Jan

NO TANGGAL NAMA PASIEN No.RM

1 Ika Wahyuningsih 07.61.48

Mar
NO TANGGAL NAMA PASIEN No.RM

1 14/3/2016 Favorita 06.10.35

Diagnosa Masuk Konsultasi
Prof dr Yusuf Misbach Rs Abdi
G 1 H. 34 -35 mgg Waluyo

Diagnosa Masuk Konsultasi

dr Pradana ( spesialis penyakit

Cholesitiasis dalam) / dr Siti ( spesialis Jantung)
 DOKTER

Laksmi,dr

DOKTER

Fach,dr / Rofi,dr
Bulan : Januari 2016
KEBIDANAN
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Fachruddin,SpOG
2 dr. Junita,SpOG
3 dr.Laksmi Maharani,SpOG
4 dr. Nana Agustina,SpOG
5 dr.Supardi,SPOG
6 dr.Chandra Asmuni,SpOG
7 dr.Frizar Irmansyah, SpOG
8 dr.Hari P, SpOG

Bulan : Januari 2016

ANAK
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Handi Rohandi,SpA
2 dr. Srie Enggar,SpA
3 dr.Dyah Istikowati, SpA
4 dr.Budiyanto,SpA
5 dr.Melina Imran,SpA
6 dr.Tb.Ferdi Fadillah,SpA

Bulan : Januari 2016

THT
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Fauziah.Fardizza,SpTHT-KL

Bulan : Januari 2016

UMUM
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Abu Bakar,SpAN,KIC

0
Bulan : Februari 2016
KEBIDANAN
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Fachruddin,SpOG
2 dr. Junita,SpOG
3 dr.Laksmi Maharani,SpOG
4 dr. Nana Agustina,SpOG
5 dr.Supardi,SPOG
6 dr.Frizar Irmansyah, SpOG
7 dr.Hari P, SpOG

Bulan : Februari 2016

ANAK ANAK
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Handi Rohandi,SpA
2 dr. Srie Enggar,SpA
3 dr.Dyah Istikowati, SpA
4 dr.Budiyanto,SpA
5 dr.Melina Imran,SpA
6 dr.Tb.Ferdi Fadillah,SpA

Bulan : Februari 2016

THT
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Fauziah.Fardizza,SpTHT-KL

Bulan : Februari 2016

UMUM UMUM
NO DOKTER DISCHARGE LAMA RAWAT LOS
1 dr.Abu Bakar,SpAN,KIC

0
 Bulan : Maret 2016
KEBIDANAN Rata- rata per bu
NO DOKTER DISCHARGE LAMA RAWAT LOS NO
1 dr.Fachruddin,SpOG 1
2 dr. Junita,SpOG 2
3 dr.Laksmi Maharani,SpOG 3
4 dr. Nana Agustina,SpOG 4
5 dr.Supardi,SPOG 5
6 dr.Frizar Irmansyah, SpOG 6
7 dr.Hari P, SpOG

Bulan : Maret 2016

ANAK
NO DOKTER DISCHARGE LAMA RAWAT LOS NO
1 dr.Handi Rohandi,SpA 7
2 dr. Srie Enggar,SpA 8
3 dr.Dyah Istikowati, SpA 9
4 dr.Budiyanto,SpA 10
5 dr.Melina Imran,SpA 11
6 dr.Tb.Ferdi Fadillah,SpA 12

Bulan : Maret 2016

THT
NO DOKTER DISCHARGE LAMA RAWAT LOS NO
1 dr.Fauziah.Fardizza,SpTHT-KL 13

Bulan : Maret 2016

UMUM
NO DOKTER DISCHARGE LAMA RAWAT LOS NO
1 dr.Abu Bakar,SpAN,KIC 14

0
Rata- rata per bulan
DOKTER LOS
dr. Fachruddin, SpOG 0.00 3
Dr. dr. Junita I, SpOG 0.00 2
dr. Laksmi M, SpOG 0.00
dr. Nana A, SpOG 0.00
dr. Supardi A.W, SPOG 0.00
dr. Hari P, SpOG 0.00
Total 0.00

Rata-rata semua dokter Obsgyn 0.00

DOKTER LOS
dr.Handi Rohandi,SpA
dr. Srie Enggar,SpA
dr.Dyah Istikowati, SpA
dr.Budiyanto,SpA
dr.Melina Imran,SpA
dr.Tb.Ferdi Fadillah,SpA
Total 0.00
Rata-rata semua dokter Anak 0.00

DOKTER LOS
dr.Fauziah.Fardizza,SpTHT-KL

DOKTER LOS
dr.Abu Bakar,SpAN,KIC

Rata-rata semua dokter 0.00

0
Form Time out Bulan Januari 2016

No Tanggal Nama Pasien No. RM

1 2/1/16 Ema Nur karima 07.33.89
2 3/1/16 Ria Amanda 07.55.12
3 4/1/2016 Silvia Anugrahwaty 02.98.30
4 5/1/2016 Tri suci lestari 07.57.90
5 6/1/2016 Chandra Wahyu 05.03.89
6 9/1/2016 Laminah 07.56.80
7 9/1/16 Fitriah 07.04.29
8 10/1/16 Erni Susilowati 07.69.44
9 11/1/16 Zahra 07.40.95
10 14/1/2016 Kartikasari 06.95.43
11 14/1/2016 Diana Agustin 07.60.02
12 15/1/2016 Yuli Andriyani 01.84.52
13 16/1/2016 Suriah 07.42.65
14 16/1/2016 Mela Suwita 07.51.71
15 16/1/2016 Rizki Novitasari 06.19.63
16 18/1/2016 Fitrotun Naja 05.63.13
17 19/1/2016 Juliani 02.94.93
18 20/1/2016 Novi Ika 07.82.14
19 201/2016 Yulia Edviana 07.63.76
20 21/1/2016 Rini Nuraisa 07.72.43
21 21/1/2016 Silvia deswari 06.14.03
22 23/1/2016 Siti Mahrusoh 00.27.69
23 24/1/2016 Sri Mardiati 07.84.26
24 27/1/2016 Dian Chrisfani 07.85.24
25 28/1/2016 Ganiesa 07.59.91
26 29/1/2016 Linda Pratiwi 06.06.22
27 29/1/2016 Wiwi 07.60.48
28 31/1/2016 Ika W 07.61.48
 Januari 2016
No Tanggal Nama Usia

1 7/1/2016 Raifano 2 thn 5 bln

2 25/1/2016 Halim 1 thn 6 bln
3 26/1/2016 Viona 11 thn

Februari 2016
No Tanggal Nama Usia
1 1/2/2016 Allister 4 thn 8 bln

2 10/2/2016 M. Husain 3 thn 6 bln

3 10/2/2016 Anya William 7 thn

4 12/2/2016 Akhtar nauf 2 thn 11 bln
5 19/2/2016 Isra Rizki 9 bln
6 22/2/2016 Aleiya Jaya 5 thn 2 bln
7 25/2/2016 Gusli Ananda 13 thn

Maret 2016
No Tanggal Nama Usia
1 2/3/2016 Handaru Daneswara 3 thn
2 14/3/2016 Satrio 12 thn
3 23/3/2016 ariztakyra
4 zidan
5 nauval farid 8 bln
 R.M Diagnosa Dokter Ruangan
Obs Vomitus + GEA+Intake
07.83.89 sulit Melina,dr
07.12.39 Morbili Dyah,dr Edelweis
07.86.44 Susp DD Dyah,dr Edelweis

R.M Diagnosa Dokter Ruangan

07.58.62 Obs Febris + Stomatitis Srie,dr Edelweis

06.16.31 Obs Febris hari ke 3 susp DD Melina,dr Flamboyan

Obs Febris hari ke 1 susp FA
07.88.43 susp ISK Srie,dr Edelweis
06.32.87 Susp Bronchopneumonia Srie,dr Edelweis
07.55.83 Obs Febris ke 3 + GEA Dyah,dr Edelweis
07.09.74 Obs Febris ke 3 Dyah,dr Flamboyan
03.57.09 Obs Demam Typhoid Dyah,dr Flamboyan

R.M Diagnosa Dokter Ruangan

06.08.61 Lekositosis Dyah,dr Flamboyan
00.47.07 Obs Febris + DD Srie,dr Flamboyan
05.78.29 Obs Febris Srie,dr Flamboyan
06.90.14 obs. Febris Srie,dr Flamboyan
07.94.64 obs. Febris Srie,dr Flamboyan
 Angka ILO 2016

No Tanggal Nama Pasien No. RM

1
2
3
4
5
6
Dokter
REKAPITULASI DATA PASIEN NYERI

Form Nyeri Bulan Januari 2016

No Tanggal Nama Pasien No. RM Nyeri
1
2
3
4
5
6
7
8
9
10
11
Form IC Bulan Januari 2016
F J Fr
No Tanggal Nama Pasien No. RM
Y T Y T Y T
1 7/1/16 Ayu 07.83.85 1
2 9/1/16 Dina Akromah 06.39.84 1
3 11/1/16 Ilip Komalasari 07.84.48 1
4 12/1/16 Anindita 07.83.64
5 2/1/2016 Siti Khairunnisa 03.97.06 1
6 2/1/2016 Doewi Afriyani 07.58.70
7 2/1/2016 Wenas Yanti 07.75.42 1
8 3/1/2016 Eka Nova 04.51.06 1
9 5/1/2016 Rizky Febrianty 07.55.58
10 7/1/2016 Witri Sitriyah 07.17.41 1
11 8/1/2016 Fifia Awalia 06.23.02 1
12 8/1/2016 Sri Devi 07.31.40
13 8/1/2016 Nugrahani 07.56.77 1
14 8/1/2016 Anila 06.93.99 1
15 9/1/2016 Martanti Endah 04.16.45 1
16 10/1/2016 Cut Cynthia 07.56.98 1
17 10/1/2016 Fransisca 04.78.22 1
18 12/1/2016 Tri Juni 02.53.24 1
19 13/1/2016 Eki Sarahwati 05.03.18 1
20 13/1/2016 Sonya Riestia 07.56.15 1
21 14/1/2016 Rina 07.56.50 1
22 2/1/16 Ema Nur karima 07.33.89
23 3/1/16 Ria Amanda 07.55.12 1
24 4/1/2016 Silvia Anugrahwaty 02.98.30 1
25 5/1/2016 Tri suci lestari 07.57.90
26 6/1/2016 Chandra Wahyu 05.03.89 1
27 9/1/2016 Laminah 07.56.80 1
28 9/1/16 Fitriah 07.04.29 1
29 10/1/16 Erni Susilowati 07.69.44
30 11/1/16 Zahra 07.40.95 1
31 14/1/2016 Kartikasari 06.95.43 1
32 14/1/2016 Diana Agustin 07.60.02
33 15/1/2016 Yuli Andriyani 01.84.52
34 16/1/2016 Suriah 07.42.65 1
35 4/1/2016 Ratih sari 07.79.04
36 8/1/2015 Zahra 07.40.95 1
37 14/1/2016 Puji 07.77.12
38 15/1/2016 Zainab 07.50.62
39 17/1/2016 Rara Ayu 07.57.65 1
40 17/1/2016 Ajeng Hidayani 07.75.28 1
41 21/1/2016 Nuri Nurain 07.45.90 1
42 21/1/2016 Noer Puspapratiwi 06.48.22 1
43 22/1/2016 Nindya Aisa 07.56.58
44 23/1/2016 Wulan sari 02.82.48
45 23/1/2016 Eliza hany 04.90.68 1
46 23/1/2016 Sofya Marline 03.10.74 1
47 24/1/2016 Athiyyah 04.64.78 1
48 27/1/2017 Nurul Syarifah 07.57.10 1
49 27/1/2015 Dian Puspitasari 07.78.83 1
50 28/1/2016 Khairul Bariyah 07.06.61 1
51 28/1/2016 Murni Handayani 02.64.22 1
52 28/1/2016 Dewi Rachmawati 05.65.02 1
53 16/1/2016 Mela Suwita 07.51.71 1
54 16/1/2016 Rizki Novitasari 06.19.63 1
55 18/1/2016 Fitrotun Naja 05.63.13 1
56 19/1/2016 Juliani 02.94.93 1
57 20/1/2016 Novi Ika 07.82.14 1
58 201/2016 Yulia Edviana 07.63.76
59 21/1/2016 Rini Nuraisa 07.72.43
60 21/1/2016 Silvia deswari 06.14.03
61 23/1/2016 Siti Mahrusoh 00.27.69 1
62 24/1/2016 Sri Mardiati 07.84.26
63 27/1/2016 Dian Chrisfani 07.85.24 1
64 28/1/2016 Ganiesa 07.59.91 1
65 29/1/2016 Linda Pratiwi 06.06.22 1
66 29/1/2016 Wiwi 07.60.48
67 17/1/2016 Rara ayu 07.57.65
68 17/1/2016 Dwi Meiyani 07.83.94 1
69 22/1/2016 Nining Pujiati 07.79.98
70 23/1/2016 Praveda Ascavintya 07.80.59
71 25/1/2016 Diana Khoiril mala 07.86.16
72 25/1/2016 Harnas kuba 00.64.79 1
73 29/1/2016 Ayu Wahyu 07.85.79
74 28/1/2016 Evi Lestari 07.86.69 1
75 16/1/2016 Ika Wahyuningsih 07.61.48
76 21/1/12016 Suriah 07.42.65 1
77 25/1/2016 Wiena 05.89.38
78 27/1/2016 Nurjanah 07.86.48
79 29/1/2016 Anita. S 07.84.52 1
80 29/1/2016 Amelia Surya 06.96.95 1
81 30/1/2016 Rina Zamia 07.74.41 1
82 31/1/2016 Ika Wahyuningsih 07.61.48
TOTAL 41 4 5 3 1 0
 TOTAL Ya 41 5 1
TOTAL Tidak 4 3 0

