6 1 1
GIZI BURUK TYPE MARASMU 23/7/2020 25/7/2020 3 1 1
SNAKE BITE 23/7/2020 23/7/2020 1 1 1
DIARE AKUT DEHIDRASI 24/7/2020 28/7/2020 5 1 1
SNAKE BITE 24/7/2020 25/7/2020 2 1 1
GIZI BURUK TYPE MARASMU 25/7/2020 27/7/2020 3 1 1
HEMATOEP ET CAUSA TB MILER 25/7/2020 28/7/2020 4 1 1
26/7/2020 28/7/2020 3 1 1
POST PARTU PDP 27/7/2020 2/8/2020 7 1 1
EKSISI TUMOR 28/7/2020 29/7/2020 2 1 1
SINDROM NEPROTIK 28/7/2020 29/7/2020 2 1 1
28/7/2020 1/8/2020 5 1 1
APENDIK AKUT 29/7/2020 29/7/2020 1 1 1
29/7/2020 1/8/2020 4 1 1
EFUSI FLEURA SINISTRA 31/7/2020 31/8/2020 1 1 1
196 21 31 1 43 4 3
STATUS KELUAR KLS SPESIALIS KAT
PINDAH MENIN KET

RUANGAN GGAL
2 1 VIP titipan DALAM ANAK OBGYN BEDAH 0-6 hr 7-2828
hr hr - <1 th
kls 3
kls 3
KELAS L P L P L P L P L P L P L
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 irna c 1 1
1 1
1 1
1 1
1 1
1 1
RSUP 1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
rsup 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
RS.UNRAM 1 1
1 1
RS.KOTA 1 1
1 1 52 12 9 13 5 0 12 1 2
KATEGORI UMUR
28 hr - <1 th
1-4 th 5-14 th15-24 th25-44 th 45-64 th ≥65 th
P L P L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 4 3 4 4 4 5 4 3 10 3 2 1
UMUR DIAGNO
UMUM/ BPJS/ KODE

NO. NAMA PESERTA NO RM BANSOS ALAMAT SPESIAL
P IS I
1 ALPIAN 17 03 59 42 UMUM KERU B CKR

2 ANTON SUPRIADI 37 03 45 76 BPJS LEKONG DENDEK D ABDOMINAL PAIN
3 MASTUM D PNEMONIA
4 HJ.SUSILAWATI D SUSP.COVID
5 H,USMAN MUHDAR 71 00 46 59 UMUM SINTUNG TIMUR b ULKUS PEDIS
6 NI KETUT SUDIARTI 61 01 44 61 BPJS KB.KUNING D GEA DEHIDRASI BERAT
7 NI KETUT SUDIARTI 61 01 44 61 BPJS KB.KUNING D GEA DEHIDRASI BERAT
8 YUNI HERAWATI 25 03 60 19 BPJS BT.RIMPANG D ASMA BRONCIALE
9 JOKO WIYONO 56 D PNEMONIA
10 ATIAH 54 30474 UMUM PESORONGAN D ABDOMINAL PAIN
11 H.HARIS MUNANDAR D PNEMONIA
12 AQ.HUSNI 60 03 59 84 UMUM DS.GERORONG D GAGAL NAPAS +PNEUMONIA
13 NURSANI 33 02 20 19 UMUM SISIK D DISPEPSIA
14 AQ.SEDAH 63 03 60 27 UMUM REPOK TEMAS D ANEMIA BERAT
15 SARSO 63 03 59 65 BPJS TANAK TEPONG D ASMA BRONCIALE
16 IDA BAGUS KETUT BAYU 12 00 45 69 BPJS PENIJOAN A FROVUS VOMITING
17 MEDINA ZAHRA RATIFA 1 03 60 83 BPJS DUMAN DASAN A PNEMONIA
18 RINDI PUTRI 17 03 16 00 BPJS SESAOT B HEMATOCHEZIA
19 L.ABDUL FATHIB AL TORIK 10 03 61 60 BPJS TL.NGEMBENG B
20 LUIRTE 59 01 82 66 BPJS PENGONONG D ANEMIA BERAT
21 HENDRA IRAWAN 27 02 29 72 BPJS MONTOR D GASTRISTIS
22 I MDE.AGUS BUDIARTA 20 03 61 66 BPJS KUANG MAYUNG D DHF
23 M.ARKAM 32 03 61 73 BPJS DS.RASABOU B APENDIK AKUT DG ABSES
24 DODI RAHMAN 20 03 61 83 BPJS KR.SIDEMEN D fistula ani
25 SAOLIATI 25 03 61 44 UMUM OMBE DESE D GAGAL NAPAS +PNEUMONIA
26 HJ.HALIMATUS SAKDIAH 58 03 61 45 BPJS SEDAYU SELATAN D PNEMONIA
27 RABIAH 56 0362 22 BPJS DS.IRENG DAYE D ANEMIA BERAT
28 HASAN 62 02 64 87 BPJS TEBAO B DM TYPE II
29 ANDI ZULFIAN HAMRAT 28 03 62 62 UMUM BT.KUMBUNG B SNAKE BITE
30 AZIRA FITRIANA 8 01 36 19 BPJS LEMBUAK KEBON A ASMA INTERMITEN
31 KARINA LESTARI 18 03 62 85 UMUM TIBU PILING D DEMAM TYPOID
32 RISMAYANTI 24 03 62 83 BPJS MEJELI PERMAI D
JML.
HARI
II III TGL JAM TGL JAM RAWAT UMUM BPJS LAIN2
1/8/2020 01,37 2/8/2020 2 1

