TANGGAL TANGGAL JENIS

NO NO KUNJUNGAN PELAYANAN ENTRI NO KARTU NAMA PESERTA KELAMIN

150301010623P000 12-06-2023
2 112 06-12-2023 08:40 0000051338946 SUMIARTI P

3 150301010623P000 06-12-2023 12-06-2023 0000051373888 SURIADI L

124 10:18

5 150301010623P000 06-12-2023 12-06-2023 0000051444033 SUMARNI P

126 10:32
6 150301010623P000 06-12-2023 12-06-2023 0000051523547 JALINA. MS P
131 11:07

7 150301010623P000 06-12-2023 12-06-2023 0000051578864 DJUMIADI L

111 08:38
8 150301010623P000 06-12-2023 12-06-2023 0000195449409 RIFQIL FAYZAN ANIFI L
133 12:30

11 150301010623P000 06-12-2023 12-06-2023 0001870923352 EDI MUSTARI L

110 08:21
12 150301010623P000 06-12-2023 12-06-2023 0001882124932 NURSIKIN P
115 08:50

13 150301010623P000 06-12-2023 12-06-2023 0001889684695 jennilyn P

114 08:46
14 150301010623P000 06-12-2023 12-06-2023 0002053928553 nuraini P
122 09:56

15 150301010623P000 06-12-2023 12-06-2023 0002056805087 ZULEICA PUTRI SUPRIADI P

132 11:10

16 150301010623P000 06-12-2023 12-06-2023 0002270722072 NUR ASVINAWATI P

113 08:43

17 150301010623P000 06-12-2023 12-06-2023 0002274250443 TETY MARYATI P

117 08:59

150301010623P000 12-06-2023
18 129 06-12-2023 10:57 0002286870928 DIAH KURNIATI P

19 150301010623P000 06-12-2023 12-06-2023 0002287588173 PATRICIUS JULIANO L

120 09:29 JEHAMBUR
20 150301010623P000 06-12-2023 12-06-2023 0002310368073 VITA P
121 09:52
150301010623P000 12-06-2023
21 127 06-12-2023 10:38 0002423018878 sahli L

150301010623P000 12-06-2023
22 118 06-12-2023 09:02 0002679865931 MUSLIMIN L

150301010623P000 12-06-2023 MUHAMMAD MUFLIH ALFATIH

116 08:52
23 06-12-2023 0002753386334 L

25 150301010623P000 06-12-2023 12-06-2023 0003019430046 RISFA TSHANIA P

125 10:25
150301010623P000 12-06-2023 KRESNA RAHARDIAN
26 128 06-12-2023 10:49 0003306765284 ALFARISQI L

27 150301010623P000 06-10-2023 10-06-2023 0000168183819 WIWIN P

105 08:27
28 150301010623P000 06-10-2023 10-06-2023 0001260998425 JAHUDDIN L
109 09:47
31 150301010623P000 06-09-2023 09-06-2023 0000051372066 RUSLI L
098 10:10
32 150301010623P000 06-09-2023 09-06-2023 0000051448094 ZULPIAN L
096 10:04
35 150301010623P000 06-09-2023 09-06-2023 0000873893373 CICA JUMIATI P
091 08:46
36 150301010623P000 06-09-2023 09-06-2023 0001262991082 SUDARMAN MASNI L
088 08:35
37 150301010623P000 06-09-2023 09-06-2023 0002050400643 HAFIZI FAUZI L
090 08:44
150301010623P000 09-06-2023
38 092 06-09-2023 08:52 0002057167089 DIANA P

39 150301010623P000 06-09-2023 09-06-2023 0002204322265 PUTRI DANITA P

089 08:37
150301010623P000 09-06-2023
40 097 06-09-2023 10:06 0002478005357 SUHARYANI P

41 150301010623P000 06-09-2023 09-06-2023 0002524080846 HADRI L

099 10:31
42 150301010623P000 06-09-2023 09-06-2023 0002524678918 VITA AULIA P
093 08:56
44 150301010623P000 06-09-2023 09-06-2023 0003527396302 SHANUM ALMAHYRA P
100 10:43
45 150301010623P000 06-08-2023 08-06-2023 0000051316143 MUHAMMAD SYUKUR L
073 08:37 TAURAN
46 150301010623P000 06-08-2023 08-06-2023 0000051331353 SUHARDI M NOER L
082 09:45
47 150301010623P000 06-08-2023 08-06-2023 0000051396783 EMILIA P
083 09:48
50 150301010623P000 06-08-2023 08-06-2023 0001229514827 MARDIAH P
080 09:33
52 150301010623P000 06-08-2023 08-06-2023 0001384023521 HERLINA P
074 08:38
53 150301010623P000 06-08-2023 08-06-2023 0001421410566 muhibbah P
071 08:23
54 150301010623P000 06-08-2023 08-06-2023 0001426825258 RUDI HARTONO L
081 09:36

150301010623P000 08-06-2023
077 09:14
55 06-08-2023 0001437903977 IKA DAMAYANTI P

56 150301010623P000 06-08-2023 08-06-2023 0001872800987 HAMIDI L

072 08:27
57 150301010623P000 06-08-2023 08-06-2023 0002103585794 HENDI L
076 09:09
58 150301010623P000 06-08-2023 08-06-2023 0002465737648 RENDI L
084 09:54
59 150301010623P000 06-08-2023 08-06-2023 0002690122656 RUSDI L
075 08:47
60 150301010623P000 06-08-2023 08-06-2023 0002972647517 JUNG KHIAN L
087 10:49
61 150301010623P000 06-08-2023 08-06-2023 0003056210717 SUTONI L
086 10:41
62 150301010623P000 06-07-2023 07-06-2023 0000032099297 MUHAMMAD ILHAM L
068 11:43 WIRATAMA
63 150301010623P000 06-07-2023 07-06-2023 0000049941573 MULYADI L
046 08:40
 150301010623P000 07-06-2023
66 065 06-07-2023 11:02 0000051518621 AZMAN L

