BPJS BLN Desember

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS
PUSKESMAS TALANG RATU

BULAN : 1 DESEMBER 2015
Kunjungan Peserta Rujukan

No. Tanggal No. Kartu Peserta Nama Peserta JK Usia Diagnosa Tanda Tangan
Peserta Terdaftar Peserta Tak Terdaftar Dirujuk Tidak
1 1-Dec-15 0001081511673 Neni Rubaidah P 32 Thn Post partum 1.

2 1-Dec-15 0000026153987 Darwat P 61 Th Asma 2.
3 1-Dec-15 0000027475773 Masiah P 58 Th Dermatts 3.
4 1-Dec-15 0000027465974 Bakri L 55 Th HHD 4.
5 1-Dec-15 0000026933264 Nur Antoni L 63 Th Diare 5.
6 1-Dec-15 0001295223862 Badiah P 46 Th sakit mata 6.
7 1-Dec-15 0001456276465 Bambang L 55 Th SAKIT MATA 7.
8 1-Dec-15 0000026814598 Lismawat P 60 Th HT 8.
9 1-Dec-15 0000027198178 Ponidi L 51 Th Dermats 9.
10 1-Dec-15 0000025636948 Rosdianah P 66 Th mata kabur 10
11 1-Dec-15 0000043786427 Sit Nuraeni P 80 Th HHD 11.
12 1-Dec-15 0000027037078 Kholifa P 55 TH Nyeri sendi 12.
13 1-Dec-15 0000026244044 Nasrudin L 57 Th Demam 13.
14 1-Dec-15 0000027094026 Maryuni P 47 Th DM 14.
15 1-Dec-15 0000026153245 Maimunah P 59 Th RA 15.
16 1-Dec-15 0001276927975 Aidil Firmansyah L 2,2 Th CEDERA kaki 16.
17 1-Dec-15 0001885598537 Rath Purwasih P 26 Th Periksa Hamil 17.
18 1-Dec-15 0000025986407 Rosnaini P 58 Th HHD 18.
19 1-Dec-15 0000026235584 M. Nasir L 59 Th Gastrits 19.
20 1-Dec-15 0000026832014 Yurlen P 62 Th HT 20.
21 1-Dec-15 0001889794045 Sultan Ali L 27 Th TAMPAL GIGI 21.
22 1-Dec-15 0000026921283 h. Rozali Achmad SH L 63 Thn Cabut gigi 22.
23 1-Dec-15 0000025989827 Cintya Margareta P 30 Th gatel2 23.
24 1-Dec-15 0001078457106 Naila Putri Areta P 6 Th ISPA 24.
25 1-Dec-15 0001836035561 Natasya Polantaza P 9 bln Imunisasi 25.
26 1-Dec-15 0000027513819 Rosmi P 51 Th TAMPAL GIGI 26.
27 1-Dec-15 0000026935053 R. Subagyo L 70 Th HHD 27.
28 1-Dec-15 0000027203905 Samsinarwaty P 62 Th HHD 28.
29 1-Dec-15 0001078208998 Athar Al Chifary L 3 Th Thalassaemia 29.
30 1-Dec-15 0000157896268 Hasan Basri L 62 Th SAKIT GIGI 30.

31 1-Dec-15 0000162907795 Nurlina P 62 th HT 31
32 1-Dec-15 0000026956405 Ady Fikri L 40 Th DM 32
33 1-Dec-15 0000199612618 Rioni satriansyah L 45 Th sakit mata 33.
34 1-Dec-15 0000325679128 Aisyah P 69 th HT 34.
35 1-Dec-15 0000324960513 Hamzah L 9 Th Cabut gigi 35.
36 1-Dec-15 0000325042255 Zulperi L 48 Th SAKIT MATA 36.
37 30-Dec-99 0000027039306 Yat Didi P 65 Th 37.
38 30-Dec-99 0 0 0 0 38.
39 30-Dec-99 0 0 0 0 39.
40 30-Dec-99 0 0 0 0 40.
41 30-Dec-99 0 0 0 0 41.
42 30-Dec-99 0 0 0 0 42.
43 30-Dec-99 0 0 0 0 43.
44 30-Dec-99 0 0 0 0 44.
45 30-Dec-99 0 0 0 0 45.
46 30-Dec-99 0 0 0 0 46.
47 30-Dec-99 0 0 0 0 47.
48 30-Dec-99 0 0 0 0 48.
49 30-Dec-99 0 0 0 0 49.
50 30-Dec-99 0 0 0 0 50.
51 30-Dec-99 0 0 0 0 51.
52 30-Dec-99 0 0 0 0 52.
53 30-Dec-99 0 0 0 0 53.
54 30-Dec-99 0 0 0 0 54.
55 30-Dec-99 0 0 0 0 55.
56 30-Dec-99 0 0 0 0 56.
57 30-Dec-99 0 0 0 0 57.
58 30-Dec-99 0 0 0 0 58.
59 30-Dec-99 0 0 0 0 59.
60 30-Dec-99 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
Tanggal No. Urut No. Kartu Peserta NamaPeserta Alamat JK Usia Status
P. Umum GIGI MTBS KIA IMUNISASI LAB
1-Dec-15 1708 0001081511673 Neni Rubaidah Jl. Swadaya pakjo P 32 Thn I 1

1-Dec-15 1109 0000026153987 Darwat Jl. Let yasin P 61 Th P 1
1-Dec-15 829 0000027475773 Masiah jl. R Kemuning P 58 Th I 1
1-Dec-15 874 0000027465974 Bakri Jl. Naskah L 55 Th P 1
1-Dec-15 2283 0000026933264 Nur Antoni Jl. SB I rt.22 no. 1141 L 63 Th P 1
1-Dec-15 2284 0001295223862 Badiah Jl. Talang ratu rt.1 rw.1 no. 36 P 46 Th P 1
1-Dec-15 625 0001456276465 Bambang Jl. Kasnariansyah L 55 Th P 1
1-Dec-15 1017 0000026814598 Lismawat Jl. Let murod P 60 Th i 1
1-Dec-15 558 0000027198178 Ponidi Jl. Kasnariansyah L 51 Th P 1
1-Dec-15 189 0000025636948 Rosdianah Jl. Naskah P 66 Th P 1
1-Dec-15 2285 0000043786427 Sit Nuraeni Jl. Let murod No.237 Rt.03 P 80 Th P 1
1-Dec-15 2119 0000027037078 Kholifa Jl. Asrama Korem Rt.20 P 55 TH I 1
1-Dec-15 2286 0000026244044 Nasrudin Jl. Flamboyan L 57 Th P 1
1-Dec-15 1249 0000027094026 Maryuni Jl. Sukabangun P 47 Th P 1
1-Dec-15 518 0000026153245 Maimunah Jl. Let murod P 59 Th P 1
1-Dec-15 1056 0001276927975 Aidil Firmansyah Jl. Talang ratu L 2,2 Th A 1
1-Dec-15 2149 0001885598537 Rath Purwasih Jl. Mandi Api Rt.26 No.1304 P 26 Th I 1
1-Dec-15 1421 0000025986407 Rosnaini Jl. Let kasnariansyah P 58 Th p 1
1-Dec-15 1421 0000026235584 M. Nasir jl. Let kasnariansyah L 59 Th P 1
1-Dec-15 2287 0000026832014 Yurlen Jl. Kasnariansyahno.31 P 62 Th P 1
1-Dec-15 2288 0001889794045 Sultan Ali jl. Srijaya rt.26 No.1183 L 27 Th P 1
1-Dec-15 532 0000026921283 h. Rozali Achmad SH Jl. Perindustrian I L 63 Thn L 1
1-Dec-15 0000025989827 Cintya Margareta Jl. Kebun bunga P 30 Th P 1
1-Dec-15 0001078457106 Naila Putri Areta Jl. Kebun bunga P 6 Th A 1
1-Dec-15 465 0001836035561 Natasya Polantaza Jl. Rusunawa P 9 bln A 1
1-Dec-15 405 0000027513819 Rosmi Lr. Kota baru no.43 P 51 Th P 1
1-Dec-15 1072 0000026935053 R. Subagyo komplek pajak permai L 70 Th P 1
1-Dec-15 835 0000027203905 Samsinarwaty komplek pajak permai P 62 Th I 1
1-Dec-15 0001078208998 Athar Al Chifary Jl. Kebun bunga L 3 Th A 1
1-Dec-15 0000157896268 Hasan Basri Jl. Sukabangun rt.25 L 62 Th P 1
Ruangan
1-Dec-15 600 0000162907795 Nurlina jl. Perumdam P 62 th P 1

1-Dec-15 181 0000026956405 Ady Fikri jl. Kasnariansyah L 40 Th L 1
1-Dec-15 2289 0000199612618 Rioni satriansyah Jl.kasnariansyah L 45 Th p 1
1-Dec-15 242 0000325679128 Aisyah Jl. Let murod P 69 th P 1
1-Dec-15 277 0000324960513 Hamzah Jl. Demang lebar daun L 9 Th A 1
1-Dec-15 278 0000325042255 Zulperi Jl. Kasnariansyah rt.17 L 48 Th I 1
1437 0000027039306 Yat Didi jl. Kasnariansyah rt.16 P 65 Th P 1
BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JAMKESMAS
BULAN : DESEMBER
Rujukan Diagnosa Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK Alamat JK Usia
Post partum 1-Dec-15 242 0000325679128 Aisyah Aisyah Jl. Let murod P 69 th
Asma 1-Dec-15 277 0000324960513 Sukma ayu Hamzah Jl. Demang lebar daun P 9 Th
Dermatts 1-Dec-15 278 0000325042255 Sit Rosalia R Zulperi Jl. Kasnariansyah rt.17 P 48 Th
RS. Bhayangkara / Jantung/003 HHD 1-Dec-15
Diare 1-Dec-15
sakit mata 1-Dec-15
SAKIT MATA 1-Dec-15
HT 1-Dec-15
Dermats 1-Dec-15
mata kabur 1-Dec-15
HHD 1-Dec-15
Nyeri sendi 1-Dec-15
Demam 1-Dec-15
Rs. Myria/PDL/15 DM 1-Dec-15
RA 1-Dec-15
CEDERA kaki 1-Dec-15
Periksa Hamil 1-Dec-15
HHD 1-Dec-15
RSIA Graha Mandiri/PDL/25 Gastrits 1-Dec-15
HT 1-Dec-15
TAMPAL GIGI 1-Dec-15
Cabut gigi 1-Dec-15
gatel2 1-Dec-15
ISPA 1-Dec-15
Imunisasi 1-Dec-15
TAMPAL GIGI 1-Dec-15
Rs. Bhayangkara/PDL/21 HHD 1-Dec-15
Rs. Bhayangkara/PDL/22 HHD 1-Dec-15
Rs. Bhayangkara/Anak/26 Thalassaemia 1-Dec-15
SAKIT GIGI 1-Dec-15
Rujukan KET
HT
DM
sakit mata
HT
Cabut gigi
SAKIT MATA
Rujukan KET
Ruangan
Status Rujukan Diagnosa
P 1 HT
A 1 Cabut gigi
I 1 SAKIT MATA

1 2-Dec-15 0000027164799 Eddy Kusnady L 57 Th HHD 1.

2 2-Dec-15 0001866021783 Melani P 26 Th ANC 2.
3 2-Dec-15 0000027207652 Drs. Harun Aroni L 50 th ISPA 3.
4 2-Dec-15 0000027207663 Nuril Amsi P 49 Th batu ginjal 4.
5 2-Dec-15 0001851541391 Kosasi L 40 Th HT 5.
6 2-Dec-15 0000027038891 Nurbait P 63 Th HHD 6.
7 2-Dec-15 0001505134541 Megawat P 30 Th pusing 7.
8 2-Dec-15 0000026049363 Tri Amelia Putri P 12 Th ISPA 8.
9 2-Dec-15 0000202833189 Sunart P 65 Th Glaukoma 9.
10 2-Dec-15 0000005308301 H. Komlian P 63 Th Stroke 10
11 2-Dec-15 0000026699883 DRS. H. Asaad Matcik L 63 Th Sakit telinga 11.
12 2-Dec-15 0001819400264 Deni kansa L 31 Th RA 12.
13 2-Dec-15 0000026956427 M. Azizun hakim L 11 Th CACAR 13.
14 2-Dec-15 0000027105636 maimunah P 55 Th HT 14.
15 2-Dec-15 0000026333515 Magdalena P 46 Th SAKIT GIGI 15.
16 2-Dec-15 0000027093609 Rame silaen L 52 Th HT 16.
17 2-Dec-15 0000026691322 Ahad L 70 Th Sakit gigi 17.
18 2-Dec-15 0000027158275 Hayat pakpahan P 58 Th cabut gigi 18.
19 2-Dec-15 0000026614157 Lanjumin L 68 Th HHD 19.
20 2-Dec-15 0000026932915 Nazaruddin L 62 Th Neurodermatts 20.
21 2-Dec-15 0000026914645 Mery lubis P 62 Th Gastrits 21.
22 2-Dec-15 0001814135016 Rizky febriansyah L 5 Th ISPA 22.
23 2-Dec-15 0000026013456 Sulasmi P 61 Th pusing 23.
24 2-Dec-15 0000026559876 Naimah P 66 Th RA 24.
25 2-Dec-15 0000027038215 Sukmawie L 60 Th cad 25.
26 2-Dec-15 0000026824533 M. Zaini L 75 Th HT 26.
27 2-Dec-15 0000026824544 Azni P 68 Th DM 27.
28 2-Dec-15 0001439703123 Firdaus L 47 Th control post op 28.
29 2-Dec-15 0000026942973 Tarmizi L 62 Th Dermatts 29.
30 2-Dec-15 0000027105715 Musiar L 47 Th sakit gigi 30.

31 2-Dec-15 0001381602082 Sri lasmiat P 48 Th gatel-gatel 31
32 2-Dec-15 0000026814587 A. Zakarsih yusuf L 65 Th HHD 32
33 2-Dec-15 0001866730059 Holida P 55 Th Demam 33.
34 2-Dec-15 0001427484374 Musiran L 52 Th Ht 34.
35 2-Dec-15 0000026129406 Mardiana P 51 Th Pusing 35.
36 2-Dec-15 0000025720255 Aulia salsabila fasa P 8 Th ISPA 36.
37 2-Dec-15 0001278276276 Rosmala dewi P 61 Th HT 37.
38 2-Dec-15 0000026211429 Nursusilawat p 39 Th Ispa 38.
39 2-Dec-15 0000026211431 dhita pransiska P 9 Th ispa 39.
40 2-Dec-15 0000025860611 Ahzahari L 40 Th Benjolan dipunggung 40.
41 2-Dec-15 0000324360494 Maliki Zahri L 74 Th susah BAK 41.
42 2-Dec-15 0000325124188 Amran L 51 Th Gastrits 42.
43 2-Dec-15 0000325095614 Ernalia P 40 Th Vertgo 43.
44 2-Dec-15 0 0 0 0 44.
45 2-Dec-15 0 0 0 0 45.
46 2-Dec-15 0 0 0 0 46.
47 2-Dec-15 0 0 0 0 47.
48 2-Dec-15 0 0 0 0 48.
49 2-Dec-15 0 0 0 0 49.
50 2-Dec-15 0 0 0 0 50.
51 2-Dec-15 0 0 0 0 51.
52 2-Dec-15 0 0 0 0 52.
53 2-Dec-15 0 0 0 0 53.
54 2-Dec-15 0 0 0 0 54.
55 2-Dec-15 0 0 0 0 55.
56 2-Dec-15 0 0 0 0 56.
57 2-Dec-15 0 0 0 0 57.
58 2-Dec-15 0 0 0 0 58.
59 2-Dec-15 0 0 0 0 59.
60 2-Dec-15 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
2-Dec-15 992 0000027164799 Eddy Kusnady lebong siarang L 57 Th S 1

2-Dec-15 1556 0001866021783 Melani Jl. Let murod P 26 Th P 1
2-Dec-15 1196 0000027207652 Drs. Harun Aroni Rss. Mandi API L 50 th P 1
2-Dec-15 192 0000027207663 Nuril Amsi Rss. Mandi API P 49 Th I 1
2-Dec-15 2028 0001851541391 Kosasi Jl. Let murod L 40 Th p 1
2-Dec-15 368 0000027038891 Nurbait Jl.Ariodillah P 63 Th P 1
2-Dec-15 679 0001505134541 Megawat Jl. Kenanga P 30 Th I 1
2-Dec-15 1576 0000026049363 Tri Amelia Putri Jl. Let murod P 12 Th A 1
2-Dec-15 2010 0000202833189 Sunart Jl.Naskah P 65 Th I 1
2-Dec-15 1241 0000005308301 H. Komlian Jl. Let murod P 63 Th P 1
2-Dec-15 1809 0000026699883 DRS. H. Asaad Matcik Jl. Komp wayhitam L 63 Th P 1
2-Dec-15 2290 0001819400264 Deni kansa Jl. Halim L 31 Th P 1
2-Dec-15 2291 0000026956427 M. Azizun hakim Jl. Kasnariansyah L 11 Th A 1
2-Dec-15 1105 0000027105636 maimunah jl. Perumdam P 55 Th P 1
2-Dec-15 602 0000026333515 Magdalena jl. Mawar P 46 Th I 1
2-Dec-15 1211 0000027093609 Rame silaen Jl. SB II L 52 Th P 1
2-Dec-15 225 0000026691322 Ahad jl. Sri hitam L 70 Th P 1
2-Dec-15 1902 0000027158275 Hayat pakpahan komp. Bougenvile P 58 Th p 1
2-Dec-15 1870 0000026614157 Lanjumin jl. Kol h burlian L 68 Th P 1
2-Dec-15 477 0000026932915 Nazaruddin jl. Bougenvile L 62 Th P 1
2-Dec-15 451 0000026914645 Mery lubis rss. Sukajadi P 62 Th I 1
2-Dec-15 1416 0001814135016 Rizky febriansyah jl. Mawar L 5 Th A 1
2-Dec-15 843 0000026013456 Sulasmi Jl. Let murod P 61 Th P 1
2-Dec-15 1551 0000026559876 Naimah Jl. Let murod P 66 Th I 1
2-Dec-15 67 0000027038215 Sukmawie jl. Mawar L 60 Th S 1
2-Dec-15 32 0000026824533 M. Zaini Jl. Let murod L 75 Th P 1
2-Dec-15 670 0000026824544 Azni Jl. Let murod P 68 Th I 1
2-Dec-15 2247 0001439703123 Firdaus jl. Kencana hat L 47 Th P 1
2-Dec-15 320 0000026942973 Tarmizi jl. Talang anyar L 62 Th P 1
2-Dec-15 1373 0000027105715 Musiar Jl. Let murod L 47 Th P 1
BULAN : DESEMBER
Ruangan
2-Dec-15 496 0001381602082 Sri lasmiat jl. Kasnariansyah P 48 Th P 1

2-Dec-15 173 0000026814587 A. Zakarsih yusuf jl. Let murod L 65 Th P 1
2-Dec-15 2132 0001866730059 Holida jl. Let murod P 55 Th I 1
2-Dec-15 363 0001427484374 Musiran jl. Kasnariansyah L 52 Th P 1
2-Dec-15 1276 0000026129406 Mardiana jl. Mayor zurbi rustam P 51 Th P 1
2-Dec-15 2292 0000025720255 Aulia salsabila fasa Jl. Mayor nurdin P 8 Th A 1
2-Dec-15 1389 0001278276276 Rosmala dewi jl. Naskah P 61 Th P 1
2-Dec-15 775 0000026211429 Nursusilawat jl. Ispektur marzuki p 39 Th P 1
2-Dec-15 830 0000026211431 dhita pransiska jl. Ispektur marzuki P 9 Th A 1
2-Dec-15 415 0000025860611 Ahzahari jl. Talang ratu L 40 Th P 1
2-Dec-15 279 0000324360494 Maliki Zahri Jl. Kasnariansyah L 74 Th p 1
2-Dec-15 13 0000325124188 Amran jl. Ariodillah L 51 Th P 1
2-Dec-15 6 0000325095614 Ernalia jl. Anggrek P 40 Th I 1
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15
2-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Rujukan Diagnosa Pekerjaan Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK Alamat JK
HHD Pemda muba 279 0000324360494 Maliki Zahri Maliki Zahri Jl. Kasnariansyah L
ANC Swasta 13 0000325124188 Amran Amran jl. Ariodillah L
ISPA Guru 6 0000325095614 Ernalia jl. Anggrek P
batu ginjal IRT
fever with chills/PDL/32 HT Supir
HHD Guru
pusing irt
ISPA Pelajar
Rs. Mata/mata/034 Glaukoma IRT
Rs. Bhayangkara/saraf/035 Stroke Pensiunan PU
Sakit telinga PNS TU
Rs. Myria/syaraf/42 RA PNS TU
CACAR Pelajar
RS. Bhayangkara/PDL/43 HHD Guru
SAKIT GIGI IRT
Rs. Bhayangkara/PDL/44 HHD Guru
Sakit gigi Pensiun Diknas
cabut gigi Guru
RS. Mryria/PDL/46 HHD Pensiun pemda
Rs. Bhayangkara/kulit/051 Neurodermatts Pensiun PNS
Gastrits IRT
ISPA Pelajar
pusing Pensiunan PEMDA
RA IRT
cad pensiun ons
Rs. Bhayangkara/PDL/55 HT pensiun pns
Rs. Bhayangkara/PDL/56 DM pensiun pns
Rs. Hermina/Bedah/54 DM swasta
Dermatts pensiun PU
sakit gigi Guru
Rujukan Diagnosa Pekerjaan
Rs. Bhayangkara/Kulit/59 gatel-gatel IRT

Rs. Bhayangkara/PDL/60 DM Pensiun pns
Demam Pedagang
Ht Buruh
Pusing Guru
ISPA Pelajar
HT PNS
Ispa Guru
ispa Pelajar
Rs. Bhayangkara/Bedah/72 Benjolan dipunggung PNS
susah BAK Buruh
Gastrits Ojek
Vertgo IRT
MKESMAS
Ruangan
Usia Status Rujukan Diagnosa Pekerjaan
74 Th p 1 susah BAK Buruh

51 Th P 1 Gastrits Ojek
40 Th I 1 Rs. Myria/Syaraf/063 Headache IRT

1 3-Dec-15 0000025659257 muzakir L 51 Th Asma 1.

2 3-Dec-15 0000025854996 baharudin siregar L 57 Th RA 2.
3 3-Dec-15 0000026536544 dra. Evi agustna sari P 47 Th Sakit gigi 3.
4 3-Dec-15 0000027191709 Rumlah P 55 Th RA 4.
5 3-Dec-15 0001785492472 M. Ikhsan L 11 Th Sakit gigi 5.
6 3-Dec-15 0001080585898 Lenawat P 43 Th Sakit gigi 6.
7 3-Dec-15 0001325846474 Triya endarsih j P 28 Th Sakit telinga 7.
8 3-Dec-15 0000026814521 Megawat P 55 Th HHD 8.
9 3-Dec-15 0000025565578 Irwan S L 59 Th Sakit mata 9.
10 3-Dec-15 0000026681332 Tahzibiyah P 70 Th ISPA 10
11 3-Dec-15 0000026166385 M. Ridho L 11 Th Demam 11.
12 3-Dec-15 0000026620345 M.noer Harun L 67 Th HT 12.
13 3-Dec-15 0000026681321 zainal arifin L 73 Th luka lutut 13.
14 3-Dec-15 0001428110807 nurhayat P 57 th RS 14.
15 3-Dec-15 0001479268787 Hasan basri L 32 Th SAKIT sakit gigi 15.
16 3-Dec-15 0001876456001 astri P 31 Th SUNTIK KB 16.
17 3-Dec-15 0000026508183 ana rohana P 58 Th mata kabur 17.
18 3-Dec-15 0000026916423 affandi benaim L 65 Th Galaukoma 18.
19 3-Dec-15 0001808085701 suliam P 67 Th skt pinggang 19.
20 3-Dec-15 0001261981361 sinarwat p 40 Th Dermatts 20.
21 3-Dec-15 0000170282744 pratama wicaksana a L 19 Th SKIT GIGI 21.
22 3-Dec-15 0001481933968 agus darmawan P 15 Th Demam 22.
23 3-Dec-15 0001797638308 evie afriza P 27 Th CONTROL post op 23.
24 3-Dec-15 0001797636723 dedi asniadi L 40 Th HT 24.
25 3-Dec-15 0001291650693 Aisah P 64 Th ht 25.
26 3-Dec-15 0001849343501 Anggun dzakiraftani P 6 bln Imunisasi 26.
27 3-Dec-15 0000026830124 Sulaiman kohapa L 73 Th TB Paru 27.
28 3-Dec-15 0000025953388 Rosdiana P 52 Th Sakit gigi 28.
29 3-Dec-15 0001325900709 Edy sunarto L 71 Th Sakit ginjal 29.
30 3-Dec-15 0001326342554 Ifan Julleo L 20 Th Sakit gigi 30.

31 3-Dec-15 0000992537291 trianan maulitania P 24 Th Suntk kb 31
32 3-Dec-15 0000027191709 Rumlah P 53 Th HT 32
33 3-Dec-15 0000324323684 cindi Agustni P 16 Th Demam 33.
34 3-Dec-15 0000992533757 Novi yuliant P 25 Th Suntk kb 34.
35 3-Dec-15 0000324862749 Zainab P 50 Th Demam 35.
36 3-Dec-15 0000325561432 Zuriant P 40 Th Suntk kb 36.
37 3-Dec-15 0 0 0 0 0 37.
38 3-Dec-15 0 0 0 0 0 38.
39 3-Dec-15 0 0 0 0 0 39.
40 3-Dec-15 0 0 0 0 0 40.
41 3-Dec-15 0 0 0 0 0 41.
42 3-Dec-15 0 0 0 0 0 42.
43 3-Dec-15 0 0 0 0 0 43.
44 3-Dec-15 0 0 0 0 0 44.
45 3-Dec-15 0 0 0 0 0 45.
46 3-Dec-15 0 0 0 0 0 46.
47 3-Dec-15 0 0 0 0 0 47.
48 3-Dec-15 0 0 0 0 0 48.
49 3-Dec-15 0 0 0 0 0 49.
50 3-Dec-15 0 0 0 0 0 50.
51 3-Dec-15 0 0 0 0 0 51.
52 3-Dec-15 0 0 0 0 0 52.
53 3-Dec-15 0 0 0 0 0 53.
54 3-Dec-15 0 0 0 0 0 54.
55 3-Dec-15 0 0 0 0 0 55.
56 3-Dec-15 0 0 0 0 0 56.
57 3-Dec-15 0 0 0 0 0 57.
58 3-Dec-15 0 0 0 0 0 58.
59 3-Dec-15 0 0 0 0 0 59.
60 3-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
BULAN : DESEMBER
Ruangan
3-Dec-15 2293 0000025659257 muzakir Komplek griya bahagia L 51 Th P 1

3-Dec-15 62 0000025854996 baharudin siregar Jl. Sb 2 L 57 Th P 1
3-Dec-15 2294 0000026536544 dra. Evi agustna sari jl. Let murod P 47 Th P 1
3-Dec-15 453 0000027191709 Rumlah jl. Kamil P 55 Th I 1
3-Dec-15 1585 0001785492472 M. Ikhsan jl. Ariodillah L 11 Th A 1
3-Dec-15 429 0001080585898 Lenawat jl. Srijaya P 43 Th I 1
3-Dec-15 649 0001325846474 Triya endarsih j jl. Swadaya P 28 Th P 1
3-Dec-15 458 0000026814521 Megawat jl. Kasnariansyah P 55 Th I 1
3-Dec-15 1921 0000025565578 Irwan S jlperumahan taman indah L 59 Th P 1
3-Dec-15 393 0000026681332 Tahzibiyah lr. Kota baru P 70 Th I 1
3-Dec-15 1778 0000026166385 M. Ridho jl. kasnariansyah L 11 Th A 1
3-Dec-15 1546 0000026620345 M.noer Harun jl. Sosial L 67 Th P 1
3-Dec-15 64 0000026681321 zainal arifin lr. Kota baru L 73 Th P 1
3-Dec-15 505 0001428110807 nurhayat jl .mawar P 57 th P 1
3-Dec-15 1588 0001479268787 Hasan basri jl .h sanusin L 32 Th P 1
3-Dec-15 1827 0001876456001 astri jl. Akbp h umar P 31 Th I 1
3-Dec-15 54 0000026508183 ana rohana jl. Swadaya P 58 Th I 1
3-Dec-15 897 0000026916423 affandi benaim lr. Cempedak L 65 Th P 1
3-Dec-15 30 0001808085701 suliam lr. Cengkeh P 67 Th p 1
3-Dec-15 1984 0001261981361 sinarwat jl. Peternakan p 40 Th i 1
3-Dec-15 2282 0000170282744 pratama wicaksana a Jl. swadaya L 19 Th A 1
3-Dec-15 936 0001481933968 agus darmawan jl. Kasna P 15 Th A 1
3-Dec-15 1090 0001797638308 evie afriza jl . Let murod P 27 Th A 1
3-Dec-15 2000 0001797636723 dedi asniadi JL. Let murod L 40 Th P 1
3-Dec-15 1769 0001291650693 Aisah lr. Peristwa P 64 Th P 1
3-Dec-15 941 0001849343501 Anggun dzakiraftani jl. Let murod P 6 bln P 1
3-Dec-15 2020 0000026830124 Sulaiman kohapa jl. SB L 73 Th P 1
3-Dec-15 495 0000025953388 Rosdiana jl. srijaya P 52 Th I 1
3-Dec-15 1862 0001325900709 Edy sunarto jl. Akbp h umar L 71 Th P 1
3-Dec-15 491 0001326342554 Ifan Julleo jl. Let murod L 20 Th A 1
BULAN : DESEMBER
Ruangan
3-Dec-15 159 0000992537291 trianan maulitania jl. Demang P 24 Th I 1

3-Dec-15 453 0000027191709 Rumlah jl.let murod P 53 Th I 1
3-Dec-15 222 0000324323684 cindi Agustni jl. Kasnariansyah P 16 Th A 1
3-Dec-15 136 0000992533757 Novi yuliant jl. Mawar P 25 Th I 1
3-Dec-15 280 0000324862749 Zainab lr. Mustakim P 50 Th I 1
3-Dec-15 125 0000325561432 Zuriant Lr tanjung no 115 rt 2 P 40 Th I 1
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15
3-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Rujukan Diagnosa Pekerjaan Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK Alamat JK Usia
Rs. Myria/PDL/81 Asma PNS 159 0000992537291 trianan maulitania Endang jl. Demang P 24 Th
RA Pensiun PU 453 0000027191709 Rumlah Fahru jl.let murod P 53 Th
Sakit gigi IRT 222 0000324323684 cindi Agustni Samsul bahri jl. Kasnariansyah P 16 Th
RA IRT 136 0000992533757 Novi yuliant budi utomo jl. Mawar P 25 Th
Sakit gigi Pelajar 280 0000324862749 Zainab R. Fuad lr. Mustakim P 50 Th
Sakit gigi YAYASAN 125 0000325561432 Zuriant Mul Yahya Lr tanjung no 115 rt P 40 Thn
Sakit telinga IRT
Rs. Bhayangkara/PDL/88 HHD IRT
Sakit mata Pensiun PU
ISPA IRT
Demam Pelajar
HT
luka lutut
RS
SAKIT sakit gigi
SUNTIK KB
Rs. Mata/Mata/76 mata kabur
Rs. Mata/Mata/75 Galaukoma
skt pinggang
Dermatts
SKIT GIGI
Demam
CONTROL post op
HT
ht
Imunisasi
TB Paru
Sakit gigi
Sakit ginjal
SAKIT GIGI
Suntk kb IRT
HT IRT
Demam pelajar
Suntk kb IRT
Demam IRT
Suntk kb IRT
AS
Ruangan
Status Rujukan Diagnosa Pekerjaan
I 1 Suntk kb IRT
I 1 HT IRT
A 1 Demam pelajar
I 1 Suntk kb IRT
I 1 Demam IRT
I 1 Suntk kb

1 3-Dec-15 0000025953388 Rosdiana P 52 Th Sakit gigi 1.

