TANGGAL 1 MEI 2016, MINGGU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BY. NURUL HIKMAYATI
NY. NURUL HIKMAYATI
BY. RAIHANUN
NY. RAIHANUN
BY. MULYANA
NY. MULYANA
MURNIATI
NUR HILMIYAH
JUMANIH
SOFIUL ABIDIN ABROR
ARMAN
SUKRIADI
NURLAELA HAYATI
JAMAL
FARIZ NAUFAL
AMINULLOH
NUR ASSIFA
LATIFA INDRIANI
RIZKI AYU ARNI
AZIZATUL YUMNA
M. YUNUS
RASTYANA MAHENDRI
LL RESTU JULIA
H. M NASRI
SAHLAN
ARYA TEKAD PRAMESTA

ALAMAT
PRINGGABAYA
PRINGGABAYA
TERARA
TERARA
MASBAGIK
MASBAGIK
PANCOR
KELAYU
PENGADANGAN
SURALAGA
MASBAGIK
PERIGI
KEROYA
SAMBELIA
WANASABA
SONGAK
SELONG
JEROWARU
MASBAGIK
AIKMEL
PENENDEM
SELONG
SAKRA
PADAMARA
SUKARARA
SELONG

NO RM
022366
022325
022487
022470
022474
022468
020971
022396
021001
022217
022141
022294
022394
022387
022175
022403
022365
022105
022255
022370
022329
022290
022398
022341
022388
022354

TANGGAL MASUK
TANGGAL KELUAR
28-1/4-5/2016
27-1/4-5/2016
30-1/4-5/2016
30-1/4-5/2016
30-1/4-5/2016
30-1/4-5/2016
28-1/4-5/2016
28-1/4-5/2016
26-1/4-5/2016
25-1/4-5/2016
24-1/4-5/2016
27-1/4-5/2016
28-1/4-5/2016
28-1/4-5/2016
29-1/4-5/2016
29-30/4/2016
28-1/4-5/2016
28-1/4-5/2016
26-1/4-5/2016
28-1/4-5/2016
27-28/4/2016
27-1/4-5/2016
29-1/4-5/2016
28-1/4-5/2016
28-1/4-5/2016
28-1/4-5/2016

27
28
29
30
31
32
33
34
35
36
JUMLAH

GGAL 1 MEI 2016, MINGGU

UMUM
830,000

240,000

CARA BAYAR
BPJS
6,516,500
530,000
2,579,250
620,000
2,350,750
3,245,400
2,006,950
3,959,600

PKS

1,767,000

3,610,000
5,709,200
2,228,900
3,072,000
2,817,000
1,944,500
762,000
852,000
2,144,000

878,000
1,080,000

2,045,000
2,424,850
3,716,600
2,561,500
1,649,600
2,392,500

1,572,400
1572400

1,514,700

1,915,100
3,015,000
1,297,000

2,715,000

1,418,000

KET

20,597,000

51,111,200

7,844,500

PASIEN PULANG 2 MEI 2016, SENIN

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

NAMA PASIEN
BY. SRI WAHYUNI
NY. SRI WAHYUNI
BY. EVI HARTATI
NY. EVI HARTATI
BY. DINI HATI
NY. DINI HATI
TARMIZI
INQ NINGSIH/AISAH
LL FATHIR YUSUF
MARIAH
SAMSURIANI
MIRZA NAHLA
SULHIYAH
BQ WIDYA ISWANTARI
AZIZ RAHMAN NAWAWI
INFIKA HARIN
FAYYAD ABDULLAH
M. AKBAR
AOLA ELMA
PARIDAYUL HIJRIAH
LL M GIFARI
AMMAR MALAKA
NAMIA SAKURA
IQ PAHRUDIN
BQ ZAHRA
NUR DAHNIAH
M. RESTU

ALAMAT
SAKRA
SAKRA
AIKMEL
AIKMEL
KALIJAGA
AIKMEL
SUELA
SUKARARA
MASBAGIK
TERARA
TERARA
DSN LEKONG
WANASABA
DANGER
PANCOR
PRINGGASELA
MASBAGIK
SAMBELIA
SANDUBAYA
SURALAGA
PANCOR
REMPUNG
REMPUNG
SUELA
SELONG
SELONG
AIKMEL

NO RM
022411
022404
022408
022406
022436
022405
022407
022283
022424
021198
022184
000348
003564
022340
022399
014294
002190
022401
022473
022502
019047
022434
022435
022308
022453
022488
022451

TANGGAL MASUK
TANGGAL KELUAR
29-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
27-30/4/2016
29-2/4-5/2016
29-2/4-5/2016
25-26/4/2016
27-2/4-5/2016
24-2/4-5/2016
28-2/4-5/2016
29-2/4-5/2016
21-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
30-2/4-5/2016
1-2/5/2016
30-2/4-5/2016
29-2/4-5/2016
29-2/4-5/2016
27-2/4-5/2016
29-2/4-5/2016
30-2/4-5/2016
29-30/4/2016

28
29
30
31
32
33
34
35
36
37
38
39
40
41
42

MASTURI

KELAYU

022282

27-2/4-5/2016

N PULANG 2 MEI 2016, SENIN

UMUM
770,000

CARA BAYAR
BPJS

PKS

KET

5,527,750
870,000
5,549,500
735,000
6,451,350
1,811,750
2,731,000
1,961,000
1,882,000

1,993,000

2,212,500
1,501,000
524,000

345,000
3,309,800
6,110,800
3,507,300
2,134,000
7,250,000

2,038,500
315,000
1,727,500

2,077,500
1,816,000
3,500,050
2,470,000
1,914,000
998,000

PMI 800.000
1,514,000

1,514,700

2,259,000

4,090,300

1,832,700

24,753,000

55,629,600

4,861,400

PASIEN PULANG 3 MEI 2016, SELASA

No

NAMA PASIEN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

DWI WAHYUNI
INQ NURMAS
HARIADI
MUNAWARAH
FAJARI
BY. TILAWATI
NY. TILAWATI
BY. SAPAAH
NY. SAPAAH
HJ. SITI SALEHA
AQ HAERUDIN
LL NASRUDIN
ERMA SURIANI
SAHAPUDIN
KODRI IDA
ARSITA FAMILIDA
M. AKHYARUDDIN
FEBRIAN NURMANSAH
LL BRILIAN SANI
LL MAKBUL
INQ SARIAH
SARBINI
HJ. NURMA SAKINAH
H. M MANSUR

ALAMAT
SEMBALUN
LD NANGKA
MT GADING
LB. HAJI
SURALAGA
KELAYU
KELAYU
SURALAGA
SURALAGA
DSN LEKONG
WANASABA
MT BETER
SELEBUNG
RENSING
SURALAGA
DANGER
REMPUNG
SAKRA
DAYAN MASJID
SAKRA BARAT
KABAR
PRINGGABAYA
SONGAK
KERUAK

NO RM
022185
022508
022490
021472
022467
022567
022523
022482
022419
002213
020809
022164
022277
016424
022464
022328
022469
022400
000351
021802
020465
022114
009352
022503