IC Bulan Februari 2016

F J Fr
No Tanggal Nama Pasien No. RM
Y T Y T Y T
1 1/2/16 Lita Fitriah 00.51.80 1
2 3/2/16 Windasari 07.87.52
3 3/2/2016 Wienna A 05.89.38
4 5/2/2016 Diah Putri 05.43.80 1
5 6/2/2016 Gita Tri 07.62.73
6 7/2/2016 Yuni Atyah 04.31.27
7 8/2/16 Suana 07.60.05
8 8/2/16 Yeni Apriyani 07.53.52
9 8/2/16 Febri Wulansari 07.77.94
10 8/2/16 Lita Yulianti 07.69.38
11 10/2/16 Maslicha Chairia 07.58.82 1
12 10/2/16 Anggun Puspita 07.61.62
13 10/2/2016 Novita Sari 06.88.42 1
14 13/2/2016 Latifah 06.55.30 1
15 14/2/2016 Mariavor corry 07.60.61 1
16 15/2/2016 Indah nur Kasanah 07.88.93
17 15/2/2016 Susiyanti 07.94.71 1
18 16/2/2016 Neneng Kamelia 01.62.73 1
19 17/2/2016 Veri Atina 07.59.23
20 18/2/2016 Puji Haryatiningsih 07.77.22
21 24/2/2016 Rika Puspitasri 07.62.37
22 24/2/2016 Dewi Ariani 01.23.69 1
23 26/2/2016 Sujiyati 07.65.90 1
24 27/2/2016 Nidya Elvandari 06.70.91
25 28/2/2016 Fiana Fega 07.58.58
26 29/2/2016 Nikmatillah 07.71.27
27 1/2/2016 Aderia 07.61.60 1
28 2/2/2016 Denis Putri 07.59.97 1
29 3/2/2016 Ananda Citra 02.82.32 1
30 4/2/2016 Emmy Dwiyanti 07.43.72
31 10/2/2016 Filly Valianti 07.61.20
32 11/2/2016 Elfa 07.59.84 1
33 11/2/2016 Fety Lani 01.31.52 1
34 11/2/2016 Eti Heriati 07.64.02 1
35 12/2/2016 Inda Purnamasari 02.90.21 1
36 13/2/2016 Layinatul Wirdha 07.37.69 1
37 13/2/2016 Curdiana 04.32.55 1
38 14/2/2016 Desy Wulandari 07.65.05 1
39 18/2/2016 Ratih Indryani 05.00.55 1
40 19/2/2016 Indri Septa devi 07.74.94
41 19/2/2016 Siti Nurofiah 07.79.92
42 20/2/2016 Setyarini Indah 07.78.79 1
43 20/2/2016 Dewi Sartika 06.62.20 1
44 21/2/2016 Siti Maryam 05.26.40 1
45 21/2/2016 Ratih Sari Dewi 07.79.04
46 24/2/2016 Irawati Prastianingsih 07.60.69 1
47 24/2/2016 Nurfitriani 07.80.60 1
48 27/2/2016 Hilda Mustika 02.83.41
49 28/2/2016 Ni Made A 03.47.74 1
50 28/2/2016 Tahira Anggia 07.63.31
51 28/2/2016 dr.Mila Widyastuti 07.62.21 1
52 29/2/2016 Fitri Harahap 06.11.74 1
53 29/2/2016 Indri Astria 05.80.38 1
54 15/2/2016 Anah Yuliani 03.46.26 1
55 21/2/2016 Hesty Yulianti 07.89.19 1
56 1/2/2016 Netik Ernawati 07.87.03 1
57 1/2/16 Barniah 07.87.23
58 12/2/16 Nashirotunnisa 07.03.98 1
59 13/2/2016 Eny Kustiningsih 06.99.22
60 17/2/2016 Sri Purwaningsih 01.84.27
61 18/2/2016 Kholipah 07.89.46
62 19/2/2016 Komariah 01.69.68 1
63 20/2/2016 Ayu Wahyuni 06.41.89 1
64 22/2/2016 Sri Hartanti 07.06.27 1
65 26/2/2016 Diah Wulan sari 04.22.08
66 28/2/2016 Elyastiningsih 06.04.09
67 1/2/2016 Gita Tri 07.62.73
68 1/2/2016 Wiena 05.89.38
69 6/2/2016 Partinah 01.89.78
70 11/2/2016 Ari Kusmiran 07.76.30
71 8/2/2016 Rika Puspitasri 07.62.37
72 13/2/2016 Mety amninuriah 07.67.90
73 12/2/2016 Anistiarini 07.59.73
74 15/2/2016 Yusniati 07.88.58
75 16/2/2016 Novi Syafitri 07.88.61
76 17/2/2016 Indri Astria 05.80.38 1
77 16/2/2016 Melta 07.85.36 1
78 17/2/2016 Puji H 07.77.12
79 18/2/2016 Heni R 03.92.88 1
80 20/2/2015 Siti Aisyah 07.87.45
81 23/2/2016 Oktaviana 07.75.81
82 23/2/2016 Fiana 07.58.58
83 27/2/2016 Usti Nugraeni 07.49.
84 28/2/2016 Titik Nurhayani 07.86.71
85
86
87
29 6 1 1 2 1

29 1 2
6 1 1

IC Bulan Maret 2016

F J Fr
No Tanggal Nama Pasien No. RM
Y T Y T Y T
1 1/3/16 Mona Oktaviany 01.70.51
2 1/3/16 Vera Amelia 07.75.06 1
3 3/3/2016 Ni Putu Eka Susanti 04.90.54 1
4 7/3/2016 Nissyia Mazhaly 06.11.37 1
5 7/3/2016 Khalifa Marina 07.91.99 1
6 10/3/2016 Susan Puspita 07.87.89
7 10/3/16 Andhini Rizkiyah 04.92.56 1
8 16/3/2016 Annisa Nur Rahma 06.63.67 1
9 1/3/2016 Zahro Fauziyah 05.82.90 1
10 4/3/2015 Lonna 02.41.66 1
11 5/3/2016 Maya Febrianti 04.36.07
12 6/3/2015 Metty Amnuriyah 07.67.90
13 7/3/2015 Siska Puspita 06.02.57 1
14 7/3/2016 Retno Wulandari 05.43.72
15 8/3/2016 Badiah 03.64.54 1
16 9/3/2016 Dewi Afridayanti 03.87.82 1
17 11/3/2016 Ajeng Deciana 06.48.12 1
18 13/3/2016 Siti Juniyati 07.68.52 1
19 13/3/2016 Rosidah 07.66.24
20 13/3/2016 Citra Reno 07.20.95
21 14/3/2016 Firaszhiah amirah 07.85.31
22 15/3/2016 Made Putri 06.67.72 1
23 17/3/2016 Syamiyah 07.90.86
24 17/3/2016 Martini 04.88.32 1
25 2/3/16 Mery Tambunan 04.06.72 1
26 8/3/16 Shenshen 07.91.14
27 8/3/16 Widya Kurniat 03.76.64 1
28 9/3/2016 Riani Komalasari 07.91.86
29 9/3/16 Rini Andayani 02.18.58
30 11/3/16 Marini 07.82.36
31 12/3/2016 Verayani 05.46.09 1
32 14/3/2016 Yuswita Bella 07.92.79 1
33 1/3/2016 Fitri Haryani 07.49.02 1
34 4/3/2016 Rini H 06.08.18
35 11/3/2016 Siti Juniyati 07.68.52 1
36 17/3/2016 Nella 06.52.04
37 13/3/2016 Yunia 07.92.32
38 13/3/2016 Putri Rizki 07.47.93
39 14/3/2016 Favorita 06.10.35 1
40 17/3/2016 Ayu Permata 07.87.40 1
41 20/3/2016 Lenny Maria 07.63.66 1
42 23/3/2016 Irma Suryani 07.64.73
43 243/2016 Indyah Kusuma 07.64.18
44 21/3/2016 Ellin 06.11.97
45 24/3/2016 Fitria Puri 07.68.33
46 21/3/2016 Lutfi Tanjung 07.93.65 1
47 24/3/2016 Siti Aminah 07.70.47 1
48 25/3/2016 Fatimah Assagaf 07.16.51
49 25/3/2016 Dwi maryani 03.10.25 1
50 25/3/2016 Raditya Hapsari 06.20.12
51 26/3/2016 Iva andina 07.88.05
52 29/3/2017 Maya deka 07.94.85 1
53 27/3/2016 winda oktapisty 07.37.73
54 28/3/2016 henny mulandari 07.94.74
55 28/3/2016 eka liliana 07.28.62
56 28/3/2016 harmony nindyta 07.94.42 1
57 28/3/2016 nur sa'adah 07.57.09 1
58 28/3/2016 sandika dwi j 04.75.84 1
59 29/3/2016 robiatul adawiyah 01.30.53 1
60 drg. Merry Winarsih 07.92.70
61 indra mustika 07.91.26
62 20/3/2016 Siti nurul 02.51.16
63 20/3/2016 Astya Azshara 07.95.05
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
19 5 4 1 2 1