2 3-Dec-15 0000026817592 drs. Turas zahri m ano L 72 Th Sakit mata 2.
3 3-Dec-15 0001317131728 M. Ridho Ramadhan L 12 Th Demam 3.
4 3-Dec-15 0000025552923 Minggu astut P 49 Th Sakit gigi 4.
6 3-Dec-15 00014584645388 saidah P 50 Th Skit Bahu 6.
7 3-Dec-15 0001646028753 Sadarlina P 34 Th Sakit telinga 7.
8 3-Dec-15 0000170887869 Emi Handayani P 25 Th ANC 8.
9 3-Dec-15 0001836035561 Natasya Polantaza P 9 bln Imunisasi 9.
10 3-Dec-15 0000026937246 Saeran L 75 Th ASMA 10
11 3-Dec-15 0000029056612 andika prima L 10 Th ISPA 11.
12 3-Dec-15 0001900167917 Ady irianto L 31 Th RA 12.
13 3-Dec-15 0000026508058 Ida yant P 54 Th Anisometropia 13.
14 3-Dec-15 0000026508025 Burhanuddin L 61 Th Anisometropia 14.
15 3-Dec-15 0000992537155 syamsul rahman L 50 Th ISPA 15.
16 3-Dec-15 0000324345284 Selvi dwihandayani P 12 Th Demam 16.
17 3-Dec-15 0000325931016 Bunyamin L 51 Th Hypertroid 17.
18 3-Dec-15 0000992538077 Helmi afriandoko L 41 Th Dermatts 18.
19 3-Dec-15 0001328041967 Saphira Evani Wijaya P 5 Th Demam 19.
20 3-Dec-15 0000325115522 Uswaini s nawawi L 50 Th ISPA 20.
21 3-Dec-15 0000324138352 Emilawat P 12 Th Demam 21.
22 3-Dec-15 0000992534433 Ningcik L 51 Th Hypertroid 22.
23 3-Dec-15 0000325208891 Andri Seprizal L 41 Th Dermatts 23.
24 3-Dec-15 0000324942546 Agus soleh L 20 Th ISPA 24.
25 3-Dec-15 0000324942693 Sara sakina p 10 Th 0 25.
26 3-Dec-15 0 0 0 0 0 26.
27 3-Dec-15 0 0 0 0 0 27.
28 3-Dec-15 0 0 0 0 0 28.
29 3-Dec-15 0 0 0 0 0 29.
30 3-Dec-15 0 0 0 0 0 30.
BULAN : DESEMBER 2015

31 1-Dec-15 0 0 0 0 0 31
32 30-Dec-99 0 0 0 0 0 32
33 30-Dec-99 0 0 0 0 0 33.
34 30-Dec-99 0 0 0 0 0 34.
35 30-Dec-99 0 0 0 0 0 35.
36 30-Dec-99 0 0 0 0 0 36.
37 30-Dec-99 0 0 0 0 0 37.
38 30-Dec-99 0 0 0 0 0 38.
39 30-Dec-99 0 0 0 0 0 39.
40 30-Dec-99 0 0 0 0 0 40.
41 30-Dec-99 0 0 0 0 0 41.
42 30-Dec-99 0 0 0 0 0 42.
43 30-Dec-99 0 0 0 0 0 43.
44 30-Dec-99 0 0 0 0 0 44.
45 30-Dec-99 0 0 0 0 0 45.
46 30-Dec-99 0 0 0 0 0 46.
47 30-Dec-99 0 0 0 0 0 47.
48 30-Dec-99 0 0 0 0 0 48.
49 30-Dec-99 0 0 0 0 0 49.
50 30-Dec-99 0 0 0 0 0 50.
51 30-Dec-99 0 0 0 0 0 51.
52 30-Dec-99 0 0 0 0 0 52.
53 30-Dec-99 0 0 0 0 0 53.
54 30-Dec-99 0 0 0 0 0 54.
55 30-Dec-99 0 0 0 0 0 55.
56 30-Dec-99 0 0 0 0 0 56.
57 30-Dec-99 0 0 0 0 0 57.
58 30-Dec-99 0 0 0 0 0 58.
59 30-Dec-99 0 0 0 0 0 59.
60 30-Dec-99 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 0 70
71 30-Dec-99 0 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 0 90.
Ruangan
4-Dec-15 495 0000025953388 Rosdiana jl. srijaya P 52 Th I 1

4-Dec-15 494 0000026817592 drs. Turas zahri m ano talang ratu L 72 Th P 1
4-Dec-15 2295 0001317131728 M. Ridho Ramadhan jl. Talang ratu L 12 Th A 1
4-Dec-15 958 0000025552923 Minggu astut jl. Tri sukses P 49 Th P 1
4-Dec-15 1882 00014584645388 saidah jl. Kota baru P 50 Th P 1
4-Dec-15 2009 0001646028753 Sadarlina jl.let murod P 34 Th I 1
4-Dec-15 2232 0000170887869 Emi Handayani jl. Srijaya no.1132 P 25 Th I 1
4-Dec-15 465 0001836035561 Natasya Polantaza Jl. Rusunawa P 9 bln A 1
4-Dec-15 1049 0000026937246 Saeran jl. Srijaya L 75 Th P 1
4-Dec-15 2296 0000029056612 andika prima jl. Swadaya L 10 Th A 1
4-Dec-15 2167 0001900167917 Ady irianto jl. Irigasi L 31 Th P 1
4-Dec-15 436 0000026508058 Ida yant jl. Soak permai P 54 Th I 1
4-Dec-15 435 0000026508025 Burhanuddin jl. Soak permai L 61 Th P 1
4-Dec-15 261 0000992537155 syamsul rahman jl, kasnariansyah L 50 Th P 1
4-Dec-15 281 0000324345284 Selvi dwihandayani lr. Kurnia P 12 Th A 1
4-Dec-15 172 0000325931016 Bunyamin Lr. Kemiri L 51 Th P 1
4-Dec-15 98 0000992538077 Helmi afriandoko jl. Ariodillah L 41 Th P 1
4-Dec-15 2202 0001328041967 Saphira Evani Wijaya Jl. Perum Griya Putra P 5 Th A 1
4-Dec-15 204 0000325115522 Uswaini s nawawi jl, kasnariansyah L 50 Th P 1
4-Dec-15 229 0000324138352 Emilawat lr. Kurnia P 12 Th A 1
4-Dec-15 160 0000992534433 Ningcik Lr. Kemiri L 51 Th P 1
4-Dec-15 282 0000325208891 Andri Seprizal jl. Ariodillah L 41 Th P 1
4-Dec-15 283 0000324942546 Agus soleh JL. Kenanga L 20 Th A 1
4-Dec-15 254 0000324942693 Sara sakina jl. kenanga p 10 Th A 1
4-Dec-15
4-Dec-15
4-Dec-15
4-Dec-15
4-Dec-15
20 3 1 1 0 0

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Sakit gigi IRT 261 0000992537155 syamsul rahman samsul rahamn jl, kasnariansyah L 50 Th
Sakit mata Pensiun PNS 281 0000324345284 Selvi dwihandayani Parni lr. Kurnia P 12 Th
Demam Pelajar 172 0000325931016 Bunyamin Bunyamin Lr. Kemiri L 51 Th
Sakit gigi PNS 98 0000992538077 Helmi afriandoko helmi afriandoko jl. Ariodillah L 41 Th
Sakit gigi Pensiun Diknas
Rs. Bhayangkara/syaraf/102 Skit Bahu IRT
Sakit telinga IRT
ANC
Imunisasi
Rs. Bhyangkara/PDL/107 ASMA
ISPA
RS. Bundo/Syaraf/110 RA Wiraswasta
Rs. Mata/mata/112 Anisometropia IRT
Rs.mata/mata/111 Anisometropia
ISPA
Demam
Rs. Myria/PDL/109 Hypertroid
Dermatts
Demam
ISPA
Demam
Hypertroid
Dermatts
ISPA
AS
Ruangan
P 1 ISPA
A 1 Demam
P 1 Hypertroid
P 1 Dermatts

1 5-Dec-15 0000026520513 Juriah P 70 Th Sakit mata 1.

2 5-Dec-15 0000027039352 Yuniar P 61 Th RA 2.
3 5-Dec-15 0001326342552 Ifan julleo L 20 Th Tampal gigi 3.
4 5-Dec-15 0000025950069 Rini Nopriana P 37 Th ISPA 4.
5 5-Dec-15 0000027035752 juri efendi L 61 Th DM 5.
6 5-Dec-15 0000027035763 Mastta p 55 Th RA 6.
7 5-Dec-15 0001390683115 Meisya P 26 Th Tampal gigi 7.
8 5-Dec-15 0000026945638 Roiani P 68 th RA 8.
9 5-Dec-15 0000036547841 Sahwyah P 48 Th ISPA 9.
10 5-Dec-15 0001294141352 Maldi Gandri P 51 Th RA 10
11 5-Dec-15 0000027192712 Rica Susanty P 44 Th dermatt 11.
12 5-Dec-15 0001443469252 Valdy ifiyanto P L 11 Th Sakit mata 12.
13 5-Dec-15 0000202855814 chici dwi O P 31 Th Sakit gigi 13.
14 5-Dec-15 0000026916491 drs. Amir syarifudin L 63 Th Vertgo 14.
15 5-Dec-15 0000026916502 Astri murni P 61 Th Gastrits 15.
16 5-Dec-15 0000026831755 widyahari yowana P 60 Th Hypertroid 16.
17 5-Dec-15 0000026831744 usman agoes L 62 Th Hypertroid 17.
18 5-Dec-15 0000211199321 Martni P 53 Th Benjolan di leher 18.
19 5-Dec-15 0000027158275 Hayat Pakpahan P 58 Th HT 19.
21 5-Dec-15 0000029610123 Roilita P 50 Th Mata kabur 21.
22 5-Dec-15 0000027198178 Ponidi L 51 Th HT 22.
23 5-Dec-15 0000976072566 Eva emilda p 29 Th Sakit pinggang 23.
24 5-Dec-15 0001082035372 Faris naufal K L 2 Th gatel-gatel 24.
25 5-Dec-15 0001495737709 Yuni Indta Sari P 31 Th Suntk Kb 25.
26 5-Dec-15 0000325115522 Uswaini s nawawi L 48 Th Cabut gigi 26.
27 5-Dec-15 0000324138352 Emilawat P 46 Th HT 27.
28 5-Dec-15 0000992534433 Ningcik P 57 Th GATEL-GATEL 28.
29 5-Dec-15 0000325208891 Andri Seprizal L 18 Th Anisometropia 29.
30 5-Dec-15 0000324942546 Agus soleh L 20 Th ISPA 30.
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS LAPORAN F

31 1-Dec-15 0 0 0 0 31
32 30-Dec-99 0 0 0 0 32
33 30-Dec-99 0 0 0 0 33.
34 30-Dec-99 0 0 0 0 34.
35 30-Dec-99 0 0 0 0 35.
36 30-Dec-99 0 0 0 0 36.
37 30-Dec-99 0 0 0 0 37.
38 30-Dec-99 0 0 0 0 38.
39 30-Dec-99 0 0 0 0 39.
40 30-Dec-99 0 0 0 0 40.
41 30-Dec-99 0 0 0 0 41.
42 30-Dec-99 0 0 0 0 42.
43 30-Dec-99 0 0 0 0 43.
44 30-Dec-99 0 0 0 0 44.
45 30-Dec-99 0 0 0 0 45.
46 30-Dec-99 0 0 0 0 46.
47 30-Dec-99 0 0 0 0 47.
48 30-Dec-99 0 0 0 0 48.
49 30-Dec-99 0 0 0 0 49.
50 30-Dec-99 0 0 0 0 50.
51 30-Dec-99 0 0 0 0 51.
52 30-Dec-99 0 0 0 0 52.
53 30-Dec-99 0 0 0 0 53.
54 30-Dec-99 0 0 0 0 54.
55 30-Dec-99 0 0 0 0 55.
56 30-Dec-99 0 0 0 0 56.
57 30-Dec-99 0 0 0 0 57.
58 30-Dec-99 0 0 0 0 58.
59 30-Dec-99 0 0 0 0 59.
60 30-Dec-99 0 0 0 0 60.
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS LAPORAN F

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
5-Dec-15 95 0000026520513 Juriah perum mega asri P 70 Th P 1

5-Dec-15 1744 0000027039352 Yuniar lr. Kota baru P 61 Th I 1
5-Dec-15 491 0001326342552 Ifan julleo jl. Let murod L 20 Th A 1
5-Dec-15 2084 0000025950069 Rini Nopriana jl.let murod P 37 Th P 1
5-Dec-15 694 0000027035752 juri efendi jl. Akbp h umar L 61 Th P 1
5-Dec-15 2297 0000027035763 Mastta jl. Akbp h umar p 55 Th I 1
5-Dec-15 2298 0001390683115 Meisya jl. Akbp h umar P 26 Th P 1
5-Dec-15 590 0000026945638 Roiani jl. Let murod P 68 th P 1
5-Dec-15 1355 0000036547841 Sahwyah jl. Srijaya rt.14 P 48 Th I 1
5-Dec-15 1484 0001294141352 Maldi Gandri Perum rakyat P 51 Th I 1
5-Dec-15 1804 0000027192712 Rica Susanty Jl. Sukabangun P 44 Th P 1
5-Dec-15 2299 0001443469252 Valdy ifiyanto P lr. Tanjung L 11 Th A 1
5-Dec-15 1059 0000202855814 chici dwi O jl. Sanjaya P 31 Th P 1
5-Dec-15 324 0000026916491 drs. Amir syarifudin jl. S hatta L 63 Th P 1
5-Dec-15 568 0000026916502 Astri murni jl. S hatta P 61 Th I 1
5-Dec-15 695 0000026831755 widyahari yowana jl.let murod P 60 Th I 1
5-Dec-15 696 0000026831744 usman agoes jl.let murod L 62 Th p 1
5-Dec-15 585 0000211199321 Martni jl. Swadaya P 53 Th I 1
5-Dec-15 1902 0000027158275 Hayat Pakpahan komp. Bougenvile P 58 Th P 1
5-Dec-15 1271 0000029610123 Roilita jl. Sukawinatan P 50 Th P 1
5-Dec-15 558 0000027198178 Ponidi jl. Kasnariansyah L 51 Th P 1
5-Dec-15 2300 0000976072566 Eva emilda jl. Aman p 29 Th I 1
5-Dec-15 2301 0001082035372 Faris naufal K Jl. aman L 2 Th A 1
5-Dec-15 0001495737709 Yuni Indta Sari jl. Maskerebet P 31 Th P 1
5-Dec-15 204 0000325115522 Uswaini s nawawi Jl. Mandi api L 48 Th P 1
5-Dec-15 229 0000324138352 Emilawat jl. Ariodillah P 46 Th I 1
5-Dec-15 160 0000992534433 Ningcik lr. Rambutan P 57 Th I 1
5-Dec-15 282 0000325208891 Andri Seprizal jl. Kenanga L 18 Th A 1
5-Dec-15 283 0000324942546 Agus soleh jl. kenanga L 20 Th A 1
BULAN : DESEMBER
Ruangan
No. Urut No. Kartu Peserta NamaPeserta Alamat JK Usia Status
Tanggal
1-Dec-15
BULAN : DESEMBER
Ruangan
No. Urut No. Kartu Peserta NamaPeserta Alamat JK Usia Status
Tanggal
1-Dec-15
BULAN : DESEMBER
Rs. Dr AK Gani/Mata/115 Sakit mata IRT 204 0000325115522 Uswaini s nawawi Uswaini s nawawi Jl. Mandi api L 48 Th
Rs. Muh/Kulit/116 RA 229 0000324138352 Emilawat Hotman jl. Ariodillah P 46 Th
Tampal gigi 160 0000992534433 Ningcik Dirta lr. Rambutan P 57 Th
ISPA 282 0000325208891 Andri Seprizal Ahmad dahlan jl. Kenanga L 18 Th
Rs. Bhyangkara/PDL/117 DM 283 0000324942546 Agus soleh Karwan junaidi jl. kenanga L 20 Th
RA 254 0000324942693 Sara sakina Karwan junaidi jl. Kenanga P 10 Th
Tampal gigi
RA
ISPA
RA
dermatt
Sakit mata
Sakit gigi
Vertgo
Gastrits
Hypertroid
Rs. Bhayangkara/PDL/121 Hypertroid
Benjolan di leher
HT
Dermatts
Mata kabur
HT
Sakit pinggang
Rs. Myria/Anak/124 gatel-gatel
Suntk Kb
Cabut gigi
HT
GATEL-GATEL
Anisometropia
ISPA
AS
Ruangan
P 1 Cabut gigi
I 1
I 1 GATEL-GATEL
A 1 Anisometropia
A 1 ISPA
A 1 ISPA

1 7-Dec-15 0000026295726 Rosmala dewi P 55 Th Gastrits 1.

2 7-Dec-15 0000026378548 Hasbullah L 70 Th Gatel-gatel 2.
3 7-Dec-15 0001799224661 Alpian L 20 Th Tubercolosi 3.
4 7-Dec-15 0000026822845 Jn. Kirom L 72 Th HHD 4.
5 7-Dec-15 0000027094274 Syamsuri L 57 Th DM 5.
6 7-Dec-15 0000026463385 Kordiat P 61 Th RA 6.
7 7-Dec-15 0000026923724 Husnaidah P 68 Th Pusing 7.
8 7-Dec-15 0000197986443 Yahinung P 61 Th RA 8.
9 7-Dec-15 0000026428768 Suryat P 62 Th HHD 9.
10 7-Dec-15 0001638998684 Agus kurniawan L 36 Th patah tangan 10
11 7-Dec-15 0000027296469 Endang susilowato P 57 Th DM 11.
12 7-Dec-15 0000026397292 mhd. Husin L 76 Th DM 12.
13 7-Dec-15 0001279234282 maqda amora P 2 Th Panas 13.
14 7-Dec-15 0000005889712 Fatmawat P 59 Th HHD 14.
16 7-Dec-15 0000037269821 RM. Jauhari L 45 Th Dermatts 16.
17 7-Dec-15 0000026302217 Hudaini P 65 Th Sakit pinggang 17.
18 7-Dec-15 0000026322243 Mahendra L 42 Th demam 18.
19 7-Dec-15 0001845220623 Khosiah P 75 Th Katarak 19.
20 7-Dec-15 0000027094511 Nuzuliua tri jayant P 17 Th benjolan payudara 20.
21 7-Dec-15 0001325900709 Edy sunarto L 71 Th Sakit ginjal 21.
22 7-Dec-15 0000026943827 Mahida P 58 Th RA 22.
23 7-Dec-15 0000026038642 Saldiyah P 56 Th Sakit mata 23.
24 7-Dec-15 0000027346173 Chandra wulan P 41 Th Gastrits 24.
25 7-Dec-15 0000025620197 Dencik P 56 Th HT 25.
26 7-Dec-15 0000026513886 Yulis P 55 Th HHD 26.
27 7-Dec-15 0000026513886 Suryat P 66 Th Demam 27.
28 7-Dec-15 0000027318363 Achmadiah tjik asin L 71 Th ISPA 28.
29 7-Dec-15 0001811380959 M. Riski fahri P L 7 Th Dermatts 29.
30 7-Dec-15 001811380342 Fitriyant P 33 Th RA 30.

31 7-Dec-15 0001321770554 Megawat P 64 Th HHD 31
32 7-Dec-15 0000026337396 Tiara U P 16 Th Demam 32
33 7-Dec-15 0000026468289 Rahma suri P 86 Th Asma 33.
34 7-Dec-15 0000026707746 Ciknah P 52 TH Osteoporosis 34.
35 7-Dec-15 0001817809481 Indah aprina P 23 Th ANC 35.
36 7-Dec-15 0001266545902 Noveko racmat L 28 Th ISPA 36.
37 7-Dec-15 0001857395496 H. Z Aizurni L 48 Th DM 37.
38 7-Dec-15 0001886501496 Yuliana P 32 Th Demam 38.
39 7-Dec-15 0001886501147 Imam kesuma L 37 Th sakit gigi 39.
40 7-Dec-15 0000026367581 Dalimin sudjadi L 70 Th ISPA 40.
41 7-Dec-15 0000149180343 Salman alfarisi L 41 Th Polip 41.
42 7-Dec-15 0000026699883 drs. H. Asa'ad matcik L 64 Th Sakit telinga 42.
43 7-Dec-15 0000027129058 Sawirul yat P 51 Th Cabut gigi 43.
44 7-Dec-15 0000027276289 Sutrisno L 45 Th HHD 44.
45 7-Dec-15 0000025741416 Nurbait P 46 Th Sakit gigi 45.
46 7-Dec-15 0001383996969 Kgs. Achmad L 65 Th HHD 46.
47 7-Dec-15 0001871548749 Alauna azzahra P 5 Th Sakit telinga 47.
48 7-Dec-15 0000027286154 Eka P 51 Th Anisometropia 48.
49 7-Dec-15 0000027286165 Seifty mujizatah P 19 Th Anisometropia 49.
50 7-Dec-15 0001822566442 Murni P 45 Th Pusing 50.
51 7-Dec-15 0000324360494 maliki zahri L 75 Th Susah baak 51.
52 7-Dec-15 0000992534951 juryat P 48 Th Stroke 52.
53 7-Dec-15 0000324358942 Johan murod l 58 Th Sakit di penis 53.
54 7-Dec-15 0000324827594 hevi zahrani p 6 th Panas 54.
55 7-Dec-15 0000324317362 M. Alfi R L 16 Th ASMA 55.
56 7-Dec-15 0000992535153 Rosmaina P 61 Th HT 56.
57 7-Dec-15 0000992538077 Helmi afriandoko L 42 Th CACAR 57.
58 7-Dec-15 0000325115572 Uswaini L 47 Th Sakit gigi 58.
59 7-Dec-15 0000992537155 syamsul R L 51 Th pusing 59.
60 7-Dec-15 0000324295716 Husnaini P 43 Th Gtastrits 60.

BULAN : DESEMBER

61 7-Dec-15 0 0 0 0 61.
62 7-Dec-15 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
7-Dec-15 0000026295726 Rosmala dewi Jl. Kikim P 55 Th P 1

7-Dec-15 1086 0000026378548 Hasbullah perumdam L 70 Th P 1
7-Dec-15 971 0001799224661 Alpian Jl. Let murod L 20 Th P 1
7-Dec-15 53 0000026822845 Jn. Kirom Jl. Let murod L 72 Th P 1
7-Dec-15 264 0000027094274 Syamsuri Jl. Aman 2 L 57 Th P 1
7-Dec-15 1858 0000026463385 Kordiat Jl.mawar P 61 Th I 1
7-Dec-15 282 0000026923724 Husnaidah jl. Sukawinatan P 68 Th P 1
7-Dec-15 187 0000197986443 Yahinung Jl. Kasnariansyah P 61 Th I 1
7-Dec-15 316 0000026428768 Suryat Jl.mawar P 62 Th I 1
7-Dec-15 1624 0001638998684 Agus kurniawan Jl. Sakura L 36 Th S 1
7-Dec-15 26 0000027296469 Endang susilowato Jl. Let murod P 57 Th I 1
7-Dec-15 1861 0000026397292 mhd. Husin Lebong siarang L 76 Th P 1
7-Dec-15 2303 0001279234282 maqda amora lr.rambutan P 2 Th A 1
7-Dec-15 74 0000005889712 Fatmawat Jl. Kasnariansyah P 59 Th P 1
7-Dec-15 1189 0000037269821 RM. Jauhari Jl. Sudirman L 45 Th S 1
7-Dec-15 1458 0000026302217 Hudaini Jl. Let murod P 65 Th P 1
7-Dec-15 1873 0000026322243 Mahendra Jl. Kelapa sawit L 42 Th P 1
7-Dec-15 1634 0001845220623 Khosiah jl. Kol h burlian P 75 Th P 1
7-Dec-15 2011 0000027094511 Nuzuliua tri jayant Jl. Talang ratu P 17 Th A 1 1
7-Dec-15 1862 0001325900709 Edy sunarto jl. Akbp H.Umar L 71 Th k+ 1
7-Dec-15 2302 0000026943827 Mahida jl. Talang betutu P 58 Th P 1
7-Dec-15 2304 0000026038642 Saldiyah jl.talang jambe P 56 Th I 1
7-Dec-15 616 0000027346173 Chandra wulan Jl. Talang ratu P 41 Th I 1
7-Dec-15 172 0000025620197 Dencik komp, pemda P 56 Th P 1
7-Dec-15 1707 0000026513886 Yulis Jl. Lebak pakis P 55 Th P 1
7-Dec-15 1707 0000026513886 Suryat Lr. Famili P 66 Th I 1
7-Dec-15 304 0000027318363 Achmadiah tjik asin perum rakyat L 71 Th P 1
7-Dec-15 2305 0001811380959 M. Riski fahri P jl. Lebak pakis L 7 Th A 1
7-Dec-15 2305 001811380342 Fitriyant Jl. Lebak pakis P 33 Th I 1
Ruangan
7-Dec-15 578 0001321770554 Megawat lr. Tanjung P 64 Th I 1

7-Dec-15 779 0000026337396 Tiara U Jl. Kasnariansyah P 16 Th A 1
7-Dec-15 903 0000026468289 Rahma suri perum rakyat P 86 Th P 1
7-Dec-15 2055 0000026707746 Ciknah jl. Wayhitam P 52 TH I 1
7-Dec-15 337 0001817809481 Indah aprina jl. Kenanga 2 P 23 Th I 1
7-Dec-15 153 0001266545902 Noveko racmat jlk. Let murod L 28 Th P 1
7-Dec-15 1344 0001857395496 H. Z Aizurni jl. Soeta L 48 Th P 1
7-Dec-15 2053 0001886501496 Yuliana lr. Pelita P 32 Th I 1
7-Dec-15 2179 0001886501147 Imam kesuma Lr. pelita L 37 Th P 1
7-Dec-15 183 0000026367581 Dalimin sudjadi jl. Naskah L 70 Th P 1
7-Dec-15 2306 0000149180343 Salman alfarisi Jl. Sukarela L 41 Th P 1
7-Dec-15 1809 0000026699883 drs. H. Asa'ad matcik jl. Way L 64 Th P 1
7-Dec-15 1694 0000027129058 Sawirul yat jl. Rimba kemuning P 51 Th P 1
7-Dec-15 2096 0000027276289 Sutrisno Jl. Kasnariansyah L 45 Th P 1
7-Dec-15 1597 0000025741416 Nurbait Jl. Aman 2 P 46 Th I 1
7-Dec-15 1842 0001383996969 Kgs. Achmad simpang kades L 65 Th P 1
7-Dec-15 2307 0001871548749 Alauna azzahra jl. Talang ratu P 5 Th A 1
7-Dec-15 2308 0000027286154 Eka lr. Kota baru P 51 Th I 1
7-Dec-15 2309 0000027286165 Seifty mujizatah lr. Kota baru P 19 Th A 1
7-Dec-15 1874 0001822566442 Murni Jl. Lr H Hazis rt 22 P 45 Th P 1
7-Dec-15 279 0000324360494 maliki zahri jl. Kasnariansyah L 75 Th P 1
7-Dec-15 285 0000992534951 juryat jl. Ariodillah 3 P 48 Th I 1
7-Dec-15 286 0000324358942 Johan murod jl.kenanga l 58 Th P 1
7-Dec-15 287 0000324827594 hevi zahrani lr. Rambutan p 6 th A 1
7-Dec-15 90 0000324317362 M. Alfi R jl. Ariodillah L 16 Th A 1
7-Dec-15 288 0000992535153 Rosmaina jl. Kasnariansyah P 61 Th I 1
7-Dec-15 98 0000992538077 Helmi afriandoko jl. Ariodillah L 42 Th P 1
7-Dec-15 204 0000325115572 Uswaini jl. Talang betutu L 47 Th P 1
7-Dec-15 261 0000992537155 syamsul R jl. Kasnariansyah L 51 Th P 1
7-Dec-15 181 0000324295716 Husnaini lr. Mustakim P 43 Th I 1

BULAN : DESEMBER
Ruangan
7-Dec-15
7-Dec-15
Gastrits 279 0000324360494 maliki zahri maliki zahri jl. Kasnariansyah L 75 Th

Gatel-gatel 285 0000992534951 juryat juryat jl. Ariodillah 3 P 48 Th
Tubercolosi 286 0000324358942 Johan murod johan murod jl.kenanga l 58 Th
Rs. Bhyangkara/PDL/140 HHD 287 0000324827594 hevi zahrani muhammadia lr. Rambutan p 6 th
Rs. Bhyangkara/PDL/142 DM 90 0000324317362 M. Alfi R Edwar pasha jl. Ariodillah L 16 Th
RA 288 0000992535153 Rosmaina basuki jl. Kasnariansyah P 61 Th
Pusing 98 0000992538077 Helmi afriandoko ybs jl. Ariodillah L 42 Th
Rs. Bhyangkara/PDL/146 RA 204 0000325115572 Uswaini Uswaini jl. Talang betutu L 47 Th
Rs. Dr. A Gani/PDL/147 HHD 261 0000992537155 syamsul R Syamsul R jl. Kasnariansyah L 51 Th
Rs. Bhayangkara/Bedah/148 patah tangan 181 0000324295716 Husnaini Zulkifli lr. Mustakim P 43 Th
DM
Rs. Bhayangkara/Jantung/149 DM
Panas
Rs. Bhayangkara/PDL/152 HHD
Sakit gigi
Dermatts
Sakit pinggang
demam
Rs. Mata/mata/156 Katarak
benjolan payudara
Rs. Bhayangkara/PDL/160 Sakit ginjal
RA
Sakit mata IRT
RSIA YK Madira/Gyn/176 Gastrits
Rs. Bhyangkara/PDL/169 HT PNS
HHD IRT
Demam IRT
ISPA Pensiun PNS
Dermatts
RA
Rs. Bhayangkara/Jantung/150 HHD IRT

Demam
Rs. Bhayangkara/PDL/179 Asma irt
Osteoporosis IRT
ANC IRT
ISPA Swasta
DM
Demam IRT
sakit gigi Wiraswasta
ISPA
Rs. Bhyangkara/THT/189 Polip
Rs. Bhayangkara/THT/182 Sakit telinga
Cabut gigi Guru
HHD
Sakit gigi
HHD
Sakit telinga
Rs. Mata/Mata/198 Anisometropia
Rs. Mata/ Mata/199 Anisometropia
Pusing
Rs. Bhyangkara/PDL.141 Susah baak buruh
Rs. Bhayangkara/Syaraf/143 Stroke IRT
Rs. Bhayangkara/bedah/159 Sakit di penis swasta
Panas
ASMA
HT
CACAR
Sakit gigi Buruh
pusing
Gtastrits
RS. Dr.AK Gani/P.Dalam/209

AS
Ruangan
P 1 Susah baak buruh

I 1 HT IRT
P 1 Rs. Bhayangkara/bedah/159 Sakit di penis swasta
A 1 Panas
A 1 ASMA
I 1 HT
P 1 CACAR
P 1 Sakit gigi Buruh
P 1 pusing
I 1 Gtastrits

1 8-Dec-15 0000026924253 Imron salam L 65 Th Parkinson 1.

2 8-Dec-15 0000025565589 Nuraini P 56 Th DM 2.
3 8-Dec-15 0001258188309 Saipon P 45 Th Sakit pinngang 3.
4 8-Dec-15 0001262533612 Muharam L 58 Th HT 4.
5 8-Dec-15 0000032031347 Dewi Darwiana P 38 Th Pusing 5.
6 8-Dec-15 0000025835883 Erni sarita p 50 Th Gatel-gatel 6.
7 8-Dec-15 0000026049339 Tibroni L 51 Th HT 7.
8 8-Dec-15 0000026795722 Suliah P 64 Th HHD 8.
9 8-Dec-15 0001885320685 Azuar anas L 28 Th demam 9.
10 8-Dec-15 0000026932915 Nazaruddin L 63 Th benjolan di mata 10
11 8-Dec-15 0000026166339 Ernawat P 58 Th HHD 11.
12 8-Dec-15 0000026825973 Abdul Latf L 80 Th HT 12.
13 8-Dec-15 0000026830923 Syamsul Huda L 66 Th HT 13.
14 8-Dec-15 0000148869617 Musilawat P 41 Th Dermatts 14.
15 8-Dec-15 0001294140352 Maldi Gandri P 51 Th Pusing 15.
16 8-Dec-15 0000027039284 Wistanio P 66 Th Katarak 16.
17 8-Dec-15 0001882399307 Bintang P 45 hariImunisasi 17.
18 8-Dec-15 0001319031911 Fatma Nayla Husna P 6 Th Cabut gigi 18.
19 8-Dec-15 0000025880679 Nyayu Nur asiah P 21 Th Tampal gigi 19.
20 8-Dec-15 0000025880668 Nyayu Muslihah P 25 Th Epilepsi 20.
21 8-Dec-15 0001107852052 Angelina Triana P P 9 Th ISPA 21.
22 8-Dec-15 0001427484374 Musiran L 52 Th HT 22.
23 8-Dec-15 0000026910123 Roilita P 50 Th Pterygium 23.
24 8-Dec-15 0000210744156 Halima maulina P 19 Th ASMA 24.
25 8-Dec-15 0000027102677 Nuraini P 47 Th HHD 25.
26 8-Dec-15 0001823787191 Dewitri Abass P 65 Th Syaraf 26.
27 8-Dec-15 0001380451815 Rokoya P 64 Th pusing 27.
28 8-Dec-15 0001380451138 Syukri L 65 Th Hydroxyapatte 28.
29 8-Dec-15 0000026942973 Tarmizi L 62 Th Gatel-gatel 29.
30 8-Dec-15 0001646028753 Sadarlina P 35 Th Sakit telinga 30.