TANGGAL MASUK
TANGGAL KELUAR
3-3/5/2016
1-3/5/2016
2-3/5/2016
25-28/4/2016
30-1/5/2016
2-3/5/2016
2-3/5/2016
2-3/5/2016
29-3/4-5/2016
1-3/5/2016
2-3/5/2016
25-2/4-5/2016
26-3/4-5/2016
2-3/5/2016
29-3/4-5/2016
29-3/4-5/2016
30-3/4-5/2016
29-3/4-5/2016
30-3/4-5/2016
30-3/4-5/2016
2-3/5/2016
23-3/4-5/2016
30-3/4-5/2016
1-3/5/2016

UMUM
560,000

1,268,000

1,106,000
1,999,000
4,870,000
6,672,000
907,000
3,405,000
3,833,000
2,155,000
1,884,000

2,900,000

27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
31,559,000

SELASA

UMUM
560,000

CARA BAYAR
BPJS

PKS

1,437,850
794,250
2,381,100
1,268,000
600,000
2,576,005
1,106,000
6,477,300
1,999,000
4,870,000
6,672,000
907,000
3,405,000
3,833,000
2,155,000

5,213,005
7,616,400

2,018,650
1,884,000
2,522,700
5,209,005
7,374,100
2,615,050
2,900,000

2,746,700

KET

31,559,000

46,835,415

2,746,700

TANGGAL 4 MEI 2016, RABU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BY. ROHAYANI
ROHAYANI
SAFII
RINI ASHRI PARHIYATI
H. LL MAHSUN
LL ANGKASAH S.IP
PAYYAD
SOFYAN HIDAYAT
MAMAN
BY. FITRI NURUL CAHYATI
AQ KARIANA
MUYA SAROH
H. MURSIDIN
AQ PARIHUN
ANGEL ROYANI
BQ AFIKA MUTIARA
LL FEBRIAN
AGUSTINI

ALAMAT
MASBAGIK
PAOK MOTONG
SAKRA BARAT
SELONG
KELAYU SELATAN
SETANGGOR
DENGGEN
PRINGGABAYA
PAOK LOMBOK
JENGGIK
LENEK LAUK
SURALAGA
NYIUR TEBEL
KERONGKONG
ANGGRAKSA
SELAPARANG
KERONGKONG
PAOK LOMBOK

NO RM
022569
022512
021000
022344
022472
022227
022506
022501
022478
022497
022493
022507
021768
021112
022539
017681
022565
022572

TANGGAL MASUK
TANGGAL KELUAR
3-4/5/2016
2-4/5/2016
28-29/4/2016
28-4/4-5/2016
30-4/4-5/2016
26-28/4/2016
1-3/5/2016
1-4/5/2016
30-4/4-5/2016
30-4/4-5/2016
30-4/5/2016
1-4/5/2016
3-4/5/2016
1-4/5/2016
2-4/5/2016
2-4/5/2016
2-4/5/2016
3-4/5/2016

27
28
29
30
31
32
33
34
35
36

L 4 MEI 2016, RABU

MASUK
KELUAR
016
016
2016
/2016
/2016
2016
016
016
/2016
/2016
2016
016
016
016
016
016
016
016

UMUM

6,188,000
1,380,000
685,000
2,104,000
1,846,000

CARA BAYAR
BPJS
570,000
2,930,250
5,198,000
3,226,250
2,784,650

2,208,500
2,313,000
3,180,250
1,587,400
1,005,400
2,871,050
860,000
1,709,000
1,027,000
2,021,950

PKS

KET

1,837,000
2,099,000

PMI 400.000

14,090,000

31,605,700

3,936,000

PASIEN PULANG 6 MEI 2016, JUMAT

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BY. LATIFAH
NY. LATIFAH
INQ IKUN
BQ CIKA DWI
LL PUTRA AUFA
SITI ZIADATUNNIAM
FATIMAH
HAJAR
AZZUDIN
IQ MUSNAN

ALAMAT
AIKMEL
AIKMEL
WANASABA
SAKRA
SELONG
AHNJANI
SAKRA
AIKMEL
WANASABA
SEMABLUN

NO RM
022618
022596
016624
022598
022611
022551
021079
001037
000985
022675

TANGGAL MASUK
TANGGAL KELUAR
3-6/5/2016
3-6/5/2016
4-6/5/2016
3-6/5/2016
3-6/5/2016
2-6/5/2016
4-6/5/2016
3-6/5/2016
2-6/5/2016
4-6/5/2016

27
28
29
30
31
32
33
34
35
36

I 2016, JUMAT
UMUM
830,000

CARA BAYAR
BPJS
5,455,050

2,100,000
2,845,000
2,624,000
3,349,000
1,713,650
2,441,000
3,522,000
1,106,000

PKS

KET

18,817,000

7,168,700

TANGGAL 5 MEI 2016, KAMIS

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
HJ. ASIAH
YA'KUB
BY. SITI ZAINAB
NY. SITI ZAINAB
SAMSUL RIZAL
TAYUB
LL. DEDI SINARYADI
HAIKAL ABID
BQ MASRAH
MISBAH
BILAL HUMAIDI FATA
RIPAAH
HALIP
SULIMAH
NURUL HIDAYAH
HIKAM AHSANUL
HANI KURNIA
AQ MUHIDIN
HILYATUL IMTIHAN
INGGIT ISTIHARAH

ALAMAT
LOYOK
PANCOR
KELAYU
KELAYU
SELONG
SUELA
JEROWARU
MASBAGIK
DENGGEN
SAKRA
AIKMEL
SIKUR
RAKAM
LENEK
SAMBELIA
TEROS
JEROWARU
SUELA
KELAYU
SELONG

NO RM
022513
006537
022562
022517
022511
022416
022393
022571
006366
022510
022514
022560
022621
022475
022010
022554
022626
021182
014703
021240

TANGGAL MASUK
TANGGAL KELUAR
2-5/5/2016
3-5/5/2016
2-5/5/2016
2-5/5/2016
2-5/5/2016
2-5/5/2016
28-29/4/2016
3-5/5/2016
28-5/4-5/2016
2-5/4/2016
2-5/5/2016
2-5/5/2016
3-5/5/2016
30-5/4-5/2016
1-5/5/2016
2-5/5/2016
4-5/5/2016
25-5/4-5/2016
2-5/5/2016
4-5/5/2016

CARA BAYAR
UMUM

830,000
1,103,000
566,000
1,800,000
2,449,000
2,884,000
3,317,500
764,000
1,477,000

5,634,000
2,143,000

27
28
29
30
31
32
33
34
35
36
22,967,500

CARA BAYAR
BPJS
2,337,300
1,564,000

PKS

PMI 600.000

5,870,750
2,617,350
2,400,750

1,514,000
1,834,600

1,094,500
4,990,350

2,541,000

2,531,250

1,767,000

3,373,300
3,239,250
2,242,500
3,176,900

3,659,350

KET

39,097,550

7,656,600

TANGGAL 7 MEI 2016, SABTU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
SUHANEP
M. ABDUL HAYYI
ABDULLAH/AQ RAMLI
ULFA INTAN PUJIANA
MUKMINAH
KHAIRUL KHASANI
JUWITA IRMAYANI
AQ HIRMAN
HJ. MAESARAH
H. SAMSUL MAKRIF
SURYA MUHAMMAD
M.ZAKI AL-ANSORI
RIZKA AYU MAULIDA
AHMAD DANISH
ZUHRATUL AINI
H. KURNAEN