ABDOMINAL PAIN 4/8/2020 7/8/2020 4 1
PNEMONIA 4/8/2020 5/8/2020 2
SUSP.COVID 4/8/2020 5/8/2020 2
ULKUS PEDIS 5/8/2020 8/8/2020 4 1
GEA DEHIDRASI BERAT 7/8/2020 10/8/2020 4 1
GEA DEHIDRASI BERAT 7/8/2020 10/8/2020 4 1
ASMA BRONCIALE 7/8/2020 10/8/2020 4 1
PNEMONIA 9/8/2020 10/8/2020 2
ABDOMINAL PAIN 10/8/2020 11/8/2020 2 1
PNEMONIA 11/8/2020 12/8/2020 2
GAGAL NAPAS +PNEUMONIA BERAT PDP 12/8/2020 14/8/2020 3 1
13/8/2020 15/8/2020 3 1
ANEMIA BERAT 13/8/2020 14/8/2020 2 1
ASMA BRONCIALE 13/8/2020 14/8/2020 2 1
FROVUS VOMITING 14/8/2020 17/8/2020 4 1
PNEMONIA PDP 14/8/2020 18/8/2020 5 1
HEMATOCHEZIA 20/8/2020 27/8/2020 8 1
22/8/2020 1/9/2020 11 1
ANEMIA BERAT 22/8/2020 25/8/2020 4 1
GASTRISTIS 23/8/2020 25/8/2020 3 1
23/8/2020 28/8/2020 6 1
APENDIK AKUT DG ABSES 24/8/2020 27/8/2020 4 1
24/8/2020 31/8/2020 7 1
GAGAL NAPAS +PNEUMONIA BERAT PDP 25/8/2020 26/8/2020 5.3 2 1
PNEMONIA pdp 25/8/2020 26/8/2020 2 1
ANEMIA BERAT 26/8/2020 30/8/2020 5 1
27/8/2020 30/8/2020 4 1
SNAKE BITE 29/8/2020 1/9/2020 4 1
ASMA INTERMITEN 30/8/2020 1/9/2020 3 1
DEMAM TYPOID 31/8/2020 3/9/2020 4 1
31/8/2020 3/9/2020 1
STATUS KELUAR KLS SPESIALIS KATEGORI UM
PIND
AH MENI KET
SEMBU RUJ PP KAB RUA NGGA
H UK UR 2 1 VIP
titipan kls DALAM ANAK OBGYN BEDAH 0-6 hr 7-2828
hr hr - <1 th
NGA L kls 3
N 3
KELAS L P L P L P L P L P L P L P
1 1 1 1
1 1 IRNA.B
1 1 IRNA.B
1 1 1
1 1 1 1
1 1 1
1 1 1
1 1 1
1 1 IRNA.B 1
1 1 1
1 1 IRNA.B
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
KATEGORI UMUR
1-4 th5-14 th
15-24 25-44
th 45-64
th th≥65 th
L P L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
UMUR UMUM/ KODE
DIAGNOSA
NO. NAMA PESERTA NO RM BPJS/ ALAMAT SPESIAL
P BANSOS IS I
L
1 ASIHIPA ALINARROHMAN 2 03 62 63 BPJS TANAK BEAK A PNEUMONIA