19 4 2
5 1 1
 N L S AB Ir Za AN
Ket
Y T Y T Y T Y T Y T Y T Y T

1 kurang 1

kurang 1
ic dr nadya -
1

1
1

1
1
 1
1

1
1
1

1
1

1
9 1 7 2 4 2 0 0 0 0 0 0 0 0 79
 9 7 4 0 0 0 0 67
1 2 2 0 0 0 0 12

N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Ket

1
1

1
1
1
1

1
1

dr Rofi

1
1
1

1
1

1
1
 1
1

1(T) dr hari

1
1
1

1
1
1
1
 1

1
1
1
1

11 2 13 3 3 1 0 0 0 1 0 0 0 0 74

11 13 3 0 0 0 0 59
2 3 1 0 1 0 0 15

N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Ket
1

1
1

1
 1
1
1

1
1
1
1

1
1
1

1
1

1
1
1
1
1
3 1 10 4 4 1 0 0 4 0 0 1 0 0 60

3 10 4 0 4 0 0 46
1 4 1 0 0 1 0 14
Form IC Bulan Januari 2016
Handi Srie
No Tanggal Nama Pasien No. RM
Y T Y T
1 2/1/2016 Siti Khairunnisa 07.83.29
2 2/1/2016 Doewi Afriyani 07.83.30
3 2/1/2016 Wenas Yanti 07.83.32
4 3/1/2016 Eka Nova 07.83.33
5 5/1/2016 Rizky Febrianty 07.83.62 1
6 7/1/2016 Witri Sitriyah 07.83.84 1
7 8/1/2016 Fifia Awalia 07.83.97
8 8/1/2016 Sri Devi 07.84.02
9 8/1/2016 Nugrahani 07.84.05
10 8/1/2016 Anila 07.84.13
11 9/1/2016 Martanti Endah 07.84.15
12 10/1/2016 Cut Cynthia 07.84.38
13 10/1/2016 Fransisca 07.84.45
14 12/1/2016 Tri Juni 07.84.60
15 13/1/2016 Eki Sarahwati 07.84.75
16 13/1/2016 Sonya Riestia 07.84.76
17 14/1/2016 Rina 07.84.88
18 2/1/16 Ema Nur karima 07.83.1
19 3/1/16 Ria Amanda 07.83.34
20 4/1/2016 Silvia Anugrahwaty 07.83.35
21 5/1/2016 Tri suci lestari 07.83.61 1
22 6/1/2016 Chandra Wahyu 07.83.77 1
23 9/1/2016 Laminah 07.84.27
24 9/1/16 Fitriah 07.84.35
25 10/1/16 Erni Susilowati 07.84.44
26 11/1/16 Zahra 07.84.54
27 14/1/2016 Kartikasari 07.84.90
28 14/1/2016 Diana Agustin 07.84.94
29 15/1/2016 Yuli Andriyani 07.85.58
30 By.Nurwullan sari 07.83.04
31 7/1/2016 Raifano 07.83.89
32 10/1/2016 Zafran 07.82.40
33 15/1/2016 Zainab 01.85.10
34 17/1/2016 Rara Ayu 07.85.44
35 17/1/2016 Ajeng Hidayani 07.85.45
36 21/1/2016 Nuri Nurain 07.85.82
37 21/1/2016 Noer Puspapratiwi 07.85.85
38 22/1/2016 Nindya Aisa 07.85.97
39 23/1/2016 Wulan sari 07.86.03
40 23/1/2016 Eliza hany 07.86.11
41 23/1/2016 Sofya Marline 07.86.13
42 24/1/2016 Athiyyah 07.86.15
43 27/1/2017 Nurul Syarifah 07.86.54 1
44 27/1/2015 Dian Puspitasari 03.86.60 1
45 28/1/2016 Khairul Bariyah 07.86.61 1
46 28/1/2016 Murni Handayani 07.86.80 1
47 28/1/2016 Dewi Rachmawati 07.86.84 1
48 16/1/2016 Mela Suwita 07.85.29
49 16/1/2016 Rizki Novitasari 07.85.34
50 18/1/2016 Fitrotun Naja 07.85.47
51 19/1/2016 Juliani 07.85.58
52 20/1/2016 Novi Ika 07.85.68
53 201/2016 Yulia Edviana 07.85.70
54 21/1/2016 Rini Nuraisa 07.85.81
55 21/1/2016 Silvia deswari 07.85.96
56 24/1/2016 Sri Mardiati
57 28/1/2016 Ganiesa 07.86.83 1
58 29/1/2016 Linda Pratiwi 07.86.85
59 29/1/2016 Wiwi 07.86.87
60 28/1/2016 Evi Lestari 07.86.77
61 24/1/2016 Salman Alfarisi 07.85.85
62 Hilya 07.86.07 1
63 25/1/2016 Halim 07.12.39
64 26/1/2016 Viona 07.86.44
65 26/1/2016 Hasan 07.85.96
66 25/1/2016 Yugo 07.86.19
67 29/1/2016 Salsabila 07.85.82
68 31/1/2016 Ika Wahyuningsih 07.87.09
69 30/1/2016 Rina Zamia 07.87.58
70
71
72
73
74
75
TOTAL 3 0 5 3

TOTAL Ya 3 5
TOTAL Tidak 0 3
IC Bulan Februari 2016
Handi Srie
No Tanggal Nama Pasien No. RM
Y T Y T
1 1/2/16 Lita Fitriah 07.87.17
2 3/2/16 Windasari 07.87.53
3 3/2/2016 Wienna A
4 5/2/2016 Diah Putri 07.87.82
5 6/2/2016 Gita Tri 07.87.96 1
6 7/2/2016 Yuni Atyah 07.88.58
7 8/2/16 Suana 07.88.13 1
8 8/2/16 Yeni Apriyani 07.88.18 1
9 8/2/16 Febri Wulansari 07.88.19 1
10 8/2/16 Lita Yulianti 07.88.23 1
11 10/2/16 Maslicha Chairia 07.88.31 1
12 10/2/16 Anggun Puspita 07.88.32
13 10/2/2016 Novita Sari 07.88.44
14 13/2/2016 Latifah 07.88.73 1
15 14/2/2016 Mariavor corry 07.88.90
16 15/2/2016 Susiyanti 07.88.94
17 16/2/2016 Neneng Kamelia 07.89.18 1
18 17/2/2016 Veri Atina 07.59.23 1
19 18/2/2016 Puji Haryatiningsih 07.89.49
20 24/2/2016 Rika Puspitasri 07.90.14
21 24/2/2016 Dewi Ariani 07.90.24 1
22 26/2/2016 Sujiyati
23 27/2/2016 Nidya Elvandari
24 28/2/2016 Fiana Fega 07.58.58 1
25 29/2/2016 Nikmatillah
26 1/2/2016 Aderia 07.87.19
27 2/2/2016 Denis Putri 07.87.35
28 3/2/2016 Ananda Citra 07.87.66
29 4/2/2016 Emmy Dwiyanti 07.87.81
30 10/2/2016 Filly Valianti 07.88.45 1
31 11/2/2016 Elfa 07.88.48 1
32 11/2/2016 Fety Lani 07.88.49 1
33 11/2/2016 Eti Heriati 07.88.60 1
34 12/2/2016 Inda Purnamasari 07.88.64 1
35 13/2/2016 Layinatul Wirdha 07.88.73 1
36 13/2/2016 Curdiana 07.88.76 1
37 14/2/2016 Desy Wulandari 07.88.87 1
38 18/2/2016 Ratih Indryani 07.89.42
39 19/2/2016 Indri Septa devi 07.89.58
40 19/2/2016 Siti Nurofiah 07.89.62
41 20/2/2016 Setyarini Indah 07.89.73
42 20/2/2016 Dewi Sartika 07.89.78
43 21/2/2016 Siti Maryam 07.89.86
44 21/2/2016 Ratih Sari Dewi 07.89.87
45 24/2/2016 Irawati Prastianingsih 07.90.15
46 24/2/2016 Nurfitriani
47 27/2/2016 Hilda Mustika
48 28/2/2016 Ni Made A 07.90.71
49 28/2/2016 Tahira Anggia 07.90.74
50 28/2/2016 dr.Mila Widyastuti 07.90.78
51 29/2/2016 Fitri Harahap 07.91.13
52 29/2/2016 Indri Astria
53 15/2/2016 Anah Yuliani 07.88.95
54 21/2/2016 Hesty Yulianti 07.89.82
55 1/2/2016 Allister 07.58.62 1
56 1/2/2016 Netik Ernawati
57 10/2/2016 M. Husain 06.16.31
58 10/2/2016 Anya William 07.88.43 1
59 12/2/2016 Akhtar nauf 06.32.87 1
60 11/2/2016 By. Yeni ( Farhan) 07.88.18 1
61 13/2/2016 Rayyan Kaled 07.86.80
62 19/2/2016 Isra Rizki 07.55.83
63 22/2/2016 Aleiya Jaya 07.09.74
64 25/2/2016 Gusli Ananda 03.57.09
65
66
67
68
69
0 0 11 12

0 11
0 12
87
40

IC Bulan Maret 2016

Handi Srie
No Tanggal Nama Pasien No. RM
Y T Y T
1 1/3/16 Mona Oktaviany 07.91.21
2 1/3/16 Vera Amelia 07.91.24
3 3/3/2016 Ni Putu Eka Susanti 04.90.54
4 7/3/2016 Nissyia Mazhaly 07.92.20
5 10/3/2016 Susan Puspita 07.92.45 1
6 10/3/16 Andhini Rizkiyah 07.92.52
7 16/3/2016 Annisa Nur Rahma 07.93.31 1
8 1/3/2016 Zahro Fauziyah 07.91.05
9 4/3/2015 Lonna 07.91.59
10 5/3/2016 Maya Febrianti 07.91.89
11 6/3/2015 Metty Amnuriyah 07.91.96
12 7/3/2015 Siska Puspita 07.92.01
13 7/3/2016 Retno Wulandari 07.92.20 1
14 8/3/2016 Badiah 07.92.26 1
15 9/3/2016 Dewi Afridayanti 07.92.42
16 11/3/2016 Ajeng Deciana 07.92.65 1
17 13/3/2016 Siti Juniyati 07.92.93
18 13/3/2016 Rosidah 07.92.98
19 13/3/2016 Citra Reno 07.92.99
20 14/3/2016 Firaszhiah amirah 07.93.03 1
21 15/3/2016 Made Putri 07.93.29 1
22 17/3/2016 Syamiyah 07.93.48
23 17/3/2016 Martini 07.93.52
24 7/3/2016 By. Shadiqa 07.90.77
25 15/3/2016 ainayah 07.90.44
26 2/3/2016 Handaru Daneswara 06.08.61
27 14/3/2016 Satrio 00.47.07 1
28 16/3/2016 Lenny Maria
29 23/3/2016 Irma Suryani
30 243/2016 Indyah Kusuma 07.94.33
31 21/3/2016 Ellin
32 24/3/2016 Fitria Puri 07.94.39
33 25/3/2016 Fatimah Assagaf 07.94.49
34 25/3/2016 Dwi maryani 07.94.50
35 25/3/2016 Raditya Hapsari 07.94.51
36 26/3/2016 Iva andina 07.94.57 1
37 Ariztakyra 05.78.29
38 Naufal Farid 07.94.64
39 28/3/2016 winda oktapisty
40 28/3/2017 henny mulandari 07.94.81
41 28/3/2018 harmony nindyta 07.94.82
42 28/3/2019 sandika dwi j
43 29/3/2020 robiatul adawiyah
44 30/3/2016 Siti nurul
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
 61
62
63
64
65
66
67
68
69 0 2 3 4