67 150301010623P000 06-07-2023 07-06-2023 0000051587469 U. SRI AGUSTINI P

067 11:12
68 150301010623P000 06-07-2023 07-06-2023 0000873892089 SAMIAT L
058 10:33
69 150301010623P000 06-07-2023 07-06-2023 0001266062466 HALEK L
050 09:11
70 150301010623P000 06-07-2023 07-06-2023 0001291347246 WARDILAH P
045 08:38
150301010623P000 07-06-2023
71 054 06-07-2023 10:14 0001300394621 TRI ERNIDA P

72 150301010623P000 06-07-2023 07-06-2023 0001592200146 TIMOTIUS APOI P

063 10:55
73 150301010623P000 06-07-2023 07-06-2023 0001885907902 SAURAH P
042 08:24
74 150301010623P000 06-07-2023 07-06-2023 0002001206261 FADILAH P
059 10:37
150301010623P000 07-06-2023
75 048 06-07-2023 08:50 0002048021561 NURSINAH P

150301010623P000 07-06-2023
057 10:29
76 06-07-2023 0002233410941 MUHAMMAD AL FARIZI L

79 150301010623P000 06-07-2023 07-06-2023 0002524680178 TAN MUSTAFA L

049 08:57
80 150301010623P000 06-07-2023 07-06-2023 0002887702637 RIAZMI YUSMASARI P
044 08:32
150301010623P000 07-06-2023
81 055 06-07-2023 10:24 0003067488099 RIZKI SAPUTRA L

84 150301010623P000 06-06-2023 06-06-2023 0000051357418 WANIHAH S. AG P

034 09:52
85 150301010623P000 06-06-2023 06-06-2023 0000051371741 BUDI KASIH L
026 08:18
86 150301010623P000 06-06-2023 06-06-2023 0000051588966 SYARIF ISHAK L
036 11:02
87 150301010623P000 06-06-2023 06-06-2023 0000167211202 DEWI SATIKA ALIDIN P
028 08:48

88 150301010623P000 06-06-2023 06-06-2023 0000873503943 HEMLAH P

037 11:13
150301010623P000 06-06-2023
027 08:39
91 06-06-2023 0001484576537 ISKANDAR L

92 150301010623P000 06-06-2023 06-06-2023 0001801619458 U. HARIADI L

032 09:32
93 150301010623P000 06-06-2023 06-06-2023 0002064783058 ELTRI P
035 10:55
94 150301010623P000 06-06-2023 06-06-2023 0002087620042 RISKA SAPUTRI P
029 08:52
95 150301010623P000 06-06-2023 06-06-2023 0002487575079 YUDA TANTOWI L
031 09:20
 150301010623P000 06-06-2023
96 030 06-06-2023 08:55 0002740632401 YANKY OKTAVIANI P

150301010623P000 06-06-2023 ELEANOR RIZQIA NAFASYA

033 09:34 DINATA
99 06-06-2023 0003291081344 P

101 150301010623P000 06-05-2023 05-06-2023 0000051343975 DWI HASTINE GIRLISKA P

022 10:59
102 150301010623P000 06-05-2023 05-06-2023 0000051348622 ERNAWATI P
011 09:17
103 150301010623P000 06-05-2023 05-06-2023 0000051445563 SUFRANDI L
021 10:41
104 150301010623P000 06-05-2023 05-06-2023 0000051478413 FEBRIN NURUL DHUHA P
020 10:36
105 150301010623P000 06-05-2023 05-06-2023 0000051585884 PURNAMAWATI P
017 09:53
109 150301010623P000 06-05-2023 05-06-2023 0001303522672 HERLINA P
024 11:36
110 150301010623P000 06-05-2023 05-06-2023 0001590359409 FATHIYATUS SA'IDAH P
013 09:22
111 150301010623P000 06-05-2023 05-06-2023 0001785512125 NYUN ALEXANDER L
014 09:28
112 150301010623P000 06-05-2023 05-06-2023 0001795223316 RIAN WIRANATA L
010 09:13
113 150301010623P000 06-05-2023 05-06-2023 0001863138947 BENY L
019 10:00
114 150301010623P000 06-05-2023 05-06-2023 0001871588439 SRI NOVA AFRIANTI P
025 11:49
150301010623P000 05-06-2023
115 012 06-05-2023 09:19 0001890427746 julina P

116 150301010623P000 06-05-2023 05-06-2023 0001891233459 RIO PAIH L

023 11:19
117 150301010623P000 06-05-2023 05-06-2023 0002240036133 DIAN KUSUMANINGRUM P
008 08:44
118 150301010623P000 06-05-2023 05-06-2023 0002251651724 JULIANA P
018 09:57
150301010623P000 05-06-2023
009 09:00
121 06-05-2023 0002478050752 AYU WALIYANI P