31 8-Dec-15 0001279234282 Maqda Amora P 2 Th Muntah 31
32 8-Dec-15 0000026820426 H. Marhan Efendi L 63 Th HHD 32
33 8-Dec-15 0000026820437 Hj. Awaliyah P 60 Th DM 33.
34 8-Dec-15 0001827004342 Dessy fitria L P 28 Th Post partum 34.
35 8-Dec-15 0000325952245 Sumarni P 64 Th Demam 35.
36 8-Dec-15 0000992534332 M. Amin L 68 Th HT 36.
37 8-Dec-15 0000324163416 Ari Hariady L 20 Th Pusing 37.
38 8-Dec-15 0000325124537 Ardi Nbopyan S L 18 Th ISPA 38.
39 8-Dec-15 0000324785632 Rukaya Yunanda P 15 Th Sakit mata 39.
40 8-Dec-15 0000324140174 inda permata sari P 7 Th Cabut gigi 40.
41 8-Dec-15 0000325975454 Alex Gustari L 51 Th Mata kabur 41.
42 8-Dec-15 0001811380342 Fitriyant P 34 Th Sakit di bahu 42.
43 8-Dec-15 0001807058193 Endang Eni Mardiyah P 42 Th Suntk KB 43.
44 8-Dec-15 0 0 0 0 44.
45 8-Dec-15 0 0 0 0 45.
46 8-Dec-15 0 0 0 0 46.
47 8-Dec-15 0 0 0 0 47.
48 8-Dec-15 0 0 0 0 48.
49 8-Dec-15 0 0 0 0 49.
50 8-Dec-15 0 0 0 0 50.
51 8-Dec-15 0 0 0 0 51.
52 8-Dec-15 0 0 0 0 52.
53 8-Dec-15 0 0 0 0 53.
54 8-Dec-15 0 0 0 0 54.
55 8-Dec-15 0 0 0 0 55.
56 8-Dec-15 0 0 0 0 56.
57 8-Dec-15 0 0 0 0 57.
58 8-Dec-15 0 0 0 0 58.
59 8-Dec-15 0 0 0 0 59.
60 8-Dec-15 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
8-Dec-15 1078 0000026924253 Imron salam jl. Naskah L 65 Th P 1

8-Dec-15 1225 0000025565589 Nuraini jl. Taman indah P 56 Th I 1
8-Dec-15 1910 0001258188309 Saipon jl. Akbp h umar P 45 Th I 1
8-Dec-15 0001262533612 Muharam jl. Plajau L 58 Th L 1
8-Dec-15 0000032031347 Dewi Darwiana Jl. Komp Gsh P 38 Th P 1
8-Dec-15 1210 0000025835883 Erni sarita komp arhanudri p 50 Th I 1
8-Dec-15 2255 0000026049339 Tibroni Talang ratu L 51 Th P 1
8-Dec-15 589 0000026795722 Suliah Jl. Swadaya P 64 Th I 1
8-Dec-15 2033 0001885320685 Azuar anas jl. Let murod L 28 Th P 1
8-Dec-15 477 0000026932915 Nazaruddin Bougenvile L 63 Th P 1
8-Dec-15 1642 0000026166339 Ernawat jl. Sriwijaya P 58 Th P 1
8-Dec-15 323 0000026825973 Abdul Latf Lr. Damar L 80 Th P 1
8-Dec-15 1876 0000026830923 Syamsul Huda jl. Mawar L 66 Th P 1
8-Dec-15 2311 0000148869617 Musilawat jl. Akbp h umar P 41 Th P 1
8-Dec-15 1484 0001294140352 Maldi Gandri Perum rakyat P 51 Th I 1
8-Dec-15 318 0000027039284 Wistanio jl. Let murod P 66 Th P 1
8-Dec-15 1827 0001882399307 Bintang jl. Akbp h umar P 45 hariA 1
8-Dec-15 2312 0001319031911 Fatma Nayla Husna jl. Kasnariansyah P 6 Th A 1
8-Dec-15 2046 0000025880679 Nyayu Nur asiah jl. Anwar arsyad P 21 Th A 1
8-Dec-15 1015 0000025880668 Nyayu Muslihah jl. Anwar arsyad P 25 Th A 1
8-Dec-15 2030 0001107852052 Angelina Triana P Asrama korem P 9 Th A 1
8-Dec-15 363 0001427484374 Musiran Lr kurnia L 52 Th P 1
8-Dec-15 1271 0000026910123 Roilita Jl. Sukawinatan P 50 Th P 1
8-Dec-15 2113 0000210744156 Halima maulina Jl. Kol. H. Burlian P 19 Th A 1
8-Dec-15 1040 0000027102677 Nuraini komp. Bougenvile P 47 Th P 1
8-Dec-15 0001823787191 Dewitri Abass jl. Sukabangun 1 P 65 Th P 1
8-Dec-15 350 0001380451815 Rokoya jl. Let murod P 64 Th P 1
8-Dec-15 0001380451138 Syukri jl. Let murod L 65 Th P 1
8-Dec-15 2009 0001646028753 Sadarlina jl. Let murod P 35 Th I 1
BULAN : DESEMBER
Ruangan
8-Dec-15 2303 0001279234282 Maqda Amora lr. Rambutan P 2 Th A 1

8-Dec-15 132 0000026820426 H. Marhan Efendi jl. Let murod L 63 Th P 1
8-Dec-15 572 0000026820437 Hj. Awaliyah jl. Let murod P 60 Th I 1
8-Dec-15 883 0001827004342 Dessy fitria L Jl. SB 2 P 28 Th P 1
8-Dec-15 289 0000325952245 Sumarni lr. Rambutan P 64 Th I 1
8-Dec-15 73 0000992534332 M. Amin jl. Ariodillah L 68 Th P 1
8-Dec-15 65 0000324163416 Ari Hariady jl. Mawar L 20 Th A 1
8-Dec-15 134 0000325124537 Ardi Nbopyan S jl. ariodillah L 18 Th A 1
8-Dec-15 290 0000324785632 Rukaya Yunanda lr. rambutan P 15 Th A 1
8-Dec-15 229 0000324140174 inda permata sari jl. Ariodillah P 7 Th A 1
8-Dec-15 291 0000325975454 Alex Gustari jl. Ariodillah L 51 Th P 1
8-Dec-15 2305 0001811380342 Fitriyant jl. Lebak pakis P 34 Th I 1
8-Dec-15 1760 0001807058193 Endang Eni Mardiyah Jl. Kenanga P 42 Th P 1
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15
8-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Rs. Bhayangkara/Syaraf/218 Parkinson Pensiunan PNS 289 0000325952245 Sumarni Nurdi lr. Rambutan P 64 Th
DM IRT 73 0000992534332 M. Amin M. Amin jl. Ariodillah L 68 Th
Sakit pinngang IRT 65 0000324163416 Ari Hariady Agus Lim jl. Mawar L 20 Th
Rs. Myria/PDL/217 HT Pensiunan PNS 134 0000325124537 Ardi Nbopyan S Amran jl. ariodillah L 18 Th
Rs. Bhyangkara/PDL/221 Pusing PNS 290 0000324785632 Rukaya Yunanda Iskandar lr. rambutan P 15 Th
Rs. Myria/Kulit/222 Gatel-gatel IRT 229 0000324140174 inda permata sari Hotman jl. Ariodillah P 7 Th
HT PNS 291 0000325975454 Alex Gustari ybs jl. Ariodillah L 51 Th
RS. Dr. AK Gani/PDL/224 HHD IRT
demam Buruh
Rs. Bhayangkara/Bedah/225 benjolan di mata Pensiunan PNS
RSIA YK Madira/PDL/226 HHD PNS Depag
HT PNS
HT PNS
Dermatts GURU
Pusing IRT
Rs. Mata/mata/230 Katarak pensiu8nan Guru
Imunisasi
Cabut gigi Pelajar
Tampal gigi Pelajar
Rs. Bhayangkara/Syaraf/233 Epilepsi Pelajar
ISPA Pelajar
HT Buruh
Rs. Mata/mata/239 Pterygium IRT
ASMA
Syaraf
Rs. Myria/syaraf/232 pusing
Rs. Myria/syaraf/241 Hydroxyapatte
Gatel-gatel pensiunan PU
Sakit telinga
Muntah
Rs. Bhayngkara/PDL/244 HHD
Rs. Bhayngkara/PDL/243 DM
RSIA YK Madira/Gyn/259 Post partum
Demam IRT
Rs. Bahyangkara/PDL/220 HT Buruh
Pusing Pelajar
ISPA Pelajar
Sakit mata Pelajar
Cabut gigi Pelajar
Rs. Mata/Mata/238 Mata kabur serabutan
Rs. Bhyangkara/Bedah/260 Sakit di bahu IRT
Suntk KB IRT
Ruangan
I 1 Demam IRT
P 1 HT Buruh
A 1 Pusing Pelajar
A 1 ISPA Pelajar
A 1 Sakit mata Pelajar
A 1 Cabut gigi Pelajar
P 1 Mata kabur serabutan

1 9-Dec-15 0000026569967 Darowardi L 67 Th HT 1.

2 9-Dec-15 0001317131919 M. Ilham habibi L 7 Th 2.
3 9-Dec-15 0000025706068 Paiza P 47 Th 3.
4 9-Dec-15 0000027535623 Syamsul bahri L 52 Th 4.
5 9-Dec-15 0000026817917 Drs. H. M. Ali mansyur L 78 Th 5.
6 9-Dec-15 0000026466592 Prihyudono L 65 Th 6.
7 9-Dec-15 0000026937246 Saeran L 76 Th 7.
8 9-Dec-15 0001853339229 Mutah Azzahra P 10 bln 8.
9 9-Dec-15 0001266277926 Dwi pertwi P 30 Th 9.
10 9-Dec-15 0 0 0 10
11 9-Dec-15 0 0 0 0 11.
12 9-Dec-15 0 0 0 0 12.
13 9-Dec-15 0 0 0 0 13.
14 9-Dec-15 0 0 0 0 14.
15 9-Dec-15 0 0 0 0 15.
16 9-Dec-15 0 0 0 0 16.
17 9-Dec-15 0 0 0 0 17.
18 9-Dec-15 0 0 0 0 18.
19 9-Dec-15 0 0 0 0 19.
20 9-Dec-15 0 0 0 0 20.
21 9-Dec-15 0 0 0 0 21.
22 9-Dec-15 0 0 0 0 22.
23 9-Dec-15 0 0 0 0 23.
24 9-Dec-15 0 0 0 0 24.
25 9-Dec-15 0 0 0 0 25.
26 9-Dec-15 0 0 0 0 26.
27 9-Dec-15 0 0 0 0 27.
28 9-Dec-15 0 0 0 0 28.
29 9-Dec-15 0 0 0 0 29.
30 9-Dec-15 0 0 0 0 30.

31 9-Dec-15 0 0 0 0 31
32 9-Dec-15 0 0 0 0 32
33 9-Dec-15 0 0 0 0 33.
34 9-Dec-15 0 0 0 0 34.
35 9-Dec-15 0 0 0 0 35.
36 9-Dec-15 0 0 0 0 36.
37 9-Dec-15 0 0 0 0 37.
38 9-Dec-15 0 0 0 0 38.
39 9-Dec-15 0 0 0 0 39.
40 9-Dec-15 0 0 0 0 40.
41 9-Dec-15 0 0 0 0 41.
42 9-Dec-15 0 0 0 0 42.
43 9-Dec-15 0 0 0 0 43.
44 9-Dec-15 0 0 0 0 44.
45 9-Dec-15 0 0 0 0 45.
46 9-Dec-15 0 0 0 0 46.
47 9-Dec-15 0 0 0 0 47.
48 9-Dec-15 0 0 0 0 48.
49 9-Dec-15 0 0 0 0 49.
50 9-Dec-15 0 0 0 0 50.
51 9-Dec-15 0 0 0 0 51.
52 9-Dec-15 0 0 0 0 52.
53 9-Dec-15 0 0 0 0 53.
54 9-Dec-15 0 0 0 0 54.
55 9-Dec-15 0 0 0 0 55.
56 9-Dec-15 0 0 0 0 56.
57 9-Dec-15 0 0 0 0 57.
58 9-Dec-15 0 0 0 0 58.
59 9-Dec-15 0 0 0 0 59.
60 9-Dec-15 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
9-Dec-15 473 0000026569967 Darowardi jl. Swadaya L 67 Th P 1

5 0001317131919 M. Ilham habibi jl. Let murod L 7 Th A 1
838 0000025706068 Paiza jl. Kol h burlian P 47 Th I 1
644 0000027535623 Syamsul bahri jl. Swadaya L 52 Th P 1
120 0000026817917 Drs. H. M. Ali mansyur jl. Let murod L 78 Th P 1
2003 0000026466592 Prihyudono jl Bumi mas L 65 Th P 1
1049 0000026937246 Saeran jl. Srijaya L 76 Th P 1
1588 0001853339229 Mutah Azzahra jl. Gotong royong P 10 bln A 1
281 0001266277926 Dwi pertwi jl. Gotong royong P 30 Th I 1
BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
HT Pensiun PNS
ISPA Pelajar
RA Guru
Asma
Sakit tenggorokan pesiun DIKNAS
ISPA
Rs. Bhayangkara/Saraf/268 RA Pensiun PNS
ISPA
Nyeri dada IRT
AS
Ruangan

1 10-Dec-15 0000026916502 Asri Murni P 62 Th HHD 1.

2 10-Dec-15 0001797787607 Zumaro L 65 Th Asma 2.
3 10-Dec-15 0000026281236 Aulia mizola P 56 Th Pusing 3.
4 10-Dec-15 0000026508172 Cholidie tjik L 70 Th Mata kabur 4.
5 10-Dec-15 00000265000166 Sadaruddin L 52 Th Gastrits 5.
6 10-Dec-15 0000026980435 Elly sri P 60 Th DM 6.
7 10-Dec-15 0000027588317 drs. Budiman zen L 62 Th DM 7.
8 10-Dec-15 0000205220046 Nostri piyuni P 26 Th ANC 8.
9 10-Dec-15 0001866501314 Yan H Ilyas L 74 Th RA 9.
10 10-Dec-15 0000027420669 M. Juliansyah L 9 Th Sakit mata 10
11 10-Dec-15 0000026933264 Nur Antoni L 63 Th HT 11.
12 10-Dec-15 0000026822856 Rosdianah P 65 Th Sakit mata 12.
13 10-Dec-15 0000026166363 Desen Yulis L 60 Th HHD 13.
14 10-Dec-15 0001506163307 Lidya Epayant P 24 Th ANC 14.
15 10-Dec-15 0000025720233 sri susant P 33 Th HT 15.
16 10-Dec-15 0000025720255 Aulia Salsabila A 8 Th Gastrits 16.
17 10-Dec-15 0001793398689 Mien Rosmini P 71 Th RA 17.
18 10-Dec-15 0000026149612 Ema Fathimah P 46 Th Vertgo 18.
19 10-Dec-15 0000026934849 Riduan L 70 Th Sakit kaki 19.
20 10-Dec-15 0001383406841 Anita P 33 Th HT 20.
21 10-Dec-15 0000026000166 M. Syukri L 75 Th DM 21.
22 10-Dec-15 0000026821113 hj. Jawariah P 74 Th Tyroid 22.
23 10-Dec-15 0000026383364 Johni Rampen L 70 Th ISPA 23.
24 10-Dec-15 0001814134151 Framelsyah brigita P 13 Th ISPA 24.
25 10-Dec-15 0001814133284 Meliyuni P 37 Th Alergi 25.
26 10-Dec-15 0000172383838 Devi febriant P 31 Th Cabut gigi 26.
27 10-Dec-15 0000029114616 Yulius P 40 Th ANC 27.
28 10-Dec-15 0000026211442 Silva P 6 Th ISPA 28.
29 10-Dec-15 0000035941341 Suharsono L 57 Th HHD 29.
30 10-Dec-15 0000026691322 Ahad P 71 Th sakit gigi 30.

31 10-Dec-15 0001800569733 M. Alfarizi Puta L 15 Th Sakit gigi 31
32 10-Dec-15 0000026817952 Drs. Indra kesuma L 72 Th RA 32
33 10-Dec-15 0001505227533 Sit fatmah P 44 Th Lepas 33.
34 10-Dec-15 0000026442944 Nungimah P 56 Th HT 34.
35 10-Dec-15 0000026442933 Rusni L 58 Th Cabut gigi 35.
36 10-Dec-15 0001857795175 Ely fitriant P 37 Th Gastrits 36.
37 10-Dec-15 0000025671508 Eni Kariza P 50 Th Dermatts 37.
38 10-Dec-15 0000210570129 Reno Winata L 20 Th Sakit mata 38.
39 10-Dec-15 0000042152411 Samuji L 55 Th Sakit tangan 39.
40 10-Dec-15 0000027105715 Musiar L 48 Th Sakit gigi 40.
41 10-Dec-15 0000026742341 drs. Achmad soedjai P 75 Th HT 41.
42 10-Dec-15 0000026932331 Nadra P 67 Th Sakit Telinga 42.
43 10-Dec-15 0001298065184 Solafide Romauli P 14 Th Anemi 43.
44 10-Dec-15 0000027375175 Nelli P 55 Th Vertgo 44.
45 10-Dec-15 0000027103432 Yangcik L 64 Th Sakit gigi 45.
46 10-Dec-15 0000027489543 Madariah P 53 Th HT 46.
47 10-Dec-15 0000324784629 Ainah P 44 Th Radang 47.
48 10-Dec-15 0000324785632 Rukaya P 15 Th Sakit mata 48.
49 10-Dec-15 0000324350381 Mainar P 65 Th Demam 49.
50 10-Dec-15 0000324995016 Suryaman L 50 Th Demam 50.
51 10-Dec-15 0000325557066 Sustriani P 28 Th Suntk kb 51.
52 10-Dec-15 0 0 0 0 0 52.
53 10-Dec-15 0 0 0 0 0 53.
54 10-Dec-15 0 0 0 0 0 54.
55 10-Dec-15 0 0 0 0 0 55.
56 10-Dec-15 0 0 0 0 0 56.
57 10-Dec-15 0 0 0 0 0 57.
58 10-Dec-15 0 0 0 0 0 58.
59 10-Dec-15 0 0 0 0 0 59.
60 10-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
10-Dec-15 568 0000026916502 Asri Murni km 11 P 62 Th I 1

10-Dec-15 2314 0001797787607 Zumaro jl. Kasnariansyah L 65 Th P 1
10-Dec-15 179 0000026281236 Aulia mizola jl. Kasnariansyah P 56 Th I 1
10-Dec-15 55 0000026508172 Cholidie tjik jl. Swadaya L 70 Th P 1
10-Dec-15 401 00000265000166 Sadaruddin jl. Kasnariansyah L 52 Th P 1
10-Dec-15 892 0000026980435 Elly sri jl. Let. Murod P 60 Th I 1
10-Dec-15 891 0000027588317 drs. Budiman zen jl. Let. Murod L 62 Th P 1
10-Dec-15 2315 0000205220046 Nostri piyuni jl. Tanah mas P 26 Th I 1
10-Dec-15 1687 0001866501314 Yan H Ilyas jl. Kasnariansyah L 74 Th P 1
10-Dec-15 2318 0000027420669 M. Juliansyah Jl. Srijaya L 9 Th A 1
10-Dec-15 2283 0000026933264 Nur Antoni Jln Sukabangun 1 L 63 Th P 1
10-Dec-15 487 0000026822856 Rosdianah lr. Biga P 65 Th P 1
10-Dec-15 753 0000026166363 Desen Yulis jl. Kasnariansyah L 60 Th P 1
10-Dec-15 2209 0001506163307 Lidya Epayant jl. Famili P 24 Th P 1
10-Dec-15 164 0000025720233 sri susant jl. Kol sulaiman P 33 Th I 1
10-Dec-15 339 0000025720255 Aulia Salsabila jl. Kol sulaiman A 8 Th A 1
10-Dec-15 311 0001793398689 Mien Rosmini jl. Kasnariansyah P 71 Th P 1
10-Dec-15 2162 0000026149612 Ema Fathimah perum rakyat P 46 Th P 1
10-Dec-15 659 0000026934849 Riduan jl. swadaya L 70 Th P 1
10-Dec-15 2321 0001383406841 Anita jl. Ariodillah P 33 Th P 1
10-Dec-15 756 0000026000166 M. Syukri jl. Naskah L 75 Th P 1
10-Dec-15 412 0000026821113 hj. Jawariah jl. Kasnariansyah P 74 Th P 1
10-Dec-15 1113 0000026383364 Johni Rampen Jl. Peridustrian L 70 Th P 1
10-Dec-15 1791 0001814134151 Framelsyah brigita jl. Mawar P 13 Th A 1
10-Dec-15 1416 0001814133284 Meliyuni jl. Mawar P 37 Th I 1
10-Dec-15 2322 0000172383838 Devi febriant jl. Let murod rt.7 no. 499 P 31 Th P 1
10-Dec-15 2316 0000029114616 Yulius jl. Taman sari P 40 Th I 1
10-Dec-15 2317 0000026211442 Silva Jl. Mandi api P 6 Th A 1
10-Dec-15 110 0000035941341 Suharsono jl. Let murod L 57 Th P 1
10-Dec-15 225 0000026691322 Ahad jl. Sri hitam P 71 Th p 1
Ruangan
10-Dec-15 704 0001800569733 M. Alfarizi Puta Jl. SB 2 L 15 Th A 1

10-Dec-15 507 0000026817952 Drs. Indra kesuma talang ratu L 72 Th P 1
10-Dec-15 2323 0001505227533 Sit fatmah jl. Kasnariansyah P 44 Th I 1
10-Dec-15 84 0000026442944 Nungimah Perumdam P 56 Th I 1
10-Dec-15 84 0000026442933 Rusni Perumdam L 58 Th P 1
10-Dec-15 1456 0001857795175 Ely fitriant jl. Kasnariansyah P 37 Th I 1
10-Dec-15 2148 0000025671508 Eni Kariza Jl. SB 2 P 50 Th I 1
10-Dec-15 2324 0000210570129 Reno Winata jl. Naskah L 20 Th A 1
10-Dec-15 2325 0000042152411 Samuji jl. Mandi api L 55 Th P 1
10-Dec-15 1371 0000027105715 Musiar jl. Kasnariansyah L 48 Th P 1
10-Dec-15 2186 0000026742341 drs. Achmad soedjai jl. Mawar P 75 Th P 1
10-Dec-15 2326 0000026932331 Nadra jl. sukamaju P 67 Th P 1
10-Dec-15 0001298065184 Solafide Romauli maskerebet P 14 Th A 1
10-Dec-15 2327 0000027375175 Nelli jl. Jat no. 265 P 55 Th I 1
10-Dec-15 1141 0000027103432 Yangcik jl. Let murod L 64 Th P 1
10-Dec-15 993 0000027489543 Madariah jl. Let murod P 53 Th P 1
10-Dec-15 84 0000324784629 Ainah lr. Rambutan P 44 Th I 1
10-Dec-15 290 0000324785632 Rukaya lr. Rambutan P 15 Th A 1
10-Dec-15 238 0000324350381 Mainar jl. Demang P 65 Th P 1
10-Dec-15 292 0000324995016 Suryaman jl. Radio L 50 Th P 1
10-Dec-15 211 0000325557066 Sustriani jl. Anggrek P 28 Th I 1
10-Dec-15
10-Dec-15
10-Dec-15
10-Dec-15
10-Dec-15
10-Dec-15
10-Dec-15
10-Dec-15
10-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
RS. Bhayangkara/PDL/269 HHD IRT 84 0000324784629 Ainah Iskandar lr. Rambutan P 44 Th

Asma Pedagang 290 0000324785632 Rukaya Iskandar lr. Rambutan P 15 Th
RS. Bhayangkara/syaraf/271 Pusing IRT 238 0000324350381 Mainar Mainar jl. Demang P 65 Th
RS. Mata/Mata/273 Mata kabur 292 0000324995016 Suryaman Suryaman jl. Radio L 50 Th
Gastrits 211 0000325557066 Sustriani Iwan jl. Anggrek P 28 Th
DM Pensiunan PNS
RS. Bhyangkara/PDL/275 DM Pensiunan PNS
ANC IRT
RA
Sakit mata
HT
Sakit mata
ANC
HT
Gastrits
RA
rsia yk madira/syaraf/285 Vertgo
Sakit kaki
Rs. Bhayangkara/PDL/288 HT
Rs. Bhayangkara/PDL/272 DM
Rs. Bhyangkara/PDL/108 Tyroid
ISPA
ISPA
Alergi
Cabut gigi PNS
ANC
ISPA
HHD
sakit gigi
Sakit gigi
Rs. Bhayangkara/PDL/300 RA
Lepas
HT IRT
Cabut gigi Pensiunan PNS
Rs. Bhyangkara/Gyn/303 Gastrits
Dermatts
Sakit mata
Sakit tangan
Sakit gigi
HT
Sakit Telinga
Anemi
Rs. Myria/syaraf/310 Vertgo
Sakit gigi
HT
Radang IRT
Sakit mata
Demam
Demam dagang
Suntk kb
AS
Ruangan
I 1 Radang IRT
A 1 Sakit mata
P 1 Demam
P 1 Demam dagang
I 1 Suntk kb

1 11-Dec-15 0001505458091 Panji Athoriq L 8 Th ISPA 1.

2 11-Dec-15 0001505458102 hmad fauzan mubarok L 4,2 th ISPA 2.
3 11-Dec-15 0000025881186 Rosadah P 55 Th RA 3.
4 11-Dec-15 0001261372217 M. Senen D P 60 Th HT 4.
5 11-Dec-15 0000025971197 Chandra kirana L 61 Th Tampal gigi 5.
6 11-Dec-15 0000026507665 Maria P 60 Th Nyeri perut 6.
7 11-Dec-15 0001643465294 Suparsih P 44 Th Nyeri perut 7.
8 11-Dec-15 0000026744747 Hj. Wagini P 69 Th DM 8.
9 11-Dec-15 0000027036966 Ermalina P 57 Th HHD 9.
10 11-Dec-15 0000269252087 Syamsiah P 71 Th HT 10
11 11-Dec-15 0000027038002 Syamsiah P 51 Th HT 11.
12 11-Dec-15 0000026287874 Nadia syafira P 12 Thnsakit mata 12.
13 11-Dec-15 0000027208653 Sit Rohmaniat P 48 Th HT 13.
14 11-Dec-15 0001866021783 Melani P 26 Th ANC 14.
15 11-Dec-15 0000026713269 Nurhana P 65 Th RA 15.
16 11-Dec-15 0000026916423 Drs. Afandi benaim L 65 Th Glaukoma 16.
17 11-Dec-15 0000026218765 Winarso L 56 Th DM 17.
18 11-Dec-15 0000027038046 Yusmani P 56 Th Nyeri kaki 18.
19 11-Dec-15 0000165802768 Daida P 43 Th Sakit gigi 19.
20 11-Dec-15 0001868906079 Winda Farrah P 23 Th Kista 20.
21 11-Dec-15 0000026295805 Suriana P 52 Th Sakit gigi 21.
22 11-Dec-15 0000026422841 Saonah P 58 Th HHD 22.
23 11-Dec-15 0001170121004 Wat P 35 Th Keputhan 23.
24 11-Dec-15 0000037269843 Naila Desta Sari P 9 Th Bisul 24.
25 11-Dec-15 0000027207595 Abdul Rachman L 55 Th HHD 25.
26 11-Dec-15 0000026509882 Hj Rumbiyah P 73 Th HHD 26.
27 11-Dec-15 0000324814599 Lamsuri L 38 Th Sakit gigi 27.
28 11-Dec-15 0000325971347 Sukmawat P 43 Th Epilepsy 28.
29 11-Dec-15 0 0 0 0 0 29.
30 11-Dec-15 0 0 0 0 0 30.

31 11-Dec-15 0 0 0 0 0 31
32 11-Dec-15 0 0 0 0 0 32
33 11-Dec-15 0 0 0 0 0 33.
34 11-Dec-15 0 0 0 0 0 34.
35 11-Dec-15 0 0 0 0 0 35.
36 11-Dec-15 0 0 0 0 0 36.
37 11-Dec-15 0 0 0 0 0 37.
38 11-Dec-15 0 0 0 0 0 38.
39 11-Dec-15 0 0 0 0 0 39.
40 11-Dec-15 0 0 0 0 0 40.
41 11-Dec-15 0 0 0 0 0 41.
42 11-Dec-15 0 0 0 0 0 42.
43 11-Dec-15 0 0 0 0 0 43.
44 11-Dec-15 0 0 0 0 0 44.
45 11-Dec-15 0 0 0 0 0 45.
46 11-Dec-15 0 0 0 0 0 46.
47 11-Dec-15 0 0 0 0 0 47.
48 11-Dec-15 0 0 0 0 0 48.
49 11-Dec-15 0 0 0 0 0 49.
50 11-Dec-15 0 0 0 0 0 50.
51 11-Dec-15 0 0 0 0 0 51.
52 11-Dec-15 0 0 0 0 0 52.
53 11-Dec-15 0 0 0 0 0 53.
54 11-Dec-15 0 0 0 0 0 54.
55 11-Dec-15 0 0 0 0 0 55.
56 11-Dec-15 0 0 0 0 0 56.
57 11-Dec-15 0 0 0 0 0 57.
58 11-Dec-15 0 0 0 0 0 58.
59 11-Dec-15 0 0 0 0 0 59.
60 11-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
11-Dec-15 1255 0001505458091 Panji Athoriq jl. Kasnariansyah L 8 Th A 1

11-Dec-15 1255 0001505458102 Ahmad fauzan mubarok jl. Kasnariansyah L 4,2 th A 1
11-Dec-15 2328 0000025881186 Rosadah Jl. Anggrek P 55 Th I 1
11-Dec-15 1036 0001261372217 M. Senen D Jl. Anggrek P 60 Th P 1
11-Dec-15 820 0000025971197 Chandra kirana jl. SB 2 L 61 Th P 1
11-Dec-15 2329 0000026507665 Maria jl. Swadaya P 60 Th I 1
11-Dec-15 1665 0001643465294 Suparsih lr. Biga P 44 Th I 1
11-Dec-15 1849 0000026744747 Hj. Wagini jl. Way hitam P 69 Th I 1
11-Dec-15 654 0000027036966 Ermalina komp. Bougenvile P 57 Th P 1
11-Dec-15 1393 0000269252087 Syamsiah jl. Suka senang P 71 Th I 1
11-Dec-15 2230 0000027038002 Syamsiah jl. Kasnariansyah P 51 Th P 1
11-Dec-15 2331 0000026287874 Nadia syafira Jl. Srijaya lr kesuma no 860 rt 18 P 12 ThnA 1
11-Dec-15 873 0000027208653 Sit Rohmaniat jl. Gotong royong P 48 Th I 1
11-Dec-15 1556 0001866021783 Melani jl. Let murod P 26 Th P 1
11-Dec-15 445 0000026713269 Nurhana jl. Mandi api P 65 Th P 1
11-Dec-15 897 0000026916423 Drs. Afandi benaim lr. Cempedak L 65 Th P 1
11-Dec-15 1773 0000026218765 Winarso lt. Muslimin L 56 Th P 1
11-Dec-15 2332 0000027038046 Yusmani jl. Kasnariansyah P 56 Th P 1
11-Dec-15 1913 0000165802768 Daida talang ratu P 43 Th P 1
11-Dec-15 2333 0001868906079 Winda Farrah lr. Cendana P 23 Th P 1
11-Dec-15 1704 0000026295805 Suriana jl. Let murod P 52 Th P 1
11-Dec-15 687 0000026422841 Saonah jl. Suparman P 58 Th I 1
11-Dec-15 0001170121004 Wat jl. Akbp H umar P 35 Th P 1
11-Dec-15 1852 0000037269843 Naila Desta Sari Jl. Jend Sudirman P 9 Th A 1
11-Dec-15 1114 0000027207595 Abdul Rachman Bumi Sembaja indah L 55 Th S 1
11-Dec-15 1082 0000026509882 Hj Rumbiyah Jl. Komp Pepabri blokj G 17 P 73 Th P 1
11-Dec-15 293 0000324814599 Lamsuri Jl. Let murod L 38 Th P 1
11-Dec-15 43 0000325971347 Sukmawat lr. Beringin P 43 Th I 1
11-Dec-15
11-Dec-15
Ruangan
11-Dec-15
BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
ISPA 293 0000324814599 Lamsuri Lamsuri Jl. Let murod L 38 Th

ISPA 43 0000325971347 Sukmawat Suyanto lr. Beringin P 43 Th
RS. Bhyangkara/PDL/312 RA
HT
Tampal gigi
Nyeri perut
Nyeri perut
DM
HHD
RS. Bhyangkara/PDL/314 HT
HT
sakit mata
HT IRT
Rs. Bhayangkara/Gyn/316 ANC Swasta
RA
Rs. Bunda/Mata/219 Glaukoma PNS
Rs. Bhayangkara/PDL/317 DM
Nyeri kaki
Sakit gigi PNS
RS. Bhyangkara/Gyn/329 Kista
Sakit gigi
HHD
Keputhan
Bisul
RS. Myria/Kulit/330 HHD Pns
RS. Myria/PDL/334 HHD
Sakit gigi pedagang
Rs. Bhyangkara/syaraf/328 Epilepsy
AS
Ruangan
P 1 Sakit gigi pedagang

I 1 Rs. Bhyangkara/syaraf/328 Epilepsy

1 12-Dec-15 0000027475773 Masiah P 58 Th ISPA 1.