0 3
2 4

46
28
Dyah Melina Ferdi Darnila Ezzy Firda
Y T Y T Y T Y T Y T Y T
1
1
1
1

tdk ada
1
1
1

1
1
1
1
1

1
1
1

1
1
1
1

1 Kurang 1
1

1
1
1
1
1
1
1
 1
1
1
1
1
1
1
1

1
1
1
1

1
1
1
1
1
1
tdk ada

28 2 9 3 1 3 0 0 0 0 0 0 57

28 9 1 0 0 0 46
2 3 3 0 0 0 11
Dyah Melina Ferdi Darnila Ezzy Firdha Ket
Y T Y T Y T Y T Y T Y T
1
1

1
1

1
1

1
1

1
1
1
1
 1
1
1
1
1
1
1
tdk ada

1
1
1
1

tdk ada
tdk ada

1
1
1
1

7 4 6 4 4 5 0 0 0 0 0 0 53

7 6 4 0 0 0 28
4 4 5 0 0 0 25
Dyah Melina Ferdi Darnila Ezzy abu Ket
Y T Y T Y T Y T Y T Y T
1 1 sirkum
1
1
1

1
1
1
1
tdk ada

tdk ada

1
 tdk ada
1

1
1
1
1
1

1
3 4 4 2 3 1 0 0 0 0 1 0 27

3 4 3 0 0 1 14
4 2 1 0 0 0 13
Form Tubak Bulan Januari 2016
F J Fr
No Tanggal Nama Pasien No. RM
Y T Y T Y T
1 7/1/16 Ayu 07.83.85
2 9/1/16 Dina Akromah 06.39.84 1
3 11/1/16 Ilip Komalasari 07.84.48 1
4 12/1/16 Anindita 07.83.64
5 2/1/2016 Siti Khairunnisa 03.97.06 1
6 2/1/2016 Doewi Afriyani 07.58.70
7 2/1/2016 Wenas Yanti 07.75.42 1
8 3/1/2016 Eka Nova 04.51.06 1
9 5/1/2016 Rizky Febrianty 07.55.58
10 7/1/2016 Witri Sitriyah 07.17.41 1
11 8/1/2016 Fifia Awalia 06.23.02 1
12 8/1/2016 Sri Devi 07.31.40
13 8/1/2016 Nugrahani 07.56.77 1
14 8/1/2016 Anila 06.93.99 1
15 9/1/2016 Martanti Endah 04.16.45 1
16 10/1/2016 Cut Cynthia 07.56.98 1
17 10/1/2016 Fransisca 04.78.22 1
18 12/1/2016 Tri Juni 02.53.24 1
19 13/1/2016 Eki Sarahwati 05.03.18
20 13/1/2016 Sonya Riestia 07.56.15 1
21 14/1/2016 Rina 07.56.50 1
22 2/1/16 Ema Nur karima 07.33.89
23 3/1/16 Ria Amanda 07.55.12 1
24 4/1/2016 Silvia Anugrahwaty 02.98.30 1
25 5/1/2016 Tri suci lestari 07.57.90
26 6/1/2016 Chandra Wahyu 05.03.89
27 9/1/2016 Laminah 07.56.80
28 9/1/16 Fitriah 07.04.29
29 10/1/16 Erni Susilowati 07.69.44
30 11/1/16 Zahra 07.40.95 1
31 14/1/2016 Kartikasari 06.95.43 1
32 14/1/2016 Diana Agustin 07.60.02
33 15/1/2016 Yuli Andriyani 01.84.52
34 16/1/2016 Suriah 07.42.65 1
35 4/1/2016 Ratih sari 07.79.04
36 8/1/2015 Zahra 07.40.95 1
37 14/1/2016 Puji 07.77.12
38 15/1/2016 Zainab 07.50.62
39 17/1/2016 Rara Ayu 07.57.65 1
40 17/1/2016 Ajeng Hidayani 07.75.28 1
41 21/1/2016 Nuri Nurain 07.45.90 1
42 21/1/2016 Noer Puspapratiwi 06.48.22 1
43 22/1/2016 Nindya Aisa 07.56.58
44 23/1/2016 Wulan sari 02.82.48
45 23/1/2016 Eliza hany 04.90.68 1
46 23/1/2016 Sofya Marline 03.10.74
47 24/1/2016 Athiyyah 04.64.78 1
48 27/1/2017 Nurul Syarifah 07.57.10 1
49 27/1/2015 Dian Puspitasari 07.78.83
50 28/1/2016 Khairul Bariyah 07.06.61 1
51 28/1/2016 Murni Handayani 02.64.22 1
52 28/1/2016 Dewi Rachmawati 05.65.02
53 16/1/2016 Mela Suwita 07.51.71
54 16/1/2016 Rizki Novitasari 06.19.63 1
55 18/1/2016 Fitrotun Naja 05.63.13
56 19/1/2016 Juliani 02.94.93 1
57 20/1/2016 Novi Ika 07.82.14
58 201/2016 Yulia Edviana 07.63.76
59 21/1/2016 Rini Nuraisa 07.72.43
60 21/1/2016 Silvia deswari 06.14.03
61 23/1/2016 Siti Mahrusoh 00.27.69 1
62 24/1/2016 Sri Mardiati 07.84.26
63 27/1/2016 Dian Chrisfani 07.85.24
64 28/1/2016 Ganiesa 07.59.91
65 29/1/2016 Linda Pratiwi 06.06.22
66 29/1/2016 Wiwi 07.60.48
67 17/1/2016 Rara ayu 07.57.65
68 17/1/2016 Dwi Meiyani 07.83.94
69 22/1/2016 Nining Pujiati 07.79.98
70 23/1/2016 Praveda Ascavintya 07.80.59
71 25/1/2016 Diana Khoiril mala 07.86.16
72 25/1/2016 Harnas kuba 00.64.79
73 29/1/2016 Ayu Wahyu 07.85.79
74 28/1/2016 Evi Lestari 07.86.69 1
75 16/1/2016 Ika Wahyuningsih 07.61.48
76 21/1/12016 Suriah 07.42.65 1
77 25/1/2016 Wiena 05.89.38
78 27/1/2016 Nurjanah 07.86.48
79 29/1/2016 Anita. S 07.84.52
80 29/1/2016 Amelia Surya 06.96.95 1
81 30/1/2016 Rina Zamia 07.74.41
82 31/1/2016 Ika Wahyuningsih 07.61.48

TOTAL 24 7 1 3 1 0

TOTAL Ya 24 1 1
 TOTAL Tidak 7 3 0

Tubak Bulan Februari 2016

F J Fr
No Tanggal Nama Pasien No. RM
Y T Y T Y T
1 1/2/16 Lita Fitriah 00.51.80 1
2 3/2/16 Windasari 07.87.52
3 3/2/2016 Wienna A 05.89.38
4 5/2/2016 Diah Putri 05.43.80 1
5 6/2/2016 Gita Tri 07.62.73
6 7/2/2016 Yuni Atyah 04.31.27
7 8/2/16 Suana 07.60.05
8 8/2/16 Yeni Apriyani 07.53.52
9 8/2/16 Febri Wulansari 07.77.94
10 8/2/16 Lita Yulianti 07.69.38
11 10/2/16 Maslicha Chairia 07.58.82 1
12 10/2/16 Anggun Puspita 07.61.62
13 10/2/2016 Novita Sari 06.88.42 1
14 13/2/2016 Latifah 06.55.30 1
15 14/2/2016 Mariavor corry 07.60.61 1
16 15/2/2016 Indah nur Kasanah 07.88.93
17 15/2/2016 Susiyanti 07.94.71
18 16/2/2016 Neneng Kamelia 01.62.73
19 17/2/2016 Veri Atina 07.59.23
20 18/2/2016 Puji Haryatiningsih 07.77.22
21 24/2/2016 Rika Puspitasri 07.62.37
22 24/2/2016 Dewi Ariani 01.23.69 1
23 26/2/2016 Sujiyati 07.65.90
24 27/2/2016 Nidya Elvandari 06.70.91
25 28/2/2016 Fiana Fega 07.58.58
26 29/2/2016 Nikmatillah 07.71.27
27 1/2/2016 Aderia 07.61.60 1
28 2/2/2016 Denis Putri 07.59.97 1
29 3/2/2016 Ananda Citra 02.82.32 1
30 4/2/2016 Emmy Dwiyanti 07.43.72
31 10/2/2016 Filly Valianti 07.61.20
32 11/2/2016 Elfa 07.59.84 1
33 11/2/2016 Fety Lani 01.31.52 1
34 11/2/2016 Eti Heriati 07.64.02
35 12/2/2016 Inda Purnamasari 02.90.21 1
36 13/2/2016 Layinatul Wirdha 07.37.69 1
37 13/2/2016 Curdiana 04.32.55 1
38 14/2/2016 Desy Wulandari 07.65.05
39 18/2/2016 Ratih Indryani 05.00.55 1
40 19/2/2016 Indri Septa devi 07.74.94
41 19/2/2016 Siti Nurofiah 07.79.92
42 20/2/2016 Setyarini Indah 07.78.79
43 20/2/2016 Dewi Sartika 06.62.20 1
44 21/2/2016 Siti Maryam 05.26.40 1
45 21/2/2016 Ratih Sari Dewi 07.79.04
46 24/2/2016 Irawati Prastianingsih 07.60.69 1
47 24/2/2016 Nurfitriani 07.80.60 1
48 27/2/2016 Hilda Mustika 02.83.41
49 28/2/2016 Ni Made A 03.47.74 1
50 28/2/2016 Tahira Anggia 07.63.31
51 28/2/2016 dr.Mila Widyastuti 07.62.21 1
52 29/2/2016 Fitri Harahap 06.11.74 1
53 29/2/2016 Indri Astria 05.80.38 1
54 15/2/2016 Anah Yuliani 03.46.26 1
55 21/2/2016 Hesty Yulianti 07.89.19 1
56 1/2/2016 Netik Ernawati 07.87.03 1
57 1/2/16 Barniah 07.87.23
58 12/2/16 Nashirotunnisa 07.03.98 1
59 13/2/2016 Eny Kustiningsih 06.99.22
60 17/2/2016 Sri Purwaningsih 01.84.27
61 18/2/2016 Kholipah 07.89.46
62 19/2/2016 Komariah 01.69.68
63 20/2/2016 Ayu Wahyuni 06.41.89 1
64 22/2/2016 Sri Hartanti 07.06.27
65 26/2/2016 Diah Wulan sari 04.22.08
66 28/2/2016 Elyastiningsih 06.04.09
67 1/2/2016 Gita Tri 07.62.73
68 1/2/2016 Wiena 05.89.38
69 6/2/2016 Partinah 01.89.78
70 11/2/2016 Ari Kusmiran 07.76.30
71 8/2/2016 Rika Puspitasri 07.62.37
72 13/2/2016 Mety amninuriah 07.67.90
73 12/2/2016 Anistiarini 07.59.73
74 15/2/2016 Yusniati 07.88.58
75 16/2/2016 Novi Syafitri 07.88.61
76 17/2/2016 Indri Astria 05.80.38 1
77 16/2/2016 Melta 07.85.36 1
78 17/2/2016 Puji H 07.77.12
79 18/2/2016 Heni R 03.92.88
80 20/2/2015 Siti Aisyah 07.87.45
81 23/2/2016 Oktaviana 07.75.81
82 23/2/2016 Fiana 07.58.58
83 27/2/2016 Usti Nugraeni 07.49.
84 28/2/2016 Titik Nurhayani 07.86.71
85
86
87
20 6 0 2 3 0