150301010623P000 05-06-2023
016 09:51
122 06-05-2023 0002698791052 YULIA P

129 06-03-2023 0000872067767 NIRMAWATI P

150301010623P000 03-06-2023
007 09:54

150301010623P000 03-06-2023
003 08:37
130 06-03-2023 0000873054549 HERDI L

131 150301010623P000 06-03-2023 03-06-2023 0000874009855 BUJANG. N L

006 09:27
134 150301010623P000 06-03-2023 03-06-2023 0002068362764 AHMAD SAFARI L
004 08:40
 STATUS
JENIS PESERTA DIAGNOSA PULANG PRB PROLANIS

PENERIMA PENSIUN Non-insulin-dependent diabetes Diabetes Mellitus Diabetes Mellitus

PNS mellitus with unspecified Rujuk Vertikal
complications

PENERIMA PENSIUN Brain stem stroke syndrome Rujuk Vertikal

PNS

PNS DAERAH Brain stem stroke syndrome Rujuk Vertikal

PNS DAERAH Brain stem stroke syndrome Rujuk Vertikal

PENERIMA PENSIUN Zoster with other complications Rujuk Vertikal

PNS
PNS DAERAH Fever, unspecified Rujuk Vertikal

- Pulpitis Rujuk Vertikal

PEGAWAI SWASTA Glaucoma, unspecified Rujuk Vertikal

PBI (APBD) Diseases of bronchus, not Rujuk Vertikal

elsewhere classified
PENERIMA PENSIUN Cataract, unspecified Rujuk Vertikal
POLRI

PEKERJA MANDIRI Pulpitis Rujuk Vertikal

PEKERJA MANDIRI Chronic kidney disease Rujuk Vertikal

PEKERJA MANDIRI Early syphilis, unspecified Rujuk Vertikal

Spontaneous abortion, incomplete,

PNS DAERAH without complication Rujuk Vertikal

PEKERJA MANDIRI Diseases of bronchus, not Rujuk Vertikal

elsewhere classified
PEGAWAI SWASTA Fever, unspecified Rujuk Vertikal

PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with unspecified Rujuk Vertikal
complications

Non-insulin-dependent diabetes
PBI (APBN) mellitus with unspecified Rujuk Vertikal
complications

PEGAWAI Specific developmental disorders

PEMERINTAH of speech and language
DENGAN PERJANJIAN
KERJA Rujuk Vertikal

PBI (APBN) Supervision of high-risk Rujuk Vertikal

pregnancy, unspecified
PEKERJA MANDIRI Other disorders of psychological
development Rujuk Vertikal

PNS DAERAH Keloid scar Rujuk Vertikal

PBI (APBD) Schizophrenia Rujuk Vertikal

PENERIMA PENSIUN Brain stem stroke syndrome Rujuk Vertikal

PNS
PNS DAERAH Other specified disorders of ear Rujuk Vertikal

PBI (APBN) Thyrotoxicosis [hyperthyroidism] Rujuk Vertikal

PEKERJA MANDIRI Senile cataract, unspecified Rujuk Vertikal

PEKERJA MANDIRI Fracture of forearm Rujuk Vertikal

Non-insulin-dependent diabetes Diabetes Mellitus Diabetes Mellitus

PNS DAERAH mellitus with unspecified Rujuk Vertikal
complications

PEKERJA MANDIRI Benign neoplasm of bones of skull Rujuk Vertikal

and face
Non-insulin-dependent diabetes
PBI (APBD) mellitus with unspecified Rujuk Vertikal
complications

PBI (APBN) Pulpitis Rujuk Vertikal

PBI (APBN) Anxiety disorder, unspecified Rujuk Vertikal

PBI (APBN) Epilepsy, unspecified Rujuk Vertikal

PENERIMA PENSIUN Hyperplasia of prostate Rujuk Vertikal

PNS
PENERIMA PENSIUN Chronic periodontitis Rujuk Vertikal Hipertensi Hipertensi
PNS
PNS DAERAH Keloid scar Rujuk Vertikal

PBI (APBN) Low back pain Rujuk Vertikal

PNS DAERAH Cholelithiasis Rujuk Vertikal

PEKERJA MANDIRI Other and unspecified ovarian Rujuk Vertikal Hipertensi Hipertensi
cysts
KEPALA DESA DAN Nasal polyp, unspecified Rujuk Vertikal
PERANGKAT DESA

PEGAWAI Benign neoplasm of eye and

PEMERINTAH adnexa
DENGAN PERJANJIAN
KERJA Rujuk Vertikal

PEKERJA MANDIRI Other specified disorders of lens Rujuk Vertikal Hipertensi

PNS DAERAH Other dental caries Rujuk Vertikal

PBI (APBD) Schizophrenia Rujuk Vertikal

PBI (APBN) Other specified diseases of inner Rujuk Vertikal

ear
PBI (APBN) Tuberculosis of nervous system, Rujuk Vertikal
unspecified
PEGAWAI SWASTA Other dental caries Rujuk Vertikal

PNS PUSAT Other specified disorders of ear Rujuk Vertikal

PNS DAERAH Chronic ischaemic heart disease, Rujuk Vertikal

unspecified
 Other specified abdominal hernia
PNS DAERAH without obstruction or gangrene Rujuk Vertikal

PNS DAERAH Low back pain Rujuk Vertikal

PBI (APBN) Chronic ischaemic heart disease, Rujuk Vertikal

unspecified
PEKERJA MANDIRI Heart failure, unspecified Rujuk Vertikal

PEKERJA MANDIRI Diseases of bronchus, not Rujuk Vertikal

elsewhere classified
PEKERJA MANDIRI Other benign neoplasm of
connective and other soft tissue of Rujuk Vertikal
abdomen