2 MISTARAH 52 03 55 62 UMUM SESAOT LAUQ D ILIUS OBTRUKSI
3 MINCI 70 03 62 74 BPJS PUNIKAN SELATAN D ASMA BRONCIALE
4 ADIBA KHAMILA 1 03 63 68 BPJS MEDAIN BARAT A KEJANG DEMAM SEDERHAN
5 MAHRUP 53 03 63 41 BPJS LINGSAR BARAT D PNEUMONIA
6 QORI ADIBA SALSABILA 1 03 64 22 UMUM DS.KETAPAN A DIARE AKUT DEHIDRASI RIN
7 I NENGAH ARYAN 1 03 64 17 UMUM GONDAWARI A DIARE AKUT DEHIDRASI RIN
8 DASWITA LARAS SANTINI 7 02 67 19 BPJS KR.ANYAR A febris h-6 ec typoid fever
9 MANSUR 40 03 64 35 UMUM PELANGAN B post debridemen
10 MANDRE 60 03 64 38 BPJS LINGSAR D HT EMERJENSI
11 IRFAN AHADI 26 03 64 56 UMUM DS.GRIA D CRONIC LIVER
12 MARIANI 33 03 64 76 BPJS KALI ANGET D KERACUNAN MAKANAN
13 SUKINE 50 03 64 78 UMUM KALI ANGET D KERACUNAN MAKANAN
14 SUARMAN 35 03 64 77 BPJS KALI ANGET D KERACUNAN MAKANAN
15 WAHYUDA SANJAYA 10 03 64 74 BPJS KALI ANGET A KERACUNAN MAKANAN
16 SUARNI 52 03 64 75 BPJS KALI ANGET D KERACUNAN MAKANAN
17 HALIMAKTUS SAKDIAH 21 03 64 79 BPJS KALI ANGET D KERACUNAN MAKANAN
18 RAFKA SATHIR RAMADHAN 1 03 4978 BPJS PEMANGKET A DIARE AKUT DEHIDRASI R/S
19 INDRA SUKMAYADI 25 03 65 08 BPJS SABA LENDANG B stt pedis dekstra
20 NASOHA 40 03 65 05 BPJS LEMBAH SEMPAGE B paronikia +abses
21 BUNGA NAZLINA HANA 2 02 14 47 UMUM DS.TERENG A diare akut dehidrasi r/s
22 BUDIONO 35 03 65 42 BPJS PEMEPEK B combustin orad II
23 HAHESA FEBIAN 6BL 03 65 53 UMUM KR.ANYAR A GEA
24 MAHIDI 80 03 62 61 BPJS BANGKET PUNIK B SUSP.SQUA MUAS CEELL
25 ALIKA NUR AZKIA 8 03 66 03 BPJS PENGONONG A FANSAMINITIS BERAT
26 HAFIYAH SYAKIRA 5 BL 03 51 62 UMUM JERANGOAN A DIARE AKUT DEHIDRASI R/S
27 ADAM FIRDAUSI 1 03 06 65 UMUM LINGSAR BARAT A DIARE AKUT DEHIDRASI R/S
28 SALMIAH 60 03 61 44 BANSOS KUMBI B SNAKE BITE
29 NI NYOMAN ASTUTI 68 03 66 34 BPJS SURANADI D GASTROPATI DIABETES
30 FATIR AL WIRA 11 BL 03 09 17 UMUM KR.ANYAR A DIARE AKUT DEHIDRASI R/S
31 I GD RADITIYA 17 03 66 48 UMUM BUWUN SEJATI B SNAKE BITE
32 I NYOMAN SULASTRA 24 03 67 14 BPJS PEMUNUT D DHF
33 INDAH RISNA AYUK 16 00 14 06 BPJS MERCE TIMUR D adhf
34 REMI 69 03 67 28 BPJS DS.TERENG D adhf
35 M.ARZAN 1 03 67 31 BPJS KR.TEMU A diare akut dehidrasi r/s
36 NILUH PUTRI 2 BL 03 66 87 UMUM NDUT A BRONKIOLITIS
DIAGNOSA MASUK KELUAR STATUS BAYAR STATUS KELUAR
JML.
HARI KAB
II III TGL JAM TGL JAM RAWAT UMUM BPJS LAIN2 SEMBUH RUJUK PP UR
PNEUMONIA 1/9/2020 2/9/2020 2 1 1

