PROGRAM TB PARU NASIONAL

DAFTAR TERSANGKA PENDERITA {SUSPEK} YANG DIPERIKSA DAHAK SPS

N0 Tanggal No. Nama Lengkap Umur Alamat Lengkap Tanggal Tgl Tangal Hasil No Bila di- No.Reg. Status Ket
di daftar Dahak Tersangka L P Pengambilan Pengiriman Hasil Pemeriksaan Reg Diagnosa ART HIV
sediaan Pasien Dahak Sediaan Diperoleh Lab TB
Identitas A B C Dahak A B C Tulis Tgl
Pembuatan
Ke Lab Kartu TB 01

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

1 Ai Surtini

2 Ade Amir

10

11

12

13
14
15
N0 Tanggal No. Nama LengkapUmur Alamat Tanggal Tgl Tangal Hasil No Bila di- No.Reg. Status Ket
di daftar Dahak Tersangka L P Lengkap Pengambilan Pengiriman Hasil Pemeriksaan Reg Diagnosa ART HIV
sediaan Pasien Dahak Sediaan Diperoleh Lab TB
Identitas A B C Dahak A B C Tulis Tgl
Pembuatan
Ke Lab Kartu TB 01

1 12/31/1899 16/00068 Ai Surtini 38 CIBEUREUM 12/23/2017 12/24/2017 12/23/2017 Neg Neg 308
/0158 P 0
2 12/22/2017 16/00068 Ade Amir 56 L TARUMAJAYA 12/23/2017 12/24/2017 12/23/2017 Neg Neg 309 0
/1239

3 12/21/2017 16/00068 Kiki 32 L CIBEUREUM 12/22/2017 12/23/2017 12/22/2017 Neg Neg 306 0
/0157

4 12/21/2017 16/00068 Tita 26 P SUKAPURA 12/22/2017 12/23/2017 12/22/2017 Neg Neg 307 0
/1238

5 12/20/2017 16/00068 Dedi 14 L CIBEUREUM 12/21/2017 12/22/2017 12/21/2017 Neg Neg 305 0
/0156

6 12/18/2017 16/00068 Usi 20 P CIHAWUK 12/19/2017 12/20/2017 12/19/2017 Neg Neg 303 0
/1236 Ramayati

7 12/18/2017 16/00068 Kadir 52 L CIKEMBANG 12/19/2017 12/20/2017 12/19/2017 Neg Neg 304 0
/0155

8 12/13/2017 16/00068 Didin 28 L CIBEUREUM 12/14/2017 12/15/2017 12/14/2017 Neg Neg 301 0
/0153

9 12/13/2017 16/00068 Ai Sumiati 29 P CIKEMBANG 12/14/2017 12/15/2017 12/14/2017 Neg Neg 301 0
/1237

10 12/12/2017 16/00068 Juhaya 0L CIBEUREUM 12/13/2017 12/14/2017 12/13/2017 Neg Neg 299 0
/0152

11 12/12/2017 16/00068 Nega Neg

Enyi 47 P TARUMAJAYA 12/13/2017 12/14/2017 12/13/2017 300 0
/1235 tif atif

12 12/11/2017 16/00068 Neng 24 P TARUMAJAYA 12/12/2017 12/13/2017 12/12/2017 Neg Neg 258 0
/1234 Neni
13 12/8/2017 16/00068 Siti 35 P TARUMAJAYA 12/9/2017 12/10/2017 12/9/2017 Neg Neg 297 0
/1233
16/00068
14 12/7/2017 /1230 Imas 33 P TARUMAJAYA 12/8/2017 12/9/2017 12/8/2017 Neg Neg 294 0

15 12/7/2017 16/00068 Ucun 45 P SUKAPURA 12/8/2017 12/9/2017 12/8/2017 Neg Neg 294 0
/1231

12/7/2017 16/00068 Amang

16 26 L CIKEMBANG 12/8/2017 12/9/2017 12/8/2017 Neg Neg 295 0
/1232 Didin

17 12/7/2017 16/00068 Eki 19 P CIBEUREUM 12/8/2017 12/9/2017 12/8/2017 Neg Neg 296 0
/0151

18 12/6/2017 16/00068 Yanto 27 L CIBEUREUM 12/7/2017 12/8/2017 12/7/2017 Neg Neg 293 0
/1229

19 12/5/2017 16/00068 Desi 28 P CIBEUREUM 12/6/2017 12/7/2017 12/6/2017 1+ 1+ 290 0

/1227

20 12/5/2017 16/00068 Ayo 61 L CIBEUREUM 12/6/2017 12/7/2017 12/6/2017 1+ 1+ 291 0

/0150

21 12/4/2017 16/00068 Haris 26 L CIKEMBANG 12/5/2017 12/6/2017 12/5/2017 Neg Neg 287 0
/1222

12/4/2017 16/00068 Nyai

22 44 P CIBEUREUM 12/5/2017 12/6/2017 12/5/2017 Neg Neg 288 0
/1223 Saidah

23 12/4/2017 16/00068 Cep Rizki 15 L KERTASARI 12/5/2017 12/6/2017 12/5/2017 Neg Neg 289 0
/1224

24 11/29/2017 16/00068 Neno 29 P TARUMAJAYA 11/30/2017 1/1/2018 11/30/2017 Neg Neg 285 0
/0148

25 11/29/2017 16/00068 Juju 45 P SUKAPURA 11/30/2017 12/1/2017 11/30/2017 Neg Neg 286 0
/0149

26 11/27/2017 16/00068 Neng 23 P TARUMAJAYA 11/28/2017 11/29/2017 11/28/2017 Neg Neg 281 0
/1217 Neni