PEGAWAI SWASTA Arthritis, unspecified Rujuk Vertikal

PBI (APBN) Disease of inner ear, unspecified Rujuk Vertikal

PBI (APBN) Tuberculosis of nervous system, Rujuk Vertikal

unspecified
Non-insulin-dependent diabetes Diabetes Mellitus
PBI (APBN) mellitus with unspecified Rujuk Vertikal
complications

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN
KERJA Nasal polyp, unspecified Rujuk Vertikal

PBI (APBN) Secondary hypertension, Rujuk Vertikal

unspecified
PEGAWAI SWASTA Other specified diseases of inner Rujuk Vertikal
ear
Other specified abdominal hernia
PNS DAERAH without obstruction or gangrene Rujuk Vertikal

PNS PUSAT Aplastic anaemia, unspecified Rujuk Vertikal

PNS DAERAH Lipomatosis, not elsewhere Rujuk Vertikal

classified
PNS DAERAH Brain stem stroke syndrome Rujuk Vertikal

KEPALA DESA DAN Supervision of high-risk Rujuk Vertikal

PERANGKAT DESA pregnancy, unspecified

PBI (APBN) Heart failure, unspecified Rujuk Vertikal

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN
KERJA Heart failure, unspecified Rujuk Vertikal

PEKERJA MANDIRI Other specified disorders of lens Rujuk Vertikal

PEKERJA MANDIRI Necrosis of pulp Rujuk Vertikal

PEKERJA MANDIRI Other dental caries Rujuk Vertikal

PEKERJA MANDIRI Necrosis of pulp Rujuk Vertikal

PEKERJA MANDIRI Non-insulin-dependent diabetes
mellitus with unspecified Rujuk Vertikal
complications

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN
KERJA Fever, unspecified Rujuk Vertikal

PNS DAERAH Fever, unspecified Rujuk Vertikal

PNS DAERAH Neuralgia and neuritis, unspecified Rujuk Vertikal

PNS DAERAH Tuberculous meningitis Rujuk Vertikal

PNS DAERAH Anomalies of tooth position Rujuk Vertikal

PNS DAERAH Arthritis, unspecified Rujuk Vertikal

PBI (APBN) Chronic viral hepatitis B with Rujuk Vertikal

delta-agent
PEGAWAI SWASTA Fever with chills Rujuk Vertikal

PEKERJA MANDIRI Fracture of femur, part unspecified Rujuk Vertikal

PEGAWAI BUMD Necrosis of pulp Rujuk Vertikal

PEKERJA MANDIRI Periapical abscess with sinus Rujuk Vertikal

PEKERJA MANDIRI Diabetes mellitus in pregnancy, Rujuk Vertikal

unspecified
PEKERJA MANDIRI Non-insulin-dependent diabetes Diabetes Mellitus Diabetes Mellitus
mellitus with unspecified Rujuk Vertikal
complications

PNS DAERAH Injury of eye and orbit, part Rujuk Vertikal

unspecified
PEKERJA MANDIRI Diseases of bronchus, not Rujuk Vertikal
elsewhere classified
PBI (APBN) Diseases of bronchus, not Rujuk Vertikal
elsewhere classified
PEGAWAI Diseases of bronchus, not
PEMERINTAH elsewhere classified
DENGAN PERJANJIAN
KERJA Rujuk Vertikal

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN
KERJA Necrosis of pulp Rujuk Vertikal

PBI (APBN) Chronic obstructive pulmonary Rujuk Vertikal

disease with acute lower
respiratory infection

PEGAWAI Other specified infectious agents as

PEMERINTAH the cause of diseases classified to
DENGAN PERJANJIAN other chapters
KERJA Rujuk Vertikal

- Congestive heart failure Rujuk Vertikal

PEGAWAI SWASTA Heart failure, unspecified Rujuk Vertikal
 150301010623P000 12-06-2023
18 129 06-12-2023 10:57 0002286870928 DIAH KURNIATI P

19 150301010623P000 06-12-2023 12-06-2023 0002287588173 PATRICIUS JULIANO L

120 09:29 JEHAMBUR

20 150301010623P000 06-12-2023 12-06-2023 0002310368073 VITA P

121 09:52

150301010623P000 12-06-2023
21 127 06-12-2023 10:38 0002423018878 sahli L

150301010623P000 12-06-2023
22 118 06-12-2023 09:02 0002679865931 MUSLIMIN L

150301010623P000 12-06-2023 MUHAMMAD MUFLIH ALFATIH

116 08:52
23 06-12-2023 0002753386334 L

24 150301010623P000 06-12-2023 12-06-2023 0002972610742 EDSA PURWANTI P

119 09:07
25 150301010623P000 06-12-2023 12-06-2023 0003019430046 RISFA TSHANIA P
125 10:25

150301010623P000 12-06-2023 KRESNA RAHARDIAN

26 128 06-12-2023 10:49 0003306765284 ALFARISQI L

27 150301010623P000 06-10-2023 10-06-2023 0000168183819 WIWIN P

105 08:27

28 150301010623P000 06-10-2023 10-06-2023 0001260998425 JAHUDDIN L

109 09:47
29 150301010623P000 06-10-2023 10-06-2023 0002221772591 TILA P
108 09:26

30 150301010623P000 06-10-2023 12-06-2023 0003508076698 YULI AHMAD YANI P

137 21:49
31 150301010623P000 06-09-2023 09-06-2023 0000051372066 RUSLI L
098 10:10

32 150301010623P000 06-09-2023 09-06-2023 0000051448094 ZULPIAN L

096 10:04

33 150301010623P000 06-09-2023 09-06-2023 0000051454293 DRS. ERISTON SIJABAT L

094 08:57

34 150301010623P000 06-09-2023 09-06-2023 0000051577536 ALIAH NUR P

095 09:03
 Spontaneous abortion, incomplete,
PNS DAERAH without complication Rujuk Vertikal