20 0 3
6 2 0

Tubak Bulan Maret 2016

F J Fr
No Tanggal Nama Pasien No. RM
Y T Y T Y T
1 1/3/16 Mona Oktaviany 01.70.51
2 1/3/16 Vera Amelia 07.75.06 1
3 3/3/2016 Ni Putu Eka Susanti 04.90.54 1
4 7/3/2016 Nissyia Mazhaly 06.11.37
5 7/3/2016 Khalifa Marina 07.91.99 1
6 10/3/2016 Susan Puspita 07.87.89
7 10/3/16 Andhini Rizkiyah 04.92.56 1
8 16/3/2016 Annisa Nur Rahma 06.63.67
9 1/3/2016 Zahro Fauziyah 05.82.90 1
10 4/3/2015 Lonna 02.41.66 1
11 5/3/2016 Maya Febrianti 04.36.07
12 6/3/2015 Metty Amnuriyah 07.67.90
13 7/3/2015 Siska Puspita 06.02.57 1
14 7/3/2016 Retno Wulandari 05.43.72
15 8/3/2016 Badiah 03.64.54 1
16 9/3/2016 Dewi Afridayanti 03.87.82
17 11/3/2016 Ajeng Deciana 06.48.12 1
18 13/3/2016 Siti Juniyati 07.68.52
19 13/3/2016 Rosidah 07.66.24
20 13/3/2016 Citra Reno 07.20.95
21 14/3/2016 Firaszhiah amirah 07.85.31
22 15/3/2016 Made Putri 06.67.72
23 17/3/2016 Syamiyah 07.90.86
24 17/3/2016 Martini 04.88.32 1
25 2/3/16 Mery Tambunan 04.06.72
26 8/3/16 Shenshen 07.91.14
27 8/3/16 Widya KurniatRiani Kumalasari 03.76.64
28 9/3/2016 Riani Komalasari 07.91.86
29 9/3/16 Rini Andayani 02.18.58
30 11/3/16 Marini 07.82.36
31 12/3/2016 Verayani 05.46.09
32 14/3/2016 Yuswita Bella 07.92.79
33 1/3/2016 Fitri Haryani 07.49.02 1
34 4/3/2016 Rini H 06.08.18
35 17/3/2016 Nella 06.52.04
36 13/3/2016 Yunia 07.92.32
37 11/3/2016 Siti Juniyati 07.68.52
38 13/3/2016 Putri Rizki 07.47.93
39 14/3/2016 Favorita 06.10.35 1
40 17/3/2016 Ayu Permata 07.87.40 1
41 16/3/2016 Lenny Maria 07.63.66 1
42 23/3/2016 Irma Suryani 07.64.73
43 243/2016 Indah Kusuma 07.64.18
44 21/3/2016 Ellin 06.11.97
45 24/3/2016 Fitria Puri 07.68.33
46 21/3/2016 Lutfi Tanjung 07.93.65 1
47 24/3/2016 Siti Aminah 07.70.47
48 25/3/2016 Fatimah Assagaf 07.16.51
49 25/3/2016 Dwi maryani 03.10.25 1
50 25/3/2016 Raditya Hapsari 06.20.12
51 26/3/2017 Iva andina 07.88.05
52 27/3/2016 winda oktapisty 07.37.73 1
53 28/3/2016 henny mulandari 07.94.74
54 28/3/2016 harmony nindyta 07.94.42
55 28/3/2016 eka liliana 07.28.62
56 28/3/2016 nur sa'adah 07.57.09
57 28/3/2016 sandika dwi j 04.75.84
58 29/3/2016 maya deka 07.94.85
59 29/3/2016 robiatul adawiyah 01.30.53
60 drg. Merry Winarsih 07.92.70
61 indra mustika 07.91.26
62 20/3/2016 Siti nurul 02.51.16
63 20/3/2016 Astya Azshara 07.95.05
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
12 1 0 2 1 1

12 0 1
1 2 1
 N L S AB Ir Za AN
Ket
Y T Y T Y T Y T Y T Y T Y T
tdk ada

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tdk ada

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7 1 6 0 3 1 0 1 0 0 0 1 0 0 56

7 6 3 0 0 0 0 42
 1 0 1 1 0 1 0 14

N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Ket

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7 5 2 0 0 0 0 37
1 5 0 1 0 1 0 16

N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Ket
1

1
1 tdk ada

tdk ada

tdk ada

1
1

tdk ada

tdk ada
1
1
1
tdk ada
1

tdk ada
1
tdk ada
1

1
 tdk ada
1 tdk ada

1
tdk ada
1
tdk ada
tdk ada
dr rofi

1
tdk ada

tdk ada
tdk ada

tdk ada
tdk ada

tdk ada
1
tdk ada
3 0 9 0 3 2 0 1 1 1 0 0 0 0 37

3 9 3 0 1 0 0 29
0 0 2 1 1 0 0 8
Form Tubak Bulan Januari 2016

No Tanggal Nama Pasien

1 2/1/2016 Siti Khairunnisa
2 2/1/2016 Doewi Afriyani
3 2/1/2016 Wenas Yanti
4 3/1/2016 Eka Nova
5 5/1/2016 Rizky Febrianty
6 7/1/2016 Witri Sitriyah
7 8/1/2016 Fifia Awalia
8 8/1/2016 Sri Devi
9 8/1/2016 Nugrahani
10 8/1/2016 Anila
11 9/1/2016 Martanti Endah
12 10/1/2016 Cut Cynthia
13 10/1/2016 Fransisca
14 12/1/2016 Tri Juni
15 13/1/2016 Eki Sarahwati
16 13/1/2016 Sonya Riestia
17 14/1/2016 Rina
18 2/1/16 Ema Nur karima
19 3/1/16 Ria Amanda
20 4/1/2016 Silvia Anugrahwaty
21 5/1/2016 Tri suci lestari
22 6/1/2016 Chandra Wahyu
23 9/1/2016 Laminah
24 9/1/16 Fitriah
25 10/1/16 Erni Susilowati
26 11/1/16 Zahra
27 14/1/2016 Kartikasari
28 14/1/2016 Diana Agustin
29 15/1/2016 Yuli Andriyani
30 By.Nurwullan sari
31 7/1/2016 Raifano
32 10/1/2016 Zafran
33 15/1/2016 Zainab
34 17/1/2016 Rara Ayu
35 17/1/2016 Ajeng Hidayani
36 21/1/2016 Nuri Nurain
37 21/1/2016 Noer Puspapratiwi
38 22/1/2016 Nindya Aisa
39 23/1/2016 Wulan sari
40 23/1/2016 Eliza hany
41 23/1/2016 Sofya Marline
42 24/1/2016 Athiyyah
43 27/1/2017 Nurul Syarifah
44 27/1/2015 Dian Puspitasari
45 28/1/2016 Khairul Bariyah
46 28/1/2016 Murni Handayani
47 28/1/2016 Dewi Rachmawati
48 16/1/2016 Mela Suwita
49 16/1/2016 Rizki Novitasari
50 18/1/2016 Fitrotun Naja
51 19/1/2016 Juliani
52 20/1/2016 Novi Ika
53 201/2016 Yulia Edviana
54 21/1/2016 Rini Nuraisa
55 21/1/2016 Silvia deswari
56 24/1/2016 Sri Mardiati
57 28/1/2016 Ganiesa
58 29/1/2016 Linda Pratiwi
59 29/1/2016 Wiwi
60 28/1/2016 Evi Lestari
61 24/1/2016 Salman Alfarisi
62 Hilya
63 25/1/2016 Halim
64 26/1/2016 Viona
65 26/1/2016 Hasan
66 25/1/2016 Yugo
67 29/1/2016 Salsabila
68 31/1/2016 Ika Wahyuningsih
69 30/1/2016 Rina Zamia
70
Tubak Bulan Februari 2016

No Tanggal Nama Pasien

1 1/2/16 Lita Fitriah
2 3/2/16 Windasari
3 3/2/2016 Wienna A
4 5/2/2016 Diah Putri
5 6/2/2016 Gita Tri
6 7/2/2016 Yuni Atyah
7 8/2/16 Suana
8 8/2/16 Yeni Apriyani
9 8/2/16 Febri Wulansari
10 8/2/16 Lita Yulianti
11 10/2/16 Maslicha Chairia
12 10/2/16 Anggun Puspita
13 10/2/2016 Novita Sari
14 13/2/2016 Latifah
15 14/2/2016 Mariavor corry
16 15/2/2016 Susiyanti
17 16/2/2016 Neneng Kamelia
18 17/2/2016 Veri Atina
19 18/2/2016 Puji Haryatiningsih
20 24/2/2016 Rika Puspitasri
21 24/2/2016 Dewi Ariani
22 26/2/2016 Sujiyati
23 27/2/2016 Nidya Elvandari
24 28/2/2016 Fiana Fega
25 29/2/2016 Nikmatillah
26 1/2/2016 Aderia
27 2/2/2016 Denis Putri
28 3/2/2016 Ananda Citra
29 4/2/2016 Emmy Dwiyanti
30 10/2/2016 Filly Valianti
31 11/2/2016 Elfa
32 11/2/2016 Fety Lani
33 11/2/2016 Eti Heriati
34 12/2/2016 Inda Purnamasari
35 13/2/2016 Layinatul Wirdha
36 13/2/2016 Curdiana
37 14/2/2016 Desy Wulandari
38 18/2/2016 Ratih Indryani
39 19/2/2016 Indri Septa devi
40 19/2/2016 Siti Nurofiah
41 20/2/2016 Setyarini Indah
42 20/2/2016 Dewi Sartika
43 21/2/2016 Siti Maryam
44 21/2/2016 Ratih Sari Dewi
45 24/2/2016 Irawati Prastianingsih
46 24/2/2016 Nurfitriani
47 27/2/2016 Hilda Mustika
48 28/2/2016 Ni Made A
49 28/2/2016 Tahira Anggia
50 28/2/2016 dr.Mila Widyastuti
51 29/2/2016 Fitri Harahap
52 29/2/2016 Indri Astria
53 15/2/2016 Anah Yuliani
54 21/2/2016 Hesty Yulianti
55 1/2/2016 Allister
56 1/2/2016 Netik Ernawati
57 10/2/2016 M. Husain
58 10/2/2016 Anya William
59 12/2/2016 Akhtar nauf
60 11/2/2016 By. Yeni ( Farhan)
61 13/2/2016 Rayyan Kaled
62 19/2/2016 Isra Rizki
63 22/2/2016 Aleiya Jaya
64 25/2/2016 Gusli Ananda
65
66
67
68
69
48
33