ALAMAT
TIRTANADI
PANCOR
PADAMARA
RENSING
PANCOR
PANCOR
PANCOR
MASBAGIK
PANCOR
MASBAGIK
PANCOR
TERARA
MAJIDI
SELONG
SUELA
RUMBUK

NO RM
022574
022683
022578
022667
002875
022624
022690
022625
001747
022705
022697
022669
022693
022515
022518
002007

TANGGAL MASUK
TANGGAL KELUAR
3-7/5/2016
5-7/5/2016
3-7/5/2016
4-7/5/2016
5-7/5/2016
3-7/5/2016
5-7/5/2016
4-7/5/2016
29-7/4-5/2016
6-7/5/2016
6-7/5/2016
4-7/5/2016
6-7/5/2016
2-7/5/2016
2-6/5/2016
4-7/5/2016

CARA BAYAR
UMUM
1,464,000

1,160,500
4,294,000
2,653,500
773,000
1,780,000
2,234,000
2,893,000

27
28
29
30
31
32
33
34
35
36
JUMLAH

17,252,000

CARA BAYAR
BPJS
2,621,200

PKS

KET

3,099,000
2,168,500
2,318,650
1,946,250
2,924,850
6,130,000

1,836,000

1,107,850
2,918,500

PMI 600.000

25,234,800

1,836,000

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36

NAMA PASIEN
SAMSINI
BQ KAIRA ASYILA
BQ YUSTISIANI
BQ UNAISAH
BY. ROHANAH
HERMAN
ALFI KHAIRI
HUNAEN
ZULHARIAH
ABD RAFIT
KHURRTAUL AINI
M. MANSUR
YOGI PUTRA EFENDI
JUHAIRIAH
NY. NOVA AYU P
BY. NOVA AYU P
M. TOHRI
SAMSUL ARIFIN

JUMLAH

TANGGAL 8 APRIL 2016

ALAMAT
SIKUR
SAKRA BARAT
MASBAGIK
AIKMEL
MT. GADING
SURALAGA
SIKUR
WANASABA
SIKUR
SUWANGI
DENGGEN
PANCOR
AIKMEL
ANJANI
SAKRA
SAKRA
SELONG
MASBGAIK

JUMLAH

NO RM
021095
021320
018219
020010
021165
0211977
021252
020593
021186
021246
021253
021315
021135
021368
021250
021281
021221
021090

UMLAH

TANGGAL 8 APRIL 2016

TANGGAL MASUK
TANGGAL KELUAR
2-7/4/2016
6-8/4/2016
4-6/4/2016
5-8/4/2016
4-8/4/2016
4-8/4/2016
6-8/4/2016
5-8/4/2016
4-8/4/2016
5-8/4/2016
6-8/4/2016
6-8/4/2016
5-6/4/2016
6-8/4/2016
5-7/4/2016
7-7/4/2016
5-8/4/2016
2-8/4/2016

CARA BAYAR
UMUM
4,447,000
2,293,500
2,344,000
1,167,000
1,944,000

9,380,000
2,091,000
424,000

1,944,000
88,000
420,000
6,290,000

32,832,500

APRIL 2016
CARA BAYAR
BPJS

PKS

1,540,600

2,043,000
4,504,000

1,938,500
1,975,500
3,350,000

1,514,700

2,304,000

2,216,000

2,043,000

19,698,600

3,730,700

KET

TANGGAL 9 MEI 2016, SENIN

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BQ. FATMAWATI
AIMAN SANJANI
KAHIROL LUBNA
DEYAN SUKARTHA
SILFA MUTIARANI
FAUZI
SARI PUSPITA DEWI
H. ABADARUDDIN
ETIS DWI SUHERMAN

ALAMAT
PANCOR
PENGADANGAN
AIKMEL
SELONG
WANASABA
ANJANI
MAJIDI
SUMBAWA BARAT
MASBAGIK

NO RM
022704
022703
022681
022638
022730
010903
022694
022677
022668

TANGGAL MASUK
TANGGAL KELUAR
6-8/5/2016
6-9/5/2016
5-9/5/2016
4-8/5/2016
7-9/5/2016
6-9/5/2016
6-9/5/2016
4-9/5/2016
4-9/5/2016

CARA B
UMUM
2,084,000
2,593,500
3,301,000
1,612,000
1,291,000
400,000
415,500
4,470,000
1,499,000

27
28
29
30
31
32
33
34
35
36
JUMLAH

17,666,000

GAL 9 MEI 2016, SENIN

CARA BAYAR
BPJS

PKS

2,234,250
2,182,500

1,834,600
1,767,000

3,266,150

1,767,000

KET

7,682,900

5,368,600

TANGGAL10 MEI 2016, SELASA

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
M. FATAN AZKA
HAKAN ABRAHAM MARZUKI
BIMA
CITRA AYU
DIA DIANA APRILIA
AZAHRA KHABIZA W
SAINAH
KAYSAN NAWFAL
H. M ZAIN
MUSTIHARAH
PAIZAH
NURUL HIZBAINI
H. SUPARLAN
SRI MARLIANI
ALIPIN CAHYO
HJ. SRI NUR HIDAYAT

ALAMAT
AIKMEL
KALIJAGA
MASBAGIK
DSN LEKONG
SEKARTEJA
PANCOR
PAOK MOTONG
LB LOMBOK
SERUNI
PENEDA GANDOR
AIKMEL
SAKRA
DSN TEPUNG
RUMBUK
AIK DEWA
GELORA

NO RM
022733
022749
022746
022750
002466
022695
022753
022684
001703
022748
022065
020799
004471
019390
022688
022701

TANGGAL MASUK
TANGGAL KELUAR
7-10/5/2016
8-10/5/2016
7-10/5/2016
8-10/5/2016
6-10/5/2016
6-10/5/2016
8-10/5/2016
5-10/5/2016
8-10/5/2016
7-10/5/2016
9-10/5/2016
9-10/5/2016
9-10/5/2016
8-10/5/2016
5-10/5/2016
6-10/5/2016

27
28
29
30
31
32
33
34
35
36
JUMLAH

ELASA
UMUM
765,500
2,130,000
1,863,500
2,197,000
2,898,000
1,072,000
2,645,000
4,689,000

CARA BAYAR
BPJS
2,532,500

1,767,000

2,585,600

1,514,000

1,820,500
1,835,000
3,332,300
3,636,000
4,800,500
1,648,500
2,586,000
4,081,000

PKS

KET

24,176,000

22,941,900

3,281,000

TANGGAL11 MEI 2016, RABU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BY. SURIANAH
NY. SURIANAH
IQ. RAEHANUN
MUHTASAR
AMAQ HURNAEN
YUSUF SAANG
SANUSI
ARFAH
MISNADI
MATUL BARIAH
QORINA NUDIATUN
BAIQ MEDINA SAFIRA
LALU RUSIADI
MASRAH
WASIL HENDRAWAN
JAKRANAH
ROHMINI
SRI MARLIANI
ENI SWASTATI
ANISA SAKILA
ADZAM DZIA ARSYAD