27 11/27/2017 16/00068 Cita Dewi 28 P TARUMAJAYA 11/28/2017 11/29/2017 11/28/2017 Neg Neg 282 0
/1218

28 11/27/2017 16/00068 Atikah / 40 P KERTASARI 11/28/2017 11/29/2017 11/28/2017 Neg 1+ 283 0

/1219
29 11/27/2017 16/00068 Siti 22 P CIBEUREUM 11/28/2017 11/29/2017 11/28/2017 Neg Neg 284 0
/1220 Amalia
16/00068
30 11/24/2017 /1211 Ade Amir 56 L TARUMAJAYA 11/25/2017 11/27/2017 11/25/2017 Neg Neg 280 0

31 11/21/2017 16/00068 Erni 32 P SANTOSA 11/21/2017 11/22/2017 Neg Neg 278 0

/1508

32 11/21/2017 16/00068 Imas 54 L SANTOSA 11/21/2017 11/22/2017 Neg Neg 279 0

/2026
Usi
33 11/20/2017 16/00068 Damayan 20 P CIHAWUK 11/20/2017 11/21/2017 Neg Neg 278 0
/1215 ti

34 11/14/2017 16/00068 Komarudi 60 L SUKAPURA 11/14/2017 11/15/2017 11/15/2018 Neg Neg 275 0
/0146 n

35 11/14/2017 16/00068 Siti 38 P CIBEUREUM 11/14/2017 11/15/2017 11/15/2017 Neg Neg 276 0
/0147 Komariah

36 11/10/2017 16/00068 amang 25 L CIBEUREUM 11/10/2017 11/11/2017 Neg Neg 274 0

/1116 didin

37 11/9/2017 16/00068 Siti 35 P TARUMAJAYA 11/9/2017 11/10/2017 Neg Neg 273 0

/1210

38 11/8/2017 16/00068 Juju 45 P SUKAPURA 11/8/2017 Neg Neg 272 0

/0145

39 11/7/2017 16/00068 Utep 39 L CIBEUREUM 11/8/2017 11/9/2017 Neg Neg 271 0

/0144

40 11/6/2017 16/00068 Yanti 35 P CIBEUREUM 11/7/2017 11/8/2017 Neg Neg 269 0

/0269

41 11/6/2017 16/00068 Odir 60 L CIBEUREUM 11/7/2017 11/8/2017 Neg Neg 270 0

/0270

42 10/31/2017 16/00068 shinta 25 L SUKAPURA 10/31/2017 11/1/2017 10/31/2017 Neg Neg 264 0
/0139

43 10/31/2017 16/00068 entoh 61 L CIKEMBANG 10/31/2017 11/1/2017 10/31/2017 Neg 1+ 265 0

/0140
44 10/31/2017 16/00068 ai sulastri 25 L TARUMAJAYA 10/31/2017 11/1/2017 10/31/2017 Neg Neg 266 0
/1022
16/00068
45 10/31/2017 /0141 Eti Sulasti 45 P SUKAPURA 10/31/2017 11/1/2017 10/31/2017 Neg Neg 267 0

46 10/31/2017 16/00068 Asep 34 L CIBEUREUM 10/31/2017 11/1/2017 1/1/2018 Neg Neg 268 0
/0268 Topik

47 10/30/2017 16/00068 hrs 67 L CIBEUREUM 10/31/2017 11/1/2017 10/31/2017 1+ 1+ 260 0

/1112 hidayat

48 10/30/2017 16/00068 dadah 56 L KERTASARI 10/31/2017 11/1/2017 10/31/2017 1+ 1+ 261 0

/1113

49 10/30/2017 16/00068 endang 63 L CIBEUREUM 10/31/2017 11/1/2017 10/31/2017 1+ 2+ 262 0

/1114

50 10/30/2017 16/00068 yuli 32 P CIBEUREUM 10/31/2017 11/1/2017 10/31/2017 Neg Neg 263 0
/1115 yulianti

51 10/19/2017 16/00068 Desi 27 P CIBEUREUM 10/20/2017 10/21/2017 10/20/2017 10/22/2017 2+ 2+ 258 0

/1111

52 10/19/2017 16/00068 tuti 26 P CIHAWUK 10/20/2017 10/21/2017 10/20/2017 Neg Neg 259 0
/0137 malawati

53 10/17/2017 16/00068 Asep 27 L CIBEUREUM 10/18/2017 10/19/2017 10/18/2017 Neg Neg 257 0
/0136 Sodik

54 10/16/2017 16/00068 Enung 43 P CIBEUREUM 10/17/2017 10/17/2017 10/17/2017 Neg 256 0

/0135

55 10/12/2017 16/00068 pipit 0L CIBEUREUM 10/13/2017 10/14/2017 Neg Neg 0

/0000

56 10/10/2017 16/00068 Wati 0L TARUMAJAYA 10/11/2017 10/12/2017 10/11/2017 Neg Neg 252 0
/0252

57 10/10/2017 16/00068 nyai 44 P CIBEUREUM 10/11/2017 10/11/2017 10/11/2017 Neg 253 0

/0253 Saidah

58 10/10/2017 16/00068 Anis 40 L RESMI TINGGAL 10/10/2017 10/11/2017 10/11/2017 Neg Neg 254 0
/0134

59 10/9/2017 16/00068 alo 42 L CIBEUREUM 10/9/2017 Neg 248 0

/2017
60 10/9/2017 16/00068 asep ahya 36 L CIBEUREUM 10/10/2017 10/11/2017 Neg 0
/0249

10/9/2017 16/00068 ai
61 40 P CIKEMBANG 10/9/2017 Neg 0
/0250 nurhayati

62 10/9/2017 16/00068 Imas 33 P TARUMAJAYA 10/9/2017 Neg 0

/0251