PEKERJA MANDIRI Diseases of bronchus, not Rujuk Vertikal

elsewhere classified

PEGAWAI SWASTA Fever, unspecified Rujuk Vertikal

PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with unspecified Rujuk Vertikal
complications

Non-insulin-dependent diabetes
PBI (APBN) mellitus with unspecified Rujuk Vertikal
complications

PEGAWAI Specific developmental disorders

PEMERINTAH of speech and language
DENGAN PERJANJIAN Rujuk Vertikal
KERJA

PBI (APBN) Surveillance of contraceptive drugs Berobat Jalan

PBI (APBN) Supervision of high-risk Rujuk Vertikal

pregnancy, unspecified

PEKERJA MANDIRI Other disorders of psychological

development Rujuk Vertikal

PNS DAERAH Keloid scar Rujuk Vertikal

PBI (APBD) Schizophrenia Rujuk Vertikal

PEKERJA MANDIRI Surveillance of contraceptive drugs Berobat Jalan

- Supervision of normal first Berobat Jalan

pregnancy
PENERIMA PENSIUN Brain stem stroke syndrome Rujuk Vertikal
PNS

PNS DAERAH Other specified disorders of ear Rujuk Vertikal

PNS DAERAH Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus Diabetes Mellitus
mellitus

PENERIMA PENSIUN Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus Diabetes Mellitus
PNS mellitus
35 150301010623P000 06-09-2023 09-06-2023 0000873893373 CICA JUMIATI P
091 08:46
36 150301010623P000 06-09-2023 09-06-2023 0001262991082 SUDARMAN MASNI L
088 08:35
37 150301010623P000 06-09-2023 09-06-2023 0002050400643 HAFIZI FAUZI L
090 08:44
150301010623P000 09-06-2023
38 092 06-09-2023 08:52 0002057167089 DIANA P

39 150301010623P000 06-09-2023 09-06-2023 0002204322265 PUTRI DANITA P

089 08:37
150301010623P000 09-06-2023
40 097 06-09-2023 10:06 0002478005357 SUHARYANI P

41 150301010623P000 06-09-2023 09-06-2023 0002524080846 HADRI L

099 10:31

42 150301010623P000 06-09-2023 09-06-2023 0002524678918 VITA AULIA P

093 08:56
43 150301010623P000 06-09-2023 12-06-2023 0003508076698 YULI AHMAD YANI P
136 21:45

44 150301010623P000 06-09-2023 09-06-2023 0003527396302 SHANUM ALMAHYRA P

100 10:43
45 150301010623P000 06-08-2023 08-06-2023 0000051316143 MUHAMMAD SYUKUR L
073 08:37 TAURAN

46 150301010623P000 06-08-2023 08-06-2023 0000051331353 SUHARDI M NOER L

082 09:45

47 150301010623P000 06-08-2023 08-06-2023 0000051396783 EMILIA P

083 09:48

48 150301010623P000 06-08-2023 08-06-2023 0000051577942 ASMITA P

078 09:18

49 150301010623P000 06-08-2023 08-06-2023 0000051589315 U. RATNA SARI P

079 09:32
50 150301010623P000 06-08-2023 08-06-2023 0001229514827 MARDIAH P
080 09:33

51 150301010623P000 06-08-2023 08-06-2023 0001316249706 RIZANA P

085 10:27
52 150301010623P000 06-08-2023 08-06-2023 0001384023521 HERLINA P
074 08:38

53 150301010623P000 06-08-2023 08-06-2023 0001421410566 muhibbah P

071 08:23
PBI (APBN) Thyrotoxicosis [hyperthyroidism] Rujuk Vertikal

PEKERJA MANDIRI Senile cataract, unspecified Rujuk Vertikal

PEKERJA MANDIRI Fracture of forearm Rujuk Vertikal

Non-insulin-dependent diabetes Diabetes Mellitus Diabetes Mellitus

PNS DAERAH mellitus with unspecified Rujuk Vertikal
complications

PEKERJA MANDIRI Benign neoplasm of bones of skull Rujuk Vertikal

and face
Non-insulin-dependent diabetes
PBI (APBD) mellitus with unspecified Rujuk Vertikal
complications

PBI (APBN) Pulpitis Rujuk Vertikal

PBI (APBN) Anxiety disorder, unspecified Rujuk Vertikal

- Supervision of normal first Sembuh

pregnancy

PBI (APBN) Epilepsy, unspecified Rujuk Vertikal

PENERIMA PENSIUN Hyperplasia of prostate Rujuk Vertikal

PNS

PENERIMA PENSIUN Chronic periodontitis Rujuk Vertikal Hipertensi Hipertensi

PNS

PNS DAERAH Keloid scar Rujuk Vertikal

PENERIMA PENSIUN Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus Diabetes Mellitus
PNS mellitus

PNS DAERAH Asthma Berobat Jalan Diabetes Mellitus

PBI (APBN) Low back pain Rujuk Vertikal

PEKERJA MANDIRI Asthma Berobat Jalan

PNS DAERAH Cholelithiasis Rujuk Vertikal

PEKERJA MANDIRI Other and unspecified ovarian Rujuk Vertikal Hipertensi Hipertensi
cysts
54 150301010623P000 06-08-2023 08-06-2023 0001426825258 RUDI HARTONO L
081 09:36