ILIUS OBTRUKSI 1/9/2020 1/9/2020 1 1 1
ASMA BRONCIALE 2/9/2020 2/9/2020 1 1 1
KEJANG DEMAM SEDERHANA 5/9/2020 7/9/2020 3 1 1
PNEUMONIA 8/9/2020 14/9/2020 7 1 1
DIARE AKUT DEHIDRASI RINGAN 9/9/2020 11/9/2020 3 1 1
DIARE AKUT DEHIDRASI RINGAN 9/9/2020 11/9/2020 3 1 1
febris h-6 ec typoid fever 10/9/2020 13/9/2020 4 1 1
post debridemen 10/9/2020 13/9/2020 4 1 1
HT EMERJENSI 11/9/2020 11/9/2020 1 1 1
CRONIC LIVER 11/9/2020 14/9/2020 4 1 1
KERACUNAN MAKANAN 13/9/2020 14/9/2020 11.45 2 1 1
KERACUNAN MAKANAN 13/9/2020 17.36 15/9/2020 3 1 1
DIARE AKUT DEHIDRASI R/S 15/9/2020 19/9/2020 5 1 1
stt pedis dekstra 15/9/2020 17/9/2020 3 1 1
paronikia +abses 15/9/2020 17/9/2020 3 1 1
diare akut dehidrasi r/s 15/9/2020 17/9/2020 3 1 1
combustin orad II 17/9/2020 21/9/2020 5 1 1
19/9/2020 20/9/2020 11.45 2 1 1
SUSP.SQUA MUAS CEELL 21/9/2020 24/9/2020 4 1 1
FANSAMINITIS BERAT 21/9/2020 28/9/2020 8 1 1
SNAKE BITE 24/9/2020 28/9/2020 5 1 1
GASTROPATI DIABETES 24/9/2020 27/9/2020 4 1 1
DIARE AKUT DEHIDRASI R/S 24/9/2020 26/9/2020 11.45 3 1 1
SNAKE BITE 25/9/2020 26/9/2020 2 1 1
28/9/2020 30/9/2020 11.45 3 1 1
28/9/2020 2/10/2020 11.45 5 1 1
29/9/2020 2/10/2020 11.45 4 1 1
diare akut dehidrasi r/s 29/9/2020 2/10/2020 11.45 4 1 1
BRONKIOLITIS 30/9/2020 1/10/2020 10.45 2 1 1
13 22 1 24 1 11
ATUS KELUAR KLS SPESIALIS KATEGORI UMUR
PIND
AH MENI KET
RUA NGG 2 1 VIP titipan DALAM ANAK OBGYN BEDAH 0-6 hr 7-28 hr28 hr - <1 th1-4 th
NGA AL kls 3 kls 3
N
KELAS L P L P L P L P L P L P L P L P
PDP 1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1
1 1
RSUP 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1 1
PDP 1 IR.C 1 1
36 6 8 6 9 6 1 2 2 3 5
KATEGORI UMUR
5-14 th15-24 th25-44 th45-64 th ≥65 th

L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 2 1 3 6 1 3 3 2 2
UMUR
UMUM/ KODE
NO. NAMA PESERTA NO RM BPJS/ ALAMAT SPESIAL
P BANSOS IS
FATIMAH SHAKILA 5 00 20 49 BPJS TELAGE NGEMBENG A