IC Bulan Maret 2016

No Tanggal Nama Pasien

1 1/3/16 Mona Oktaviany
2 1/3/16 Vera Amelia
3 3/3/2016 Ni Putu Eka Susanti
4 7/3/2016 Nissyia Mazhaly
5 7/3/2016 Khalifa Marina
6 10/3/2016 Susan Puspita
7 10/3/16 Andhini Rizkiyah
8 16/3/2016 Annisa Nur Rahma
9 1/3/2016 Zahro Fauziyah
10 4/3/2015 Lonna
11 5/3/2016 Maya Febrianti
12 6/3/2015 Metty Amnuriyah
13 7/3/2015 Siska Puspita
14 7/3/2016 Retno Wulandari
15 8/3/2016 Badiah
16 9/3/2016 Dewi Afridayanti
17 11/3/2016 Ajeng Deciana
18 13/3/2016 Siti Juniyati
19 13/3/2016 Rosidah
20 13/3/2016 Citra Reno
21 14/3/2016 Firaszhiah amirah
22 15/3/2016 Made Putri
23 17/3/2016 Syamiyah
24 17/3/2016 Martini
25 15/3/2016 ainayah
26 7/3/2016 By. Shadiqa
27 2/3/2016 Handaru Daneswara
28 14/3/2016 Satrio
29 16/3/2016 Lenny Maria
30 23/3/2016 Irma Suryani
31 243/2016 Indyah Kusuma
32 21/3/2016 Ellin
33 24/3/2016 Fitria Puri
34 25/3/2016 Fatimah Assagaf
35 25/3/2016 Dwi maryani
36 25/3/2016 Raditya Hapsari
37 26/3/2016 Iva andina
38 Ariztakyra
39 Naufal Farid
40 28/3/2016 winda oktapisty
41 28/3/2017 henny mulandari
42 28/3/2018 harmony nindyta
43 28/3/2019 sandika dwi j
44 29/3/2020 robiatul adawiyah
45 30/3/2016 Siti nurul
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
29
8
 Handi Srie Dyah Melina Ferdi Darnila Ezzy
No. RM
Y T Y T Y T Y T Y T Y T Y T
07.83.29 1
07.83.30
07.83.32 1
07.83.33
07.83.62 1
07.83.84 1
07.83.97
07.84.02
07.84.05
07.84.13 1
07.84.15
07.84.38 1
07.84.45
07.84.60
07.84.75
07.84.76
07.84.88
07.83.13
07.83.34
07.83.35
07.83.61 1
07.83.77 1
07.84.27
07.84.35 1
07.84.44 1
07.84.54 1
07.84.90
07.84.94
07.85.58
07.83.04 1
07.83.89 1
07.82.40
01.85.10 1
07.85.29
07.85.45
07.85.82
07.85.85
07.85.97
07.86.03

07.86.13
07.86.15
 07.86.54 1
03.86.60
07.86.61
07.86.80
07.86.84
07.85.29
07.85.34
07.85.47 1
07.85.58
07.85.68
07.85.70
07.85.81 1
07.85.96 1

07.86.83 1
07.86.85
07.86.87
07.86.77 1
07.85.85 1
07.86.07
07.12.39 1
07.86.44 1
07.85.96
07.86.19
07.85.82
07.87.09 1
07.87.58

TOTAL 1 0 2 3 9 5 1 3 0 0 0 0 0 0

TOTAL Ya 1 2 9 1 0 0 0
TOTAL Tidak 0 3 5 3 0 0 0
 Handi Srie Dyah Melina Ferdi Darnila Ezzy
No. RM
Y T Y T Y T Y T Y T Y T Y T
07.87.17
07.87.53

07.87.82
07.87.96 1
07.88.58
07.88.13
07.88.18 1
07.88.19 1
07.88.23 1
07.88.31 1
07.88.32 1
07.88.44
07.88.73 1
07.88.90 1
07.88.94
07.89.18 1
07.59.23 1
07.89.49 1
07.90.14
07.90.24

07.58.58 1

07.87.19
07.87.35
07.87.66 1
07.87.81 1
07.88.45 1
07.88.48
07.88.49
07.88.60
07.88.64 1
07.88.73
07.88.76 1
07.88.87
07.89.42 1
07.89.58 1
07.89.62 1
07.89.73
07.89.78
07.89.86
07.89.87
07.90.15

07.90.71
07.90.74 1
07.90.78
07.91.13

07.88.95
07.89.82
07.58.62 1

06.16.31 1
07.88.43 1
06.32.87 1
07.88.18 1
07.86.80
07.55.83 1
07.09.74 1
03.57.09

0 0 7 9 1 3 3 1 0 4 0 0 0 0

0 7 1 3 0 0 0
0 9 3 1 4 0 0
 Handi Srie Dyah Melina Ferdi Darnila Ezzy
No. RM
Y T Y T Y T Y T Y T Y T Y T
07.91.21
07.91.24
04.90.54 1
07.92.20

07.92.45
07.92.52
07.93.31
07.91.05
07.91.59 1
07.91.89
07.91.96
07.92.01
07.92.20
07.92.26 1
07.92.42
07.92.65
07.92.93
07.92.98
07.92.99
07.93.03
07.93.29 1
07.93.48
07.93.52
07.90.44
07.90.77 1
06.08.61 1
00.47.07 1
07.94.27
07.94.33

07.94.39
07.94.49
07.94.50
07.94.51
07.94.57
05.78.29
07.94.64

07.94.81
07.94.82

0 1 0 2 0 2 1 0 0 1 0 0 0 0

0 0 0 1 0 0 0
1 2 2 0 1 0 0
 Firda
Y T

tdk ada

tdk ada
tdk ada
tdk ada
tdk ada

tidak ada
tidak ada

tdk ada

tdk ada
tdk ada
tdk ada
tdk ada
tdk ada
 tdk ada
tdk ada
tdk ada
tdk ada
tdk ada
tdk ada

tdk ada
tdk ada
tdk ada

tdk ada

tdk ada
tdk ada

tdk ada

tdk ada
tdk ada
tdk ada

tdk ada

0 0 24
55
0 13 25
0 11
 Firdha Ket
Y T
tdk ada
tdk ada

tdk ada

Tdk ada
Tdk ada

tdk ada

tdk ada

tdk ada
tdk ada

tdk ada
tdk ada

tdk ada
tdk ada
tdk ada

tdk ada
 tdk ada
tdk ada
tdk ada
tdk ada
tdk ada

tdk ada

tdk ada
tdk ada

tdk ada
tdk ada

tdk ada

tdk ada

0 0 28

0 11
0 17
 Firdha Ket
Y T
tdk ada
tdk ada

tdk ada

tdk ada
tdk ada
tdk ada
tdk ada

tdk ada
tdk ada
tdk ada
tdk ada

tdk ada
tdk ada
tdk ada
tdk ada
tdk ada
tdk ada

tdk ada
tdk ada
tdk ada
 tdk ada

tdk ada
tdk ada
tdk ada
tdk ada

0 0 7

0 1
0 6
Pengelolaan darah
Januari

No Tanggal Nama Pasien R.M

1 6/1/2016 Chandra Wahyu 05.03.89

2 9/1/2016 Laminah 07.56.80
3 9/1/16 Fitriah 07.04.29
4 20/1/2016 Yulia Edviana 07.63.76
5 21/1/2016 Rini Nuraisa 07.72.43
6 29/1/2016 Wiwi 07.60.48

Pengelolaan darah
Februari

No Tanggal Nama Pasien R.M

1 5/2/2016 Diah Putri 05.43.80
2 8/2/16 Febri Wulansari 07.88.19
3 7/2/2016 Yuni Atyah 04.31.27
4 11/2/2016 Ari Kusmiran 07.76.30
5 14/2/2016 Mariavor corry 07.60.61

Pengelolaan darah
Maret

No Tanggal Nama Pasien R.M

1 10/3/16 Andhini Rizkiyah 04.92.56
2 14/3/2016 Favorita 06.10.35
3
4
5
 HB Awal Darah HB Post Tranfusi
Tdk diberikan HB 10.0-
10 sedia drh 250 cc 11.0
12.5 Nitip Darah 12,0
9.4 sedia drh 250 cc Tdk diberikan HB 9.9
10.8 Nitip Darah 10.2
9.1 Darah 200cc 10.1
9.3 Nitip Darah 9.9

HB Awal Darah HB Post Tranfusi

8.5 Darah 432 cc 11.1
7.9 Darah 290 cc 17
9.1 Darah 403 cc 11.4
7.4 Darah 623 cc 10.1
9.8 hpp 8.6 Darah 396 cc 9.9

HB Awal Darah HB Post Tranfusi

7.3 Darah 431 cc 9.8
7.7 Darah 426 cc 10.2
 Dokter
F J Fr N L S
Daftar Tilik Y T Y T Y T Y T Y T Y T

1
cansel 1
1
1
1
1

Dokter
F J Fr N L S
Daftar Tilik Y T Y T Y T Y T Y T Y T
1

1
1
1

Dokter
F J Fr N L S
Daftar Tilik Y T Y T Y T Y T Y T Y T
+ 1
1
 Ket
AB Ir Za
Y T Y T Y T

ter Ket
AB Ir Za Srie
Y T Y T Y T Y T

ter
AB Ir Za Srie
Y T Y T Y T Y T
CPPT Bulan Januari 2016
F J
No Tanggal Nama Pasien No. RM
Y T Y T
1 7/1/16 Ayu 07.83.85
2 9/1/16 Dina Akromah 06.39.84
3 11/1/16 Ilip Komalasari 07.84.48
4 12/1/16 Anindita 07.83.64
5 2/1/2016 Siti Khairunnisa 03.97.06 1
6 2/1/2016 Doewi Afriyani 07.58.70
7 2/1/2016 Wenas Yanti 07.75.42 1
8 3/1/2016 Eka Nova 04.51.06 1
9 5/1/2016 Rizky Febrianty 07.55.58
10 7/1/2016 Witri Sitriyah 07.17.41 1
11 8/1/2016 Fifia Awalia 06.23.02 1
12 8/1/2016 Sri Devi 07.31.40
13 8/1/2016 Nugrahani 07.56.77 1
14 8/1/2016 Anila 06.93.99 1
15 9/1/2016 Martanti Endah 04.16.45 1
16 10/1/2016 Cut Cynthia 07.56.98
17 10/1/2016 Fransisca 04.78.22 1
18 12/1/2016 Tri Juni 02.53.24 1
19 13/1/2016 Eki Sarahwati 05.03.18 1
20 13/1/2016 Sonya Riestia 07.56.15 1
21 14/1/2016 Rina 07.56.50 1
22 2/1/16 Ema Nur karima 07.33.89
23 3/1/16 Ria Amanda 07.55.12 1
24 4/1/2016 Silvia Anugrahwaty 02.98.30 1
25 5/1/2016 Tri suci lestari 07.57.90
26 6/1/2016 Chandra Wahyu 05.03.89 1
27 9/1/2016 Laminah 07.56.80 1
28 9/1/16 Fitriah 07.04.29 1
29 10/1/16 Erni Susilowati 07.69.44
30 11/1/16 Zahra 07.40.95 1
31 14/1/2016 Kartikasari 06.95.43 1
32 14/1/2016 Diana Agustin 07.60.02
33 15/1/2016 Yuli Andriyani 01.84.52
34 16/1/2016 Suriah 07.42.65 1
35 4/1/2016 Ratih sari 07.79.04
36 8/1/2015 Zahra 07.40.95 1
37 14/1/2016 Puji 07.77.12
38 15/1/2016 Zainab 07.50.62
39 17/1/2016 Rara Ayu 07.57.65 1
40 17/1/2016 Ajeng Hidayani 07.75.28 1
41 21/1/2016 Nuri Nurain 07.45.90 1
42 21/1/2016 Noer Puspapratiwi 06.48.22 1
43 22/1/2016 Nindya Aisa 07.56.58
44 23/1/2016 Wulan sari 02.82.48
45 23/1/2016 Eliza hany 04.90.68 1
46 23/1/2016 Sofya Marline 03.10.74 1
47 24/1/2016 Athiyyah 04.64.78 1
48 27/1/2017 Nurul Syarifah 07.57.10 1
49 27/1/2015 Dian Puspitasari 07.78.83 1
50 28/1/2016 Khairul Bariyah 07.06.61 1
51 28/1/2016 Murni Handayani 02.64.22 1
52 28/1/2016 Dewi Rachmawati 05.65.02 1
53 16/1/2016 Mela Suwita 07.51.71 1
54 16/1/2016 Rizki Novitasari 06.19.63 1
55 18/1/2016 Fitrotun Naja 05.63.13 1
56 19/1/2016 Juliani 02.94.93 1
57 20/1/2016 Novi Ika 07.82.14 1
58 201/2016 Yulia Edviana 07.63.76
59 21/1/2016 Rini Nuraisa 07.72.43
60 21/1/2016 Silvia deswari 06.14.03
61 23/1/2016 Siti Mahrusoh 00.27.69 1
62 24/1/2016 Sri Mardiati 07.84.26
63 27/1/2016 Dian Chrisfani 07.85.24 1
64 28/1/2016 Ganiesa 07.59.91 1
65 29/1/2016 Linda Pratiwi 06.06.22 1
66 29/1/2016 Wiwi 07.60.48
67 17/1/2016 Rara ayu 07.57.65
68 17/1/2016 Dwi Meiyani 07.83.94
69 22/1/2016 Nining Pujiati 07.79.98
70 23/1/2016 Praveda Ascavintya 07.80.59
71 25/1/2016 Diana Khoiril mala 07.86.16
72 25/1/2016 Harnas kuba 00.64.79
73 29/1/2016 Ayu Wahyu 07.85.79
74 28/1/2016 Evi Lestari 07.86.69 1
75 16/1/2016 Ika Wahyuningsih 07.61.48
76 21/1/12016 Suriah 07.42.65 1
77 25/1/2016 Wiena 05.89.38
78 27/1/2016 Nurjanah 07.86.48
79 29/1/2016 Anita. S 07.84.52 1
80 29/1/2016 Amelia Surya 06.96.95 1
81 30/1/2016 Rina Zamia 07.74.41 1
82 31/1/2016 Ika Wahyuningsih 07.61.48
83
41 0 7 0