150301010623P000 08-06-2023
077 09:14
55 06-08-2023 0001437903977 IKA DAMAYANTI P

56 150301010623P000 06-08-2023 08-06-2023 0001872800987 HAMIDI L

072 08:27

57 150301010623P000 06-08-2023 08-06-2023 0002103585794 HENDI L

076 09:09

58 150301010623P000 06-08-2023 08-06-2023 0002465737648 RENDI L

084 09:54
59 150301010623P000 06-08-2023 08-06-2023 0002690122656 RUSDI L
075 08:47
60 150301010623P000 06-08-2023 08-06-2023 0002972647517 JUNG KHIAN L
087 10:49

61 150301010623P000 06-08-2023 08-06-2023 0003056210717 SUTONI L

086 10:41
62 150301010623P000 06-07-2023 07-06-2023 0000032099297 MUHAMMAD ILHAM L
068 11:43 WIRATAMA

63 150301010623P000 06-07-2023 07-06-2023 0000049941573 MULYADI L

046 08:40
64 150301010623P000 06-07-2023 07-06-2023 0000051338946 SUMIARTI P
043 08:31

65 150301010623P000 06-07-2023 07-06-2023 0000051357701 ELIS SURYANI P

061 10:45
150301010623P000 07-06-2023
66 065 06-07-2023 11:02 0000051518621 AZMAN L

67 150301010623P000 06-07-2023 07-06-2023 0000051587469 U. SRI AGUSTINI P

067 11:12

68 150301010623P000 06-07-2023 07-06-2023 0000873892089 SAMIAT L

058 10:33
69 150301010623P000 06-07-2023 07-06-2023 0001266062466 HALEK L
050 09:11

70 150301010623P000 06-07-2023 07-06-2023 0001291347246 WARDILAH P

045 08:38
KEPALA DESA DAN Nasal polyp, unspecified Rujuk Vertikal
PERANGKAT DESA

PEGAWAI Benign neoplasm of eye and

PEMERINTAH adnexa
DENGAN PERJANJIAN Rujuk Vertikal
KERJA

PEKERJA MANDIRI Other specified disorders of lens Rujuk Vertikal Hipertensi

PNS DAERAH Other dental caries Rujuk Vertikal

PBI (APBD) Schizophrenia Rujuk Vertikal

PBI (APBN) Other specified diseases of inner Rujuk Vertikal

ear
PBI (APBN) Tuberculosis of nervous system, Rujuk Vertikal
unspecified

PEGAWAI SWASTA Other dental caries Rujuk Vertikal

PNS PUSAT Other specified disorders of ear Rujuk Vertikal

PNS DAERAH Chronic ischaemic heart disease, Rujuk Vertikal

unspecified
PENERIMA PENSIUN Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus Diabetes Mellitus
PNS mellitus

PNS DAERAH Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus Diabetes Mellitus
mellitus
Other specified abdominal hernia
PNS DAERAH without obstruction or gangrene Rujuk Vertikal

PNS DAERAH Low back pain Rujuk Vertikal

PBI (APBN) Chronic ischaemic heart disease, Rujuk Vertikal

unspecified
PEKERJA MANDIRI Heart failure, unspecified Rujuk Vertikal

PEKERJA MANDIRI Diseases of bronchus, not Rujuk Vertikal

elsewhere classified
 150301010623P000 07-06-2023
71 054 06-07-2023 10:14 0001300394621 TRI ERNIDA P

72 150301010623P000 06-07-2023 07-06-2023 0001592200146 TIMOTIUS APOI P

063 10:55

73 150301010623P000 06-07-2023 07-06-2023 0001885907902 SAURAH P

042 08:24

74 150301010623P000 06-07-2023 07-06-2023 0002001206261 FADILAH P

059 10:37

150301010623P000 07-06-2023
75 048 06-07-2023 08:50 0002048021561 NURSINAH P

150301010623P000 07-06-2023
057 10:29
76 06-07-2023 0002233410941 MUHAMMAD AL FARIZI L

150301010623P000 07-06-2023
77 047 06-07-2023 08:48 0002419670979 FITRIANI P

150301010623P000 07-06-2023
78 051 06-07-2023 09:24 0002454287016 SOKME P

79 150301010623P000 06-07-2023 07-06-2023 0002524680178 TAN MUSTAFA L

049 08:57
80 150301010623P000 06-07-2023 07-06-2023 0002887702637 RIAZMI YUSMASARI P
044 08:32

150301010623P000 07-06-2023
81 055 06-07-2023 10:24 0003067488099 RIZKI SAPUTRA L

82 150301010623P000 06-07-2023 07-06-2023 0003514577152 Siti aliyah P

069 15:00

83 150301010623P000 06-07-2023 07-06-2023 0003514577152 Siti aliyah P

070 15:02
84 150301010623P000 06-06-2023 06-06-2023 0000051357418 WANIHAH S. AG P
034 09:52
85 150301010623P000 06-06-2023 06-06-2023 0000051371741 BUDI KASIH L
026 08:18
86 150301010623P000 06-06-2023 06-06-2023 0000051588966 SYARIF ISHAK L
036 11:02
PEKERJA MANDIRI Other benign neoplasm of
connective and other soft tissue of Rujuk Vertikal
abdomen

PEGAWAI SWASTA Arthritis, unspecified Rujuk Vertikal

PBI (APBN) Disease of inner ear, unspecified Rujuk Vertikal

PBI (APBN) Tuberculosis of nervous system, Rujuk Vertikal

unspecified

Non-insulin-dependent diabetes Diabetes Mellitus

PBI (APBN) mellitus with unspecified Rujuk Vertikal
complications

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN Nasal polyp, unspecified Rujuk Vertikal
KERJA