2 12-Dec-15 0000026598104 Hasbullah L 68 Th Nyeri dada 2.
3 12-Dec-15 0001445636529 Kartni P 30 Th Periksa KB 3.
4 12-Dec-15 0001317131919 M. Ilham Habibi L 8 Th ISPA 4.
5 12-Dec-15 0000026536544 Dra. Evi Agustna Sari P 48 Th Tampal gigi 5.
6 12-Dec-15 0000026817928 Hj, Dasniah P 72 Th RA 6.
7 12-Dec-15 0001450267525 Maryama P 55 Th RA 7.
8 12-Dec-15 0001450267929 Dwi Henny Maya S P 31 Th ISPA 8.
9 12-Dec-15 0000026324932 M. Amin abu jagur P 66 Th Mata kabur 9.
10 12-Dec-15 0000026916423 Drs. Affandi Benaim L 65 Th HHD 10
11 12-Dec-15 0000026154909 Muslih Ali p 57 th Sakit telinga 11.
12 12-Dec-15 0001808056754 Maha feri r P 47 Th Mata kabur 12.
13 12-Dec-15 0001808057755 Meita Ismalinda P 22 Th Mata kabur 13.
14 12-Dec-15 0000202855814 Chici dwi oktarika P 32 Th Cabut gigi 14.
15 12-Dec-15 0000027311174 Nurbait P 54 Th HHD 15.
16 12-Dec-15 0000027600296 Asni Aprizah P 32 Th Gatel-gatel 16.
17 12-Dec-15 0001481934497 Lina susant P 13 Th DIARE 17.
18 12-Dec-15 0000026822992 Surya Ilyas L 61 Th RA 18.
19 12-Dec-15 0000025880679 Nyayu Nur Asiah P 20 Th Sakit gigi 19.
20 12-Dec-15 0000025977374 Inderawat P 51 Th ISPA 20.
21 12-Dec-15 0001276515674 Rosidah P 58 Th Dermatts 21.
22 12-Dec-15 0000026234763 Puspa Etka P 52ThnNyeri sendi 22.
23 12-Dec-15 0000026921283 H. Rozali acmad L 62 Th Sakit gigi 23.
25 12-Dec-15 0000026049352 Tahta Anugrah P L 16 Th Alergi 25.
26 12-Dec-15 0000158073906 Suratmi P 46 Th Luka kaki 26.
27 12-Dec-15 0000026248915 Toiba P 36 Th ISPA 27.
28 12-Dec-15 0001829375616 Abdullah Raziq H L 1,3 Th ISPA 28.
29 12-Dec-15 0000203060103 Qhanita P 4,6 Th ISPA 29.
30 12-Dec-15 0000027037181 Mascik P 51 Th Cervits Kronis 30.

31 12-Dec-15 0000026213859 Sri nani P 57 Th 31
32 12-Dec-15 0000026938697 Seniman zen L 63 Th 32
33 12-Dec-15 0000325027271 Maimana P 29 Th 33.
34 12-Dec-15 0 0 0 34.
35 12-Dec-15 0 0 0 0 35.
36 12-Dec-15 0 0 0 0 36.
37 12-Dec-15 0 0 0 0 37.
38 12-Dec-15 0 0 0 0 38.
39 12-Dec-15 0 0 0 0 39.
40 12-Dec-15 0 0 0 0 40.
41 12-Dec-15 0 0 0 0 41.
42 12-Dec-15 0 0 0 0 42.
43 12-Dec-15 0 0 0 0 43.
44 12-Dec-15 0 0 0 0 44.
45 12-Dec-15 0 0 0 0 45.
46 12-Dec-15 0 0 0 0 46.
47 12-Dec-15 0 0 0 0 47.
48 12-Dec-15 0 0 0 0 48.
49 12-Dec-15 0 0 0 0 49.
50 12-Dec-15 0 0 0 0 50.
51 12-Dec-15 0 0 0 0 51.
52 12-Dec-15 0 0 0 0 52.
53 12-Dec-15 0 0 0 0 53.
54 12-Dec-15 0 0 0 0 54.
55 12-Dec-15 0 0 0 0 55.
56 12-Dec-15 0 0 0 0 56.
57 12-Dec-15 0 0 0 0 57.
58 12-Dec-15 0 0 0 0 58.
59 12-Dec-15 0 0 0 0 59.
60 12-Dec-15 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
12-Dec-15 829 0000027475773 Masiah jl. R kemuning P 58 Th I 1

12-Dec-15 742 0000026598104 Hasbullah jl. Let murod L 68 Th P 1
12-Dec-15 1851 0001445636529 Kartni jl. Jend. Sudirman P 30 Th I 1
12-Dec-15 5 0001317131919 M. Ilham Habibi jl. Let murod L 8 Th A 1
12-Dec-15 2294 0000026536544 Dra. Evi Agustna Sari jl. Let murod P 48 Th P 1
12-Dec-15 780 0000026817928 Hj, Dasniah lr. Lada P 72 Th I 1
12-Dec-15 37 0001450267525 Maryama Jl. Padat karya P 55 Th I 1
12-Dec-15 1696 0001450267929 Dwi Henny Maya S jl. S suparman P 31 Th I 1
12-Dec-15 879 0000026324932 M. Amin abu jagur jl. Anggrek P 66 Th P 1
12-Dec-15 897 0000026916423 Drs. Affandi Benaim lr. Ce4mpedak L 65 Th P 1
12-Dec-15 2335 0000026154909 Muslih Ali jl. SB 2 p 57 th P 1
12-Dec-15 2160 0001808056754 Maha feri r jl. Let murod P 47 Th I 1
12-Dec-15 2336 0001808057755 Meita Ismalinda jl. Let murod P 22 Th A 1
12-Dec-15 1059 0000202855814 Chici dwi oktarika jl swadaya P 32 Th P 1
12-Dec-15 832 0000027311174 Nurbait jl. Sanjaya P 54 Th P 1
12-Dec-15 0000027600296 Asni Aprizah jl. Let murod P 32 Th P 1
12-Dec-15 1793 0001481934497 Lina susant jl. Let murod P 13 Th A 1
12-Dec-15 97 0000026822992 Surya Ilyas jl. Let murod L 61 Th S 1
12-Dec-15 0000025880679 Nyayu Nur Asiah Jl. K. Answar arsyad P 20 Th A 1
12-Dec-15 0000025977374 Inderawat jl. SB 2 P 51 Th P 1
12-Dec-15 29 0001276515674 Rosidah jl. Aman P 58 Th I 1
12-Dec-15 1517 0000026234763 Puspa Etka Jl. Perumahan rakyat no 41 rt 15 P 52Thn I 1
12-Dec-15 532 0000026921283 H. Rozali acmad jl. Perindustrian L 62 Th P 1
12-Dec-15 243 0000026049352 Tahta Anugrah P jl. Let murod L 16 Th A 1
12-Dec-15 1963 0000158073906 Suratmi jl. Sanusi P 46 Th P 1
12-Dec-15 2337 0000026248915 Toiba jl . Mandi api P 36 Th I 1
12-Dec-15 204 0001829375616 Abdullah Raziq H jl. Mandi api L 1,3 Th A 1
12-Dec-15 2338 0000203060103 Qhanita jl. Mandi api P 4,6 Th A 1
12-Dec-15 1478 0000027037181 Mascik jl. Let murod P 51 Th P 1
Ruangan
12-Dec-15 1148 0000026213859 Sri nani Maskerebet P 57 Th P 1

12-Dec-15 13 0000026938697 Seniman zen jl. Naskah L 63 Th P 1
12-Dec-15 045 0000325027271 Maimana Jl. Let Murod rt 3 rw 1 P 29 Th I 1
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15
12-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
ISPA IRT 045 0000325027271 Maimana Sunarko Jl. Let Murod rt 3 rwP 29 Th
Rs. Bhyangkara/PDL/340 Nyeri dada Pensiunan PNS
Periksa KB IRT
ISPA Pelajar
Tampal gigi Guru
RA IRT
RA
ISPA
RS. Mata/Mata/343 Mata kabur
RS. Bunda/PDL/346 HHD
Sakit telinga
Mata kabur
RS. Mata/ Mata/ 349 Mata kabur
Cabut gigi
RS. Bhyangkara/jantung/352 HHD
Gatel-gatel
DIARE
RA
Sakit gigi
ISPA
Dermatts
Nyeri sendi
RS. Myria/gigi/360 Sakit gigi
Dermatts
Alergi
Luka kaki
ISPA
ISPA
ISPA
Cervits Kronis
RS. Myria/PDL/363 HHD

RS. Myria/Bedah/364 DM
Suntk Kb IRT
AS
Ruangan
I 1 Suntk Kb IRT

1 14-Dec-15 0001302865659 Farida P 67 Th HT 1.

2 14-Dec-15 0001258188309 Saipon P 45 Th Sakit pinggang 2.
3 14-Dec-15 0000026559865 Alimak djailani L 72 Th ISPA 3.
4 14-Dec-15 0000027504235 Nur ainun P 58 Th HHD 4.
5 14-Dec-15 0000026823374 Ny. Choiron Ramlan P 78 Th HHD 5.
6 14-Dec-15 0001505458078 Patriyani palarestu S P 10 Th ISPA 6.
7 14-Dec-15 0000026920967 H. A Faizolo hamzah L 67 Th HHD 7.
8 14-Dec-15 0000027207595 Abdul rachman L 55 Th Gatel-gatel 8.
9 14-Dec-15 0000026558223 Ahmad syahri kupik L 62 Th RA 9.
10 14-Dec-15 0001903441893 m. Farih P 12 Th Demam 10
11 14-Dec-15 0000026463442 Badiah P 78 Th HHD 11.
12 14-Dec-15 0001078481878 Najemah P 54 Th RA 12.
13 14-Dec-15 0000026779465 M. Arifin P 75 Th HHD 13.
14 14-Dec-15 0000026154909 Muslih Ali9 L 56 Th Sakit telinga 14.
15 14-Dec-15 0000026440582 M. Ali L 72 Th HHD 15.
16 14-Dec-15 0000026507226 Alawiyah P 75 Th Osteoporosis 16.
17 14-Dec-15 0000027535623 Syamsul bahri L 52 Th Sakit mata 17.
18 14-Dec-15 0001173281591 Rusmaini P 31 Th ANC 18.
19 14-Dec-15 0000117382602 Saskia fahreza P 9 Th Cabut gigi 19.
20 14-Dec-15 0000026529243 Sri Yulia P 40 Th Lupus 20.
21 14-Dec-15 0001874768545 Fitri Hartni P 37 Th Suntk KB 21.
22 14-Dec-15 0001874767702 Zaskia nailatur R P 5,4 Th ISPA 22.
23 14-Dec-15 0001269080821 Fatnah zahra P 8 Th ISPA 23.
24 14-Dec-15 0000162907795 Nurlina P 61 Th DM 24.
25 14-Dec-15 0000027369369 Choirunisa P 46 Th HT 25.
26 14-Dec-15 0001451472726 Amran L 69 Th ISPA 26.
27 14-Dec-15 0000025959846 Ida rovida P 53 Th Gastrits 27.
28 14-Dec-15 0000027036786 Maisaroh p 49 Th HT 28.
29 14-Dec-15 0000027036775 Zulkopli L 52 Th HHD 29.
30 14-Dec-15 0000173503809 M raissa P 5,6 Th Cacar 30.

31 14-Dec-15 0000026132286 Retno Sulistyowat P 41 Th Sakit gigi 31
32 14-Dec-15 0001305652612 Gunawan L 72 Th HHD 32
33 14-Dec-15 0000026016636 Eka Yesmiat P 38 Th ISPA 33.
34 14-Dec-15 0000026013453 Sulasmi P 61 Th DM 34.
35 14-Dec-15 0000026916491 Drs. Amir syarifuddin L 63 Th DM 35.
36 14-Dec-15 0000026916502 Asri murni P 62 Th HT 36.
37 14-Dec-15 0001460143146 Rosdiana P 65 Th RA 37.
38 14-Dec-15 0000027037181 Mascik L 60 Th HT 38.
39 14-Dec-15 0000976224148 Prastyo L 15 Th Sakit telinga 39.
40 14-Dec-15 0001456276465 Bambang Sulistono L 55 Th HT 40.
41 14-Dec-15 0000027389147 Rekasmi P 47 Th Gastrits 41.
42 14-Dec-15 0000026934849 Riduan L 70 Th Sakit kaki 42.
43 14-Dec-15 0000026282046 Benny L 53 Th Sakit gigi 43.
44 14-Dec-15 0000027038739 Hamlah P 60 Th HT 44.
45 14-Dec-15 0000026334674 Muzakir M L 56 Th HHD 45.
46 14-Dec-15 0000026828774 Yusmawat P 55 Th HHD 46.
47 14-Dec-15 0000325027271 Maimana P 30 Th HT 47.
48 14-Dec-15 0000992538907 Tut Sunarsih P 51 Th RA 48.
49 14-Dec-15 0000325952245 Sumarni P 63 Th RA 49.
50 14-Dec-15 0000171826837 Intan Oktavira P 6 Th Demam 50.
51 14-Dec-15 0 0 0 0 51.
52 14-Dec-15 0 0 0 0 52.
53 14-Dec-15 0 0 0 0 53.
54 14-Dec-15 0 0 0 0 54.
55 14-Dec-15 0 0 0 0 55.
56 14-Dec-15 0 0 0 0 56.
57 14-Dec-15 0 0 0 0 57.
58 14-Dec-15 0 0 0 0 58.
59 14-Dec-15 0 0 0 0 59.
60 14-Dec-15 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
14-Dec-15 1700 0001302865659 Farida jl. Sudirman P 67 Th P 1

14-Dec-15 1910 0001258188309 Saipon jl. Akbp h umar P 45 Th I 1
14-Dec-15 870 0000026559865 Alimak djailani jl. Let murod L 72 Th P 1
14-Dec-15 827 0000027504235 Nur ainun jl. Mandi api P 58 Th P 1
14-Dec-15 162 0000026823374 Ny. Choiron Ramlan jl. Let murod P 78 Th P 1
14-Dec-15 1255 0001505458078 Patriyani palarestu S Jl. Kasnariansyah P 10 Th A 1
14-Dec-15 1652 0000026920967 H. A Faizolo hamzah jl. Sukabakt L 67 Th P 1
14-Dec-15 1114 0000027207595 Abdul rachman jl. Let murod L 55 Th P 1
14-Dec-15 785 0000026558223 Ahmad syahri kupik jl. Let murod L 62 Th I 1
14-Dec-15 2339 0001903441893 m. Farih talang ratu P 12 Th A 1
14-Dec-15 584 0000026463442 Badiah Jl. Kasnariansyah P 78 Th P 1
14-Dec-15 2340 0001078481878 Najemah jl. Swadaya P 54 Th I 1
14-Dec-15 2175 0000026779465 M. Arifin jl. Let murod P 75 Th P 1
14-Dec-15 2335 0000026154909 Muslih Ali9 Jl. SB 21 L 56 Th P 1
14-Dec-15 2341 0000026440582 M. Ali PEPABRI L 72 Th P 1
14-Dec-15 623 0000026507226 Alawiyah jl. Instansan P 75 Th P 1
14-Dec-15 644 0000027535623 Syamsul bahri jl. swadaya L 52 Th P 1
14-Dec-15 2342 0001173281591 Rusmaini Jl. Kasnariansyah P 31 Th I 1
14-Dec-15 2343 0000117382602 Saskia fahreza Jl. Kasnariansyah P 9 Th A 1
14-Dec-15 1261 0000026529243 Sri Yulia Jl. Kasnariansyah P 40 Th I 1
14-Dec-15 1845 0001874768545 Fitri Hartni Jl. Kasnariansyah P 37 Th I 1
14-Dec-15 2344 0001874767702 Zaskia nailatur R Jl. Kasnariansyah P 5,4 Th A 1
14-Dec-15 905 0001269080821 Fatnah zahra Jl. Kasnariansyah P 8 Th A 1
14-Dec-15 600 0000162907795 Nurlina perumdam P 61 Th I 1
14-Dec-15 432 0000027369369 Choirunisa lr. Kota baru P 46 Th I 1
14-Dec-15 1916 0001451472726 Amran jl. Akbp h umar L 69 Th P 1
14-Dec-15 656 0000025959846 Ida rovida jl. swadaya P 53 Th I 1
14-Dec-15 398 0000027036786 Maisaroh komp sd 43 p 49 Th P 1
14-Dec-15 1186 0000027036775 Zulkopli komp. Sd 43 L 52 Th P 1
14-Dec-15 1107 0000173503809 M raissa jl. Gandus P 5,6 Th A 1
BULAN : DESEMBER
Ruangan
14-Dec-15 2345 0000026132286 Retno Sulistyowat jl. Tri sukses P 41 Th P 1

14-Dec-15 242 0001305652612 Gunawan lr. Jambu L 72 Th P 1
14-Dec-15 2346 0000026016636 Eka Yesmiat jl. Rimba kemuning P 38 Th P 1
14-Dec-15 843 0000026013453 Sulasmi jl. Let murod P 61 Th P 1
14-Dec-15 324 0000026916491 Drs. Amir syarifuddin jl. S. Hatta L 63 Th P 1
14-Dec-15 568 0000026916502 Asri murni Jl. S. hatta P 62 Th I 1
14-Dec-15 1346 0001460143146 Rosdiana jl. Sosial P 65 Th P 1
14-Dec-15 1478 0000027037181 Mascik jl. Let murod L 60 Th P 1
14-Dec-15 2104 0000976224148 Prastyo jl. Kasnariansyah L 15 Th A 1
14-Dec-15 625 0001456276465 Bambang Sulistono jl. Kasnariansyah L 55 Th P 1
14-Dec-15 2347 0000027389147 Rekasmi perumda P 47 Th I 1
14-Dec-15 659 0000026934849 Riduan jl. Swadaya L 70 Th P 1
14-Dec-15 28 0000026282046 Benny komp. Perum rakyat L 53 Th P 1
14-Dec-15 388 0000027038739 Hamlah jl. swadaya P 60 Th P 1
14-Dec-15 1410 0000026334674 Muzakir M Perum rakyat L 56 Th P 1
14-Dec-15 241 0000026828774 Yusmawat jl. Kasnariansyah P 55 Th I 1
14-Dec-15 45 0000325027271 Maimana jl. Let murod P 30 Th I 1
14-Dec-15 294 0000992538907 Tut Sunarsih lr. Kembang P 51 Th I 1
14-Dec-15 289 0000325952245 Sumarni lr. Rambutan P 63 Th I 1
14-Dec-15 295 0000171826837 Intan Oktavira jl. R. Sukamto P 6 Th A 1
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15
14-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Rs. Bhayangkara/PDL/367 HT IRT 45 0000325027271 Maimana sunarko jl. Let murod P 30 Th

Rs. Bhayangkara/syaraf/368 Sakit pinggang IRT 294 0000992538907 Tut Sunarsih Marbawi yusuf lr. Kembang P 51 Th
ISPA Pensiun PNS 289 0000325952245 Sumarni Nurdi lr. Rambutan P 63 Th
Rs. Bahayangkara/PDL/370 HHD 295 0000171826837 Intan Oktavira Akhmad jauhari jl. R. Sukamto P 6 Th
HHD
ISPA
Rs. Myria/PDL/371 HHD
RS. Bhyangkara/Kulit/372 Gatel-gatel
RA
Demam
RS. Bhyangkara/PDL/373 HHD
RA
HHD
Sakit telinga
HHD
RS. Dr. AK Gani/ORT/382 Osteoporosis
Sakit mata PNS
Rs. Hermina/Gyn/389 ANC
Cabut gigi
RS. Bhyangkara/Rheumatologi/3Lupus swasta
Suntk KB IRT
ISPA
ISPA
RS. Dr. AK GANI/PDL/394 DM IRT
HT IRT
ISPA
Gastrits IRT
RS. Dr. AK Gani/ Bedah/397 HT
RS. Dr. AK Gani/PDL/398 HHD
Cacar
Sakit gigi
RS. Bhyangkara/Jantung/399 HHD
ISPA PNS
DM Pensiun PNS
DM
HT
RA IRT
HT
Sakit telinga
HT
RS. Myria/PDL/405 Gastrits
Sakit kaki
Sakit gigi
HT
RS. Hermina/jantung/414 HHD
HT IRT
RA IRT
RA IRT
Demam
AS
Ruangan
I 1 HT IRT
I 1 RA IRT
I 1 RA IRT
A 1 Demam

1 15-Dec-15 0000027158275 Hayat pakpahan P 58 Th HT 1.

2 15-Dec-15 0000025903607 Denny Ara L 55 Th Sakit mata 2.
3 15-Dec-15 0000026394816 Nurbayanah P 62 Th Pusing 3.
4 15-Dec-15 0000027384862 Nurhasanah P 51 Th Sakit perut 4.
5 15-Dec-15 0001204977521 M. Ronaldo Alivian L 16 Th Sakit gigi 5.
6 15-Dec-15 0000026559865 Alimak Djailani L 72 Th Katarak 6.
7 15-Dec-15 0001477977118 Fatara kirana R p 1,6 Th ISPA 7.
8 15-Dec-15 0000025880679 Nyayu Nur Asiah P 21 Th Cabut gigi 8.
9 15-Dec-15 0001278525735 Rosdanelah P 48 Th HHD 9.
10 15-Dec-15 0000026831542 Murtat P 59 Th HT 10
11 15-Dec-15 0000025880646 M. Daud L 56 Th HHD 11.
12 15-Dec-15 0000025854996 Baharudin siregar L 57 Th RA 12.
13 15-Dec-15 0001279034842 RA Mainiar P 51 Th HT 13.
14 15-Dec-15 0000027220307 Rodiah P 57 Th HHD 14.
15 15-Dec-15 0001819114648 Syakban Nurmansyah L 45 Th Sakit gigi 15.
16 15-Dec-15 0000026675403 Torik sani L 67 Th Syaraf 16.
17 15-Dec-15 0001176418607 Murlini P 41 Th HT 17.
18 15-Dec-15 0001138586736 Marjani L 48 Th Sakit mata 18.
19 15-Dec-15 0001081221377 Djuariah P 77 Th Katarak 19.
20 15-Dec-15 0000026932915 Nazaruddin L 62 Th HT 20.
21 15-Dec-15 0001895922246 Esnani P 40 Th USG 21.
22 15-Dec-15 0000025941341 Suharsono L 56 Th Diare 22.
23 15-Dec-15 0000026934131 Marwilis P 70 Th HHD 23.
24 15-Dec-15 0000027035752 Juri efendi L 60 Th RA 24.
25 15-Dec-15 0000027035763 Matta P 56 Th RA 25.
26 15-Dec-15 0000026779465 M. Arifin L 75 Th HHD 26.
27 15-Dec-15 0000027203848 ghaly Ramadhan L 20 Th Anisimetropia 27.
28 15-Dec-15 0000026295895 Nurdjanah P 67 Th Sakit mata 28.
29 15-Dec-15 0001853624463 Musdika avhmar L 18 Th Pusing 29.
30 15-Dec-15 0001324657517 Rahmat febriansyah L 33 Th Skizofrenia 30.

31 15-Dec-15 0001505134563 Medi Oktariansyah L 4,2 Th ISPA 31
32 15-Dec-15 0000027038079 Yusnani P 62 Th ASMA 32
33 15-Dec-15 0000025980805 Maijun enidar P 56 Th Muntah-muntah 33.
34 15-Dec-15 0001790495199 Ali yusuf L 60 Th HHD 34.
35 15-Dec-15 0000026213859 Sri Nani P 57 Th GGN Refraksi 35.
36 15-Dec-15 0000026464264 Masnia P 65 Th HHD 36.
37 15-Dec-15 0000026464363 H. M. Toyib I 90 Th HHD 37.
38 15-Dec-15 0000324150647 Ahmad Gandi L 41 Th Pusing 38.
39 15-Dec-15 0000324151018 Jamilah P 36 Th Suntk KB 39.
40 15-Dec-15 0000325159334 Zaleha P 47 Th ISPA 40.
41 15-Dec-15 0000992536165 Suhaimi L 73 Th Sakit mata 41.
42 15-Dec-15 0000324755627 Nurhayat P 52 Th HT 42.
43 15-Dec-15 0000325548876 M. Guntur L 15 Th Pusing 43.
44 15-Dec-15 0000326087245 Safei L 55 Th HT 44.
45 15-Dec-15 0000324780849 Richi Anggraini P 29 Th HT 45.
46 15-Dec-15 0000326093398 Nyimas Rohana P 56 Th RA 46.
47 15-Dec-15 0000326093488 Eka miana P 28 Th ANC 47.
48 15-Dec-15 0 0 0 0 0 48.
49 15-Dec-15 0 0 0 0 0 49.
50 15-Dec-15 0 0 0 0 0 50.
51 15-Dec-15 0 0 0 0 0 51.
52 15-Dec-15 0 0 0 0 0 52.
53 15-Dec-15 0 0 0 0 0 53.
54 15-Dec-15 0 0 0 0 0 54.
55 15-Dec-15 0 0 0 0 0 55.
56 15-Dec-15 0 0 0 0 0 56.
57 15-Dec-15 0 0 0 0 0 57.
58 15-Dec-15 0 0 0 0 0 58.
59 15-Dec-15 0 0 0 0 0 59.
60 15-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
15-Dec-15 1902 0000027158275 Hayat pakpahan komp. bougenvile P 58 Th P 1

15-Dec-15 2171 0000025903607 Denny Ara jl. Tanjung raya L 55 Th P 1
15-Dec-15 27 0000026394816 Nurbayanah jl. Let kasna P 62 Th P 1
15-Dec-15 2111 0000027384862 Nurhasanah jl. Surya sakt P 51 Th P 1
15-Dec-15 2348 0001204977521 M. Ronaldo Alivian jl. Kasna L 16 Th A 1
15-Dec-15 870 0000026559865 Alimak Djailani jl. Let murod L 72 Th P 1
15-Dec-15 2349 0001477977118 Fatara kirana R Jl. SB 2 p 1,6 Th A 1
15-Dec-15 2046 0000025880679 Nyayu Nur Asiah jl. K anwar anwar P 21 Th A 1
15-Dec-15 1670 0001278525735 Rosdanelah lr. Biga P 48 Th I 1
15-Dec-15 544 0000026831542 Murtat jl. Mawar P 59 Th I 1
15-Dec-15 2350 0000025880646 M. Daud Jl. Wayhitam L 56 Th P 1
15-Dec-15 62 0000025854996 Baharudin siregar jl. SB 1 L 57 Th P 1
15-Dec-15 1111 0001279034842 RA Mainiar lr. biga P 51 Th I 1
15-Dec-15 1130 0000027220307 Rodiah jl. Gotong royong P 57 Th P 1
15-Dec-15 2128 0001819114648 Syakban Nurmansyah jl. Talang ratu L 45 Th P 1
15-Dec-15 52 0000026675403 Torik sani jl. Let murod L 67 Th P 1
15-Dec-15 1333 0001176418607 Murlini jl. Naskah P 41 Th i 1
15-Dec-15 1507 0001138586736 Marjani jl. Naskah L 48 Th P 1
15-Dec-15 1714 0001081221377 Djuariah lr. Lada P 77 Th P 1 `
15-Dec-15 477 0000026932915 Nazaruddin komp. bougenvile L 62 Th P 1
15-Dec-15 2351 0001895922246 Esnani jl. Rusunawa P 40 Th I 1
15-Dec-15 110 0000025941341 Suharsono jl. Let murod L 56 Th P 1
15-Dec-15 1843 0000026934131 Marwilis jl. Kol H burlian P 70 Th P 1
15-Dec-15 694 0000027035752 Juri efendi jl. Akbp h umar L 60 Th P 1
15-Dec-15 2297 0000027035763 Matta jl. Akbp h umar P 56 Th I 1
15-Dec-15 2175 0000026779465 M. Arifin jl. Kasna L 75 Th P 1
15-Dec-15 2352 0000027203848 ghaly Ramadhan RSS Srijaya L 20 Th A 1
15-Dec-15 1236 0000026295895 Nurdjanah jl. Swadaya P 67 Th P 1
15-Dec-15 1573 0001853624463 Musdika avhmar jl. Karya baru L 18 Th A 1
15-Dec-15 273 0001324657517 Rahmat febriansyah jl. Kasna L 33 Th P 1
Ruangan
15-Dec-15 598 0001505134563 Medi Oktariansyah jl. Talang ratu L 4,2 Th A 1

15-Dec-15 1128 0000027038079 Yusnani lr. H aziz P 62 Th P 1
15-Dec-15 0000025980805 Maijun enidar perum rakyat P 56 Th P 1
15-Dec-15 1435 0001790495199 Ali yusuf jl. Let murod L 60 Th P 1
15-Dec-15 1148 0000026213859 Sri Nani maskerebet P 57 Th P 1
15-Dec-15 427 0000026464264 Masnia jl. Let murod P 65 Th P 1
15-Dec-15 428 0000026464363 H. M. Toyib jl. Let murod I 90 Th I 1
15-Dec-15 89 0000324150647 Ahmad Gandi jl. Ariodillah L 41 Th P 1
15-Dec-15 89 0000324151018 Jamilah jl. Ariodillah P 36 Th I 1
15-Dec-15 9 0000325159334 Zaleha lr. Damai P 47 Th I 1
15-Dec-15 153 0000992536165 Suhaimi Jl. Ariodillah L 73 Th P 1
15-Dec-15 296 0000324755627 Nurhayat jl. Kasna P 52 Th I 1
15-Dec-15 297 0000325548876 M. Guntur jl. Let murod L 15 Th A 1
15-Dec-15 241 0000326087245 Safei lr. Hikmah L 55 Th P 1
15-Dec-15 168 0000324780849 Richi Anggraini jl. Ariodillah P 29 Th I 1
15-Dec-15 72 0000326093398 Nyimas Rohana jl. Kasna P 56 Th I 1
15-Dec-15 35 0000326093488 Eka miana jl. Kasna P 28 Th I 1
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15
15-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JAM
BULAN : DESEMBER
Rujukan Diagnosa Pekerjaan No HP Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK
HT PNS 081367017750 89 0000324150647 Ahmad Gandi Ahmad gandi

RS. Mata/Mata/418 Sakit mata PNS 28127395280 89 0000324151018 Jamilah Ahmad gandi
RS. Bhayngkara/syaraf/419 Pusing 9 0000325159334 Zaleha jabart
Sakit perut 153 0000992536165 Suhaimi Suhaimi
Sakit gigi 296 0000324755627 Nurhayat Burmawi
Rs. Mata/Mata/421 Katarak 297 0000325548876 M. Guntur slamet
ISPA 241 0000326087245 Safei Safei
Cabut gigi 168 0000324780849 Richi Anggraini Sulomo
RS. Bhayangkara/PDL/422 HHD 72 0000326093398 Nyimas Rohana mait murod
RS. Bhayangkara/PDL/420 HT 35 0000326093488 Eka miana Eko manunggal
HHD PNS 081367601392
RA
HT IRT 085273014201
RS. Bhyangkara/Bedah/424 HHD PNS 082175725560
Sakit gigi wiraswasta 081271379900
Syaraf
HT wiraswasta 082175112199
RS.Mata/Mata/427 Sakit mata wiraswasta 082175112199
RS. Mata/Mata/428 Katarak IRT 081278361615
HT PNS 081994976584
USG
Diare PNS 081367728037
RS. Myria/Jantung/430 HHD IRT 08136807652
RA
RA
RS. Bhyangkara/Jantung/432 HHD PNS 0821345011
RS. Mata/Mata/433 Anisimetropia
Sakit mata IRT 0812784421200
RS. Myria/syaraf/442 Pusing pusing
Skizofrenia
Rujukan Diagnosa Pekerjaan No HP
ISPA
RS. Bhayngkara/PDL/446 ASMA
Muntah-muntah
RS. Bhayangkara/PDL/453 HHD Wiraswasta 082179925000
RS. Mata/ mata/454 GGN Refraksi PNS 081368045607
RS. Dr AK Gani/Jantung/456 HHD
HHD
Pusing buruh 085273730401
Suntk KB IRT
ISPA IRT
Sakit mata Buruh
HT IRT
RS. DR ERBA/Jiwa/426 Pusing
HT Buruh 085289427554
HT IRT 082376862270
RA IRT 08999167809
ANC IRT 08999167809
AN DAN RUJUKAN JAMKESMAS
TALANG RATU
DESEMBER
Ruangan
Alamat JK Usia Status Rujukan Diagnosa Pekerjaan No HP
jl. Ariodillah L 41 Th P 1 Pusing buruh 085273730401

jl. Ariodillah P 36 Th I 1 Suntk KB IRT
lr. Damai P 47 Th I 1 ISPA IRT
Jl. Ariodillah L 73 Th P 1 Sakit mata Buruh
jl. Kasna P 52 Th I 1 HT IRT
jl. Let murod L 15 Th A 1 RS. DR ERBA/Jiwa/426 Pusing
lr. Hikmah L 55 Th P 1 HT Buruh 085289427554
jl. Ariodillah P 29 Th I 1 HT IRT 082376862270
jl. Kasna P 56 Th I 1 RA IRT 08999167809
jl. Kasna P 28 Th I 1 ANC IRT 08999167809

1 16-Dec-15 0000026599206 Heroes Sitohang L 59 Th DM 1.