41 7
0 0

CPPT Bulan Februari 2016

F J
No Tanggal Nama Pasien No. RM
Y T Y T
1 1/2/16 Lita Fitriah 00.51.80 1
2 3/2/16 Windasari 07.87.52
3 3/2/2016 Wienna A 05.89.38
4 5/2/2016 Diah Putri 05.43.80 1
5 6/2/2016 Gita Tri 07.62.73
6 7/2/2016 Yuni Atyah 04.31.27
7 8/2/16 Suana 07.60.05
8 8/2/16 Yeni Apriyani 07.53.52
9 8/2/16 Febri Wulansari 07.77.94
10 8/2/16 Lita Yulianti 07.69.38
11 10/2/16 Maslicha Chairia 07.58.82
12 10/2/16 Anggun Puspita 07.61.62
13 10/2/2016 Novita Sari 06.88.42 1
14 13/2/2016 Latifah 06.55.30 1
15 14/2/2016 Mariavor corry 07.60.61
16 15/2/2016 Indah nur Kasanah 07.88.93
17 15/2/2016 Susiyanti 07.94.71 1
18 16/2/2016 Neneng Kamelia 01.62.73 1
19 17/2/2016 Veri Atina 07.59.23
20 18/2/2016 Puji Haryatiningsih 07.77.22
21 24/2/2016 Rika Puspitasri 07.62.37
22 24/2/2016 Dewi Ariani 01.23.69 1
23 26/2/2016 Sujiyati 07.65.90 1
24 27/2/2016 Nidya Elvandari 06.70.91
25 28/2/2016 Fiana Fega 07.58.58
26 29/2/2016 Nikmatillah 07.71.27
27 1/2/2016 Aderia 07.61.60 1
28 2/2/2016 Denis Putri 07.59.97 1
29 3/2/2016 Ananda Citra 02.82.32 1
30 4/2/2016 Emmy Dwiyanti 07.43.72
31 10/2/2016 Filly Valianti 07.61.20
32 11/2/2016 Elfa 07.59.84 1
33 11/2/2016 Fety Lani 01.31.52
34 11/2/2016 Eti Heriati 07.64.02 1
35 12/2/2016 Inda Purnamasari 02.90.21 1
36 13/2/2016 Layinatul Wirdha 07.37.69 1
37 13/2/2016 Curdiana 04.32.55 1
38 14/2/2016 Desy Wulandari 07.65.05 1
39 18/2/2016 Ratih Indryani 05.00.55 1
40 19/2/2016 Indri Septa devi 07.74.94
41 19/2/2016 Siti Nurofiah 07.79.92
42 20/2/2016 Setyarini Indah 07.78.79 1
43 20/2/2016 Dewi Sartika 06.62.20 1
44 21/2/2016 Siti Maryam 05.26.40 1
45 21/2/2016 Ratih Sari Dewi 07.79.04
46 24/2/2016 Irawati Prastianingsih 07.60.69 1
47 24/2/2016 Nurfitriani 07.80.60 1
48 27/2/2016 Hilda Mustika 02.83.41
49 28/2/2016 Ni Made A 03.47.74 1
50 28/2/2016 Tahira Anggia 07.63.31
51 28/2/2016 dr.Mila Widyastuti 07.62.21 1
52 29/2/2016 Fitri Harahap 06.11.74 1
53 29/2/2016 Indri Astria 05.80.38 1
54 15/2/2016 Anah Yuliani 03.46.26 1
55 1/2/2016 Netik Ernawati 07.87.03 1
56 21/2/2016 Hesty Yulianti 07.89.19 1
57 1/2/16 Barniah 07.87.23
58 12/2/16 Nashirotunnisa 07.03.98
59 13/2/2016 Eny Kustiningsih 06.99.22
60 17/2/2016 Sri Purwaningsih 01.84.27
61 18/2/2016 Kholipah 07.89.46
62 19/2/2016 Komariah 01.69.68
63 20/2/2016 Ayu Wahyuni 06.41.89
64 22/2/2016 Sri Hartanti 07.06.27 1
65 26/2/2016 Diah Wulan sari 04.22.08
66 28/2/2016 Elyastiningsih 06.04.09
67 1/2/2016 Gita Tri 07.62.73
68 1/2/2016 Wiena 05.89.38
69 6/2/2016 Partinah 01.89.78
70 11/2/2016 Ari Kusmiran 07.76.30
71 8/2/2016 Rika Puspitasri 07.62.37
72 13/2/2016 Mety amninuriah 07.67.90
73 12/2/2016 Anistiarini 07.59.73
74 15/2/2016 Yusniati 07.88.58
75 16/2/2016 Novi Syafitri 07.88.61
76 17/2/2016 Indri Astria 05.80.38 1
77 16/2/2016 Melta 07.85.36 1
78 17/2/2016 Puji H 07.77.12
79 18/2/2016 Heni R 03.92.88 1
80 20/2/2015 Siti Aisyah 07.87.45
81 23/2/2016 Oktaviana 07.75.81
82 23/2/2016 Fiana 07.58.58
83 27/2/2016 Usti Nugraeni 07.49.
84 28/2/2016 Titik Nurhayani 07.86.71
85
86
32 0 2 0

32 2
0 0

CPPT Bulan Maret 2016

F J
No Tanggal Nama Pasien No. RM
Y T Y T
1 1/3/16 Mona Oktaviany 01.70.51
2 1/3/16 Vera Amelia 07.75.06 1
3 3/3/2016 Ni Putu Eka Susanti 04.90.54 1
4 7/3/2016 Nissyia Mazhaly 06.11.37 1
5 7/3/2016 Khalifa Marina 07.91.99
6 10/3/2016 Susan Puspita 07.87.89
7 10/3/16 Andhini Rizkiyah 04.92.56 1
8 16/3/2016 Annisa Nur Rahma 06.63.67 1
9 1/3/2016 Zahro Fauziyah 05.82.90 1
10 4/3/2015 Lonna 02.41.66 1
11 5/3/2016 Maya Febrianti 04.36.07
12 6/3/2015 Metty Amnuriyah 07.67.90
13 7/3/2015 Siska Puspita 06.02.57 1
14 7/3/2016 Retno Wulandari 05.43.72
15 8/3/2016 Badiah 03.64.54 1
16 9/3/2016 Dewi Afridayanti 03.87.82 1
17 11/3/2016 Ajeng Deciana 06.48.12 1
18 13/3/2016 Siti Juniyati 07.68.52 1
19 13/3/2016 Rosidah 07.66.24
20 13/3/2016 Citra Reno 07.20.95
21 14/3/2016 Firaszhiah amirah 07.85.31
22 15/3/2016 Made Putri 06.67.72 1
23 17/3/2016 Syamiyah 07.90.86
24 17/3/2016 Martini 04.88.32 1
25 2/3/16 Mery Tambunan 04.06.72
26 8/3/16 Shenshen 07.91.14
27 8/3/16 Widya KurniatRiani Kumalasari 03.76.64
28 9/3/2016 Riani Komalasari 07.91.86
29 9/3/16 Rini Andayani 02.18.58
30 11/3/16 Marini 07.82.36
31 12/3/2016 Verayani 05.46.09
32 14/3/2016 Yuswita Bella 07.92.79
33 1/3/2016 Fitri Haryani 07.49.02
34 4/3/2016 Rini H 06.08.18
35 17/3/2016 Nella 06.52.04
36 13/3/2016 Yunia 07.92.32
37 11/3/2016 Siti Juniyati 07.68.52 1
38 13/3/2016 Putri Rizki 07.47.93
39 14/3/2016 Favorita 06.10.35 1
40 17/3/2016 Ayu Permata 07.87.40 1
41 16/3/2016 Lenny Maria 07.63.66
42 23/3/2016 Irma Suryani 07.64.73
43 243/2016 Indyah Kusuma 07.64.18
44 21/3/2016 Ellin 06.11.97
45 24/3/2016 Fitria Puri 07.68.33
46 21/3/2016 Lutfi Tanjung 07.93.65
47 24/3/2016 Siti Aminah 07.70.47
48 25/3/2016 Fatimah Assagaf 07.16.51
49 25/3/2016 Dwi maryani 03.10.25
50 25/3/2016 Raditya Hapsari 06.20.12
51 26/3/2017 Iva andina 07.88.05
52 27/3/2016 winda oktapisty 07.37.73 1
53 28/3/2016 henny mulandari 07.94.74
54 28/3/2016 harmony nindyta 07.94.42 1
55 28/3/2016 eka liliana 07.28..62
56 28/3/2016 nur sa'adah 07.57.09
57 28/3/2016 sandika dwi j 04.75.84
58 29/3/2016 maya deka 07.94.85
59 29/3/2016 robiatul adawiyah 01.30.53
60 drg. Merry Winarsih 07.92.70
61 indra mustika 07.91.26
62 20/3/2016 Siti nurul 02.51.16
63 20/3/2016 Astya Azshara 07.95.05
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
16 1 2 0

16 2
1 0
 Fr N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Y T

1
1

1
1
 1
1

1
1
1

1
1

1
 1 0 10 0 8 0 5 0 0 0 0 0 0 0 0 0

1 10 8 5 0 0 0 0
0 0 0 0 0 0 0 0

Fr N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Y T

1
1

1
1
1
1

1
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 0 13 0 14 2 5 0 0 0 0 0 0 0 0 0