PEKERJA MANDIRI Diabetes Mellitus Diabetes Mellitus

Heart failure, unspecified Berobat Jalan Hipertensi Hipertensi

Chronic obstructive pulmonary

PBI (APBN) disease, unspecified Berobat Jalan

PBI (APBN) Secondary hypertension, Rujuk Vertikal

unspecified
PEGAWAI SWASTA Other specified diseases of inner Rujuk Vertikal
ear

Other specified abdominal hernia

PNS DAERAH without obstruction or gangrene Rujuk Vertikal

- Supervision of normal first Sembuh

pregnancy

- Supervision of normal first Berobat Jalan

pregnancy
PNS PUSAT Aplastic anaemia, unspecified Rujuk Vertikal

PNS DAERAH Lipomatosis, not elsewhere Rujuk Vertikal

classified
PNS DAERAH Brain stem stroke syndrome Rujuk Vertikal
87 150301010623P000 06-06-2023 06-06-2023 0000167211202 DEWI SATIKA ALIDIN P
028 08:48

88 150301010623P000 06-06-2023 06-06-2023 0000873503943 HEMLAH P

037 11:13
89 150301010623P000 06-06-2023 06-06-2023 0001317913244 RIRIN PURNAMASARI P
038 17:51
90 150301010623P000 06-06-2023 06-06-2023 0001317913244 RIRIN PURNAMASARI P
039 17:53
150301010623P000 06-06-2023
027 08:39
91 06-06-2023 0001484576537 ISKANDAR L

92 150301010623P000 06-06-2023 06-06-2023 0001801619458 U. HARIADI L

032 09:32
93 150301010623P000 06-06-2023 06-06-2023 0002064783058 ELTRI P
035 10:55

94 150301010623P000 06-06-2023 06-06-2023 0002087620042 RISKA SAPUTRI P

029 08:52
95 150301010623P000 06-06-2023 06-06-2023 0002487575079 YUDA TANTOWI L
031 09:20

150301010623P000 06-06-2023
96 030 06-06-2023 08:55 0002740632401 YANKY OKTAVIANI P

97 150301010623P000 06-06-2023 06-06-2023 0002918411662 U. NUR ISNANIARTI P

040 18:27

98 150301010623P000 06-06-2023 06-06-2023 0002918411662 U. NUR ISNANIARTI P

041 18:29

150301010623P000 06-06-2023 ELEANOR RIZQIA NAFASYA

033 09:34 DINATA
99 06-06-2023 0003291081344 P

100 150301010623P000 06-05-2023 10-06-2023 0000051329902 ISMAIL L

107 08:30

101 150301010623P000 06-05-2023 05-06-2023 0000051343975 DWI HASTINE GIRLISKA P

022 10:59
102 150301010623P000 06-05-2023 05-06-2023 0000051348622 ERNAWATI P
011 09:17
KEPALA DESA DAN Supervision of high-risk Rujuk Vertikal
PERANGKAT DESA pregnancy, unspecified

PBI (APBN) Heart failure, unspecified Rujuk Vertikal

- Supervision of normal first Sembuh

pregnancy
- Supervision of normal first Berobat Jalan
pregnancy
PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN Heart failure, unspecified Rujuk Vertikal
KERJA

PEKERJA MANDIRI Other specified disorders of lens Rujuk Vertikal

PEKERJA MANDIRI Necrosis of pulp Rujuk Vertikal

PEKERJA MANDIRI Other dental caries Rujuk Vertikal

PEKERJA MANDIRI Necrosis of pulp Rujuk Vertikal

PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with unspecified Rujuk Vertikal
complications

- Supervision of normal first Sembuh

pregnancy

- Supervision of normal first Berobat Jalan

pregnancy

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN Fever, unspecified Rujuk Vertikal
KERJA

PNS DAERAH Low back pain Berobat Jalan

PNS DAERAH Fever, unspecified Rujuk Vertikal

PNS DAERAH Neuralgia and neuritis, unspecified Rujuk Vertikal

103 150301010623P000 06-05-2023 05-06-2023 0000051445563 SUFRANDI L
021 10:41
104 150301010623P000 06-05-2023 05-06-2023 0000051478413 FEBRIN NURUL DHUHA P
020 10:36
105 150301010623P000 06-05-2023 05-06-2023 0000051585884 PURNAMAWATI P
017 09:53
106 150301010623P000 06-05-2023 05-06-2023 0000209963081 CHI SHIN L
015 09:42
107 150301010623P000 06-05-2023 10-06-2023 0001262745685 SUDI L
106 08:29
108 150301010623P000 06-05-2023 10-06-2023 0001264379872 SUDARMI P
103 08:20

109 150301010623P000 06-05-2023 05-06-2023 0001303522672 HERLINA P

024 11:36

110 150301010623P000 06-05-2023 05-06-2023 0001590359409 FATHIYATUS SA'IDAH P

013 09:22

111 150301010623P000 06-05-2023 05-06-2023 0001785512125 NYUN ALEXANDER L

014 09:28

112 150301010623P000 06-05-2023 05-06-2023 0001795223316 RIAN WIRANATA L

010 09:13
113 150301010623P000 06-05-2023 05-06-2023 0001863138947 BENY L
019 10:00

114 150301010623P000 06-05-2023 05-06-2023 0001871588439 SRI NOVA AFRIANTI P

025 11:49
150301010623P000 05-06-2023
115 012 06-05-2023 09:19 0001890427746 julina P