3 16-Dec-15 0000026822845 JN. Kirom L 72 Th Katarak 3.
5 16-Dec-15 0000026302217 Hudaini P 65 TH ISPA 5.
6 16-Dec-15 0000026630177 M. Wahjudi L 65 Th Tubercolosis 6.
7 16-Dec-15 0001292929007 Yenni P 55 Th RA 7.
8 16-Dec-15 0000164035271 Ramadhandi M L 10 Th Dermatts 8.
9 16-Dec-15 0001078481878 Najemah P 53 Th RA 9.
10 16-Dec-15 0000026515809 Sri marliyah P 70 Th RA 10
11 16-Dec-15 0001820011061 Ranni saphira P 3 Th Sakit gigi 11.
12 16-Dec-15 0000026132286 Retno Sulistyowat P 40 Th Sakit gigi 12.
13 16-Dec-15 0001819987165 Indah Atfah Khairina P 5,8 Th Sakit tenggorokan 13.
14 16-Dec-15 0000026442944 Nungimah P 56 Th Vertgo 14.
15 16-Dec-15 0001481928928 Zulkifli L 45 Th Demam 15.
16 16-Dec-15 0000026779465 M. Arifin L 75 Th HHD 16.
17 16-Dec-15 0000027252281 Heliat P 42 Th Dermatts 17.
19 16-Dec-15 0000325679128 Asiah P 70 Th ISPA 19.
20 16-Dec-15 0001439825139 Riri sariska P 18 ThnISPA 20.
21 16-Dec-15 0000027039036 Achmad usman L 52 Th ISPA 21.
24 16-Dec-15 0001261379709 Ismail Iragi L 70 Th Stroke 24.
25 16-Dec-15 0001427484374 Musiran L 53 Th HHD 25.
26 16-Dec-15 0000026932915 Nazaruddin L 62 Th HHD 26.
27 16-Dec-15 0000976072566 Eva Emilda P 28 Th Gastrits 27.
28 16-Dec-15 0000026321512 Amrizal L 46 Th ISPA 28.
29 16-Dec-15 0000324961299 Sunaini P 54 Th HT 29.
30 16-Dec-15 0000324329905 Marli mario L 14 Th Sakit gigi 30.

31 16-Dec-15 0000324821092 Zulkifli L 42 Th ISPA 31
32 16-Dec-15 0000325957533 Tri slitrisno L 12 Th ISPA 32
33 16-Dec-15 0000324370811 Dahri Oskandar L 40 Th Sakit mata 33.
34 16-Dec-15 0000324938507 Eka Supriani P 20 Th Sakit Perut 34.
35 16-Dec-15 0000026132286 Retno Sulistyowat P 40 Th Sakit gigi 35.
36 16-Dec-15 0 0 0 0 0 36.
37 16-Dec-15 0 0 0 0 0 37.
38 16-Dec-15 0 0 0 0 0 38.
39 16-Dec-15 0 0 0 0 0 39.
40 16-Dec-15 0 0 0 0 0 40.
41 16-Dec-15 0 0 0 0 0 41.
42 16-Dec-15 0 0 0 0 0 42.
43 16-Dec-15 0 0 0 0 0 43.
44 16-Dec-15 0 0 0 0 0 44.
45 16-Dec-15 0 0 0 0 0 45.
46 16-Dec-15 0 0 0 0 0 46.
47 16-Dec-15 0 0 0 0 0 47.
48 16-Dec-15 0 0 0 0 0 48.
49 16-Dec-15 0 0 0 0 0 49.
50 16-Dec-15 0 0 0 0 0 50.
51 16-Dec-15 0 0 0 0 0 51.
52 16-Dec-15 0 0 0 0 0 52.
53 16-Dec-15 0 0 0 0 0 53.
54 16-Dec-15 0 0 0 0 0 54.
55 16-Dec-15 0 0 0 0 0 55.
56 16-Dec-15 0 0 0 0 0 56.
57 16-Dec-15 0 0 0 0 0 57.
58 16-Dec-15 0 0 0 0 0 58.
59 16-Dec-15 0 0 0 0 0 59.
60 16-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
16-Dec-15 909 0000026599206 Heroes Sitohang jl. Kelapa sawit L 59 Th P 1

16-Dec-15 0000036547841 Sahwyah jl. Srijaya P 48 Th I 1
16-Dec-15 53 0000026822845 JN. Kirom jl. Let murod L 72 Th P 1
16-Dec-15 487 0000026822856 Rosdianah jl. Let murod P 65 Th I 1
16-Dec-15 1458 0000026302217 Hudaini jl. Let murod P 65 TH i 1
16-Dec-15 622 0000026630177 M. Wahjudi jl. SB 2 L 65 Th P 1
16-Dec-15 1446 0001292929007 Yenni talang ratu P 55 Th K+ 1
16-Dec-15 2523 0000164035271 Ramadhandi M jl. Let murod L 10 Th A 1
16-Dec-15 2340 0001078481878 Najemah jl. Swadaya P 53 Th I 1
16-Dec-15 114 0000026515809 Sri marliyah jl. SB 2 P 70 Th P 1
16-Dec-15 2143 0001820011061 Ranni saphira jl. Tri sukses P 3 Th A 1
16-Dec-15 2345 0000026132286 Retno Sulistyowat jl. Tri sukses P 40 Th I 1
16-Dec-15 2354 0001819987165 Indah Atfah Khairina jl. Tri sukses P 5,8 Th A 1
16-Dec-15 84 0000026442944 Nungimah perumdam P 56 Th I 1
16-Dec-15 1019 0001481928928 Zulkifli jl. Kasna L 45 Th P 1
16-Dec-15 2175 0000026779465 M. Arifin jl. Kasna L 75 Th P 1
16-Dec-15 454 0000027252281 Heliat jl. swadaya P 42 Th P 1
16-Dec-15 2255 0000026049339 Tibroni jl. Let murod L 52 Th P 1
16-Dec-15 242 0000325679128 Asiah jl. Let murod P 70 Th I 1
16-Dec-15 1401 0001439825139 Riri sariska Jl. Aman 2 rt 42 no 2399 P 18 ThnP 1
16-Dec-15 1816 0000027039036 Achmad usman jl. Talang ratu L 52 Th S 1
16-Dec-15 975 0001261379709 Ismail Iragi jl. Akbp h umar L 70 Th P 1
16-Dec-15 363 0001427484374 Musiran jl. Kasna L 53 Th P 1
16-Dec-15 477 0000026932915 Nazaruddin kompl. Bougenvile L 62 Th P 1
16-Dec-15 2300 0000976072566 Eva Emilda jl. Aman P 28 Th P 1
16-Dec-15 271 0000026321512 Amrizal bougenvile L 46 Th P 1
16-Dec-15 008 0000324961299 Sunaini jl. Let murod P 54 Th I 1
16-Dec-15 098 0000324329905 Marli mario lt. Biga L 14 Th A 1
Ruangan
16-Dec-15 141 0000324821092 Zulkifli jl. Kasna L 42 Th P 1

16-Dec-15 298 0000325957533 Tri slitrisno jl. Ariodillah L 12 Th A 1
16-Dec-15 179 0000324370811 Dahri Oskandar jl. Let murod L 40 Th P 1
16-Dec-15 269 0000324938507 Eka Supriani Jl. Anggrek P 20 Th A 1
16-Dec-15 2345 0000026132286 Retno Sulistyowat jl. Tri sukses P 40 Th I 1
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15
16-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JA
RS. Myria/PDL/458 DM PNS 008 0000324961299 Sunaini Fahrul

ISPA IRT 098 0000324329905 Marli mario Hatono
RS. Mata/Mata/460 Katarak PNS 141 0000324821092 Zulkifli Zulkifli
RS. Mata/Mata/459 Sakit mata IRT 298 0000325957533 Tri slitrisno Safaruddin
ISPA PNS 179 0000324370811 Dahri Oskandar ybs
RS. Bhayangkara/PDL/462 Tubercolosis PNS 082186331547 269 0000324938507 Eka Supriani Ari Pai
RA IRT 081373280946
Dermatts Pelajar
RA IRT 087897393062
RS. Bhyangkara/PDL/471 RA IRT
Sakit gigi
Sakit gigi
Sakit tenggorokan
RS. Dr. A. Gani/syaraf/474 Vertgo IRT 08218395669
Demam Buruh 082177841728
HHD
Dermatts Guru 081532992933
HT PNS 08127347274
ISPA
ISPA 087897202013
ISPA Swasta
Cabut gigi
Dermatts
RS. Hermina/syaraf/483 Stroke swasta 082178347475
HHD Buruh 081994835863
RS. Bhayangkara/PDL/462 HHD PNS
Gastrits GURU
ISPA GURU 0853675988911
HT IRT
Sakit gigi
ISPA B uruh 085268744947

ISPA Pelajar
Sakit mata Sawasta 081368272302
Sakit Perut Swasta
Sakit gigi
AN DAN RUJUKAN JAMKESMAS
TALANG RATU
DESEMBER 2015
Ruangan
jl. Let murod P 54 Th I 1 HT IRT

lt. Biga L 14 Th A 1 Sakit gigi
jl. Kasna L 42 Th P 1 ISPA B uruh 085268744947
jl. Ariodillah L 12 Th A 1 ISPA Pelajar
jl. Let murod L 40 Th P 1 Sakit mata Sawasta 081368272302
Jl. Anggrek P 20 Th A 1 Sakit Perut Swasta

1 17-Dec-15 0000026508328 Darmawan L 75 Th Pusing 1.

2 17-Dec-15 0000027221567 M. DASI L 60 Th Sakit mata 2.
3 17-Dec-15 0000027221578 Zunaini P 57 Th Sakit mata 3.
4 17-Dec-15 0000079405108 Sumardi L 76 Th Sakit gigi 4.
5 17-Dec-15 0000025880646 M. Daud L 57 Th BAK Terus menerus 5.
6 17-Dec-15 0001505668037 Fitri Purnamasari P 25 Th ASMA 6.
7 17-Dec-15 0000026707746 Ciknah P 52 Th Osteoporosis 7.
8 17-Dec-15 0000034238362 M. Ansyori L 45 Th Katarak 8.
9 17-Dec-15 0000027035752 Juri Efendi P 56 Th RA 9.
10 17-Dec-15 0000027035763 Mastta L 60 Th RA 10
11 17-Dec-15 0001439840643 Dewi purwat P 26 Th Cabut gigi 11.
12 17-Dec-15 0001796295587 Zaleha P 63 Th Sakit mata 12.
14 17-Dec-15 0000027038441 Usman L 61 Th Gatel-gatel 14.
15 17-Dec-15 0001265197779 Pingkan umari P 11 Th Sakit perut 15.
16 17-Dec-15 0001633889046 Frista Aura P 7 Th Sakit gigi 16.
17 17-Dec-15 0001800569733 m. Alfarizi puta L 14 Th Tampal gigi 17.
18 17-Dec-15 0000020164037 Hj. Emizar rusdi P 71 Th HHD 18.
19 17-Dec-15 0000027318363 Achmadiah tjik asin L 71 Th Demam 19.
20 17-Dec-15 0000026378548 Hasbullah L 71 Th HHD 20.
21 17-Dec-15 0000027586607 Zulkifli B L 59 Th HHD 21.
22 17-Dec-15 0000026919775 Edison Manik L 63 Th HHD 22.
23 17-Dec-15 0000026919786 Parni sri Murno P 60 Th HHD 23.
24 17-Dec-15 0000173259808 Porlin feronika P 32 Th ANC 24.
25 17-Dec-15 0000026949519 Rahunar umar P 71 Th Stroke 25.
26 17-Dec-15 0000027039306 Yat Didi P 65 Th RA 26.
27 17-Dec-15 0001404914905 Suratman L 45 Th ISPA 27.
28 17-Dec-15 0000325187008 Nurhidayat P 34 Th Suntk KB 28.
29 17-Dec-15 0000324316811 E3dwar pasha L 52 Th ISPA 29.
30 17-Dec-15 0000324138352 Emilawat P 46 Th RA 30.

31 17-Dec-15 0001506483134 Eli Triana P 25 Th Muntah-muntah 31
32 17-Dec-15 0001261379902 Tasniah P 65 Th Mata kabur 32
33 17-Dec-15 0 0 0 0 0 33.
34 17-Dec-15 0 0 0 0 0 34.
35 17-Dec-15 0 0 0 0 0 35.
36 17-Dec-15 0 0 0 0 0 36.
37 17-Dec-15 0 0 0 0 0 37.
38 17-Dec-15 0 0 0 0 0 38.
39 17-Dec-15 0 0 0 0 0 39.
40 17-Dec-15 0 0 0 0 0 40.
41 17-Dec-15 0 0 0 0 0 41.
42 17-Dec-15 0 0 0 0 0 42.
43 17-Dec-15 0 0 0 0 0 43.
44 17-Dec-15 0 0 0 0 0 44.
45 17-Dec-15 0 0 0 0 0 45.
46 17-Dec-15 0 0 0 0 0 46.
47 17-Dec-15 0 0 0 0 0 47.
48 17-Dec-15 0 0 0 0 0 48.
49 17-Dec-15 0 0 0 0 0 49.
50 17-Dec-15 0 0 0 0 0 50.
51 17-Dec-15 0 0 0 0 0 51.
52 17-Dec-15 0 0 0 0 0 52.
53 17-Dec-15 0 0 0 0 0 53.
54 17-Dec-15 0 0 0 0 0 54.
55 17-Dec-15 0 0 0 0 0 55.
56 17-Dec-15 0 0 0 0 0 56.
57 17-Dec-15 0 0 0 0 0 57.
58 17-Dec-15 0 0 0 0 0 58.
59 17-Dec-15 0 0 0 0 0 59.
60 17-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
17-Dec-15 360 0000026508328 Darmawan jl. Perumdam kartka L 75 Th P 1

17-Dec-15 2204 0000027221567 M. DASI Jl. Kasnariansyah L 60 Th P 1
17-Dec-15 2205 0000027221578 Zunaini Jl. Kasnariansyah P 57 Th I 1
17-Dec-15 219 0000079405108 Sumardi jl. Talang ratu L 76 Th P 1
17-Dec-15 2350 0000025880646 M. Daud jl. Wayhitam L 57 Th P 1
17-Dec-15 2101 0001505668037 Fitri Purnamasari Jl. Kasnariansyah P 25 Th P 1
17-Dec-15 2055 0000026707746 Ciknah jl. wayhitam P 52 Th I 1
17-Dec-15 0000034238362 M. Ansyori lr. Kmbang No. 124 L 45 Th P 1
17-Dec-15 694 0000027035752 Juri Efendi jl. Akbp h umar P 56 Th I 1
17-Dec-15 2297 0000027035763 Mastta jl. Akbp h umar L 60 Th p 1
17-Dec-15 1888 0001439840643 Dewi purwat jl. Let murod P 26 Th P 1
17-Dec-15 1201 0001796295587 Zaleha jl. Aman rt.38 P 63 Th P 1
17-Dec-15 946 0000027038441 Usman jl. Mawar rt.05 L 61 Th S 1
17-Dec-15 2355 0001265197779 Pingkan umari jl. Akbp h umar P 11 Th A 1
17-Dec-15 2356 0001633889046 Frista Aura jl. Mandi api P 7 Th A 1
17-Dec-15 704 0001800569733 m. Alfarizi puta jl. SB 2 L 14 Th A 1
17-Dec-15 381 0000020164037 Hj. Emizar rusdi jl. Akbp h umar P 71 Th P 1
17-Dec-15 304 0000027318363 Achmadiah tjik asin perum rakyat L 71 Th P 1
17-Dec-15 1086 0000026378548 Hasbullah perumdam kartka L 71 Th P 1
17-Dec-15 128 0000027586607 Zulkifli B Jl. Mawar L 59 Th P 1
17-Dec-15 408 0000026919775 Edison Manik jl. Srijaya L 63 Th P 1
17-Dec-15 407 0000026919786 Parni sri Murno jl. Srijaya P 60 Th I 1
17-Dec-15 1381 0000173259808 Porlin feronika jl. Mandi api P 32 Th I 1
17-Dec-15 1462 0000026949519 Rahunar umar jl. Brum mesansa P 71 Th P 1
17-Dec-15 1437 0000027039306 Yat Didi jl. Kasnariansyah rt.16 P 65 Th P 1
17-Dec-15 146 0001404914905 Suratman jl. Irigasi rt.54 L 45 Th P 1
17-Dec-15 97 0000325187008 Nurhidayat lr. Kembang no.73 P 34 Th I 1
17-Dec-15 102 0000324316811 E3dwar pasha jl. Ariodillah rw.11 L 52 Th P 1
17-Dec-15 229 0000324138352 Emilawat jl. Ariodillah P 46 Th I 1
BULAN : DESEMBER
Ruangan
17-Dec-15 2357 0001506483134 Eli Triana jl. Kasmariansyah P 25 Th P 1

17-Dec-15 747 0001261379902 Tasniah jl. Akbp h umar P 65 Th P 1
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15
17-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJU
BULAN : DESEMBER
Pusing PNS 081272267090 97 0000325187008 Nurhidayat Yahmadi

RS. Mata/Mata/491 Sakit mata GURU 082176081561 102 0000324316811 E3dwar pasha ybs
RS. Mata/Mata/490 Sakit mata IRT 082176081561 229 0000324138352 Emilawat Hotman
Sakit gigi Pensiun PNS 082175954029 45 0000325027271 Maimana Sunarko
BAK Terus menerus PNS 081367601392 299 0000325089787 M . Rafly handika Ahmad
RS. Hermina/Gyn/495 ASMA Swasta 08994375522
Osteoporosis IRT 085368552548
RS. MATA/Mata/494 Katarak PNS 085269999321
RA Pensiunan GURU
RA IRT
Cabut gigi IRT 08980908382
Cabut gigi Pelajar 089618512206
Gatel-gatel Jl. Mawar 082185986066
Sakit perut Pelajar 081273748611
Sakit gigi Pelajar 081351909234
Tampal gigi Pelajar 085384215634
HHD IRT 0711410415
Demam Pensiun PNS 0711411053
HHD Pensiun PNS 0711416822
HHD Pensiun PNS
RS. Myria/PDL/505 HHD Pensiun PNS
RS. Bhayngkara/PDL/506 HHD IRT
RS. Bunda/Gyn/504 ANC GURU 085664755705
RS. Bhayangkara/syaraf/509 Stroke Pensiun PNS 082375348558
RA Pensiun PNS
ISPA Wiraswasta 082176550926
Suntk KB IRT 082177755248
ISPA Ngojek 081274816742
RA IRT
Muntah-muntah swasta 082177319180

Mata kabur IRT 085100820183
NGAN DAN RUJUKAN JAMKESMAS
AS TALANG RATU
: DESEMBER
Ruangan
lr. Kembang no.73 P 34 Th I 1 Suntk KB IRT 082177755248

jl. Ariodillah rw.11 L 52 Th P 1 ISPA Ngojek 081274816742
jl. Ariodillah P 46 Th I 1 RA IRT
jl. Let murod rt.03 P 30 Th I 1 HT IRT
lr. Rambutan rt.12 L 10 Th A 1 RS. Bhayangkara/Anak/517 ISPA Pelajar

1 18-Dec-15 0000168823967 Sit jamiah P 55 Th Dermatts 1.

2 18-Dec-15 0000027369358 Kailani L 52 Th nyeri empedu 2.
3 18-Dec-15 0001282210312 Kenzo rawa rizki L 2,1 Th Nyeri tulang 3.
4 18-Dec-15 0000026463385 Kordiat P 61 Th Syaraf 4.
5 18-Dec-15 0000166949807 Dicky Herwansyah L 28 Th DM 5.
6 18-Dec-15 0000194058887 M. Zulkarnain L 62 Th RA 6.
7 18-Dec-15 0000194059056 Nursani P 52 Th Sakit gigi 7.
8 18-Dec-15 0001795938851 Suryat P 56 Th Alergi 8.
9 18-Dec-15 0000026141905 Maryani Risnawat P 51 Th HHD 9.
10 18-Dec-15 0001305651982 Yuli Anggraini P 16 Th Dermatts 10
11 18-Dec-15 0000026073516 M. Hatta Achmad L 58 Th HT 11.
12 18-Dec-15 0000026510286 Mintarmi P 67 Th DM 12.
13 18-Dec-15 0001866501214 Yan H ilyas L 73 Th HHD 13.
14 18-Dec-15 0001866501494 Robiah P 71 Th Herpes 14.
15 18-Dec-15 0001299747677 Syarifah P 69 Th Nyeri kaki 15.
16 18-Dec-15 0001299712239 Mgs. Yangcik ali L 71 Th Sakit gigi 16.
17 18-Dec-15 0000018240693 Ravina Mutara sari P 33 Th ISPA 17.
18 18-Dec-15 0001404919282 Sonny Eddy Robi L 45 Th ISPA 18.
19 18-Dec-15 0001474550662 Fauzan anwar R L 2,6 Th TB Paru 19.
20 18-Dec-15 0001265197779 Pingkan umari P 11 Th Sakit perut 20.
21 18-Dec-15 0000026831542 Murtat P 59 Th Pusing 21.
22 18-Dec-15 0000025992437 A. Fanani L 60 Th DM 22.
23 18-Dec-15 0000025992448 Enima P 60 Th Gastrits 23.
24 18-Dec-15 0000027384862 Nurhasanah P 51 Th Sakit perut 24.
25 18-Dec-15 0000026551506 A. Yusri L 63 Th Luka kaki 25.
26 18-Dec-15 0000020124562 Edief Hanum L 81 Th RA 26.
27 18-Dec-15 0001313713304 Rosidah P 47 Th HT 27.
28 18-Dec-15 0000026913532 Roaini P 60 Th Nyeri kaki 28.
29 18-Dec-15 0000025636948 Rosdianah P 66 Th mata kabur 29.
30 18-Dec-15 0001280968874 Nuraini Armin P 71 Th ISPA 30.

31 18-Dec-15 0000026010843 Zaipil L 52 Th HT 31
32 18-Dec-15 0000992535445 Deid Afrianto L 33 Th Demam 32
33 18-Dec-15 0000992692653 Habibah P 50 Th ASMA 33.
34 18-Dec-15 0000324344092 Zakaria L 31 Th ISPA 34.
35 18-Dec-15 0000324344676 Sri ningsih P 31 Th ISPA 35.
36 18-Dec-15 0000325167221 Rohaman L 9 Th Demam 36.
37 18-Dec-15 0000992534387 Ali Arman L 57 Th ISPA 37.
38 18-Dec-15 0000324932455 Inda maya Sari P 35 Th ispa 38.
39 18-Dec-15 0 0 0 0 0 39.
40 18-Dec-15 0 0 0 0 0 40.
41 18-Dec-15 0 0 0 0 0 41.
42 18-Dec-15 0 0 0 0 0 42.
43 18-Dec-15 0 0 0 0 0 43.
44 18-Dec-15 0 0 0 0 0 44.
45 18-Dec-15 0 0 0 0 0 45.
46 18-Dec-15 0 0 0 0 0 46.
47 18-Dec-15 0 0 0 0 0 47.
48 18-Dec-15 0 0 0 0 0 48.
49 18-Dec-15 0 0 0 0 0 49.
50 18-Dec-15 0 0 0 0 0 50.
51 18-Dec-15 0 0 0 0 0 51.
52 18-Dec-15 0 0 0 0 0 52.
53 18-Dec-15 0 0 0 0 0 53.
54 18-Dec-15 0 0 0 0 0 54.
55 18-Dec-15 0 0 0 0 0 55.
56 18-Dec-15 0 0 0 0 0 56.
57 18-Dec-15 0 0 0 0 0 57.
58 18-Dec-15 0 0 0 0 0 58.
59 18-Dec-15 0 0 0 0 0 59.
60 18-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 18-Dec-15 0 0 0 0 61.
62 18-Dec-15 0 0 0 0 62.
63 18-Dec-15 0 0 0 0 63.
64 18-Dec-15 0 0 0 0 64.
65 18-Dec-15 0 0 0 0 65.
66 18-Dec-15 0 0 0 0 66.
67 18-Dec-15 0 0 0 0 67.
68 18-Dec-15 0 0 0 0 68.
69 18-Dec-15 0 0 0 0 69.
70 18-Dec-15 0 0 0 0 70
71 18-Dec-15 0 0 0 0 71.
72 18-Dec-15 0 0 0 0 72.
73 18-Dec-15 0 0 0 0 73.
74 18-Dec-15 0 0 0 0 74.
75 18-Dec-15 0 0 0 0 75.
76 18-Dec-15 0 0 0 0 76.
77 18-Dec-15 0 0 0 0 77.
78 18-Dec-15 0 0 0 0 78.
79 18-Dec-15 0 0 0 0 79.
80 18-Dec-15 0 0 0 0 80.
81 18-Dec-15 0 0 0 0 81.
82 18-Dec-15 0 0 0 0 82.
83 18-Dec-15 0 0 0 0 83.
84 18-Dec-15 0 0 0 0 84.
85 18-Dec-15 0 0 0 0 85.
86 18-Dec-15 0 0 0 0 86.
87 18-Dec-15 0 0 0 0 87.
88 18-Dec-15 0 0 0 0 88.
89 18-Dec-15 0 0 0 0 89.
90 18-Dec-15 0 0 0 0 90.
Ruangan
18-Dec-15 1390 0000168823967 Sit jamiah Jl. Panca karya P 55 Th I 1

18-Dec-15 432 0000027369358 Kailani jl. Perindustrian L 52 Th P 1
18-Dec-15 2358 0001282210312 Kenzo rawa rizki talang ratu L 2,1 Th A 1
18-Dec-15 1858 0000026463385 Kordiat jl. Mawar P 61 Th I 1
18-Dec-15 365 0000166949807 Dicky Herwansyah jl. Kasnariansyah L 28 Th P 1
18-Dec-15 492 0000194058887 M. Zulkarnain jl. Akbp h umar L 62 Th P 1
18-Dec-15 2359 0000194059056 Nursani jl. Akbp h umar P 52 Th I 1
18-Dec-15 1947 0001795938851 Suryat Jl. SB 2 P 56 Th I 1
18-Dec-15 868 0000026141905 Maryani Risnawat jl. Balayuda no.5170 P 51 Th P 1
18-Dec-15 14 0001305651982 Yuli Anggraini lr. Pandan P 16 Th A 1
18-Dec-15 2360 0000026073516 M. Hatta Achmad perum rakyat L 58 Th P 1
18-Dec-15 781 0000026510286 Mintarmi lr. Kenanga P 67 Th P 1
18-Dec-15 1687 0001866501214 Yan H ilyas jl. Kasnariansyah L 73 Th P 1
18-Dec-15 1686 0001866501494 Robiah jl. Kasnariansyah P 71 Th I 1
18-Dec-15 1376 0001299747677 Syarifah jl. Mangun jaya P 69 Th I 1
18-Dec-15 2361 0001299712239 Mgs. Yangcik ali jl. Mangun jaya L 71 Th P 1
18-Dec-15 2362 0000018240693 Ravina Mutara sari jl. Kasnariansyah P 33 Th P 1
18-Dec-15 1342 0001404919282 Sonny Eddy Robi jl. Mandi api L 45 Th P 1
18-Dec-15 575 0001474550662 Fauzan anwar R Jl. Let murod L 2,6 Th A 1
18-Dec-15 2355 0001265197779 Pingkan umari jl. Akbp h umar P 11 Th A 1
18-Dec-15 544 0000026831542 Murtat jl. mawar P 59 Th P 1
18-Dec-15 1636 0000025992437 A. Fanani Jl. Let murod L 60 Th P 1
18-Dec-15 313 0000025992448 Enima Jl. Let murod P 60 Th I 1
18-Dec-15 2111 0000027384862 Nurhasanah jl. Surya sakt P 51 Th P 1
18-Dec-15 1009 0000026551506 A. Yusri jl. H. Aziz L 63 Th P 1
18-Dec-15 693 0000020124562 Edief Hanum jl. Akbp h umar L 81 Th P 1
18-Dec-15 1608 0001313713304 Rosidah jl. mawar P 47 Th I 1
18-Dec-15 2070 0000026913532 Roaini jl. Kol. H, Burlian P 60 Th I 1
18-Dec-15 189 0000025636948 Rosdianah Jl. Naskah P 66 Th P 1
18-Dec-15 2180 0001280968874 Nuraini Armin Jl. Let murod P 71 Th P 1
0

Ruangan
18-Dec-15 2363 0000026010843 Zaipil jl. Let murod rt.10 L 52 Th P 1

18-Dec-15 67 0000992535445 Deid Afrianto jl. Mawar no. 178 L 33 Th P 1
18-Dec-15 202 0000992692653 Habibah jl. Suka karya P 50 Th P 1
18-Dec-15 187 0000324344092 Zakaria jl. Mawar L 31 Th P 1
18-Dec-15 55 0000324344676 Sri ningsih jl. Mawar P 31 Th I 1
18-Dec-15 143 0000325167221 Rohaman jl. Let murod no. 73 L 9 Th A 1
18-Dec-15 300 0000992534387 Ali Arman jl. Kenanga L 57 Th P 1
18-Dec-15 100 0000324932455 Inda maya Sari jl. Let murod P 35 Th i 1
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15

BULAN : DESEMBER
Ruangan
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
18-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUK
BULAN : DESEMBER
Dermatts IRT 18-Dec-15 67 0000992535445 Deid Afrianto ybs

RS. Bhayangkara/PDL/522 nyeri empedu PNS 085279103034 18-Dec-15 202 0000992692653 Habibah ybs
Nyeri tulang 081278692923 18-Dec-15 187 0000324344092 Zakaria Zakaria
Syaraf IRT 081367336970 18-Dec-15 55 0000324344676 Sri ningsih zakaria
DM PNS 0000166949807 18-Dec-15 143 0000325167221 Rohaman Hidayatullah
RA PNS 085267750351 18-Dec-15 300 0000992534387 Ali Arman Ali arman
Sakit gigi IRT 085267750351 18-Dec-15 100 0000324932455 Inda maya Sari M. Soleh
Alergi IRT 081367929202 18-Dec-15
HHD PNS 081271375948 18-Dec-15
Dermatts 18-Dec-15
HT PNS 0416896 18-Dec-15
DM IRT 18-Dec-15
RSIA YK Madira/PDL/526 HHD 18-Dec-15
Herpes 18-Dec-15
RS. Bhayangkara/Bedah/527 Nyeri kaki IRT 351827 18-Dec-15
Sakit gigi Swasta 351827 18-Dec-15
ISPA GURU 082167299667 18-Dec-15
ISPA Swasta 08128806771 18-Dec-15
RS. Hermina/Anak/528 TB Paru 18-Dec-15
Sakit perut Pelajar 081273748611 18-Dec-15
RS. Bhayangkara/syaraf/529 Pusing IRT 081273109495 18-Dec-15
DM PNS 082184745074 18-Dec-15
RS. Bhayangkara/PDL/531 Gastrits IRT 082184745074 18-Dec-15
RSIA YK Madira/Gyn/530 Sakit perut PNS 08127330031 18-Dec-15
Luka kaki PNS 08218475965 18-Dec-15
RA IRT 081373796190 18-Dec-15
HT IRT 18-Dec-15
RS. Myria/PDL/533 Nyeri kaki IRT 081377750348 18-Dec-15
mata kabur PNS 18-Dec-15
RS. Bunda/PDL/532 ISPA IRT 081271268632 18-Dec-15
HT PNS 081273957472
Demam Buruh 081278777217
ASMA IRT 082374223264
ISPA Buruh 0813677039184
ISPA IRT 0813677039184
Demam 081271152886
ISPA Swasta 081273313111
ispa
UNGAN DAN RUJUKAN JAMKESMAS
MAS TALANG RATU
N: DESEMBER
Ruangan
jl. Mawar no. 178 L 33 Th P 1 Demam Buruh 081278777217

jl. Suka karya P 50 Th P 1 ASMA IRT 082374223264
jl. Mawar L 31 Th P 1 ISPA Buruh 0813677039184
jl. Mawar P 31 Th I 1 ISPA IRT 0813677039184
jl. Let murod no. 73 L 9 Th A 1 Demam 081271152886
jl. Kenanga L 57 Th P 1 ISPA Swasta 081273313111
jl. Let murod P


2 19-Dec-15 0000026598104 Hasbullah L 68 Th Nyeri dada 2.
3 19-Dec-15 0000027256239 Maidar P 51 Th ISPA 3.
4 19-Dec-15 0001484177938 Uskiah P 70 Th sakit pantat 4.
5 19-Dec-15 0000027384412 Herlina P 50 Th sakit gigi 5.
6 19-Dec-15 0000026145652 Teri sulah P 47 Th Hht 6.
7 19-Dec-15 0000026831531 Tubran L 71 Th RA 7.
8 19-Dec-15 00001259948305 Dhony shaumanta L 26 Th CAS 8.
9 19-Dec-15 0000027308114 Zarini P 52 Th Demam 9.
10 19-Dec-15 0001450267929 Dwi Henny Maya S P 31 Th ISPA 10
11 19-Dec-15 0000025271223 Halmah P 55 Th HT 11.
12 19-Dec-15 0001871549245 Nadya Alyssa P 3,1 th ISPA 12.
13 19-Dec-15 0001261372217 M. Senen D P 60 Th Hypertrophy 13.
14 19-Dec-15 0000025994575 Eliyana P 48 Th RA 14.
15 19-Dec-15 0001269080821 Fatnah zahra P 8 Th ISPA 15.
16 19-Dec-15 0000026945594 Zulkarnain P 75 Th Sakit mata 16.
17 19-Dec-15 0001436258351 Suhaimi P 49 Th HHD 17.
18 19-Dec-15 0000025975631 Haryant P 38 Th RA 18.
19 19-Dec-15 0000027026651 Homsiah P 62 Th RA 19.
20 19-Dec-15 0000325075454 Nuraini P 32 Th ISPA 20.
21 21.
22 22.
23 23.
24 24.
25 25.
26 26.
27 27.
28 28.
29 29.
30 30.