ALAMAT
JEROWARU
JEROWARU
KERUAK
KALIJAGA
BATU YANG
LAB. LOMBOK
SURALAGA
PIJOT
SEMBALUN
SEMBALUN
SEKARTEJA
PADAMARA
SUKAMULIA
PRINGGABAYA
AMPENAN
SIKUR
SAKRA
RUMBUK
RAKAM
MASBAGIK
SERUNI

NO RM
022870
022841
022728
004831
018388
021350
001948
022713
022732
022410
022763
022741
000303
014195
006298
022761
022813
019390
022188
022766
0228977

TANGGAL MASUK
TANGGAL KELUAR
10-11/5/2016
10-11/5/2016
7-11/5/2016
3-8/5/2016
9-10/5/2016
9-10/5/2016
9-10/5/2016
7-11/5/2016
7-11/5/2016
9-11/5/2016
9-11/5/2016
7-11/5/2016
3-11/5/2016
6-11/5/2016
9-11/5/2016
8-11/5/2016
9-11/5/2016
10-11/5/2016
9-11/5/2016
9-11/5/2016
11-11/5/2016

27
28
29
30
31
32
33
34
35
36
JUMLAH

ABU
UMUM

2,007,000

1,566,000
3,656,000
5,430,000

CARA BAYAR
BPJS
635,000
2,256,250
2,967,500
4,752,650
5,180,750
5,188,250
5,185,750
1,898,150
2,477,000
1,372,600
1,568,800
3,138,000
6,197,450

PKS

2,746,000

1,572,400
2,541,000

1,599,100
2,292,600
4,402,000
591,500
1,258,000
1,649,000
665,000

5,567,000

4,309,000

KET

16,822,500

56,678,850

11,168,400

TANGGAL12 MEI 2016, KAMIS

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
HJ. MAEMUNAH
HAMRINUDIN
HJ. JAMILAH
SITI RAUHUN
HUMAIRA RAHMA
FANIA DWI
MUTIA KHALIZA
M. FARIS ZAHIRUDDIN
H. MANSUR
MARTINI
LILIA MAISUROH
YUSUF ANDROMEDIA
BQ. HUSNAWATI
MUHAMMAD
SRIANI
HJ. HALMATUSSAKDIAH
H. ARIPIN
MASRURI
RUSLIWATI
ESTI KRISNA BAYU
H.M HAMDAN SAROJI
BQ WIWIN KURNI
BY. INDRAWATI
INDRAWATI
HJ. HIDAYATI
MASDAH

ALAMAT
MASBAGIK
LB. LOMBOK
TANJUNG
RUMBUK
SAKRA
MASBAGIK
RUMAH SEHAT
SIKUR
KALIJAGA
SELONG
PANCOR
LD NANGKA
MASBAGIK
SAKRA
PAOK MOTONG
SURALAGA
PAOK MOTONG
KORLEKO
SIKUR
SEKARTEJA
ANJANI
SAKRA
WANASABA
WANASABA
SUKAMULIA
AIKMEL

NO RM
018532
002193
018885
021117
022765
022742
022839
022767
022745
022770
021461
022821
006739
015339
022224
001231
022835
022832
021826
022844
021989
020999
022902
022875
020615
022538

TANGGAL MASUK
TANGGAL KELUAR
5-11/5/2016
4-11/5/2016
9-12/5/2016
10-12/5/2016
9-12/5/2016
7-12/5/2016
9-12/5/2016
9-12/5/2016
7-11/5/2016
11-12/5/2016
11-12/5/2016
9-12/5/2016
9-12/5/2016
8-12/5/2016
11-12/5/2016
9-12/5/2016
9-12/5/2016
9-12/5/2016
29-11/4-5/2016
10-12/5/2016
10-12/5/2016
9-12/5/2016
11-12/5/2016
10-12/5/2016
11-12/5/2016
11-12/5/2016

27
28
29
30

M. ALIFULLAH

SELONG

021488

JUMLAH

8-12/5/2016

MIS
UMUM
1,780,000
6,670,000
2,810,500
372,000
4,430,500
959,000
5,820,000
416,000

425,000
185,000
6,926,000
139,000

CARA BAYAR
BPJS
5,149,050

PKS
3,369,000

1,252,300
2,206,500

1,834,600

1,924,500
2,531,300

1,572,400

1,931,050
4,024,500
2,211,900
2,225,850
3,121,100
831,500
2,432,200
2,256,250
2,019,900
9,467,000
1,818,800
1,905,750
2,894,850
600,000
2,666,750
5,174,750
5,169,250

1,514,700

1,831,100
1,834,600
2,541,000
1,767,000

KET

4,780,000

30,933,000

63,815,050

21,044,400

LIPPO

TANGGAL13 MEI 2016, JUMAT

No

NAMA PASIEN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

BY. ARTI OKTAVIA

NY. ARTI OKTAVIA
BY. ELI FITRIANI
NY. ELI FITRIANI
SEPINAH
ASIAH/HJ.SAKMAH
ANANDA MALIKA P
MASIAH
ADLI SURURI
ASHABUL YAMIN
HAMSIN
FAKHIRA SHAKILA
ABDUL MALIK ARSYAD
RINGGO TRINGGARA
SAEPUL AHMAD
M. SARIP
HJ. RAHMAH
AMIRA JUNIARTI
LISA ARMANINGRUM
HULDIAH

ALAMAT
MT.GAMANG
MT. GAMANG
AIKMEL
AIKMEL
SAKRA
WANASABA
LD. NANGKA
SAKRA
KOTARAJA
SURALAGA
PRINGGASELA
AIKMEL
SAKRA
SEMBALUN
AIKMEL
SAKRA
APITAIK
POHGADING
KUMBUNG
PANCOR

NO RM
022499
022479
023018
023011
022803
014245
018374
022137
022892
017880
009461
004296
002271
022818
022891
022840
000264
022838
022954
022900

JUMLAH

TANGGAL MASUK
TANGGAL KELUAR
30-4/4-5/2016
30-4/4-5/2016
12-13/5/2016
12-13/5/2016
9-12/5/2016
11-13/5/2016
10-13/5/2016
23-29/4/2016
10-13/5/2016
10-13/5/2016
9-13/5/2016
10-13/5/2016
7-13/5/2016
9-13/5/2016
12-13/5/2016
10-13/5/2016
11-13/5/2016
9-13/5/2016
11-13/5/2016
11-13/5/2016

UMAT
UMUM

CARA BAYAR
BPJS

PKS
907,500
6,166,150

250,000
550,000
2,609,250
2,335,000
1,603,000
470,000
1,764,000
2,453,000
2,392,000
1,181,000
984,500
2,323,500
3,907,000