3 13 14 5 0 0 0 0
0 0 2 0 0 0 0 0

Fr N L S AB Ir Za As
Y T Y T Y T Y T Y T Y T Y T Y T
1

1
1

1
1

1
 1
1
1

1
1
1

1
1
1

1
1

1
1

1
1 0 3 0 13 1 4 1 1 0 0 0 0 0 0 0

1 3 13 4 1 0 0 0
0 0 1 1 0 0 0 0
 CPPT Bulan Januari 2016

No Tanggal Nama Pasien No. RM

Ket
tdk ada 1 2/1/2016 Siti Khairunnisa 07.83.29
tdk ada 2 2/1/2016 Doewi Afriyani 07.83.30
tdk ada 3 2/1/2016 Wenas Yanti 07.83.32
4 3/1/2016 Eka Nova 07.83.33
5 5/1/2016 Rizky Febrianty 07.83.62
6 7/1/2016 Witri Sitriyah 07.83.84
7 8/1/2016 Fifia Awalia 07.83.97
8 8/1/2016 Sri Devi 07.84.02
9 8/1/2016 Nugrahani 07.84.05
10 8/1/2016 Anila 07.84.13
11 9/1/2016 Martanti Endah 07.84.15
12 10/1/2016 Cut Cynthia 07.84.38
13 10/1/2016 Fransisca 07.84.45
14 12/1/2016 Tri Juni 07.84.60
15 13/1/2016 Eki Sarahwati 07.84.75
16 13/1/2016 Sonya Riestia 07.84.76
17 14/1/2016 Rina 07.84.88
18 2/1/16 Ema Nur karima 07.83.1
19 3/1/16 Ria Amanda 07.83.34
20 4/1/2016 Silvia Anugrahwaty 07.83.35
21 5/1/2016 Tri suci lestari 07.83.61
22 6/1/2016 Chandra Wahyu 07.83.77
23 9/1/2016 Laminah 07.84.27
24 9/1/16 Fitriah 07.84.35
25 10/1/16 Erni Susilowati 07.84.44
26 11/1/16 Zahra 07.84.54
27 14/1/2016 Kartikasari 07.84.90
28 14/1/2016 Diana Agustin 07.84.94
29 15/1/2016 Yuli Andriyani 07.85.58
30 By.Nurwullan sari 07.83.04
31 7/1/2016 Raifano 07.83.89
32 10/1/2016 Zafran 07.82.40
33 15/1/2016 Zainab 01.85.10
34 17/1/2016 Rara Ayu 07.85.45
tdk ada 35 17/1/2016 Ajeng Hidayani 07.85.45
36 21/1/2016 Nuri Nurain 07.85.82
37 21/1/2016 Noer Puspapratiwi 07.85.85
38 22/1/2016 Nindya Aisa 07.85.97
39 23/1/2016 Wulan sari 07.86.03
 40 23/1/2016 Eliza hany
41 23/1/2016 Sofya Marline 07.86.13
42 24/1/2016 Athiyyah 07.86.15
43 27/1/2017 Nurul Syarifah 07.86.54
44 27/1/2015 Dian Puspitasari 03.86.60
45 28/1/2016 Khairul Bariyah 07.86.61
46 28/1/2016 Murni Handayani 07.86.80
47 28/1/2016 Dewi Rachmawati 07.86.84
48 16/1/2016 Mela Suwita 07.85.29
49 16/1/2016 Rizki Novitasari 07.85.34
50 18/1/2016 Fitrotun Naja 07.85.47
51 19/1/2016 Juliani 07.85.58
52 20/1/2016 Novi Ika 07.85.68
53 201/2016 Yulia Edviana 07.85.70
54 21/1/2016 Rini Nuraisa 07.85.81
55 21/1/2016 Silvia deswari 07.85.96
56 24/1/2016 Sri Mardiati
57 28/1/2016 Ganiesa 07.86.83
58 29/1/2016 Linda Pratiwi 07.86.85
59 29/1/2016 Wiwi 07.86.87
60 28/1/2016 Evi Lestari 07.86.77
61 24/1/2016 Salman Alfarisi 07.85.85
62 Hilya 07.86.07
63 25/1/2016 Halim 07.12.39
64 26/1/2016 Viona 07.86.44
65 26/1/2016 Hasan 07.85.96
66 25/1/2016 Yugo 07.86.19
67 29/1/2016 Salsabila 07.85.82
tdk ada 68 31/1/2016 Ika Wahyuningsih 07.87.09
69 30/1/2016 Rina Zamia 07.87.58
70
tdk ada
tdk ada
 72 120
1
72
0

CPPT Bulan Februari 2016

Ket
No Tanggal Nama Pasien No. RM

1 1/2/16 Lita Fitriah 07.87.17

2 3/2/16 Windasari 07.87.53
3 3/2/2016 Wienna A
4 5/2/2016 Diah Putri 07.87.82
5 6/2/2016 Gita Tri 07.87.96
6 7/2/2016 Yuni Atyah 07.88.58
7 8/2/16 Suana 07.88.13
8 8/2/16 Yeni Apriyani 07.88.18
9 8/2/16 Febri Wulansari 07.88.19
10 8/2/16 Lita Yulianti 07.88.23
11 10/2/16 Maslicha Chairia 07.88.31
12 10/2/16 Anggun Puspita 07.88.32
13 10/2/2016 Novita Sari 07.88.44
14 13/2/2016 Latifah 07.88.73
dr Rofi 15 14/2/2016 Mariavor corry 07.88.90
16 15/2/2016 Susiyanti 07.88.94
17 16/2/2016 Neneng Kamelia 07.89.18
18 17/2/2016 Veri Atina 07.59.23
19 18/2/2016 Puji Haryatiningsih 07.89.49
20 24/2/2016 Rika Puspitasri 07.90.14
21 24/2/2016 Dewi Ariani 07.90.24
22 26/2/2016 Sujiyati
23 27/2/2016 Nidya Elvandari
24 28/2/2016 Fiana Fega 07.58.58
25 29/2/2016 Nikmatillah
26 1/2/2016 Aderia 07.87.19
27 2/2/2016 Denis Putri 07.87.35
28 3/2/2016 Ananda Citra 07.87.66
 29 4/2/2016 Emmy Dwiyanti 07.87.81
30 10/2/2016 Filly Valianti 07.88.45
31 11/2/2016 Elfa 07.88.48
32 11/2/2016 Fety Lani 07.88.49
33 11/2/2016 Eti Heriati 07.88.60
34 12/2/2016 Inda Purnamasari 07.88.64
35 13/2/2016 Layinatul Wirdha 07.88.73
36 13/2/2016 Curdiana 07.88.76
37 14/2/2016 Desy Wulandari 07.88.87
38 18/2/2016 Ratih Indryani 07.89.42
39 19/2/2016 Indri Septa devi 07.89.58
40 19/2/2016 Siti Nurofiah 07.89.62
41 20/2/2016 Setyarini Indah 07.89.73
42 20/2/2016 Dewi Sartika 07.89.78
43 21/2/2016 Siti Maryam 07.89.86
44 21/2/2016 Ratih Sari Dewi 07.89.87
45 24/2/2016 Irawati Prastianingsih 07.90.15
46 24/2/2016 Nurfitriani
47 27/2/2016 Hilda Mustika
48 28/2/2016 Ni Made A 07.90.71
1(Y) dr hari 49 28/2/2016 Tahira Anggia 07.90.74
50 28/2/2016 dr.Mila Widyastuti 07.90.78
51 29/2/2016 Fitri Harahap 07.91.13
52 29/2/2016 Indri Astria
53 15/2/2016 Anah Yuliani 07.88.95
54 21/2/2016 Hesty Yulianti 07.89.82
55 1/2/2016 Allister 07.58.62
56 1/2/2016 Netik Ernawati
tdk ada 57 10/2/2016 M. Husain 06.16.31
58 10/2/2016 Anya William 07.88.43
59 12/2/2016 Akhtar nauf 06.32.87
60 11/2/2016 By. Yeni ( Farhan) 07.88.18
tdk ada 61 13/2/2016 Rayyan Kaled 07.86.80
tdk ada 62 19/2/2016 Isra Rizki 07.55.83
63 22/2/2016 Aleiya Jaya 07.09.74
64 25/2/2016 Gusli Ananda 03.57.09
65
66
67
68
69
tdk ada

69
46

71

69
2

CPPT Bulan Maret 2016

Ket
No Tanggal Nama Pasien No. RM
1 1/3/16 Mona Oktaviany 07.91.21
2 1/3/16 Vera Amelia 07.91.24
3 3/3/2016 Ni Putu Eka Susanti 04.90.54
4 7/3/2016 Nissyia Mazhaly 07.92.20
5 7/3/2016 Khalifa Marina
6 10/3/2016 Susan Puspita 07.92.45
7 10/3/16 Andhini Rizkiyah 07.92.52
8 16/3/2016 Annisa Nur Rahma 07.93.31
9 1/3/2016 Zahro Fauziyah 07.91.05
10 4/3/2015 Lonna 07.91.59
11 5/3/2016 Maya Febrianti 07.91.89
12 6/3/2015 Metty Amnuriyah 07.91.96
13 7/3/2015 Siska Puspita 07.92.01
14 7/3/2016 Retno Wulandari 07.92.20
 15 8/3/2016 Badiah 07.92.26
16 9/3/2016 Dewi Afridayanti 07.92.42
17 11/3/2016 Ajeng Deciana 07.92.65
18 13/3/2016 Siti Juniyati 07.92.93
19 13/3/2016 Rosidah 07.92.98
20 13/3/2016 Citra Reno 07.92.99
21 14/3/2016 Firaszhiah amirah 07.93.03
22 15/3/2016 Made Putri 07.93.29
23 17/3/2016 Syamiyah 07.93.48
tdk ada 24 17/3/2016 Martini 07.93.52
25 15/3/2016 ainayah 07.90.44
tidak ada 26 7/3/2016 By. Shadiqa 07.90.77
27 2/3/2016 Handaru Daneswara 06.08.61
28 14/3/2016 Satrio 00.47.07
29 16/3/2016 Lenny Maria
tdk ada 30 23/3/2016 Irma Suryani
tdk ada 31 243/2016 Indyah Kusuma 07.94.33
tdk ada 32 21/3/2016 Ellin
33 24/3/2016 Fitria Puri 07.94.39
34 25/3/2016 Fatimah Assagaf 07.94.49
35 25/3/2016 Dwi maryani 07.94.50
36 25/3/2016 Raditya Hapsari 07.94.51
37 26/3/2016 Iva andina 07.94.57
dr rofi 38 Ariztakyra 05.78.29
39 Naufal Farid 07.94.64
40 28/3/2016 winda oktapisty
41 28/3/2016 henny mulandari 07.94.81
42 28/3/2016 harmony nindyta 07.94.82
43 28/3/2016 sandika dwi j
44 29/3/2016 robiatul adawiyah
45 30/3/2016 Siti nurul
46
47
48
49
50
51
52
53
54
55
tdk ada 56
tdk ada 57
 58
59
60
61
62
63
64
65
66
67
68
69

40
19

43

40
3
Handi Srie Dyah Melina Ferdi Darnila Ezzy Firdha Ket
Y T Y T Y T Y T Y T Y T Y T Y T
1
1

1
1
tdk ada

1
1
1
1
1

1
1
1
1
1
1
1
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1
1

1
1

1
1
1
1
 1
1
1
1
1
1
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1
1
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tdk ada
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4 0 7 1 24 0 11 0 2 0 0 0 0 0 0 0 49

4 7 24 11 2 0 0 0 48
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Handi Srie Dyah Melina Ferdi Darnila Ezzy Firdha Ket
Y T Y T Y T Y T Y T Y T Y T Y T
1
1

1
1
1
1
1
1
1
1
1
1
1
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1
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1
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1
1
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1
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 2 0 20 0 12 0 9 1 1 0 0 0 0 0 0 0 45

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Handi Srie Dyah Melina Ferdi Darnila Ezzy Firdha Ket

Y T Y T Y T Y T Y T Y T Y T Y T
1
tdk ada
1
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1
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