31 19-Dec-15 0 0 0 0 0 31
32 19-Dec-15 0 0 0 0 0 32
33 19-Dec-15 0 0 0 0 0 33.
34 19-Dec-15 0 0 0 0 0 34.
35 19-Dec-15 0 0 0 0 0 35.
36 19-Dec-15 0 0 0 0 0 36.
37 19-Dec-15 0 0 0 0 0 37.
38 19-Dec-15 0 0 0 0 0 38.
39 19-Dec-15 0 0 0 0 0 39.
40 19-Dec-15 0 0 0 0 0 40.
41 19-Dec-15 0 0 0 0 0 41.
42 19-Dec-15 0 0 0 0 0 42.
43 19-Dec-15 0 0 0 0 0 43.
44 19-Dec-15 0 0 0 0 0 44.
45 19-Dec-15 0 0 0 0 0 45.
46 19-Dec-15 0 0 0 0 0 46.
47 19-Dec-15 0 0 0 0 0 47.
48 19-Dec-15 0 0 0 0 0 48.
49 19-Dec-15 0 0 0 0 0 49.
50 19-Dec-15 0 0 0 0 0 50.
51 19-Dec-15 0 0 0 0 0 51.
52 19-Dec-15 0 0 0 0 0 52.
53 19-Dec-15 0 0 0 0 0 53.
54 19-Dec-15 0 0 0 0 0 54.
55 19-Dec-15 0 0 0 0 0 55.
56 19-Dec-15 0 0 0 0 0 56.
57 19-Dec-15 0 0 0 0 0 57.
58 19-Dec-15 0 0 0 0 0 58.
59 19-Dec-15 0 0 0 0 0 59.
60 19-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan

19-Dec-15 742 0000026598104 Hasbullah jl. Let murod L 68 Th P 1
19-Dec-15 2226 0000027256239 Maidar jl. Let murod P 51 Th I 1
19-Dec-15 815 0001484177938 Uskiah jl. Let murod P 70 Th I 1
19-Dec-15 1775 0000027384412 Herlina P 50 Th P 1
19-Dec-15 40 0000026145652 Teri sulah jl. Let murod P 47 Th P 1
19-Dec-15 860 0000026831531 Tubran jl. Mawar L 71 Th P 1
19-Dec-15 1932 00001259948305 Dhony shaumanta jl. Talang ratu L 26 Th A 1
19-Dec-15 887 0000027308114 Zarini km 12 P 52 Th I 1
19-Dec-15 1696 0001450267929 Dwi Henny Maya S jl. S suparman P 31 Th I 1
19-Dec-15 1275 0000025271223 Halmah perum bougenvile P 55 Th P 1
19-Dec-15 2364 0001871549245 Nadya Alyssa lr. Bigs rt.05 P 3,1 th A 1
19-Dec-15 1036 0001261372217 M. Senen D Jl. Anggrek P 60 Th P 1
19-Dec-15 1907 0000025994575 Eliyana jl. Amal rt.36 P 48 Th P 1
19-Dec-15 905 0001269080821 Fatnah zahra Jl. Kasnariansyah P 8 Th A 1
19-Dec-15 1058 0000026945594 Zulkarnain jl. Let murod P 75 Th P 1
19-Dec-15 124 0001436258351 Suhaimi talang ratu P 49 Th I 1
19-Dec-15 0000025975631 Haryant bukit P 38 Th P 1
19-Dec-15 0000027026651 Homsiah jl. SB 2 P 62 Th P 1
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
Ruangan
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JAMKE
Rujukan Diagnosa Pekerjaan No HP Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK Alamat
HT Buruh 081994835863 19-Dec-15 21 0000325075454 Nuraini m. Daim jl. Ariodillah

Nyeri dada Pensiunan PNS 19-Dec-15
ISPA IRT 19-Dec-15
sakit pantat IRT 0711415173 19-Dec-15
sakit gigi PNS 08127347703 19-Dec-15
Hht pns 082183775691 19-Dec-15
RA PNS 082179535445 19-Dec-15
CAS PNS 085267030063 19-Dec-15
Demam IRT 081373727298 19-Dec-15
ISPA Honor 085368008896 19-Dec-15
HT PNS 19-Dec-15
ISPA 081291909455 19-Dec-15
RS. Myria/THT/534 Hypertrophy PNS 081271735558 19-Dec-15
RA PNS 085286664810 19-Dec-15
ISPA Pelajar 081271234669 19-Dec-15
Sakit mata Pensiunan PNS 19-Dec-15
rs. Bhayangkara/ PDL/536 HHD IRT 082178148124 19-Dec-15
RA PNS 19-Dec-15
PNS 19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
19-Dec-15
JUKAN JAMKESMAS
TU
2015
Ruangan
JK Usia Status Rujukan Diagnosa Pekerjaan No HP
P 32 Th I 1 ISPA IRT 085383466984


1 21-Dec-15 0000026729921 Abu yani L 75 Th HT 1.

2 21-Dec-15 0001886501496 Yuliana P 31 Th Sakit gigi 2.
3 21-Dec-15 0000026662421 Sjukri Bakri L 65 Th HT 3.
4 21-Dec-15 0001276400362 Sri purnama P 61 Th Syaraf 4.
5 21-Dec-15 0000026324943 Zainab Aji P 61 Th Low back pain 5.
6 21-Dec-15 0001296179515 Rita Mulya P 44 Th ASMA 6.
7 21-Dec-15 0000027024906 Yogi pratama L 14 Th Mata kabur 7.
8 21-Dec-15 0000026929541 Maria ratyah P 75 Th RA 8.
9 21-Dec-15 0000203687201 Eka sant P 30 Th Amandel 9.
10 21-Dec-15 0000026916423 Drs. Affandi Benaim L 65 Th HHD 10
11 21-Dec-15 0000026932915 Nazaruddin L 62 Th Syaraf 11.
12 21-Dec-15 0000027103691 Ahymad ismail L 52 Th HHD 12.
13 21-Dec-15 0000026468278 Zainmuddin L 91 Th HHD 13.
14 21-Dec-15 0000164035271 Ramadhandi M L 10 Th Dermatts 14.
16 21-Dec-15 0000025676834 Sutriasih P 46 Th Nyeri tangan 16.
17 21-Dec-15 0000026383364 Johni Rampen L 70 Th ISPA 17.
18 21-Dec-15 0001856315619 Husnaini P 40 Th HHD 18.
19 21-Dec-15 0001874767702 Zaskia nailatur R P 5,4 Th ISPA 19.
20 21-Dec-15 0000026431121 Yahusin gonggot L 88 Th ISPA 20.
21 21-Dec-15 0000172498792 Salamah P 72 Th Sakit telionga 21.
22 21-Dec-15 0000027094026 Maryuni P 47 Th sakit hidung 22.
23 21-Dec-15 0001869609172 Cici yuniar P 26 Th ANC 23.
24 21-Dec-15 0000147913604 Andi Dharmawan L 35 T ISPA 24.
25 21-Dec-15 0000027038046 Yusmani P 56 Th Nyeri kaki 25.
26 21-Dec-15 0000172383838 Devi febriant P 31 Th Cabut gigi 26.
27 21-Dec-15 0001506381208 Rika Rahim P 22 Th Sakit gigi 27.
28 21-Dec-15 0000027308114 Zarini P 52 Th Gastrits 28.
29 21-Dec-15 0000211046938 Ana min H tul P 15 TH Tampal gigi 29.

31 21-Dec-15 00018815814787 Elisa P 34 Th ANC 31
32 21-Dec-15 0000026943827 Mahida P 59 th Dermatts 32
33 21-Dec-15 0001717497538 Sultan L 28 Th Mata kabur 33.
34 21-Dec-15 0000027105963 Rusidah P 52 Th HT 34.
35 21-Dec-15 0000026440787 Jusuf letong P 70 Th HHD 35.
36 21-Dec-15 0000026073213 Drs. Amir hamzzah L 50 Th Demam 36.
37 21-Dec-15 0000026073202 Lamria sianturi P 52 Th mata kabur 37.
38 21-Dec-15 0000026073224 agnes carolina P 17 Th Mata kabur 38.
39 21-Dec-15 0000026938269 Sanusi L 71 Th HHD 39.
40 21-Dec-15 0000026938271 Ruaida L 60 Th DM 40.
41 21-Dec-15 0000026154088 Dr. Muh mawangir L 57 Th HT 41.
43 21-Dec-15 0001835985587 Khanza P 1,4 Th ISPA 43.
44 21-Dec-15 0001835984722 Raissa P 5,6 Th ISPA 44.
45 21-Dec-15 0001313713304 Rosidah P 47 Th HT 45.
46 21-Dec-15 0000025738301 Meriyat P 42 Th Control mata 46.
47 21-Dec-15 0000027192712 Rica Susanty P 43 ThnAmenohrea 47.
48 21-Dec-15 00012370637021 Rustam Anzori L 76 Th HHD 48.
50 21-Dec-15 0001296179515 Rita Mulya P 44 Th ASMA 50.
52 21-Dec-15 0000992536468 Nurpida P 75 Th RA 52.
53 21-Dec-15 0000325133774 Dedi sipriadi L 33 Th Demam 53.
54 21-Dec-15 0000992534433 Ningcik P 57 Th RA 54.
55 21-Dec-15 0000325933435 Suripah P 38 Th pil KB 55.
56 56.
57 57.
58 58.
59 59.
60 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
21-Dec-15 702 0000026729921 Abu yani jl. Kasnariansyah rtr.06 L 75 Th P 1

21-Dec-15 2053 0001886501496 Yuliana lr. Pelita rt.2 P 31 Th I 1
21-Dec-15 1102 0000026662421 Sjukri Bakri jl. Let murod L 65 Th P 1
21-Dec-15 978 0001276400362 Sri purnama lr biga P 61 Th P 1
21-Dec-15 490 0000026324943 Zainab Aji jl. Anggrek P 61 Th P 1
21-Dec-15 943 0001296179515 Rita Mulya Jl. Radio P 44 Th I 1
21-Dec-15 2365 0000027024906 Yogi pratama jl. Srijaya L 14 Th A 1
21-Dec-15 800 0000026929541 Maria ratyah talang ratu P 75 Th P 1
21-Dec-15 7807 0000203687201 Eka sant jl let murod P 30 Th P 1
21-Dec-15 897 0000026916423 Drs. Affandi Benaim lr. Cempedak L 65 Th P 1
21-Dec-15 477 0000026932915 Nazaruddin kompl. Bougenvile L 62 Th P 1
21-Dec-15 1207 0000027103691 Ahymad ismail kompl. Bougenvile L 52 Th S 1
21-Dec-15 422 0000026468278 Zainmuddin perum rakyat L 91 Th P 1
21-Dec-15 2523 0000164035271 Ramadhandi M jl. Let murod L 10 Th A 1
21-Dec-15 1944 0000025676834 Sutriasih lebong siarang P 46 Th I 1
21-Dec-15 1113 0000026383364 Johni Rampen Jl. Peridustrian L 70 Th P 1
21-Dec-15 2366 0001856315619 Husnaini jl. anggrek P 40 Th I 1
21-Dec-15 1845 0001874767702 Zaskia nailatur R Jl. Kasnariansyah P 5,4 Th A 1
21-Dec-15 466 0000026431121 Yahusin gonggot talang ratu L 88 Th P 1
21-Dec-15 9720 0000172498792 Salamah jl. Sukamaju P 72 Th P 1
21-Dec-15 1685 0001869609172 Cici yuniar jl. Let murod P 26 Th I 1
21-Dec-15 2360 0000147913604 Andi Dharmawan jl. Kasnariansyah L 35 T P 1
21-Dec-15 2332 0000027038046 Yusmani jl. Kasnariansyah P 56 Th P 1
21-Dec-15 2322 0000172383838 Devi febriant jl. Let murod rt.7 no. 499 P 31 Th P 1
21-Dec-15 2369 0001506381208 Rika Rahim jl. Swadaya P 22 Th P 1
21-Dec-15 887 0000027308114 Zarini km 12 P 52 Th I 1
21-Dec-15 1432 0000211046938 Ana min H tul km 12 P 15 TH A 1
Ruangan
21-Dec-15 2225 00018815814787 Elisa jl. Adisucipto santoso P 34 Th I 1

21-Dec-15 2302 0000026943827 Mahida talang betutu P 59 th I 1
21-Dec-15 2370 0001717497538 Sultan jl. Talang ratu rt 10 L 28 Th P 1
21-Dec-15 771 0000027105963 Rusidah perumdam kartka P 52 Th P 1
21-Dec-15 1774 0000026440787 Jusuf letong jl. Siring agung P 70 Th P 1
21-Dec-15 962 0000026073213 Drs. Amir hamzzah jl. SB 2 L 50 Th P 1
21-Dec-15 691 0000026073202 Lamria sianturi jl. SB 2 P 52 Th I 1
21-Dec-15 270 0000026073224 agnes carolina jl. SB 2 P 17 Th A 1
21-Dec-15 539 0000026938269 Sanusi garuda putra L 71 Th P 1
21-Dec-15 540 0000026938271 Ruaida garuda putra L 60 Th I 1
21-Dec-15 1894 0000026154088 Dr. Muh mawangir perum rakyat L 57 Th P 1
21-Dec-15 2371 0001835985587 Khanza jl. Akbo h umar P 1,4 Th A 1
21-Dec-15 2372 0001835984722 Raissa jl. Akbo h umar P 5,6 Th A 1
21-Dec-15 1608 0001313713304 Rosidah jl. mawar P 47 Th I 1
21-Dec-15 1512 0000025738301 Meriyat perumnas talang kelapa P 42 Th P 1
21-Dec-15 1804 0000027192712 Rica Susanty jl. Talang ratu P 43 ThnP 1
21-Dec-15 2373 00012370637021 Rustam Anzori kompl, garuda putra L 76 Th P 1
21-Dec-15 943 0001296179515 Rita Mulya Jl. Radio P 44 Th I 1
21-Dec-15 2365 0000027024906 Yogi pratama jl. Srijaya L 14 Th A 1
21-Dec-15 115 0000992536468 Nurpida jl. Let murod P 75 Th P 1
21-Dec-15 246 0000325133774 Dedi sipriadi lr. Sekolah L 33 Th P 1
21-Dec-15 137 0000325933435 Suripah jl. Kasna P 38 Th I 1
21-Dec-15
21-Dec-15
21-Dec-15
21-Dec-15
21-Dec-15

Ruangan
1-Dec-15
BULAN : DESEMBER
HT PNS 085382584064 115 0000992536468 Nurpida ybs

Sakit gigi IRT 246 0000325133774 Dedi sipriadi ybs
HT PNS 0711129927 160 0000992534433 Ningcik Dirta
Syaraf IRT 137 0000325933435 Suripah Tri wardoyo
Low back pain PNS 081367122354
ASMA IRT 085273224464
Mata kabur 081374925051
RA
Amandel swasta 081373004604
HHD PNS 081279444342
Syaraf PNS 081994976504
HHD Swasta
HHD PNS 082184746136
RS. Mata/mata/939 Dermatts Pelajar
RS. Mata/mata/640 Dermatts IRT 085208718584
RS. Bhayangkara/Bedah/59 Nyeri tangan GURU 085267003574
ISPA PNS
HHD IRT 085268939110
ISPA '0813730470944
ISPA PNS 0711416005
Sakit telionga
sakit hidung GURU 085323087296
ANC swasta 081279863989
ISPA PNS 085268529800
Nyeri kaki GURU 082177772714
Cabut gigi PNS 081377848252
Sakit gigi swasta 089638435704
RS. Myria/PDL/542 Gastrits IRT 081373727298
Tampal gigi PNS 081373727298
HT PNS 0711412860
ANC IRT 082179815530

Dermatts 08526746369
RS. Mata/Mata/547 Mata kabur swasta 081368827170
HT
RS. Bhayangkara/Jantung/554 HHD PNS '082182579582
Demam pns
RS. Mata/Mata/557 mata kabur IRT
Mata kabur Pelajar
RS. Dr. AK Gani/PDL/558 HHD PNS 0711417008
RS. Dr. AK Gani/PDL/559 DM IRT 0711417009
HT Dosen 083177772637
Dermatts PNS
ISPA
ISPA
HT IRT 08127326644
RS. Bhayangkara/Mata/561 Control mata PNS 081273068791
Amenohrea Guru 082181865779
RS. Bhanyangkara/PDL/577 HHD swasta
ASMA IRT 085273224464
Mata kabur 081374925051
RA
Demam Swasta
RA Swasta 081367129918
pil KB IRT
GAN DAN RUJUKAN JAMKESMAS
TALANG RATU
DESEMBER
Ruangan
jl. Let murod P 75 Th P 1 RA

lr. Sekolah L 33 Th P 1 Demam Swasta
lr. Rambutan P 57 Th I 1 RA Swasta 081367129918
jl. Kasna P 38 Th I 1 pil KB IRT

1 22-Dec-15 0001276400362 Sri purnama P 61 Th Syaraf 1.

2 22-Dec-15 0000027311174 Nurbait P 54 Th RA 2.
3 22-Dec-15 0000131371593 Ratna wilis P 63 Th HHD 3.
4 22-Dec-15 0000131422522 Drs. Abdillah L 63 Th HT 4.
5 22-Dec-15 0000026287841 Supaiman L 45 Th HT 5.
6 22-Dec-15 0000027038057 Zailbuldin L 57 Th HT 6.
7 22-Dec-15 0000026513875 Paiman sapra L 73 Th Sakit ulu hat 7.
8 22-Dec-15 0000025967002 Pudjiman L 58 Th RA 8.
10 22-Dec-15 0001427484374 Musiran L 53 Th HT 10
11 22-Dec-15 0000027311174 Nurbait P 64 Th RA 11.
12 22-Dec-15 0000026821102 H. Suhiman duarap L 74 Th Sakit gigi 12.
13 22-Dec-15 0001288326857 Hj, nuroh P 55 Th Sakit telinga 13.
15 22-Dec-15 0001482277645 Putri Ardelia P 14 Th Gendongan 15.
16 22-Dec-15 0001390674126 Alan mubaki L 12 Th Benjolan di kepala 16.
17 22-Dec-15 0000027039159 Sumiyat P 53 Th Sakit gigi 17.
18 22-Dec-15 0001862897433 M. Daffa AL Faridzi L 5,5 Th Demam 18.
19 22-Dec-15 0001862894676 M. Alhafiz L 15 Th demam 19.
20 22-Dec-15 0001290957175 Romli L 45 Th Nyeri dada 20.
21 22-Dec-15 0000026421243 Suharsono L 72 Th Mata kabur 21.
22 22-Dec-15 0000025979139 A. Suhairi L 45 Th HHD 22.
23 22-Dec-15 0001291650693 Aisah P 64 Th ht 23.
25 22-Dec-15 0000027284062 Zainab hartat P 47 Th Mata kabur 25.
26 22-Dec-15 0000025741416 Nurbait P 46 Th Gastrits 26.
27 22-Dec-15 0001831966301 Ashabi ikhsa L 10 Bln RA 27.
28 22-Dec-15 0000027547997 Khoirunisak P 53 Th RA 28.
29 22-Dec-15 0000026154088 Dr. Muh mawangir L 57 Th RA 29.
30 22-Dec-15 0000026831531 Tubran L 71 Th Buka jahitan 30.

31 22-Dec-15 0000026515765 Ratena P 62 Th HHD 31
32 22-Dec-15 0001294141149 Denny saputra L 24 Th Demam 32
33 22-Dec-15 00003235206246 Warsini P 42 Th Nyeri tangan 33.
34 22-Dec-15 0001906376995 Eni Pusriani P 25 Th ANC 34.
35 22-Dec-15 0001106021902 M. Ario Pratto L 19 Th Dermatts 35.
36 22-Dec-15 0000026699894 Hj, Dra. Nurbaya P 61 Th Vertgo 36.
37 22-Dec-15 0000027219879 Leli mardiana P 51 Th HT 37.
38 22-Dec-15 0000026697958 Nurhuda P 67 Th HT 38.
39 22-Dec-15 0000026422841 Saonah P 58 Th Sakit mata 39.
40 22-Dec-15 0000026422852 Dinda Irawat P 17 Th Sakit mata 40.
41 22-Dec-15 0001823258711 Nuraini P 23 Th HT 41.
42 22-Dec-15 0000325159503 Elvira P 27 Th Vertgo 42.
43 22-Dec-15 0000324741701 Fathan Alizah L 11 Th Sariawan 43.
44 22-Dec-15 0000326093196 Maid bun murod L 53 Th Sakit mata 44.
45 22-Dec-15 0000325130422 M. Junaidi L 9 Th ISPA 45.
46 22-Dec-15 0000325975915 Erika sept G P 16 Th Benjola leher 46.
47 22-Dec-15 0000325182881 Cek non P 46 Th ISPA 47.
48 22-Dec-15 0 0 0 0 0 48.
49 22-Dec-15 0 0 0 0 0 49.
50 22-Dec-15 0 0 0 0 0 50.
51 22-Dec-15 0 0 0 0 0 51.
52 22-Dec-15 0 0 0 0 0 52.
53 22-Dec-15 0 0 0 0 0 53.
54 22-Dec-15 0 0 0 0 0 54.
55 22-Dec-15 0 0 0 0 0 55.
56 22-Dec-15 0 0 0 0 0 56.
57 22-Dec-15 0 0 0 0 0 57.
58 22-Dec-15 0 0 0 0 0 58.
59 22-Dec-15 0 0 0 0 0 59.
60 22-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
22-Dec-15 978 0001276400362 Sri purnama lr biga P 61 Th P 1

22-Dec-15 832 0000027311174 Nurbait jl. Sanjaya P 54 Th P 1
22-Dec-15 686 0000131371593 Ratna wilis jl. Kol sulaiman P 63 Th P 1
22-Dec-15 685 0000131422522 Drs. Abdillah jl. Kol sulaiman L 63 Th S 1
22-Dec-15 480 0000026287841 Supaiman jl. Srijaya L 45 Th P 1
22-Dec-15 1220 0000027038057 Zailbuldin jl. Kasnariansyah L 57 Th P 1
22-Dec-15 731 0000026513875 Paiman sapra jl. Sosial L 73 Th P 1
22-Dec-15 2374 0000025967002 Pudjiman jl. Gotong royong L 58 Th P 1
22-Dec-15 368 0000027311174 Nurbait jl. AriodillaH P 64 Th I 1
22-Dec-15 1335 0000026821102 H. Suhiman duarap jl. Kasnariansyah L 74 Th P 1
22-Dec-15 1075 0001288326857 Hj, nuroh jl. Let murod P 55 Th I 1
22-Dec-15 1633 0001482277645 Putri Ardelia jl. Kasnariansyah P 14 Th A 1
22-Dec-15 2376 0001390674126 Alan mubaki jl. Tanah mas L 12 Th A 1
22-Dec-15 1658 0000027039159 Sumiyat jl. Akbp Ha umar P 53 Th P 1
22-Dec-15 1764 0001862897433 M. Daffa AL Faridzi jl. Let murod L 5,5 Th A 1
22-Dec-15 2063 0001862894676 M. Alhafiz jl. Let murod L 15 Th A 1
22-Dec-15 2377 0001290957175 Romli desa pelajau L 45 Th P 1
22-Dec-15 1811 0000026421243 Suharsono komp. Korem L 72 Th P 1
22-Dec-15 0000025979139 A. Suhairi jl. sosial L 45 Th S 1
22-Dec-15 1769 0001291650693 Aisah lr. Peristwa P 64 Th P 1
22-Dec-15 2378 0000027284062 Zainab hartat jl. Perumda P 47 Th P 1
22-Dec-15 1597 0000025741416 Nurbait Jl. Aman 2 P 46 Th I 1
22-Dec-15 1493 0001831966301 Ashabi ikhsa jlSB 1 L 10 Bln A 1
22-Dec-15 2379 0000027547997 Khoirunisak jl. Naskah P 53 Th P 1
22-Dec-15 1894 0000026154088 Dr. Muh mawangir perum rakyat L 57 Th P 1
22-Dec-15 860 0000026831531 Tubran jl. Mawar L 71 Th P 1
Ruangan
22-Dec-15 182 0000026515765 Ratena Jl. SB 2 P 62 Th I 1

22-Dec-15 1709 0001294141149 Denny saputra jl. Let murod rt.13 L 24 Th A 1
22-Dec-15 133 00003235206246 Warsini jl. Anggrek P 42 Th I 1
22-Dec-15 2381 0001906376995 Eni Pusriani lr. Tanjung P 25 Th I 1
22-Dec-15 2382 0001106021902 M. Ario Pratto korem no. 1578 L 19 Th A 1
22-Dec-15 294 0000026699894 Hj, Dra. Nurbaya jl. Musi 6 P 61 Th I 1
22-Dec-15 203 0000027219879 Leli mardiana jl. Let murod P 51 Th P 1
22-Dec-15 275 0000026697958 Nurhuda Jl. Sei talo rt.2 P 67 Th I 1
22-Dec-15 687 0000026422841 Saonah jl. Suparman rt.46 P 58 Th P 1
22-Dec-15 2375 0000026422852 Dinda Irawat jl. Suparman rt.46 P 17 Th A 1
22-Dec-15 0001823258711 Nuraini Jl. Kasnariansyah P 23 Th i 1
22-Dec-15 152 0000325159503 Elvira jl. Let murod P 27 Th I 1
22-Dec-15 302 0000324741701 Fathan Alizah jl. Rambutan L 11 Th A 1
22-Dec-15 140 0000326093196 Maid bun murod jl. Kasnariansyah L 53 Th P 1
22-Dec-15 303 0000325130422 M. Junaidi jl. Kasnariansyah L 9 Th A 1
22-Dec-15 234 0000325975915 Erika sept G jl. Ariodillah P 16 Th A 1
22-Dec-15 304 0000325182881 Cek non jl. Kasnariansyah P 46 Th I 1
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15
22-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKA
Syaraf IRT 152 0000325159503 Elvira sit zaleha

RS. Myria/syaraf/584 RA IRT 08127883965 302 0000324741701 Fathan Alizah M,. Ali
RS.Bhayangkara/PDL/587 HHD PNS 0711411131 140 0000326093196 Maid bun murod ybs
RS. Bhayangkara/PDL/585 HT PNS 071141113 303 0000325130422 M. Junaidi Hendri junan
HT PNS 081273210473 234 0000325975915 Erika sept G Alex
HT Swasta 082177772714 304 0000325182881 Cek non cek umar
Sakit ulu hat pensiun ABRI
RA PNS 08127317369
HT Buruh 081994835863
HT Buruh 081994835863
RA IRT 082186269177
Sakit gigi Pensuinan PNS 0711411971
Sakit telinga IRT
Alergi IRT
Gendongan 081273347178
Benjolan di kepala 081290520976
Sakit gigi GURU 081271786140
Demam
demam
rs myria/bedah/614 Nyeri dada 081368287745
Mata kabur Pensiunan TNI 081373233318
ht Swasta '0711410148
Dermatts IRT 085208718584
Mata kabur GURU 081367685788
Gastrits dagang
RA '085367992584
RA GURU 0711420715
RA Dosen 083177772637
Buka jahitan PNS
HHD IRT 081320460065

Demam
Nyeri tangan IRT 08999878198
ANC Perawat 082376344320
Dermatts 085273362019
Vertgo dosen 08566956340
HT 081278341426
RS.Bhayangkara/PDL/588 HT 082178000980
Sakit mata 081377663322
Sakit mata 081377663322
HT
Vertgo Buruh 08238910100
Sariawan Pelajar
Sakit mata Buruh 082175579988
ISPA
RS. Bhayangkara/Bedah/615 Benjola leher 085273125215
ISPA IRT 0813672442994
NGAN DAN RUJUKAN JAMKESMAS
AS TALANG RATU
22 DESEMBER 2015
Ruangan
jl. Let murod P 27 Th I 1 Vertgo Buruh 08238910100

jl. Rambutan L 11 Th A 1 Sariawan Pelajar
jl. Kasnariansyah L 53 Th P 1 Sakit mata Buruh 082175579988
jl. Kasnariansyah L 9 Th A 1 ISPA
jl. Ariodillah P 16 Th A 1 Benjola leher 085273125215
jl. Kasnariansyah P 46 Th I 1 ISPA IRT 0813672442994

1 23-Dec-15 0001291245917 Hery iswanto L 59 Th Control post OP 1.

2 23-Dec-15 0000026073516 M. Hatta Achmad L 58 Th HT 2.
4 23-Dec-15 0000026943816 Umar Siali L 64 Th DM 4.
5 23-Dec-15 0001479268787 Hasan basri L 32 Th Deramttos 5.
6 23-Dec-15 0001807767505 Nurlely P 66 Th HHD 6.
7 23-Dec-15 0001429503478 Tesar Arifki L 29 Th Demam 7.
8 23-Dec-15 0000027105884 Ranauwiyah P 57 Th DM 8.
9 23-Dec-15 0000026794811 Samun L 78 Th Nyeri hidung 9.
10 23-Dec-15 0000029186831 Makmur Faizi Bakri L 72 Th HT 10
11 23-Dec-15 0000026060411 Sutarman L 53 Th Gastrits 11.
12 23-Dec-15 0000026964044 Armiat P 54 Th Sakit gigi 12.
13 23-Dec-15 0000026139756 Dewi masitoh P 50 Th Anisimetropia 13.
14 23-Dec-15 0000026776462 Matdui bin pasiah L 83 Th HHD 14.
15 23-Dec-15 0000027549909 Abdul latf L 58 Th Sakit gigi 15.
17 23-Dec-15 0000027296471 Erhamna P 58 Th Sakit gigi 17.
18 23-Dec-15 0000027102396 Kasma boty P 55 Th Dermatts 18.
19 23-Dec-15 0000027037078 Kholifa P 55 TH Nyeri sendi 19.
20 23-Dec-15 0001446073852 Fadli L 35 Th Cabut gigi 20.
21 23-Dec-15 0001136366908 Liliant P 34 Th Suntk KB 21.
22 23-Dec-15 0000026915826 H. Saiman L 72 Th HHD 22.
23 23-Dec-15 0000026699883 drs. H. Asa'ad matcik L 64 Th Sakit telinga 23.
24 23-Dec-15 0000026536544 dra. Evi agustna sari P 47 Th Sakit gigi 24.
25 23-Dec-15 0000026929348 Oki sukmawat P 24 Th Nyeri perut 25.
26 23-Dec-15 0000026929326 Rosiawaty P 54 Th Pusing 26.
27 23-Dec-15 0000026395132 Marinawat6i P 70 Th RA 27.
28 23-Dec-15 0000026817928 Hj, Dasniah P 72 Th RA 28.
30 23-Dec-15 001811380342 Fitriyant P 33 Th Suntk KB 30.