6,631,300
2,236,750

5,028,300
1,767,000

3,926,700
2,751,500
4,820,550

2,746,000
1,767,000
2,497,000

5,274,750
2,767,000
1,333,000
2,747,000
1,421,500
2,453,000

28,963,000

30,222,300

20,878,950

KET
PLN

TANGGAL14 APRIL 2016, KAMIS

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
YAZID ALBUSTOMI
H. SAEH NURHADI
SITI JENAR AZZAHRA
TALITA HASNA H
KHALIFA RIZKIANA
JINAN YASA
BQ. DIAN RETNO
INQ HERMAN
SITI MARTINI
INQ ISMAN
AZWAN WIRYAPANI
MUJAKKIR
FEBRIANA HALIZA
INQ SURYA JAYA
ARUM SEKAR W
AQILA HAYAZA
BQ SIFA AZZAHRA
AQ. TAUFIK
MUSTIANAH
ASPUDI
NURUL HAYATI

ALAMAT
PESANGGRAHAN
SALASEK TENG
SAKRA
TIRTANADI
AIKMEL
SAKRA
SUGIAN
MT GADING
SELONG
GELORA
SAKRA
SUELA
SAKRA
TEBABAN
SELONG
PANCOR
AIKMEL
SAKRA
AIKMEL
KETANGGA
JURIT

NO RM
002263
007454
021455
021517
021523
021522
021550
021596
016848
021408
020745
021477
021524
001383
021436
016456
013688
021435
021480
021295
010948

TANGGAL MASUK
TANGGAL KELUAR
11-14/4/2016
11-14/4/2016
11-14/4/2016
11-14/4/2016
12-14/4/2016
12-14/4/2016
12-14/4/2016
12-14/4/2016
12-14/4/2016
9-14/4/2016
9-14/4/2016
11-13/4/2016
12-14/4/2016
12-14/4/2016
10-14/4/2016
12-14/4/2016
11-14/4/2016
11-14/4/2016
11-14/4/2016
7-14/4/2016
11-13/4/2016

27
28
29
30
31
32
33
34
35
36
JUMLAH

UMUM
2,665,500
4,438,500

CARA BAYAR
BPJS

PKS

2,743,500
1,210,000
1,124,000
43,000
2,116,000
1,557,500

1,877,800

1,834,600

3,790,750
4,248,300
5,150,000
2,766,000
1,888,000
1,717,000
1,619,500
1,753,000
3,304,000
1,721,000

3,386,500

2,018,400
4,752,650
515,000

1,767,000

KET

33,588,000

22,817,900

3,601,600

TANGGAL15 MEI 2016, MINGGU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23

NAMA PASIEN
MUHRIM
ZUHRATUL AINI
DAHRI
NASRI
M. HUSNI TAMRIN
DINDA SALWA NAFISA
INQ MASKURI
NAERA NALIFA
IJE ABDUL GANI
SUMARTI
NADIA SABILA
HIKMAH
FAHIRA ARSY SHEILA
IMTIHAN ROSADI
RAMA HASBUL YAMIN
PAPUK SADARIAH
LL. AGATA

ALAMAT

NO RM

SUELA
SUELA
KESIK
WANASABA
SELONG
TERARA
SUKARMA
MASBAGIK
PAOK LOMBOK
TERARA
KABAR
SUELA
SERUNI
ANJANI
MASBGAIK
PRINGGABAYA
SELONG

020798
023109
023008
022941
023021
023053
023088
023017
023015
022966
022991
023083
023024
022876
023025
022729
023084

JUMLAH

TANGGAL MASUK
TANGGAL KELUAR
13-15/5/2016
14-15/5/216
12-15/5/2016
11-15/5/2016
13-15/5/2016
13/15/5/2016
13-15/5/2016
12-15/5/2016
12-15/5/2016
13-15/5/2016
12-15/5/2016
13-15/5/2016
13-15/5/2016
10-15/5/2016
13-15/5/2016
12-15/5/2016
13-15/5/2016

GGU
UMUM

CARA BAYAR
BPJS
5,718,250

PKS

665,500
3,363,000
2,169,550
1,377,000
165,500

1,932,500
1,350,850

1,767,000

3,054,500
3,031,000
1,861,500
1,905,100
1,782,150
1,739,500
4,842,000
1,847,000
2,920,000
1,410,000

24,537,000

16,597,900

1,767,000

KET

TANGGAL16 MEI 2016, SENIN

No

NAMA PASIEN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

BY. HIDAYATI
NY. HIDAYATI
BY. MIFTAHUL WASLI
NY. MIFTAHUL WASLI
BY. AIDA SANKO
NY. AIDA SANKO
MARSYA HIDAYAT
LANANG DWI F
TIA ROSANI
NAUFAL ALIMUN
RUMENAH
HJ. SAHUMAWATI
RANDA RIVALDI
H. LL KENTANOM
RAHMTA SUGIONO
VERI ROSDIANA
ARI FATIMATUZOHRAH
MUANNAH
HASAN
JAWAINI
HIDAYAH

ALAMAT

NO RM

WANASABA
WANASABA
AIKMEL
AIKMEL
KALIJAGA
KALIJAGA
DANGER
SELONG
SELAGIK
PRINGGABAYA
SAKRA
LENEK
KESIK
SAKRA
SAKRA
AIKMEL
PRINGGABYA
PANCOR
TANJUNG TEROS
WANASABA
SEKARTEJA

JUMLAH

023068
023029
023107
023062
022975
022955
022893
023136
023056
023080
023094
018029
023019
022904
023089
023097
023108
017009
022894
023157
022959

TANGGAL MASUK
TANGGAL KELUAR
13-14/5/2016
13-14/5/2016
14-16/5/2016
13-16/5/2016
12-15/5/2016
12-15/5/2016
10-14/5/2016
14-16/5/2016
13-16/5/2016
13-16/5/2016
14-15/5/2016
13-15/5/2016
13-16/5/2016
11-16/5/2016
13-16/5/2016
14-16/5/2016
14-16/5/2016
14-16/5/2016
10-16/5/2016
16-16/5/2016
11-16/5/2016

JUMLAH

SENIN
UMUM
342,500
2,017,500
472,500
2,300,000
1,142,500
4,407,500
73,000

CARA BAYAR
BPJS

8,833,500

PKS

4,426,000
3,942,600

KET

GARDA MEDIKA

1,572,100
2,865,000
1,940,000
1,610,000
3,060,000
972,000
664,000
224,000
2,270,000
1,914,000

2,739,000
3,161,350
2,739,250

1,767,000
2,497,600
2,514,800

1,812,000
5,179,100
1,536,000
3,290,200

24,260,500

32,876,500

PMI 200.000

15,148,000

24,260,500

32,876,500

15,148,000

TANGGAL17 MEI 2016, SELASA

No

NAMA PASIEN

1
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

BY. HARNIWATI
NY. HARNIWATI
BY. AGUSTINA
NY. AGUSTINA
BY. DEWI RATNA
NY. DEWI RATNA
BY. SITI AISAH
NY. SITI AISAH
BY. SARINI
NY. SARINI
BY. MASNAH
NY. MASNAH
SANEP
HJ. SITI SALEHA
ARDIN
JAMIAH
MUANIK
HAQUL MUBIN
EVI OKTAVIA PUJI
M. DEDE APRI
NURINTIHAN
PELANGI APSIN
GADIS KAELA
NADA PUTRI
HIZATUL IFTIHAJ
PERKASA ROSMANTO