HJ.ROHANAH 64 03 56 78 BPJS SEDAYU TENGAH D
WARIAH 45 03 67 91 BPJS KARNANG MAS D
RUSNI 46 03 67 97 UMUM TN.BEAK B
WAHYUNI 60 02 50 02 BPJS ENDUT D
SURIADI 65 03 68 76 BPJS KERU D
SETYA JUNI 3 03 68 76 UMUM BT.KANTAR A
SAKNAH 64 00 51 97 BPJS BUWUN SEJATI D
M.BILAL ALGIFARI 1 BL 03 69 18 UMUM BT.KANTAR A
JML. HARI
I II III TGL JAM TGL JAM RAWAT UMUM
MALARIA 1/10/2020 22.1 5/10/2020 11 5

anemia sedang 1/10/2020 21.34 3/10/2020 11.45 3
2/10/2020 23.19 3/10/2020 11.45 2
ANEMIA BERAT 3/10/2020 10.23 7/10/2020 16.45 5
SNAKE BITE 3/10/2020 11.4 5/10/2020 11.45 3
STT.COLLI 6/10/2020 11.45 8/10/2020 11.45 3
OBS.SAIZARE 7/10/2020 11.14 8/10/2020 14.35 2 1
9/10/2020 21.11
SEPSIS 9/10/2010 10/10/2020 14.3 2 1
STATUS BAYAR STATUS KELUAR KLS SPESIALIS
LAIN2 SEM RUJU PP KABU PINDAH

RUANGA MENIN
KET
BPJS
BUH K R GGAL
2 1 VIP DALAM ANAK OBGYN BEDAH 0-6 hr
N kls 3 titipan
kls 3
KELAS L P L P L P L P L P
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1
1 1 1
1 1 1
KATEGORI UMUR
7-28 hr 28 hr - <1 th 1-4 th 5-14 th 15-24 th 25-44 th 45-64 th ≥65 th
L P L P L P L P L P L P L P L P
1
1
1
1
1
1
1
1
1

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UMUR

1 SAYID ALBIAN HIDAYAH 11 BL 02 27 70 BPJS TEBAO

A PNEUMONIA BERAT 18/1/2020 7.04 24/1/2020 11.45

1 HISBULLAH 18 03 18 18 UMUM SEMBUNG TIMUR D

DHF GR II 27/2/2020 11.14 1/2/2020 11.45 6 1

1 MUTHIANI 17 03 26 60 BPJS KR.BAYAN

D DHF GR I 28/2/2020 11.53 1/3/2020 11.45 3

1 JUMHURI AZHAR 30 03 35 43 BPJS BERTAIS

D DHF GR I 28/3/2020 22.36 1/4/2020 11.45 5

1 MULTAZAM 29 03 42 76 BPJS SIGERONGAN B

SNAKE BITE 29/4/2020 22.42 2/5/2020 11.45 4

NO. NAMA PESERTA L P NO RM ALAMAT KODE SPI II

1 ZILFAN SAPUTRA 10 01 77 59 BT KUTA A EPILEPSI

SEM RUJU KAB

PDP 2/6/2020 4/6/2020 3 1 1

28 hr - <1 th1-4 th 5-14 th 15-24 th 25-44 th 45-64 th ≥65 th

1 MERTASARI 38 03 53 77 BANSOS SEDAU D DHF

PINDAH MENIN KET

UMUM/ BPJS/ KODE

1 ALPIAN 17 03 59 42 UMUM KERU B CKR

1/8/2020 01,37 2/8/2020 2 1

1 ASIHIPA ALINARROHMAN 2 03 62 63 BPJS TANAK BEAK A PNEUMONIA

PNEUMONIA 1/9/2020 2/9/2020 2 1 1

5-14 th15-24 th25-44 th45-64 th ≥65 th

FATIMAH SHAKILA 5 00 20 49 BPJS TELAGE NGEMBENG A

MALARIA 1/10/2020 22.1 5/10/2020 11 5

LAIN2 SEM RUJU PP KABU PINDAH

7-28 hr 28 hr - <1 th 1-4 th 5-14 th 15-24 th 25-44 th 45-64 th ≥65 th

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