31 23-Dec-15 0000026651046 Rokiah samid P 75 Th HT 31
32 23-Dec-15 0001266278185 Ahmad zahran L 4 Th Demam 32
33 23-Dec-15 0001316977007 M. Benni L 40 Th Sakit gigi 33.
34 23-Dec-15 0000026073527 Supart P 57 Th Cabut gigi 34.
35 23-Dec-15 0000173524162 Rensy Gustni P 28 Th ANC 35.
36 23-Dec-15 0000026916502 Asri murni P 62 Th Sakit perut 36.
37 23-Dec-15 0000027403413 Suhaimi Muhamad L 65 Th Cabut gigi 37.
38 23-Dec-15 00002301264219 Sit lutfia U P 14 Th Sakit gigi 38.
39 23-Dec-15 0001266277926 Dwi pertwi P 30 Th ISPA 39.
40 23-Dec-15 0000196836287 Sri Wahyuni Rahayu P 49 Th Mata kabur 40.
41 23-Dec-15 0000027220105 Nurhudayah Zaini P 56 Th RA 41.
42 23-Dec-15 0000027094487 Zulkarnain L 50 Th DM 42.
43 23-Dec-15 0000324979852 Sela wani P 12 Th Tampal gigi 43.
44 23-Dec-15 0000324979852 Seli wani P 12 Th Tampal gigi 44.
45 23-Dec-15 0000026252537 Heri Astaman L 53 Th Sakit mata 45.
46 23-Dec-15 0001799224661 Alpian L 20 Th Tubercolosi 46.
47 23-Dec-15 0001868597796 Ellis komala sari P 46 Th 47.
48 23-Dec-15 0 0 0 0 0 48.
49 23-Dec-15 0 0 0 0 0 49.
50 23-Dec-15 0 0 0 0 0 50.
51 23-Dec-15 0 0 0 0 0 51.
52 23-Dec-15 0 0 0 0 0 52.
53 23-Dec-15 0 0 0 0 0 53.
54 23-Dec-15 0 0 0 0 0 54.
55 23-Dec-15 0 0 0 0 0 55.
56 23-Dec-15 0 0 0 0 0 56.
57 23-Dec-15 0 0 0 0 0 57.
58 23-Dec-15 0 0 0 0 0 58.
59 23-Dec-15 0 0 0 0 0 59.
60 23-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
23-Dec-15 1924 0001291245917 Hery iswanto lr. Kenanga L 59 Th P 1

23-Dec-15 2360 0000026073516 M. Hatta Achmad perum rakyat L 58 Th P 1
23-Dec-15 487 0000026822856 Rosdianah jl. Let murod P 65 Th I 1
23-Dec-15 1354 0000026943816 Umar Siali talang betutu L 64 Th P 1
23-Dec-15 1588 0001479268787 Hasan basri jl .h sanusin L 32 Th L 1
23-Dec-15 1518 0001807767505 Nurlely jl. Let murod P 66 Th I 1
23-Dec-15 1063 0001429503478 Tesar Arifki jl. Naskah L 29 Th A 1
23-Dec-15 1223 0000027105884 Ranauwiyah jl. Kikim P 57 Th P 1
23-Dec-15 1380 0000026794811 Samun jl. Pakjo L 78 Th P 1
23-Dec-15 730 0000029186831 Makmur Faizi Bakri jl. Let murod L 72 Th S 1
23-Dec-15 16 0000026060411 Sutarman jl. Isp. Marzuki L 53 Th P 1
23-Dec-15 2983 0000026964044 Armiat jl. Tanah merah rt.39 P 54 Th I 1
23-Dec-15 2384 0000026139756 Dewi masitoh jl. Let sudirman P 50 Th P 1
23-Dec-15 1195 0000026776462 Matdui bin pasiah jl. Karya baru L 83 Th P 1
23-Dec-15 612 0000027549909 Abdul latf jl. Mandi api L 58 Th P 1
23-Dec-15 2385 0000027296471 Erhamna jl. Maskerebet P 58 Th P 1
23-Dec-15 478 0000027102396 Kasma boty jl. naskah P 55 Th P 1
23-Dec-15 2119 0000027037078 Kholifa Jl. Asrama Korem Rt.20 P 55 TH I 1
23-Dec-15 1564 0001446073852 Fadli jl. Balayudha L 35 Th P 1
23-Dec-15 2386 0001136366908 Liliant jl. Let murod P 34 Th P 1
23-Dec-15 554 0000026915826 H. Saiman jl. Mandi api L 72 Th S 1
23-Dec-15 1809 0000026699883 drs. H. Asa'ad matcik jl. Way L 64 Th P 1
23-Dec-15 2294 0000026536544 dra. Evi agustna sari jl. Let murod P 47 Th P 1
23-Dec-15 1678 0000026929348 Oki sukmawat jl. Garuda P 24 Th A 1
23-Dec-15 384 0000026929326 Rosiawaty jl. Garuda P 54 Th i
23-Dec-15 392 0000026395132 Marinawat6i jl. Kamil P 70 Th I 1
23-Dec-15 780 0000026817928 Hj, Dasniah lr. Lada P 72 Th I 1
23-Dec-15 2305 001811380342 Fitriyant Jl. Lebak pakis P 33 Th I 1
Ruangan
23-Dec-15 165 0000026651046 Rokiah samid jl. Let murod P 75 Th P 1

23-Dec-15 2212 0001266278185 Ahmad zahran jl. Aman L 4 Th A 1
23-Dec-15 2387 0001316977007 M. Benni jl. Talang ratu L 40 Th P 1
23-Dec-15 2388 0000026073527 Supart perum rakyat P 57 Th I 1
23-Dec-15 2389 0000173524162 Rensy Gustni jl. Sukarela P 28 Th P 1
23-Dec-15 568 0000026916502 Asri murni Jl. S. hatta P 62 Th I 1
23-Dec-15 2390 0000027403413 Suhaimi Muhamad jl. Let murod L 65 Th P 1
23-Dec-15 2391 00002301264219 Sit lutfia U Jl. Tanjung api2 no.28 P 14 Th A 1
23-Dec-15 281 0001266277926 Dwi pertwi jl. Gotong royong P 30 Th I 1
23-Dec-15 2392 0000196836287 Sri Wahyuni Rahayu jl. Sukamaju P 49 Th I 1
23-Dec-15 2266 0000027220105 Nurhudayah Zaini jl. Srijaya P 56 Th P 1
23-Dec-15 671 0000027094487 Zulkarnain lr. Damar L 50 Th P 1
23-Dec-15 305 0000324979852 Sela wani jl. Kasnariansyah P 12 Th A 1
23-Dec-15 305 0000324979852 Seli wani jl. Kasnariansyah P 12 Th A 1
23-Dec-15 2393 0000026252537 Heri Astaman jl. Jendral sudirman L 53 Th P 1
23-Dec-15 971 0001799224661 Alpian Jl. Let murod L 20 Th P 1
23-Dec-15 2153 0001868597796 Ellis komala sari jl. Let murod rt.13 P 46 Th P `
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15
23-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JAMKE
Control post OP Swasta 085367505494 23-Dec-15 305 0000324979852 Sela wani Jumadi jl. Kasnariansyah
HT PNS 0416896 23-Dec-15 305 0000324979852 Seli wani Jumadi jl. Kasnariansyah
RS. Mata/Mata/459 Sakit mata IRT 23-Dec-15
DM 23-Dec-15
Deramttos Wiraswasta 082182313942 23-Dec-15
HHD 23-Dec-15
Demam Wiraswasta 23-Dec-15
DM GURU 085279045420 23-Dec-15
Nyeri hidung PNS 23-Dec-15
HT Wiraswasta 081908730795 23-Dec-15
Gastrits PNS 081238317793 23-Dec-15
Sakit gigi IRT 082182847185 23-Dec-15
Anisimetropia GURU 081367219525 23-Dec-15
HHD PNS 08127314000 23-Dec-15
Sakit gigi PNS 081278273400 23-Dec-15
Alergi IRT 081367929202 23-Dec-15
Sakit gigi PNS 081272139933 23-Dec-15
Dermatts GURU 081278427094 23-Dec-15
Nyeri sendi GURU 081271515975 23-Dec-15
Cabut gigi Wiraswasta 08197891091 23-Dec-15
Suntk KB IRT 0711416896 23-Dec-15
HHD Advokat 08127836575 23-Dec-15
Rs. Bhayangkara/THT/182 Sakit telinga PNS 085366832101 23-Dec-15
Sakit gigi GURU 23-Dec-15
Nyeri perut 23-Dec-15
Pusing 23-Dec-15
RA IRT 081273700924 23-Dec-15
RA IRT 0711410750 23-Dec-15
Dermatts IRT '085268024650 23-Dec-15
Suntk KB 23-Dec-15
HT PNS 082183411150
Demam 085269509881
Sakit gigi wiraswasta
Cabut gigi IRT 0711416896
ANC PNS 081274220721
Sakit perut IRT
Cabut gigi PNS 081278253485
Sakit gigi 085379024961
ISPA IRT 085269509881
Mata kabur IRT 082182666334
RA GURU 081373729557
DM
Tampal gigi
Tampal gigi
Sakit mata PNS 08127845912
Tubercolosi
UJUKAN JAMKESMAS
ATU
2015
Ruangan
P 12 Th A 1 Tampal gigi
P 12 Th A 1 Tampal gigi

1 26-Dec-15 0001276515674 Rosidah P 59 Th RA 1.

2 26-Dec-15 0000025979275 Linda marlina P 37 Th ISPA 2.
3 26-Dec-15 0000025979308 Albi rizki L 8 Th ISPA 3.
4 26-Dec-15 0000025979286 Mukminin L 38 Th ISPA 4.
5 26-Dec-15 0001279034842 RA Mainiar P 50 Th HT 5.
6 26-Dec-15 0000028941341 Suharsono L 56 Th Diare 6.
7 26-Dec-15 '0001505668037 Fitri purnamasari P 25 Th ASMA 7.
8 26-Dec-15 0000027039352 Yuniar p 60 Th RA 8.
10 26-Dec-15 0001646028753 Sadarlina P 35 Th Sakit telinga 10
11 26-Dec-15 0000324785632 Rukaya P 15 Th Sakit mata 11.
12 26-Dec-15 0000027384412 Herlina P 50 Th sakit gigi 12.
13 26-Dec-15 0001505458078 Patriyani palarestu S P 10 Th cabut gigi 13.
14 26-Dec-15 0 0 0 0 0 14.
15 26-Dec-15 0 0 0 0 0 15.
16 26-Dec-15 0 0 0 0 0 16.
17 26-Dec-15 0 0 0 0 0 17.
18 26-Dec-15 0 0 0 0 0 18.
19 26-Dec-15 0 0 0 0 0 19.
20 26-Dec-15 0 0 0 0 0 20.
21 26-Dec-15 0 0 0 0 0 21.
22 26-Dec-15 0 0 0 0 0 22.
23 26-Dec-15 0 0 0 0 0 23.
24 26-Dec-15 0 0 0 0 0 24.
25 26-Dec-15 0 0 0 0 0 25.
26 26-Dec-15 0 0 0 0 0 26.
27 26-Dec-15 0 0 0 0 0 27.
28 26-Dec-15 0 0 0 0 0 28.
29 26-Dec-15 0 0 0 0 0 29.
30 26-Dec-15 0 0 0 0 0 30.

31 26-Dec-15 0 0 0 0 0 31
32 26-Dec-15 0 0 0 0 0 32
33 26-Dec-15 0 0 0 0 0 33.
34 26-Dec-15 0 0 0 0 0 34.
35 26-Dec-15 0 0 0 0 0 35.
36 26-Dec-15 0 0 0 0 0 36.
37 26-Dec-15 0 0 0 0 0 37.
38 26-Dec-15 0 0 0 0 0 38.
39 26-Dec-15 0 0 0 0 0 39.
40 26-Dec-15 0 0 0 0 0 40.
41 26-Dec-15 0 0 0 0 0 41.
42 26-Dec-15 0 0 0 0 0 42.
43 26-Dec-15 0 0 0 0 0 43.
44 26-Dec-15 0 0 0 0 0 44.
45 26-Dec-15 0 0 0 0 0 45.
46 26-Dec-15 0 0 0 0 0 46.
47 26-Dec-15 0 0 0 0 0 47.
48 26-Dec-15 0 0 0 0 0 48.
49 26-Dec-15 0 0 0 0 0 49.
50 26-Dec-15 0 0 0 0 0 50.
51 26-Dec-15 0 0 0 0 0 51.
52 26-Dec-15 0 0 0 0 0 52.
53 26-Dec-15 0 0 0 0 0 53.
54 26-Dec-15 0 0 0 0 0 54.
55 26-Dec-15 0 0 0 0 0 55.
56 26-Dec-15 0 0 0 0 0 56.
57 26-Dec-15 0 0 0 0 0 57.
58 26-Dec-15 0 0 0 0 0 58.
59 26-Dec-15 0 0 0 0 0 59.
60 26-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
26-Dec-15 29 0001276515674 Rosidah Jl. Aman P 59 Th P 1

26-Dec-15 0000025979275 Linda marlina Jl. Mandi api P 37 Th P 1
26-Dec-15 0000025979308 Albi rizki Jl. Mandi api L 8 Th A 1
26-Dec-15 0000025979286 Mukminin Jl. Mandi api L 38 Th P 1
26-Dec-15 1111 0001279034842 RA Mainiar lr. Biga P 50 Th I 1
26-Dec-15 110 0000028941341 Suharsono Jl. Let murod L 56 Th P 1
26-Dec-15 2101 '0001505668037 Fitri purnamasari jl. Kasnariansyah P 25 Th I 1
26-Dec-15 1744 0000027039352 Yuniar lr. Kota baru p 60 Th I 1
26-Dec-15 2255 0000026049339 Tibroni talang ratu L 51 Th P 1
26-Dec-15 2009 0001646028753 Sadarlina Jl. Let murod P 35 Th I 1
26-Dec-15 290 0000324785632 Rukaya lr. Rambutan P 15 Th A 1
26-Dec-15 1775 0000027384412 Herlina jl. Balayudha P 50 Th P 1
26-Dec-15 1255 0001505458078 Patriyani palarestu S Jl. Kasnariansyah P 10 Th A 1
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
BULAN : DESEMBER
Ruangan
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15
26-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JAMKES
BULAN : DESEMBER
RA GURU
ISPA
ISPA
ISPA
HT
Diare
ASMA
RA
HT
Sakit telinga
Sakit mata
sakit gigi PNS 08127347703
cabut gigi
UJUKAN JAMKESMAS
ATU
ER
Ruangan

1 28-Dec-15 0000026921294 Hj. Naila P 58 Th Hypertensi 1.

2 28-Dec-15 0000026729921 Abu yani L 75 Th HT 2.
3 28-Dec-15 0001437980499 Unag supriatna L 68 Th Batuk2 3.
4 28-Dec-15 0000027091923 Rulia rismawat P 41 Th DM 4.
5 28-Dec-15 0001456276465 Bambang Sulistono L 55 Th HT 5.
6 28-Dec-15 0000026015062 Sit komarin P 47 Th HHD 6.
7 28-Dec-15 0001335892048 M. Fahri L 2,1 Th Panas 7.
8 28-Dec-15 '0000026650686 Rodiah P 71 Th RA 8.
9 28-Dec-15 0001327559782 Teni purwaningsih P 26 Th Tampal gigi 9.
10 28-Dec-15 0000026817592 drs. Turas zahri m ano L 72 Th Sakit mata 10
11 28-Dec-15 0001261846258 Maria ulfa P 54 Th HT 11.
12 28-Dec-15 0000026961715 Sumiat P 58 Th RA 12.
13 28-Dec-15 0000027039058 M. Arief L 20 Th ISPA 13.
14 28-Dec-15 0001307568273 Muflihahdini P 16 Th Diare 14.
15 28-Dec-15 0000027039159 Sumiyat P 53 Th Tampal gigi 15.
16 28-Dec-15 0001839223539 Sri asyuni p 51 Th Mata kabur 16.
17 28-Dec-15 0000204435009 Desiana P 38 Th Tampal gigi 17.
18 28-Dec-15 0000026941274 Supardi L 63 Th HHD 18.
19 28-Dec-15 0000026024624 Syahrizal irfan L 51 Th HHD 19.
20 28-Dec-15 0000025578213 Yulinar P 42 Th ANC 20.
21 28-Dec-15 0000169626576 M. Firmansyah L 53 Th HHD 21.
23 28-Dec-15 0000202833189 Sunart P 65 Th control post op 23.
24 28-Dec-15 0000027036786 Maisaroh p 49 Th Stroke 24.
25 28-Dec-15 0000026339196 M. Syubli L 60 Th Mata kabur 25.
26 28-Dec-15 0001871541022 Seta zuheni P 21 Th Mata kabur 26.
27 28-Dec-15 0000026635241 Agusnar p 77 th Mata kabur 27.
28 28-Dec-15 0000027094026 Maryuni P 47 Th sakit hidung 28.
29 28-Dec-15 0000026357826 Sit saripah P 72 Th HT 29.
30 28-Dec-15 0000026166363 Desen Yulis L 60 Th HHD 30.

31 28-Dec-15 0000027106885 Nurhani P 58 Th RA 31
32 28-Dec-15 0000201264219 Sit luthfia P 14 Th Mata kabur 32
33 28-Dec-15 0001871548042 Sepriyant P 34 Th HT 33.
34 28-Dec-15 0000025860611 Ahzahari L 40 Th Benjolan dipunggung 34.
35 28-Dec-15 0000992534433 Ningcik P 57 Th gatel-gatel 35.
36 28-Dec-15 0000025697608 Tamrin L 58 Th Benjolan di paha 36.
37 28-Dec-15 0000025872726 Novrizal L 36 Th HT 37.
38 28-Dec-15 0000025659257 Muzakir L 51 Th HHD 38.
39 28-Dec-15 0001792690582 Ahmda Yulizar L 49 Th Sakit perut 39.
40 28-Dec-15 0000026924253 Imron L 65 th Pusing 40.
41 28-Dec-15 0000026559865 Alimar Jailani L 73 Th Asma 41.
42 28-Dec-15 0001438134243 Sidi Mahyunis L 74 th Prostat 42.
43 28-Dec-15 0000026656686 Robiah P 71 Th Nyeri Sendi 43.
44 28-Dec-15 0001873913646 Nirwana P 53 ThnNyeri Sendi 44.
45 28-Dec-15 0001901260912 Ica sucitra L 26Th kista 45.
46 28-Dec-15 0001327558397 Wiwik P 56 ThnPusing 46.
47 28-Dec-15 0000026964044 Armiat P 53 Th Pusing 47.
48 28-Dec-15 0001446073852 Fadli L 35 Th Gigi 48.
49 28-Dec-15 0001868880475 Fata Nada Almira P 1 bln Pebris 49.
50 28-Dec-15 0001438134243 Raka L 10 Th Mata 50.
51 28-Dec-15 000027102396 Kasmaboty P 55 ThnSakit perut 51.
52 28-Dec-15 0000026681332 Tahzabiyah P 71 Th HHD 52.
53 28-Dec-15 0001390674126 Alan Mubaki L 12 Th benjolan 53.
54 28-Dec-15 0001450267525 Maryama P 55 ThnHT 54.
55 28-Dec-15 0000324318791 Rizka Putri P 6 Thn Ispa 55.
56 28-Dec-15 0000324317182 Elwarni P 46 ThnIspa 56.
57 28-Dec-15 0000324316811 Edwar L 51 Th HT 57.
58 28-Dec-15 0000026996725 Nurbaity P 39 Th Sakit telinga 58.
59 28-Dec-15 0000025841002 Zuhirman L 45 ThnIspa 59.
60 28-Dec-15 0001269081821 Fatna Zahra L 7 Th Ispa 60.


61 28-Dec-15 00003235188371 Oktariansyah L 9 Th ASMA 61.
62 28-Dec-15 0000324755919 Santuri L 48 Th ISPA 62.
63 28-Dec-15 0000992537076 Hevizar L 35 Th Tampal gigi 63.
64 28-Dec-15 0000324369674 Samani L 68 Th Dermatts 64.
65 28-Dec-15 0000325174149 Yuli P 17 Th Demam 65.
66 28-Dec-15 0000325115278 Ida P 13 Th Sakit mata 66.
67 28-Dec-15 0000325174601 Nur R P 9 Th Demam 67.
68 28-Dec-15 0000324979424 Aisyah P 70 Th HT 68.
69 28-Dec-15 0000026015062 Wardiah P 48 Th gigi 69.
70 28-Dec-15 0001335892048 Raihan L 8 th Muntah 70
71 28-Dec-15 '0000026650686 Zulkarnain L 47 Th HT 71.
72 28-Dec-15 0001327559782 Nuriah P 35 th Ispa 72.
73 28-Dec-15 0000026817592 M. Gilang L 12 Th Panas 73.
74 28-Dec-15 0001261846258 Fathan Alizar L 11 Th Sariaswan 74.
75 28-Dec-15 0001261846259 Nurbaini P 43 Th Sakit Mata 75.
76 28-Dec-15 0000324316811 Edwar L 51 Th Stomatts 76.
77 28-Dec-15 0000202833189 Sunart P 48 Th HT 77.
78 28-Dec-15 0000027036786 Maisaroh P 55 Th HT 78.
79 28-Dec-15 0000026339196 M. Syubli L 60 Th HHD 79.
80 28-Dec-15 0001871541022 Seta zuheni P 37 Th ISPA 80.
81 28-Dec-15 0 Nuriah 0 0 81.
82 28-Dec-15 0 M. Gilang 0 0 82.
83 28-Dec-15 0 Fathan Alizar 0 0 83.
84 28-Dec-15 0000324738167 Nurbaini 0 0 84.
85 28-Dec-15 0000324316811 Edwar 0 0 85.
86 28-Dec-15 0 0 0 0 86.
87 28-Dec-15 0 0 0 0 87.
88 28-Dec-15 0 0 0 0 88.
89 28-Dec-15 0 0 0 0 89.
90 28-Dec-15 0 0 0 0 90.
Ruangan
28-Dec-15 1 0000026921294 Hj. Naila Jl Perindustrian I P 58 Th I 1

28-Dec-15 702 0000026729921 Abu yani jl. Kasnariansyah rtr.06 L 75 Th P 1
28-Dec-15 836 0001437980499 Unag supriatna komp. Bougenvile L 68 Th P 1
28-Dec-15 274 0000027091923 Rulia rismawat jl. SB 2 P 41 Th I 1
28-Dec-15 625 0001456276465 Bambang Sulistono jl. Kasnariansyah L 55 Th P 1
28-Dec-15 63 0000026015062 Sit komarin jl. Let murod P 47 Th P 1
28-Dec-15 2395 0001335892048 M. Fahri jl. Akbp h umar L 2,1 Th A 1
28-Dec-15 1696 '0000026650686 Rodiah talang betutu P 71 Th I 1
28-Dec-15 2397 0001327559782 Teni purwaningsih jl. Kasna P 26 Th A 1
28-Dec-15 494 0000026817592 drs. Turas zahri m ano talang ratu L 72 Th P 1
28-Dec-15 81 0001261846258 Maria ulfa lr. Pelita P 54 Th I 1
28-Dec-15 893 0000026961715 Sumiat jl. Ketahun P 58 Th P 1
28-Dec-15 2399 0000027039058 M. Arief Jl. Mawar L 20 Th A 1
28-Dec-15 2400 0001307568273 Muflihahdini jl. Naskah P 16 Th A 1
28-Dec-15 1658 0000027039159 Sumiyat jl. Akbp h umar P 53 Th P 1
28-Dec-15 633 0001839223539 Sri asyuni jl. SB 1 p 51 Th I 1
28-Dec-15 1548 0000204435009 Desiana lr. Kota baru P 38 Th P 1
28-Dec-15 1229 0000026941274 Supardi lr. Biga L 63 Th P 1
28-Dec-15 1951 0000026024624 Syahrizal irfan jl. Sedap malam L 51 Th P 1
28-Dec-15 1743 0000025578213 Yulinar jl. Mandi api P 42 Th I 1
28-Dec-15 660 0000169626576 M. Firmansyah jl. Let murod L 53 Th S 1
28-Dec-15 2010 0000202833189 Sunart Jl.Naskah P 65 Th I 1
28-Dec-15 398 0000027036786 Maisaroh komp sd 43 p 49 Th P 1
28-Dec-15 2402 0000026339196 M. Syubli talang ratu L 60 Th P 1
28-Dec-15 2404 0001871541022 Seta zuheni jl. Talang ratu P 21 Th A 1
28-Dec-15 949 0000026635241 Agusnar jl. SB 2 p 77 th P 1
28-Dec-15 461 0000026357826 Sit saripah jl. naskah P 72 Th I 1
28-Dec-15 753 0000026166363 Desen Yulis jl. Kasnariansyah L 60 Th P 1
Ruangan
28-Dec-15 1842 0000027106885 Nurhani jl. Kebun bunga P 58 Th I 1

28-Dec-15 2391 0000201264219 Sit luthfia jl. Tanjuung api2 P 14 Th A 1
28-Dec-15 2319 0001871548042 Sepriyant lr. Biga P 34 Th P 1
28-Dec-15 415 0000025860611 Ahzahari jl. Talang ratu L 40 Th P 1
28-Dec-15 536 0000025697608 Tamrin jl. SB 2 L 58 Th P 1
28-Dec-15 2409 0000025872726 Novrizal jl. SB I rt 24 L 36 Th P 1
28-Dec-15 2293 0000025659257 Muzakir Komp Griya rt 4 L 51 Th P 1
28-Dec-15 1231 0001792690582 Ahmda Yulizar Jl. Srijaya rt 6 L 49 Th 1
28-Dec-15 1078 0000026924253 Imron Jl. Naskah L 65 th 1
28-Dec-15 870 0000026559865 Alimar Jailani Jl. Let Murod L 73 Th 1
28-Dec-15 2394 0001438134243 Sidi Mahyunis Lr. Limas L 74 th 1
28-Dec-15 1686 0000026656686 Robiah Jl. Kasna P 71 Th 1
28-Dec-15 2261 0001873913646 Nirwana Lr. Tanjung P 53 Thn 1
28-Dec-15 2396 0001901260912 Ica sucitra perumahan rakyat L 26Th P 1
28-Dec-15 2398 0001327558397 Wiwik Jl. Let Murod P 56 Thn 1
28-Dec-15 2383 0000026964044 Armiat Jl. Let Murod P 53 Th
28-Dec-15 1564 0001446073852 Fadli Jl. Balayudha L 35 Th 1
28-Dec-15 1943 0001868880475 Fata Nada Almira Jl. Kenanga P 1 bln 1
28-Dec-15 2401 0001438134243 Raka Jl. Let Murod L 10 Th 1
28-Dec-15 478 000027102396 Kasmaboty Jl. Naskah P 55 Thn 1
28-Dec-15 393 0000026681332 Tahzabiyah Lr. Kota Baru P 71 Th
28-Dec-15 2376 0001390674126 Alan Mubaki Jl. Tanah Mas L 12 Th 1
28-Dec-15 37 0001450267525 Maryama JL. Padat Karya P 55 Thn 1
28-Dec-15 14 0000324318791 Rizka Putri Jl. Ariodillah P 6 Thn 1
28-Dec-15 70 0000324317182 Elwarni Jl. Ariodillah P 46 Thn 1
28-Dec-15 70 0000324316811 Edwar Jl. Ariodillah L 51 Th 1
28-Dec-15 2403 0000026996725 Nurbaity Jl. T Kelapo P 39 Th 1
28-Dec-15 1002 0000025841002 Zuhirman Jl. Kasna L 45 Thn 1
28-Dec-15 905 0001269081821 Fatna Zahra Jl. Kasna L 7 Th 1

BULAN : DESEMBER
Ruangan
28-Dec-15 590 0000026945638 Roaini Jl. Let Murod P 78 Thn 1

2405 0001887303464 M. Dzaky Jl. Macam Kumbang L 12 Th 1
283 0000020171969 Usmaidar Jl. R Kemuning P 69 th 1
2407 0001882762222 Vera Anggraini Jl. Let Murod Lr Biga P 32 Thn 1
271 0000026321512 Amrizal Jl. Perumdam L 47 Th 1
795 0001831448575 Malik Jl. Perumdam L 8 Th 1
2408 0001882762222 Ema Mayang sari Jl. Gotong royong no 1889 P 27 Th I 1
305 0000324979424 Seli wani Jl. Let Kasna P 12 Th P 1
0000204435009 Desiana jl. Let murod P 39 Th P 1
306 00003235188371 Oktariansyah
263 0000324755919 Santuri
308 0000992537076 Hevizar
24 0000324369674 Samani
195 0000325174149 Yuli
215 0000325115278 Ida
66 0000325174601 Nur R
242 Aisyah
46 Wardiah
3 Raihan
309 Zulkarnain
119 Nuriah
119 M. Gilang
106 Fathan Alizar
76 0000324738167 Nurbaini
102 0000324316811 Edwar
BULAN : DESEMBER
RS. BHAYANGKARA/PDL/709 Hypertensi IRT 306 00003235188371 Oktariansyah Royani jl. Anggrek
HT PNS 085382584064 263 0000324755919 Santuri ybs jl. Ariodillah
RS. Bhayngkara/PDL/710 Batuk2 swasta 081367255769 308 0000992537076 Hevizar M. Abuzar jl. Let murod
Rs. Bhyangkara/PDL/715 DM IRT 081278684573 24 0000324369674 Samani ybs lr. Rambutan
HT 195 0000325174149 Yuli hendri jl. Let murod
HHD IRT 0819684956 215 0000325115278 Ida mat sani jl. Let murod
RS. Bunda/Anak/721 Panas 085279728823 66 0000325174601 Nur R Supardi jl. Let murod
RA PNS 242 Aisyah Jl. Let Murod
Tampal gigi Guru 08526862329+0 46 Wardiah Johan jl. Let murod
Sakit mata Pensiun PNS 081273756028 3 Raihan Hermansyah jl. Kanariansyah
RS. MATA/MATA/731 HT IRT 081368860846 309 Zulkarnain Jl. Ariodillah
RA IRT 085216051771 119 Nuriah M. Yani jl. Let murod
ISPA 089930505171 119 M. Gilang M. Yani jl. Let murod
Diare 081273573995 106 Fathan Alizar M. Ali Jl. Rambutan rw 5
Tampal gigi guru 081271786140 76 0000324738167 Nurbaini M. Ali Lr rambutan rw 5
RS. MATA/MATA/734 Mata kabur IRT 085233342294 102 0000324316811 Edwar Edwar Jl. Ariodilah
Tampal gigi GURU 081373732221
HHD PNS 08127872330
HHD PNS 082175389463
RS. Bunda/Gyn/749 ANC PNS 085268880007
RS. Bhayangkara/Jantung/740 HHD Swasta 08127803701
RS. BHAYANGKARA/KULIT/742 Dermatts '085268024650
RS. Mata/Mata/745 control post op IRT 082178830115
Stroke
Mata kabur PNS 081995121995
RS. MATA/MATA/751 Mata kabur swasta 085368519494
Mata kabur
RS. MYRIA/THT/753 sakit hidung GURU 085323087296
HT IRT 081268321290
RS. BHAYANGKARA/THT/747 RA GURU 085379024961

Mata kabur 085379024961
HT
Rs. Bhayangkara/Bedah/72 Benjolan dipungguPNS 085368949788
gatel-gatel Swasta 081367129918
RSIA GRAHA MANDIRI/BEDAH/761 Benjolan di paha PNS 08127357207
HT pns
RS. MYRIA/PDL/711 HHD Pns 081367345892
Sakit perut
RS. BHAYANGKARA/PDL/714 Pusing
rs. Bhayangkara/PDL/716 Asma pns
Prostat
Nyeri Sendi Irt
RS. Bhyangkara/PDL/722 Nyeri Sendi Irt 0711413310
kista Irt 085377248464
Pusing Irt 085378585200
Pusing Irt
Gigi Wiraswasta
Pebris
Mata
Rs. Bhayangkara/Obgy/738 Sakit perut Guru 081278427094
HHD
RS. MYRIA/BEDAH/743 benjolan 081290520976
HT Irt 085368008896
Ispa
Ispa
HT
Rs. Bhayangkara/THT/747 Sakit telinga irt 082374301768
Ispa
Ispa

Telp
RA Irt
081276152208
Sakit Mata Irt 081273730075
RS. MATA/MATA/770 Sakit Mata
Alergi
Rs. Bunda/Obgy/774 Pendarahan pervaginam
RS. BHAYANGKARA/GIGI/741 Sakit gigi

UJUKAN JAMKESMAS
ATU
ER
Ruangan
L 9 Th A 1 RS. BHAYANGKARA/ANAK/713 ASMA 085219242028

L 48 Th P 1 ISPA Buruh 08526829794
L 35 Th A 1 Tampal gigi
L 68 Th P 1 Dermatts swasta 081279305150
P 17 Th A 1 Demam
P 13 Th A 1 Sakit mata
P 9 Th A 1 Demam
P 70 Thn P 1 HT
P 48 Th 1 gigi 085366621953
L 8 th 1 Muntah
L 47 Th 087897757827
P 35 th I 1 Ispa
L 12 Th A 1
L 11 Th A 1 Sariaswan
P 43 Th I 1 Sakit Mata
L 51 th P 1 Gigi

1 29-Dec-15 0000171980616 Ayuhanis P 52 Th DM 1.

2 29-Dec-15 0000026349704 Ragil barokah L 12 Th Muntah-muntah 2.
3 29-Dec-15 0001324657517 Rahmat febriansyah L 33 Th Skizofrenia 3.
4 29-Dec-15 0000026172369 Nurhapanis idris P 47 Th HT 4.
5 29-Dec-15 0000026818931 hj. Sismaiyat P 62 Th DM 5.
6 29-Dec-15 0001278153562 Yudit indriyani P 40 Th DM 6.
7 29-Dec-15 0001482471224 M. Radja Rizki L 8 Th Cabut gigi 7.
8 29-Dec-15 0000025574512 Wani yuzana P 46 Th mata kabur 8.
9 29-Dec-15 0000025574512 Efendi Arifin L 48 Th mata kabur 9.
10 29-Dec-15 0000026648987 Rusnia simatupang P 64 Th HHD 10
11 29-Dec-15 0000027038283 Cik nayu ruslan P 55 Th Dermatts 11.
12 29-Dec-15 0001326342554 Ifan julleo L 19 Th Sakit gigi 12.
13 29-Dec-15 0000164546425 Ningyuna P 65 Th DM 13.
14 29-Dec-15 0001173281602 Saskia P 8 Th Sakit gigi 14.
16 29-Dec-15 0001446073852 Fadli L 34 Th Sakit gigi 16.
17 29-Dec-15 0000027354115 Rusnawaty umar P 65 Th HT 17.
19 29-Dec-15 0001801916032 Felicia Dwi putri P 3 Th Sakit gigi 19.
20 29-Dec-15 0001801915953 fadhlan wirhakim L 5 Th diare 20.
21 29-Dec-15 0000026678452 Wasik P 67 Th HHD 21.
22 29-Dec-15 0000026808772 tjikya L 67 Th DM 22.
23 29-Dec-15 0000025552923 Minggu astut P 49 Th Sakit gigi 23.
24 29-Dec-15 0000027129058 Sawirul P 51 Th Sakit gigi 24.
25 29-Dec-15 0000025966271 Dra. Yuspanizar P 51 Th HHD 25.
26 29-Dec-15 0000026739933 Asiyah P 76 Th HHD 26.
27 29-Dec-15 0000026916434 Nurtaty P 60 Th HHD 27.
28 29-Dec-15 0001261379902 Tasniah P 65 Th HHD 28.
29 29-Dec-15 0000201264219 Sit luthfia P 14 Th Mata kabur 29.
30 29-Dec-15 0000025286512 Ermawat P 55 Th HHD 30.