ALAMAT
SAKRA
SAKRA
PANCOR
PANCOR
LB. HAJI
LB. HAJI
SAKRA TIMUR
SAKRA TIMUR
MASBAGIK
MASBAGIK
TERARA
TERARA
KESIK
DSN LEKONG
LB. LOMBOK
PANCOR
MAMBEN DAYA
PENEDA GANDOR
LEPAK
SELONG
SELONG
PRINGGBAYA
PANCOR
TANJUNG LUAR
SAKRA
PENEDA GANDOR

NO RM
023120
023095
023105
022302
023127
023102
023146
023145
023155
023131
023058
022968
021708
002213
023093
023091
022903
023023
023140
023099
023101
023098
010904
023106
023103
007597

TANGGAL MASUK
TANGGAL KELUAR
14-17/5/2016
14-17/5/2016
14-16/5/2016
14-16/5/2016
14-17/5/2016
14-17/5/2016
15-17/5/2016
15-17/5/2016
15-17/5/2016
14-17/5/2016
13-17/5/2016
12-17/5/2016
13-17/5/2016
10-13/5/2016
14-17/5/2016
13-17/5/2016
11-16/5/2016
13-16/5/2016
15-17/5/2016
14-17/5/2016
14-17/5/2016
14-17/5/2016
14-17/5/2016
14-17/5/2016
14-17/5/2016
13-15/5/2016

28
29
30
31
32
33
34
35
36

ULAN MANDASARI
IZZAIYAH
ASNAN
GOWI FARIQ
HASIAH/SAIAH
SAODAH
HJ. SURIANTI

SELONG
SURALAGA
WANASABA
MASBAGIK
AIKMEL
KABAR
SAKRA TIMUR

021329
023160
023119
023132
023125
023028
016279

JUMLAH

16-17/5/2016
16-17/5/2016
14-17/5/2016
14-17/5/2016
15-17/5/2016
13-17/5/2016
15-17/5/2016

ELASA
UMUM
830,000

CARA BAYAR
BPJS

PKS

KET

5,911,750
1,148,000
3,563,500

830,000
5,698,750
600,000
2,308,250
575,000
2,891,750
830,000
5,961,650
3,460,000
3,195,000
4,699,000

637,000
342,000
2,190,000

30,000

5,874,050
6,350,850
5,792,800
2,390,750
2,471,500
2,178,400

1,834,600
1,836,000

1,727,500
1,864,000
1,849,500
2,210,900

2,140,600

SINAR MAS

549,500
2,080,750
2,767,000
437,000

20,247,000

2,337,750
2,408,250
2,639,000
2,419,900

1,834,600

69,092,550

12,357,300

TANGGAL18 MEI 2016, RABU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BY. MIFTAHURRIZKAH
NY. MIFTAHUURIZKAH
M. ANSOR ADITIA
MAHYIN
BY. JAMIAH
BY. EVI OKTAVIA
M. ARBIAN
AQ RENA
NADIN
M. NAKSIA
HENNI
HJ. SITI HAPSAH
MAULIZA USFA
MANAZILU ARHAM
NASRUN
NURAINI
DWIKI GHANIYA AL
HJ. JOHARIAH
HJ. NURUL HENNI
SUAEB
LL BAIHAQI
ANNAYA
L. M ALFATIH
ABD LATIF
INQ SAUFIAN
H. MUSTIAH

ALAMAT

NO RM

MAJIDI
MAJIDI
PANCOR
WANASABA
PANCOR
LEPAK
ANJANI
JEROWARU
SURALAGA
PAOK MOTONG
MASBAGIK
LKEMBANG KERANG
LEPAK
SURABAYA
KORLEKO
PANCOR
SUELA
SUELA
RUMBUK
BERMIS
PANCOR
MASBAGIK
SAKRA
KORLEKO
SURALAGA
IJOBALIT

023228
023228
023223
020652
023092
023154
023205
023014
023150
023143
023139
023104
023110
023196
022993
021314
023153
023186
023137
016507
023156
023149
023152
023224
023151
023271

TANGGAL MASUK
TANGGAL KELUAR
17-18/5/2016
17-18/5/2016
16-18/5/2016
15-18/5/2016
14-18/5/2016
15-18/5/2016
16-17/5/2016
12-17/5/2016
15-18/5/2016
15-18/5/2016
15-18/5/2016
14-18/5/2016
14-18/5/2016
16--18/5/2016
17-18/5/2016
13-18/5/2016
15-18/5/2016
16-18/5/2016
15-18/5/2016
11-17/5/2016
15-18/5/2016
15-18/5/2016
15-18/5/2016
16-18/5/2016
15-18/5/2016
17-18/5/2016

27
28
29
JUMLAH

16, RABU
UMUM

CARA BAYAR
BPJS
615,000
2,244,000

PKS

1,881,000
2,632,700
1,219,500
827,500
1,241,500
9,090,000
1,510,000
2,128,000
1,820,000
4,619,000
294,000

874,500
2,000,000
1,414,000
4,370,500
2,448,000
2,559,500
1,423,000
2,137,000

2,442,600
1,507,700
5,185,000
3,006,900
2,560,375

1,685,800

3,181,350
7,258,500

1,767,000
2,888,000

2,839,900

1,416,600

1,590,750
629,000

1,214,100

KET

42,486,000

35,064,775

8,971,500

TANGGAL19 MEI 2016, KAMIS

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
BY. MALA ERNA
NY. MALA ERNA
EMA AGUSTINA
HJ. MAEMUNAH
BY. MAENAH
NY. MAENAH
INQ ISMAYANI
JUNAIDI
ZAINAB TOYYIBAH
FAIQ TSAKIB
HAPSAH
ALIN KARIMA SIFA
HILMAN HUMAIDI
AQ ALWI
DELISA ALMIRA
BY. SITI MAULIDA
NY. SITI MAULIDA
AQ SUMIATUN

ALAMAT
LB. HAJI
LB. HAJI
RAKAM
PANCOR
TERARA
TERARA
JENGGIK
WANASABA
KALIJAGA
SELONG
LB. LOMBOK
KELAYU
SAKRA
SUELA
TANJUNG
SAKRA
SAKRA
DENGER

NO RM
023290
023289
023142
002516
023225
023193
023165
023241
023003
023214
023030
023268
023202
023230
023147
023226
023226
021063

TANGGAL MASUK
TANGGAL KELUAR
18-18/5/2016
18-18/5/2016
15-19/5/2016
18-19/5/2016
17-19/5/2016
16-19/5/2016
16-19/5/2016
17-19/5/2016
17-19/5/2016
16-19/5/2016
13-19/5/2016
17-19/5/2016
16-19/5/2016
17-18/5/2016
15-18/5/2016
17-18/5/2016
17-18/5/2016
17-19/5/2016