116 150301010623P000 06-05-2023 05-06-2023 0001891233459 RIO PAIH L

023 11:19
117 150301010623P000 06-05-2023 05-06-2023 0002240036133 DIAN KUSUMANINGRUM P
008 08:44

118 150301010623P000 06-05-2023 05-06-2023 0002251651724 JULIANA P

018 09:57

119 150301010623P000 06-05-2023 10-06-2023 0002263981689 SRI WAHYUNI P

104 08:21

120 150301010623P000 06-05-2023 10-06-2023 0002453738398 IMANUDDIN L

102 08:19
PNS DAERAH Tuberculous meningitis Rujuk Vertikal

PNS DAERAH Anomalies of tooth position Rujuk Vertikal

PNS DAERAH Arthritis, unspecified Rujuk Vertikal

PNS DAERAH Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus Diabetes Mellitus
mellitus
PEKERJA MANDIRI Pure hypercholesterolaemia Berobat Jalan

PBI (APBD) Schizophrenia Berobat Jalan

PBI (APBN) Chronic viral hepatitis B with Rujuk Vertikal

delta-agent

PEGAWAI SWASTA Fever with chills Rujuk Vertikal

PEKERJA MANDIRI Fracture of femur, part unspecified Rujuk Vertikal

PEGAWAI BUMD Necrosis of pulp Rujuk Vertikal

PEKERJA MANDIRI Periapical abscess with sinus Rujuk Vertikal

PEKERJA MANDIRI Diabetes mellitus in pregnancy, Rujuk Vertikal

unspecified
PEKERJA MANDIRI Non-insulin-dependent diabetes Diabetes Mellitus Diabetes Mellitus
mellitus with unspecified Rujuk Vertikal
complications

PNS DAERAH Injury of eye and orbit, part Rujuk Vertikal

unspecified
PEKERJA MANDIRI Diseases of bronchus, not Rujuk Vertikal
elsewhere classified

PBI (APBN) Diseases of bronchus, not Rujuk Vertikal

elsewhere classified

PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

PNS PUSAT Non-insulin-dependent diabetes Berobat Jalan

mellitus
 150301010623P000 05-06-2023
009 09:00
121 06-05-2023 0002478050752 AYU WALIYANI P

150301010623P000 05-06-2023
016 09:51
122 06-05-2023 0002698791052 YULIA P

123 150301010623P000 06-05-2023 07-06-2023 0002777116645 YULITA P

062 10:46

124 150301010623P000 06-04-2023 07-06-2023 0000514691561 IIS ISTIKOMAH P

064 10:58
125 150301010623P000 06-04-2023 07-06-2023 0000514691561 IIS ISTIKOMAH P
066 11:04

126 150301010623P000 06-04-2023 07-06-2023 0001891536491 TRISNI P

053 10:07
127 150301010623P000 06-04-2023 07-06-2023 0002777116645 YULITA P
060 10:42

128 150301010623P000 06-03-2023 10-06-2023 0000051334569 JAMIAT L

101 08:18
129 06-03-2023 0000872067767 NIRMAWATI P
150301010623P000 03-06-2023
007 09:54

150301010623P000 03-06-2023
003 08:37
130 06-03-2023 0000873054549 HERDI L

131 150301010623P000 06-03-2023 03-06-2023 0000874009855 BUJANG. N L

006 09:27
150301010623P000 03-06-2023
005 08:56
132 06-03-2023 0001848968335 NURI GEMPITA P

133 150301010623P000 06-03-2023 07-06-2023 0001891536491 TRISNI P

052 10:02
134 150301010623P000 06-03-2023 03-06-2023 0002068362764 AHMAD SAFARI L
004 08:40
PEGAWAI Diseases of bronchus, not
PEMERINTAH elsewhere classified
DENGAN PERJANJIAN Rujuk Vertikal
KERJA

PEGAWAI
PEMERINTAH
DENGAN PERJANJIAN Necrosis of pulp Rujuk Vertikal
KERJA

- Supervision of normal first Berobat Jalan

pregnancy

- Supervision of normal first Sembuh

pregnancy
- Supervision of normal first Berobat Jalan
pregnancy

- Supervision of normal first Berobat Jalan

pregnancy
- Supervision of normal first Sembuh
pregnancy

PNS DAERAH Epilepsy, unspecified Berobat Jalan Hipertensi

PBI (APBN) Chronic obstructive pulmonary Rujuk Vertikal

disease with acute lower
respiratory infection

PEGAWAI Other specified infectious agents as

PEMERINTAH the cause of diseases classified to
DENGAN PERJANJIAN other chapters Rujuk Vertikal
KERJA

- Congestive heart failure Rujuk Vertikal

PEGAWAI Surveillance of contraceptive drugs

PEMERINTAH
DENGAN PERJANJIAN Berobat Jalan
KERJA

- Supervision of normal first Sembuh

pregnancy
PEGAWAI SWASTA Heart failure, unspecified Rujuk Vertikal
135 150301010623P000 06-03-2023 07-06-2023 0002777116645 YULITA P
056 10:27
136 150301010623P000 06-01-2023 02-06-2023 0001591694864 DAHLIANA P
001 10:27
137 150301010623P000 06-01-2023 02-06-2023 0001591694864 DAHLIANA P
002 11:11
- Supervision of normal first Berobat Jalan
pregnancy
- Supervision of normal first Sembuh
pregnancy
- Supervision of normal first Berobat Jalan
pregnancy