31 29-Dec-15 0001204977519 Rusmiyats P 50 Th Sakit mata 31
32 29-Dec-15 0000026817917 Drs. H. M. Ali mansyur L 78 Th Sakit tenggorokan 32
33 29-Dec-15 0001284852295 Emy Apriyant P 41 Th Pusing 33.
34 29-Dec-15 0000026060411 Sutarman L 52 Th HT 34.
35 29-Dec-15 0000026041318 Rustam effendi L 56 Th Katarak 35.
36 29-Dec-15 0001827950253 Eni Pusri P 38 Th Routne post part 36.
37 29-Dec-15 0001901260912 Icha sucitra P 26 Th Kista 37.
38 29-Dec-15 0000026938438 Panut P 65 Th Gatel2 38.
39 29-Dec-15 0000027039306 Yat Didi P 65 Th RA 39.
40 29-Dec-15 0001437259195 Kartni P 25 Th Sakit tenggorokan 40.
41 29-Dec-15 0001458203758 Nurlina P 57 Th HT 41.
42 29-Dec-15 0000992536683 Suparmi P 67 Th HHD 42.
43 29-Dec-15 0000324961299 Sunaini P 54 Th HT 43.
44 29-Dec-15 0000992536479 Ahmad yani L 52 Th HT 44.
45 29-Dec-15 0000326084297 Tamara P 6 Th Cabut gigi 45.
46 29-Dec-15 0000324150647 Ahmad Gandi L 41 Th Pusing 46.
47 29-Dec-15 0000201264219 Sit luthfia p 12 Th Mata kabur 47.
48 29-Dec-15 0 0 0 0 0 48.
49 29-Dec-15 0 0 0 0 0 49.
50 29-Dec-15 0 0 0 0 0 50.
51 29-Dec-15 0 0 0 0 0 51.
52 29-Dec-15 0 0 0 0 0 52.
53 29-Dec-15 0 0 0 0 0 53.
54 29-Dec-15 0 0 0 0 0 54.
55 29-Dec-15 0 0 0 0 0 55.
56 29-Dec-15 0 0 0 0 0 56.
57 29-Dec-15 0 0 0 0 0 57.
58 29-Dec-15 0 0 0 0 0 58.
59 29-Dec-15 0 0 0 0 0 59.
60 29-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
29-Dec-15 804 0000171980616 Ayuhanis jl. Tj raya P 52 Th P 1

29-Dec-15 2410 0000026349704 Ragil barokah lr. Damar L 12 Th A 1
29-Dec-15 273 0001324657517 Rahmat febriansyah jl. Kasna L 33 Th P 1
29-Dec-15 343 0000026172369 Nurhapanis idris jl. Let murod no.35 P 47 Th P 1
29-Dec-15 512 0000026818931 hj. Sismaiyat jl. Let murod no.35 P 62 Th I 1
29-Dec-15 3 0001278153562 Yudit indriyani jl. Kol. H burlian P 40 Th I 1
29-Dec-15 2412 0001482471224 M. Radja Rizki jl. Sosial no.420 L 8 Th A 1
29-Dec-15 2414 0000025574512 Wani yuzana jl. Tri sukses P 46 Th i 1
29-Dec-15 2415 0000025574512 Efendi Arifin jl. Tri sukses L 48 Th P 1
29-Dec-15 1630 0000026648987 Rusnia simatupang jl. Let murod P 64 Th P 1
29-Dec-15 688 0000027038283 Cik nayu ruslan jl. Belimbing P 55 Th P 1
29-Dec-15 491 0001326342554 Ifan julleo jl. Let murod L 19 Th A 1
29-Dec-15 2411 0000164546425 Ningyuna Jl. Perumdam P 65 Th P 1
29-Dec-15 2343 0001173281602 Saskia jl. Kasnariansyah lr. Mustakim P 8 Th A 1
29-Dec-15 1564 0001446073852 Fadli jl. Balayudha L 34 Th P 1
29-Dec-15 1423 0000027354115 Rusnawaty umar jl. Sosial P 65 Th P 1
29-Dec-15 2365 000027024906 Yogi pratama jl. Srijaya rt.23 L 14 Th A 1
29-Dec-15 127 0001801916032 Felicia Dwi putri jl. Papara P 3 Th A 1
29-Dec-15 125 0001801915953 fadhlan wirhakim jl. Papara L 5 Th A 1
29-Dec-15 571 0000026678452 Wasik jl. Kol. H burlian P 67 Th P 1
29-Dec-15 570 0000026808772 tjikya jl. Kol. H burlian L 67 Th i 1
29-Dec-15 958 0000025552923 Minggu astut jl. Tri sukses P 49 Th P 1
29-Dec-15 1964 0000027129058 Sawirul jl. R Kemuninga P 51 Th P 1
29-Dec-15 647 0000025966271 Dra. Yuspanizar jl. Kasnariansyah rt.14 P 51 Th I 1
29-Dec-15 648 0000026739933 Asiyah Jl. Kasnariansyah P 76 Th I 1
29-Dec-15 170 0000026916434 Nurtaty jl. Srijaya P 60 Th I 1
29-Dec-15 747 0001261379902 Tasniah jl. Akbp h umar P 65 Th P 1
29-Dec-15 2391 0000201264219 Sit luthfia jl. Tanjuung api2 P 14 Th A 1
29-Dec-15 1367 0000025286512 Ermawat jl. Kasnariansyah P 55 Th I 1
BULAN : DESEMBER
Ruangan
29-Dec-15 2406 0001204977519 Rusmiyats Jl. Kasnariansyah P 50 Th I 1

29-Dec-15 120 0000026817917 Drs. H. M. Ali mansyur jl. Let murod L 78 Th P 1
29-Dec-15 767 0001284852295 Emy Apriyant lr. Kota baru P 41 Th P 1
29-Dec-15 16 0000026060411 Sutarman jl. Ins marzuki L 52 Th P 1
29-Dec-15 2415 0000026041318 Rustam effendi jl. Kol h burlian L 56 Th P 1
29-Dec-15 0001827950253 Eni Pusri jl. Ins marzuki Lr. Irigasi P 38 Th I 1
29-Dec-15 2396 0001901260912 Icha sucitra jl perum rakyat P 26 Th I 1
29-Dec-15 2416 0000026938438 Panut Jl. SB 2 P 65 Th I 1
29-Dec-15 1437 0000027039306 Yat Didi jl. Kasnariansyah rt.16 P 65 Th P 1
29-Dec-15 1033 0001437259195 Kartni jl. Mawar P 25 Th A 1
29-Dec-15 1235 0001458203758 Nurlina jl. Talang ratu P 57 Th I 1
29-Dec-15 192 0000992536683 Suparmi jl. Ariodillah P 67 Th P 1
29-Dec-15 008 0000324961299 Sunaini jl. Let murod P 54 Th I 1
29-Dec-15 63 0000992536479 Ahmad yani jl. Jend sudirman L 52 Th P 1
29-Dec-15 310 0000326084297 Tamara jl. Mawar P 6 Th A 1
29-Dec-15 89 0000324150647 Ahmad Gandi jl. Ariodillah L 41 Th P 1
29-Dec-15 2391 0000201264219 Sit luthfia jl. Let murod p 12 Th A 1
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15
29-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
BULAN : DESEMBER
Rujukan Diagnosa Pekerjaan No HP Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK Alamat JK Usia
DM PNS 085273181568 192 0000992536683 Suparmi ybs jl. Ariodillah P 67 Th

Muntah-muntah 082179539862 008 0000324961299 Sunaini Fahrul jl. Let murod P 54 Th
Skizofrenia 63 0000992536479 Ahmad yani ybs jl. Jend sudirman L 52 Th
RS. Bhyangkara/PDL/791 HT GURU 082306388836 310 0000326084297 Tamara Carpin jl. Mawar P 6 Th
DM IRT 085669400545 89 0000324150647 Ahmad Gandi Ahmad gandijl. Ariodillah L 41 Th
DM IRT 082373906831 2391 0000201264219 Sit luthfia jl. Tanjuung P 14 Th A
Cabut gigi 085367805360
mata kabur IRT 081377666165
mata kabur PNS 081377666165
HHD IRT 082180033658
Dermatts GURU 081271298686
Sakit gigi 081278960450
DM 085279254040
Sakit gigi 081368731974
Sakit gigi
HT PNS 081367007878
RS. Mata/Mata/793 Mata kabur 081373925051
Sakit gigi
diare
HHD
RS. Bhayangkara/Jantung/804 DM
Sakit gigi PNS 08117826566
Sakit gigi 082178012526
HHD
RS. Bhayangkara/Jantung/805 HHD
RS. Bhayangkara/PDL/806 HHD IRT 08127944342
HHD IRT 085100820183
Mata kabur 085379024961
HHD IRT 085377700328
5

Sakit tenggorokan DIKNAS
Pusing 0711414235
HT PNS 081238317793
RS. Mata/Mata/819 Katarak PNS 081367535005
Routne post part IRT
Kista IRT 085377248464
Gatel2 IRT
RA Pensiun PNS
Sakit tenggorokan
HT IRT 081267751976
HHD Pedagan 082383925557
HT IRT
HT Swasta 085366648337
Cabut gigi 081245979566
Pusing buruh 085273730401
Mata kabur 0853790'085379024961
ESMAS
Ruangan
Status Rujukan Diagnosa Pekerjaan No HP
P 1 HHD Pedagang 082383925557

I 1 HT IRT
P 1 HT Swasta 085366648337
A 1 Cabut gigi 081245979566
P 1 Pusing buruh 085273730401
1 Mata kabur 085379024961

1 30-Dec-15 0000027396022 A. Zaini L 61 Th HHD 1.

2 30-Dec-15 0001204977519 Rusmiyats P 50 Th Sakit mata 2.
3 30-Dec-15 0000026707735 Ismail tahir L 70 Th Sakit gigi 3.
4 30-Dec-15 0001383596177 Azka Dapunta Wijaya L 2,2 Th Panas 4.
5 30-Dec-15 0000199597083 Hj. Rosifah azidah P 63 Th RA 5.
6 30-Dec-15 0000030213235 M. Irsyad al fahrizi L 9 Th Gatel-gatel 6.
7 30-Dec-15 0001276916038 Ferry L 40 Th ISPA 7.
8 30-Dec-15 0000026073303 Megawanah P 56 Th DM 8.
9 30-Dec-15 0000027089829 Afrita Ziarmi P 50 Th Benjolan di paha 9.
10 30-Dec-15 0001445636529 Kartni P 30 Th Periksa KB 10
11 30-Dec-15 0001862893337 Evi susant P 41 Th RA 11.
13 30-Dec-15 0000027354115 Rusnawaty umar P 65 Th DM 13.
14 30-Dec-15 0000027471846 Eni kariza p 52 Th Dermatts 14.
15 30-Dec-15 0000027542215 Rama hardiansyah L 17 Th ISPA 15.
16 30-Dec-15 0000026517611 Uswatun Hasanah P 47 Th Sakit mata 16.
17 30-Dec-15 0000026517633 Anggoro puspito L 17 Th Sakit mata 17.
18 30-Dec-15 0000027252281 Heliat P 42 Th Dermatts 18.
19 30-Dec-15 0000204604997 Neli edi L 39 Th RA 19.
20 30-Dec-15 0000026832464 Zuryat P 65 Th ISPA 20.
21 30-Dec-15 0001278692144 M. Rafif khairi L 6 Th ISPA 21.
22 30-Dec-15 000127869444 M. Aufa ibnu L 4 Th ISPA 22.
23 30-Dec-15 0001888469739 Novi jumiyant P 28 Th Kontrol KB 23.
24 30-Dec-15 0000324371823 Asiah P 72 Th RA 24.
25 30-Dec-15 0000324869668 Reza pebriant P 14 Th Dermatts 25.
26 30-Dec-15 0001445636529 Kartni P 30 Th Periksa KB 26.
27 30-Dec-15 0 0 0 0 0 27.
28 30-Dec-15 0 0 0 0 0 28.
29 30-Dec-15 0 0 0 0 0 29.
30 30-Dec-15 0 0 0 0 0 30.
BULAN : DESEMBER 2015

31 30-Dec-15 0 0 0 0 0 31
32 30-Dec-15 0 0 0 0 0 32
33 30-Dec-15 0 0 0 0 0 33.
34 30-Dec-15 0 0 0 0 0 34.
35 30-Dec-15 0 0 0 0 0 35.
36 30-Dec-15 0 0 0 0 0 36.
37 30-Dec-15 0 0 0 0 0 37.
38 30-Dec-15 0 0 0 0 0 38.
39 30-Dec-15 0 0 0 0 0 39.
40 30-Dec-15 0 0 0 0 0 40.
41 30-Dec-15 0 0 0 0 0 41.
42 30-Dec-15 0 0 0 0 0 42.
43 30-Dec-15 0 0 0 0 0 43.
44 30-Dec-15 0 0 0 0 0 44.
45 30-Dec-15 0 0 0 0 0 45.
46 30-Dec-15 0 0 0 0 0 46.
47 30-Dec-15 0 0 0 0 0 47.
48 30-Dec-15 0 0 0 0 0 48.
49 30-Dec-15 0 0 0 0 0 49.
50 30-Dec-15 0 0 0 0 0 50.
51 30-Dec-15 0 0 0 0 0 51.
52 30-Dec-15 0 0 0 0 0 52.
53 30-Dec-15 0 0 0 0 0 53.
54 30-Dec-15 0 0 0 0 0 54.
55 30-Dec-15 0 0 0 0 0 55.
56 30-Dec-15 0 0 0 0 0 56.
57 30-Dec-15 0 0 0 0 0 57.
58 30-Dec-15 0 0 0 0 0 58.
59 30-Dec-15 0 0 0 0 0 59.
60 30-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
30-Dec-15 2120 0000027396022 A. Zaini jl. Let murod rt.02 L 61 Th P 1

30-Dec-15 2406 0001204977519 Rusmiyats Jl. Kasnariansyah P 50 Th I 1
30-Dec-15 703 0000026707735 Ismail tahir jl. Wayhitam L 70 Th P 1
30-Dec-15 900 0001383596177 Azka Dapunta Wijaya jl. Mandi api L 2,2 Th A 1
30-Dec-15 2418 0000199597083 Hj. Rosifah azidah jl. Let murod lr biga P 63 Th P 1
30-Dec-15 2419 0000030213235 M. Irsyad al fahrizi Jl. Let murod. Lr biga L 9 Th A 1
30-Dec-15 1881 0001276916038 Ferry jl. Let murod L 40 Th P 1
30-Dec-15 261 0000026073303 Megawanah jl. T. Melat P 56 Th I 1
30-Dec-15 1595 0000027089829 Afrita Ziarmi komp. Bougenvile P 50 Th P 1
30-Dec-15 1960 0001862893337 Evi susant lr. Pelita P 41 Th I 1
30-Dec-15 1355 0000036547841 Sahwyah jl. Srijaya P 48 Th I 1
30-Dec-15 1423 0000027354115 Rusnawaty umar jl. Sosial P 65 Th P 1
30-Dec-15 1648 0000027471846 Eni kariza Jl. SB 2 p 52 Th P 1
30-Dec-15 2420 0000027542215 Rama hardiansyah Jl. Kasnariansyah L 17 Th A 1
30-Dec-15 2421 0000026517611 Uswatun Hasanah jl. Swadaya P 47 Th P 1
30-Dec-15 2422 0000026517633 Anggoro puspito jl. Swadaya L 17 Th A 1
30-Dec-15 454 0000027252281 Heliat jl. swadaya P 42 Th P 1
30-Dec-15 1448 0000204604997 Neli edi jl. Talang kelapa L 39 Th P 1
30-Dec-15 460 0000026832464 Zuryat Jl. Kasnariansyah P 65 Th P 1
30-Dec-15 1979 0001278692144 M. Rafif khairi jl. Mawar L 6 Th A 1
30-Dec-15 1980 000127869444 M. Aufa ibnu jl. Mawar L 4 Th A 1
30-Dec-15 2041 0001888469739 Novi jumiyant jl. Gotong royong P 28 Th I 1
30-Dec-15 311 0000324371823 Asiah jl. Kasnariansyah P 72 Th I 1
30-Dec-15 105 0000324869668 Reza pebriant Jl. Let murod rt.8 P 14 Th A 1
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
Ruangan
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15
30-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN JAMKESM
BULAN : DESEMBER
Rujukan Diagnosa Pekerjaan No HP Tanggal No. Urut No. Kartu Peserta Nama Peserta Nama KK Alamat JK
RS. BHAYANGKARA/PDL/836 HHD PNS 08127862457 311 0000324371823 Asiah Asiah jl. Kasnariansyah P
Sakit mata IRT 081373072211 105 0000324869668 Reza pebriant Marjoni Jl. Let murod rt.8 P
Sakit gigi PNS 0711411629 312 0000325967185 Sherin okta rizki junaidi jl. Ariodillah P
Panas 081367471464
RA GURU 0711416014
Gatel-gatel 0711416014
ISPA Swasta 085377254690
DM IRT 081373326181
RS. Myria/Bedah/842 Benjolan di paha PNS 081312373638
Periksa KB IRT 081328528320
RA IRT 081271393374
ISPA IRT
RS. MYRIA/PDL/850 DM PNS 081367007878
Dermatts GURU 081273576324
ISPA 081279304165
RS.MATA/MATA/854 Sakit mata IRT 081273071968
Sakit mata 081273071968
Dermatts Guru 081532992933
RA PNS 085369258279
ISPA PNS 082175898155
ISPA
ISPA
Kontrol KB GURU 085764447001
RA
Dermatts
Periksa KB IRT 081328528320
AN JAMKESMAS
Ruangan
Usia Status Rujukan Diagnosa Pekerjaan No HP
72 Th I 1 RA
14 Th A 1 Dermatts
15 Th A 1 Demam 089504595693

1 31-Dec-15 0000026821945 Hj. Sit Hawa P 84 Th HT 1.

2 31-Dec-15 0000025571553 Pironika L 36 Th ANC 2.
3 31-Dec-15 0000027096794 Yuniningsih P 38 Th Mata kabur 3.
4 31-Dec-15 0001505760074 Budiman putra L 35 Th Mata kabur 4.
5 31-Dec-15 0000025607542 RD. Aca muharam L 60 Th HHD 5.
6 31-Dec-15 0001438134243 Sidi Mahyunis L 75 Th Prostat 6.
7 31-Dec-15 0000026337374 Sri Linda Lismawat P 54 Th RA 7.
8 31-Dec-15 0000027296469 Endang susilowato P 57 Th Tampal gigi 8.
9 31-Dec-15 0000027384412 Herlina P 50 Th Sakit gigi 9.
10 31-Dec-15 0000025959835 Jauhari L 54 Th Sakit gigi 10
11 31-Dec-15 0000026664129 Emiyat P 55 Th Sakit gigi 11.
12 31-Dec-15 0001284828783 Wasiat P 71 Th HHD 12.
13 31-Dec-15 0000026050735 Hasanudin L 52 Th Sakit pinggang 13.
14 31-Dec-15 0000026820437 Hj. Awaliyah P 60 Th sakit mata 14.
15 31-Dec-15 0000201570041 Rio dwi putra L 22 Th Buka pain 15.
16 31-Dec-15 0000026468278 Zainuddin L 91 Th HHD 16.
17 31-Dec-15 0001814135016 Rizky febriansyah L 5 Th demam 17.
18 31-Dec-15 0000027038237 Cik ija P 51 Th Sakit gigi 18.
19 31-Dec-15 0000027105996 Sulastri P 48 Th Gastrits 19.
20 31-Dec-15 0001868880475 Fathiah nada almira P 5 Bln Imunisasi 20.
21 31-Dec-15 0000976887426 Ernawat P 54 Th Gastrits 21.
22 31-Dec-15 0001292780889 Devi susant P 33 Th Cabut gigi 22.
23 31-Dec-15 0000026120171 Ernawat P 62 Th HHD 23.
24 31-Dec-15 0001874513079 Faiz L 3 Bln Imunisasi 24.
25 31-Dec-15 0001823257091 Betawi L 31 Th ISPA 25.
26 31-Dec-15 0001404914949 M. Ewaldo Wafi L 3 Th Pnas 26.
27 31-Dec-15 0000020171968 Usmanidar P 68 Th DM 27.
28 31-Dec-15 0000025540097 Ngatjan L 59 Th Gatel2 28.
29 31-Dec-15 0000026817592 drs. Turas zahri L 72 Th Sakit mata 29.
30 31-Dec-15 0000025663162 Titn hartat P 56 Th DM 30.

31 31-Dec-15 0000166614849 Serli marlinda P 33 Th sakit mata 31
32 31-Dec-15 0000026536555 Sutat P 58 Th RA 32
33 31-Dec-15 0001294141149 Denny saputra L 24 Th Demam 33.
34 31-Dec-15 0000026938697 Seniman zen L 63 Th DM 34.
35 31-Dec-15 0000992537076 Hevizar L 34 Th Tampal gigi 35.
36 31-Dec-15 0000324758518 Rizki lidya kinantu P 22 Th demam 36.
37 31-Dec-15 0000324932455 Inda maya Sari P 28 Th Suntk KB 37.
38 31-Dec-15 0000324172146 Mursida P 41 Th ANC 38.
39 31-Dec-15 0000325016684 Mardinono L 56 Th Glosits 39.
41 31-Dec-15 0 0 0 0 0 41.
42 31-Dec-15 0 0 0 0 0 42.
43 31-Dec-15 0 0 0 0 0 43.
44 31-Dec-15 0 0 0 0 0 44.
45 31-Dec-15 0 0 0 0 0 45.
46 31-Dec-15 0 0 0 0 0 46.
47 31-Dec-15 0 0 0 0 0 47.
48 31-Dec-15 0 0 0 0 0 48.
49 31-Dec-15 0 0 0 0 0 49.
50 31-Dec-15 0 0 0 0 0 50.
51 31-Dec-15 0 0 0 0 0 51.
52 31-Dec-15 0 0 0 0 0 52.
53 31-Dec-15 0 0 0 0 0 53.
54 31-Dec-15 0 0 0 0 0 54.
55 31-Dec-15 0 0 0 0 0 55.
56 31-Dec-15 0 0 0 0 0 56.
57 31-Dec-15 0 0 0 0 0 57.
58 31-Dec-15 0 0 0 0 0 58.
59 31-Dec-15 0 0 0 0 0 59.
60 31-Dec-15 0 0 0 0 0 60.

BULAN : DESEMBER

61 1-Dec-15 0 0 0 0 61.
62 30-Dec-99 0 0 0 0 62.
63 30-Dec-99 0 0 0 0 63.
64 30-Dec-99 0 0 0 0 64.
65 30-Dec-99 0 0 0 0 65.
66 30-Dec-99 0 0 0 0 66.
67 30-Dec-99 0 0 0 0 67.
68 30-Dec-99 0 0 0 0 68.
69 30-Dec-99 0 0 0 0 69.
70 30-Dec-99 0 0 0 0 70
71 30-Dec-99 0 0 0 0 71.
72 30-Dec-99 0 0 0 0 72.
73 30-Dec-99 0 0 0 0 73.
74 30-Dec-99 0 0 0 0 74.
75 30-Dec-99 0 0 0 0 75.
76 30-Dec-99 0 0 0 0 76.
77 30-Dec-99 0 0 0 0 77.
78 30-Dec-99 0 0 0 0 78.
79 30-Dec-99 0 0 0 0 79.
80 30-Dec-99 0 0 0 0 80.
81 30-Dec-99 0 0 0 0 81.
82 30-Dec-99 0 0 0 0 82.
83 30-Dec-99 0 0 0 0 83.
84 30-Dec-99 0 0 0 0 84.
85 30-Dec-99 0 0 0 0 85.
86 30-Dec-99 0 0 0 0 86.
87 30-Dec-99 0 0 0 0 87.
88 30-Dec-99 0 0 0 0 88.
89 30-Dec-99 0 0 0 0 89.
90 30-Dec-99 0 0 0 0 90.
Ruangan
31-Dec-15 0000026821945 Hj. Sit Hawa Jl. Let Murod P 84 Th P 1

31-Dec-15 2423 0000025571553 Pironika Jl. Mawar lr. Kembang L 36 Th P 1
31-Dec-15 2424 0000027096794 Yuniningsih jl. Suka karya no.98 P 38 Th I 1
31-Dec-15 2425 0001505760074 Budiman putra jl. Let murod lr. Biga rt.12 L 35 Th S 1
31-Dec-15 755 0000025607542 RD. Aca muharam perumdam lr. Sara L 60 Th P 1
31-Dec-15 2394 0001438134243 Sidi Mahyunis lr. Limas rt. 29 L 75 Th P 1
31-Dec-15 709 0000026337374 Sri Linda Lismawat jl. Kasnariansyah no.,28 P 54 Th P 1
31-Dec-15 26 0000027296469 Endang susilowato Jl. Let murod P 57 Th I 1
31-Dec-15 1775 0000027384412 Herlina jl balayudha rt.4 P 50 Th P 1
31-Dec-15 1909 0000025959835 Jauhari jl. Swadaya no.; 2735 L 54 Th P 1
31-Dec-15 172 0000026664129 Emiyat jl. Kasnariansyah no.52 P 55 Th P 1
31-Dec-15 1915 0001284828783 Wasiat jl. Komp. Bougenvile P 71 Th P 1
31-Dec-15 1205 0000026050735 Hasanudin RSS. Srijaya L 52 Th S 1
31-Dec-15 572 0000026820437 Hj. Awaliyah jl. Let murod P 60 Th I 1
31-Dec-15 2427 0000201570041 Rio dwi putra jl naskah 3 rt.12 L 22 Th A 1
31-Dec-15 422 0000026468278 Zainuddin perum rakyat L 91 Th P 1
31-Dec-15 1416 0001814135016 Rizky febriansyah jl. Mawar L 5 Th A 1
31-Dec-15 2016 0000027038237 Cik ija jl. Mawar lr. Tanjung P 51 Th P 1
31-Dec-15 1023 0000027105996 Sulastri komp. Bougenvile P 48 Th P 1
31-Dec-15 1943 0001868880475 Fathiah nada almira jl. Kenanga P 5 Bln A 1
31-Dec-15 1394 0000976887426 Ernawat jl SB 2 P 54 Th I 1
31-Dec-15 0001292780889 Devi susant Plaju P 33 Th P 1
31-Dec-15 474 0000026120171 Ernawat jl. Swadata rt.39 P 62 Th P 1
31-Dec-15 351 0001874513079 Faiz jl. Kasnariansyah L 3 Bln A 1
31-Dec-15 1560 0001823257091 Betawi jl.kasnariansyah rt.19 L 31 Th P 1
31-Dec-15 2428 0001404914949 M. Ewaldo Wafi jl. Irigasi rt.54 L 3 Th A 1
31-Dec-15 283 0000020171968 Usmanidar jl. R. Kemuning P 68 Th P 1
31-Dec-15 1839 0000025540097 Ngatjan Jl SB 1 RT. 23 L 59 Th P 1
31-Dec-15 494 0000026817592 drs. Turas zahri talang ratu L 72 Th P 1
31-Dec-15 34 0000025663162 Titn hartat komp. Kencana hat P 56 Th P 1
Ruangan
31-Dec-15 2429 0000166614849 Serli marlinda jl. Perumnas talang kelapa P 33 Th P 1

31-Dec-15 2021 0000026536555 Sutat jl. Kasnariansyah P 58 Th P 1
31-Dec-15 1709 0001294141149 Denny saputra jl. Let murod rt.13 L 24 Th A 1
31-Dec-15 13 0000026938697 Seniman zen jl. Naskah L 63 Th P 1
31-Dec-15 308 0000992537076 Hevizar jl. Let murod rt.03 L 34 Th P 1
31-Dec-15 313 0000324758518 Rizki lidya kinantu jl. Ariodillah 3 no. 25 P 22 Th A 1
31-Dec-15 100 0000324932455 Inda maya Sari jl. Let murod P 28 Th I 1
31-Dec-15 227 0000324172146 Mursida jl. Ariodillah 3 no.2401 P 41 Th I 1
31-Dec-15 314 0000325016684 Mardinono jl. Let murod no.803 L 56 Th P 1
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15
31-Dec-15

BULAN : DESEMBER
Ruangan
1-Dec-15
HT 308 0000992537076 Hevizar M. Abuzar jl. Let murod rt.03

RS. BHAYANGKARA/GYN/868 ANC PNS 08137309269 313 0000324758518 Rizki lidya kinantu Santuri jl. Ariodillah 3 no. 25
Mata kabur IRT 085381918691 100 0000324932455 Inda maya Sari M. Soleh jl. Let murod
RS. MATA/MATA/867 Mata kabur sopir 081368633456 227 0000324172146 Mursida kurniawan jl. Ariodillah 3 no.2401
RS. BHAYANGKARA/PDL/869 HHD PNS 314 0000325016684 Mardinono ybs jl. Let murod no.803
RS. BHAYANGKARA/BEDAH/870 Prostat 2186 0000026742341 drs. Achmad soedjai jl. Mawar P
RA PNS 0711412640
Tampal gigi GURU 085267672929
Sakit gigi IRT 08992801520
RS. HERMINA/PDL/873 HHD IRT 082182233400
RS. PUSRI/SYARAF/880 Sakit pinggang swasta 081367908928
sakit mata IRT
RS. BHAYANGKARA/BEDAH/884 Buka pain 081377844332
HHD PNS 082184746136
demam Pelajar
Gastrits GURU 081532674033
Imunisasi 085378326558
Gastrits IRT
Cabut gigi
HHD PNS 082180655585
Imunisasi
ISPA Buruh 085208200625
Pnas 081369103144
DM IRT 081273730075
Gatel2 PNS 0711410002
Sakit mata Pensiun PNS 081273756028
DM PNS 082379721052
RS. MATA/MATA/906 sakit mata GURU

RA GURU 0813666864176
Demam swasta 082186322094
RS. MYRIA/PDL/909 DM
Tampal gigi
demam swasta 085268629794
Suntk KB IRT 081278825442
RS. Bhayangkara/gyn/905 ANC IRT
RS. BHAYANGKARA/GIGI/904 Glosits Buruh 082372722214
HT PNS 0711412860
KAN JAMKESMAS
U
015
Ruangan
L 34 Th P 1 Tampal gigi
P 22 Th A 1 demam swasta 085268629794
P 28 Th I 1 Suntk KB IRT 081278825442
P 41 Th I 1 RS. Bhayangkara/gyn/905 ANC IRT
L 56 Th P 1 Gatel2 Buruh 082372722214
75 Th P 1 HT PNS 0711412860

BPJS BLN Desember

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PUSKESMAS TALANG RATU

Kunjungan Peserta Rujukan

1 1-Dec-15 0001081511673 Neni Rubaidah P 32 Thn Post partum 1.

Kunjungan Peserta Rujukan

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Kunjungan Peserta Rujukan

1-Dec-15 1708 0001081511673 Neni Rubaidah Jl. Swadaya pakjo P 32 Thn I 1

1-Dec-15 600 0000162907795 Nurlina jl. Perumdam P 62 th P 1

Kunjungan Peserta Rujukan

1 2-Dec-15 0000027164799 Eddy Kusnady L 57 Th HHD 1.

Kunjungan Peserta Rujukan

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Kunjungan Peserta Rujukan

2-Dec-15 992 0000027164799 Eddy Kusnady lebong siarang L 57 Th S 1

2-Dec-15 496 0001381602082 Sri lasmiat jl. Kasnariansyah P 48 Th P 1

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Rs. Bhayangkara/Kulit/59 gatel-gatel IRT

74 Th p 1 susah BAK Buruh

Kunjungan Peserta Rujukan

1 3-Dec-15 0000025659257 muzakir L 51 Th Asma 1.

Kunjungan Peserta Rujukan

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Kunjungan Peserta Rujukan

3-Dec-15 2293 0000025659257 muzakir Komplek griya bahagia L 51 Th P 1

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LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Kunjungan Peserta Rujukan

1 3-Dec-15 0000025953388 Rosdiana P 52 Th Sakit gigi 1.

Kunjungan Peserta Rujukan

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Kunjungan Peserta Rujukan

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LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Kunjungan Peserta Rujukan

1 5-Dec-15 0000026520513 Juriah P 70 Th Sakit mata 1.

Kunjungan Peserta Rujukan

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS LAPORAN F

Kunjungan Peserta Rujukan

5-Dec-15 95 0000026520513 Juriah perum mega asri P 70 Th P 1

Kunjungan Peserta Rujukan

1 7-Dec-15 0000026295726 Rosmala dewi P 55 Th Gastrits 1.

Kunjungan Peserta Rujukan

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Kunjungan Peserta Rujukan

7-Dec-15 0000026295726 Rosmala dewi Jl. Kikim P 55 Th P 1

7-Dec-15 578 0001321770554 Megawat lr. Tanjung P 64 Th I 1

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Gastrits 279 0000324360494 maliki zahri maliki zahri jl. Kasnariansyah L 75 Th

Rs. Bhayangkara/Jantung/150 HHD IRT

Rujukan Diagnosa Pekerjaan

RS. Dr.AK Gani/P.Dalam/209

P 1 Susah baak buruh

Kunjungan Peserta Rujukan

1 8-Dec-15 0000026924253 Imron salam L 65 Th Parkinson 1.

Kunjungan Peserta Rujukan

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Kunjungan Peserta Rujukan

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8-Dec-15 2303 0001279234282 Maqda Amora lr. Rambutan P 2 Th A 1

LAPORAN FORMAT KUNJUNGAN DAN RUJUKAN BPJS

Kunjungan Peserta Rujukan

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