27
28
29
30
31
32
33
34
35
36
JUMLAH

KAMIS
UMUM

CARA BAYAR
BPJS

PKS
425,000
1,906,000

4,275,000
1,815,000
665,000
3,235,000
3,183,000
1,415,000
3,587,650
2,397,000
4,601,000
580,000
1,836,000

1,566,500
3,077,000

2,497,000
2,208,000

600,000
2,270,750
3,837,250

KET

22,587,000

16,354,150

7,036,000

TANGGAL, 20 MEI 2016, JUMAT

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23

NAMA PASIEN
GADIS KAELA FAT
HJ. MASTURAH
INQ UDIN
SYAFIATUN NUFUS
BQ. RATNAWASIH
NURHAYATI RUM
THALITA SAVA
AHMAD BUSAIRI
H. ARIPIN
TITIN YAYANG K
LAELY INAYAH
AGUNG PAEDOS
WARNAEN
USMAN
ASIAH
MEL HARDIANTI
BY. DESI SUSILAWATI
NY. DESI SUSILAWATI
M. SODDIQUL ALAMIN
ZAITUN

ALAMAT

NO RM

PANCOR
WANASABA
SAMBELIA
DAMES DAMAI
SELONG
TERARA
PAOK MOTONG
KESIK
MASBAGIK
AIKMEL
KABAR
MASBAGIK
SELONG
WANASABA
SUELA
WANASABA
LEPAK
LEPAK
SEMBALUN
AIKMEL

010904
023294
023141
023212
014191
001632
023222
023167
022835
023378
022707
023200
010445
023243
023365
020832
023350
023349
023380
023258

JUMLAH

TANGGAL MASUK
TANGGAL KELUAR
18-20/5/2016
18-20/5/2016
15-19/5/2016
16-20/5/2016
18-20/5/2016
18-20/5/2016
16-20/5/2016
17-20/5/2016
14-20/5/2016
19-20/5/2016
7-8/5/2016
16-20/5/2016
17-20/5/2016
17-20/5/2016
19-20/5/2016
18-20/5/2016
19-20/5/2016
19-20/5/2016
19-20/5/2016
20-20/5/2016

JUMAT
UMUM

1,127,000

669,000
7,621,000
2,878,000

212,000
571,000

CARA BAYAR
BPJS
1,248,500
1,744,000
2,229,150
2,894,000
2,316,450
2,439,600
2,436,000
7,595,500
260,000
1,154,500
2,228,000
2,753,350
2,337,750
993,000

PKS

1,767,000

1,767,000
4,717,300

2,541,200
1,767,000

2,748,000
550,000
2,448,000
761,000
1,107,000

17,694,000

35,627,800

12,559,500

KET

TANGGAL, 21 APRIL 2016, KAMIS

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
SITI HAJAR
H. M RUSNI
AHMAD TUHUR
BQ ZAENAB
JOHARAH
HJ. RAHMAH
BQ HALWAH S
H. SSAEH NURHADI
MAHYIN
YUZAK RATEADI
KURNIATUN
MAHSUDIN/SEMILAH
M. SUBHAN HADI
ZIZAM APRIADI
DICKY TRITAMA
PURNAWAN HAKIM
ROHANI
LL. HASAN
SITI ROZANA
RAISYA
AQ ANCAH
JONI ANDIKA
MANSUR
NUR RIFAINI
M. DEVLIN FIRDAUS
H. SAEFUDIN ZURI

ALAMAT
PANCOR
TERARA
KELAYU
SAKRA
AIKMEL
APITAIK
LD. BEDURIK
SALASEK TEN
WANASABA
SAKRA
BAG PAYUNG
AIKMEL
SIKUR
SAKRA
RENSING
PRINGGASELA
TERARA
JURIT
RENSING
SELONG
PADAMARA
BILA KEMBAR
AIKMEL
SANDUBAYA
MT BAAN
PANCOR

NO RM
021899
010367
019359
002621
021724
000264
021825
007454
020652
021924
010493
021743
018937
021946
021756
021985
021160
021772
021754
021897
021823
021824
002812
021738
012985
003493

TANGGAL MASUK
TANGGAL KELUAR
19-21/4/2016
17-21/4/2016
18-21/4/2016
18-21/4/2016
15-21/4/2016
20-21/4/2016
17-21/4/2016
17-20/4/2016
19-21/4/2016
19-21/4/2016
19-21/4/2016
15-21/4/2016
18-21/4/2016
19-21/4/2016
19-20/4/2016
20-21/4/2016
19-21/4/2016
15-21/4/2016
19-21/4/2016
19-20/4/2016
17-21/4/2016
17-21/4/2016
19-21/4/2016
20-21/4/2016
18-21/4/2016
17-21/4/2016

UMUM
5,324,000
738,000
7,010,000
1,184,000
624,000
3,324,500

CARA BAYAR
BPJS

2,280,700
2,297,550

3,121,886
2,225,900

1,479,000
1,479,000
4,404,150
2,645,500
1,430,000
2,904,000

4,821,750
912,000
3,638,500
5,058,950
3,737,500

1,368,000
2,240,800
2,306,000
1,839,000
2,145,000
1,127,000

5,788,500
1,913,500
3,563,100

27 FATIMAH
28 HJ. BQ ENY ROSTINAH
29
30
31
32
33
34
35
36

SAWING
MASBGAIK

JUMLAH

007363
014796

19-21/4/2016
21-21/4/2016

1,768,500
560,000

37,487,000

47,773,286

BAYAR
PKS
2,183,750
1,542,400

2,497,600

1,917,400

3643100
3,563,100

KET
GARDA MEDIKA

15,347,350

TANGGAL, 26 APRIL 2016, SELASA

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36

NAMA PASIEN
ZAENAL ARIFIN
BY. EKA SUSIANTI
NY. EKA SUSIANTI
BY. YULIA PARHANA
NY. YULIA PARHANA
BY. ZAKIANI
NY. ZAKIANI
BY. NURUL H
NY. NURUL H
BY. FITRIA NINGSIH
NY. FITRIA NINGSIH
SAHDAN
MARYAM
MASTURAH HAYAZA
PUTRIANA RAPSANJANI
NURUL AINI
ROHADI
SALIM
MAHINI
H. SURDI S.SOS
RATU CELESTA
RAZIL ABDILLAH
LATIFA INDRIANI
MULIANAH
SUPRIADI
M. KHAIRUL IHSAN
ASNAWI
DIANA MAULINA
H. SAEFUDIN ZUHRI
M. AZKA ALFATIH
NAYSIRA AFR5A
KHAIRUL RUSLI
BUKRAN

ALAMAT
SSAKRA BARAT
WANASABA
WANASABA
SONGAK
SONGAK
WANASABA
WANASABA
SAMBELIA
SAMBELIA
PRINGGABAYA
PRINGGABAYA
SETANGGOR
TEBABAN
PANCOR
PANCOR
PRINGGASELA
TEBABAN
GUNUG RAJAK
SIKUR
LD NANGKA
SELONG
SAKRA
JEROWARU
RAKAM
PANCOR
SAKRA
MASBAGIK
PAOK LOMBOK
PANCOR
SELONG
AIKMEL
RENSING
SURALAGA

JUMLAH

NO RM
020000
022119
022052
022089
022016
022207
022166
022013
022010
021957
021935
019169
021170
022139
022229
021242
007037
022130
021963
022116
000544
022154
022105
021632
022004
006731
013960
022029
003493
022155
022136
022232
022046

TANGGAL MASUK
TANGGAL KELUAR
25-26/4/2016
23-26/4/2016
22-26/4/2016
22-26/4/2016
21-26/4/2016
25-26/4/2016
25-26/4/2016
21-26/4/2016
21-26/4/2016
20-23/4/2016
19-26/4/2016
25-26/4/2016
25-26/4/2016
24-26/4/2016
26-26/4/2016
14-26/4/2016
24-26/4/2016
23-26/4/2016
25-26/4/2016
23-26/4/2016
22-26/4/2016
24-26/4/2016
22-26/4/2016
25-26/4/2016
20-26/4/2016
22-26/4/2016
19-26/4/2016
26-26/4/2016
21-26/4/2016
24-26/4/2016
23-26/4/2016
26-26/4/2016
21-22/4/2016

UMUM
1,532,000
947,000
4,211,000
845,000

CARA BAYAR
BPJS

PKS

8,637,500

4,426,800

KET

5,713,550
345,000
2,647,250
666,000
7,280,750

PMI 200.000

913,000
5,986,500
5,156,750
5,386,250
932,000
817,500
4,611,000
1,385,000
1,959,550
3,947,250
2,562,750
46,000
828,000
217,500
1,456,500

3,682,500

3,270,500

3053000

5,401,500
2,648,000
4,144,000
550,000
4,410,000
1,187,000

6,684,650

2541000

2,083,500
950,000
2,330,000

31,015,500

71,674,250

13,703,300

SINAR MAS

TANGGAL, 27 APRIL 2016, RABU

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

NAMA PASIEN
NM
HJ. RAHMAH
YUNITA KHAERUNNISA
AQ SUSILAWATI
AYU MAHENDRI N
GIAN KASUARI
HUSNUL AENI
M. ZIKRI
HAFIZA ADIFA
RABITHAH RAHIL
RAMZI R
BADRAN AC
M. YUSRI ISPAN

ALAMAT

NO RM

BAGEK NYAKA
PANCOR
AIKMEL
SUGIAN
SELONG
SUELA
LB. LOMBOK
SAKRA
MASBAGIK
SELONG
KELAYU
MASBGAIK
LB. HAJI

021851
021265
022100
022147
022163
022149
022206
004394
022156
022101
022157
013615
022151

TANGGAL MASUK
TANGGAL KELUAR
23-27/4/2016
26-27/4/2016
22-27/4/2016
24-27/4/2016
25-27/4/2016
24-27/4/2016
25-27/4/2016
21-27/4/2016
24-27/4/2016
22-27/4/2016
25-27/4/2016
27-27/4/2016
24-26/4/2016

CARA BAYAR
UMUM
3,188,000
1,978,000

1,526,000
2,075,000
1,539,000
1,907,000
2,070,000

28
29
30
31
32
33
34
35
36
JUMLAH

14,283,000

CARA BAYAR
BPJS
5,412,750
3,814,300
1,676,400
1,160,750

3,111,800
4,448,100

PKS

KET

1,836,100

7,351,550
1,572,400
2,541,000

GARDA MEDIKA

1,834,050

LIPPO

831,000

20,455,100

15,135,100

TANGGAL, 28 APRIL 2016, KAMIS

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

NAMA PASIEN
MURNIATI
BY. ROHANA
NY. ROHANA
BY. SITI RAMDANIYAH
NY. SITI RAMDANIYAH
BY. HAODI
NY. HAODI
BY. NURMILIP
NY. NURMILIP
LL SADAR
BQ NURHIJAH
AQ RIDONI
KARINA ISLAMI
NAJRAENI
NABILA KHANSA
ERNA SAPITRI
MUNAREP
SITI HANAYATUS S

ALAMAT
PANCOR
TERARA
TERARA
BOROK TOYANG
BOROK TOYANG
AIKMEL
AIKMEL
SEMBALUN
SEMBALUN
MASBAGIK
PRINGGASELA
AIKMEL
LD NANGKA
SEMBALUN
MAJIDI
PANCOR
JEROWARU
SUKAMULIA

NO RM
020971
022322
022289
022234
022223
022222
016738
022160
022158
009494
022153
019072
022215
022237
022214
013281
021960
022140

TANGGAL MASUK
TANGGAL KELUAR
26-28/4/2016
27-28/4/2016
4-28/4/2016
26-28/4/2016
26-28/4/2016
26-28/4/2016
25-28/4/2016
25-28/4/2016
25-28/4/2016
24-28/4/2016
24-28/4/2016
22-28/4/2016
25-28/4/2016
26-28/4/2016
25-28/4/2016
25-28/4/2016
22-27/4/2016
24-28/4/2016

CARA B
UMUM
1,227,000

370,000
340,000
963,000
5,669,000
915,000
1,096,000

27
28
29
30
31
32
33
34
35
36
JUMLAH

10,580,000

IS
CARA BAYAR
BPJS

PKS

KET

475,000
2,376,750
475,000
2,841,500
550,000
2,763,250
3,056,500
2,518,200

2,178,000

2,682,000

1,767,000

2,428,000
2,141,500
3,831,100
2,626,000

PMI 1.200.000
GARDA MEDIKA

26,138,800

6,571,000

TANGGAL, 29 APRIL 2016, JUMAT

No

NAMA PASIEN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

RIADAH
MALIK ULIL ALBAB
SRIANI
AULIA WULAN ANANDA
CLARA JULIA
HUNADI
DINI KHAIRO F
MEGAWATI
JAINAH
M. TAHIR

ALAMAT
SURALAGA
MASBAGIK
PAOK MOTONG
MASBAGIK
SUKAMULIA
SUELA
SELONG
MAJIDI
SELONG
JEROWARU

NO RM
022145
022142
022224
022202
022258
022231
03465
022192
021506
022219

TANGGAL MASUK
TANGGAL KELUAR
24-29/4/2016
24-29/4/2016
26-29/4/2016
25-28/4/2016
26-29/4/2016
26-29/4/2016
28-29/4/2016
26-29/4/2016
26-29/4/2016
25-29/4/2016

27
28
29
30
31
32
33
34
35
36
JUMLAH

6, JUMAT
UMUM
4,627,000

4,343,000
1,849,500

265,000

CARA BAYAR
BPJS
3,070,000
2,473,250
6,260,250
2,625,750
706,500
2,097,900
3,275,750
1,980,900

PKS

KET

PMI 600.000
1,917,000

1,832,700

11,084,500

22,490,300

3,749,700