RUMAH SAKIT

KARTIKA HUSADA SETU

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JENIS KUNJUNGAN ASAL PASIEN

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NO NO RM NAMA PASIEN UMUR

LAMA

BARU
L P
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
1 054400 TIRTA PUTRA PRATAMA 6 th 9 bl 0 hr V V V
2 053548 ELONA ,AN 0 th 4 bl 0 hr V V V
3 054636 ROHMA, AN 0 th 4 bl 0 hr V V V
4 022420 ADELLE NATANIA TIO M 2 th 8 bl 0 hr V V V
5 040949 KHAIRIN SHAKAYLA AZKA1 th 1 bl 0 hr V V V
6 039426 NI MADE LUNA R ,AN 1 th 3 bl 0 hr V V V
7 028767 HANNA TRIANA, NN 18 th 5 bl 0 hr V V V
8 054074 MITA MONICA, AN 12 th 3 bl 0 hr V V V
9 054655 CAHAYA HAIRANI LATIFAH28 th 10 bl 0 hr V V V
10 054661 ARMANIH, NY 47 th 8 bl 0 hr V V V
11 054235 ROSITA, NY 23 th 0 bl 0 hr V V V
12 054663 JOKO NURWANTO, TN 37 th 8 bl 0 hr V V V
13 053665 UTAMI NINGSIH, NY 33 th 8 bl 0 hr V V V
14 033968 ADZKANA AULIA NADA , 4 th 11 bl 0 hr V V V
15 051776 NILNA ATHIYA MUMTAZ ,5 th 0 bl 0 hr V V V
16 041557 RUSMAWATI DEWI ,NN 16 th 9 bl 0 hr V V V
17 054638 PRITA AYU NOVIYANTI ,N26 th 10 bl 0 hr V V V
18 054639 FITRI AFRIYANTI, NY 26 th 3 bl 0 hr V V V
19 054641 ARIPAH BT KUDIRA, NY 40 th 9 bl 0 hr V V V
20 053273 RISKA PRASETIA, NY 22 th 11 bl 0 hr V V V
21 054643 SITI TAKHYATI, NY 32 th 5 bl 0 hr V V V
22 054356 TINA TRIANA, NY 31 th 11 bl 0 hr V V V
23 054061 DESI ROHMAWATI, NY 21 th 9 bl 0 hr V V V
24 012232 VENIRANDA,NY 30 th 5 bl 0 hr V V V
25 020023 FAMAY ARDIAN UTAMI, 27 th 4 bl 0 hr V V V
26 054645 NOFIYATI , NY 26 th 10 bl 0 hr V V V
27 054647 TINI , NY(YANG BNER 05 32 th 6 bl 0 hr V V V
28 054432 AYU WARDANI, NY 25 th 8 bl 0 hr V V V
29 010004 PITRI LIANI.NY 26 th 0 bl 0 hr V V V
30 050228 CELVERIA SITUMORANG,26 th 5 bl 0 hr V V V
31 054653 RIA ARIANI, NY 25 th 9 bl 0 hr V V V
32 054656 SITI HADITSA FACHRAINI 30 th 0 bl 0 hr V V V
33 054595 MELAN ,NY 33 th 9 bl 0 hr V V V
34 054566 ASMAULIDIN, AN 14 th 9 bl 0 hr V V V
35 054633 SARMAT, TN 29 th 9 bl 0 hr V V V
36 045357 UJANG BIN NEIN, TN 45 th 6 bl 0 hr V V V
37 054649 ANONG, NY 65 th 9 bl 0 hr V V V
38 054387 MUHAMAD IRFAN, TN 22 th 9 bl 0 hr V V V
39 047951 IKAH MARSIAH ,NY 26 th 7 bl 0 hr V V V
40 041057 NARSIH , NY 58 th 3 bl 0 hr V V V
41 054487 BAMBANG SURETNO, TN37 th 3 bl 0 hr V V V
42 030569 NGATINI, NY 46 th 9 bl 0 hr V V V
43 054648 YADI BIN KOTEN, TN 53 th 1 bl 0 hr V V V
44 053245 MAAH MINTARSIH ,NY 29 th 5 bl 0 hr V V V
45 054448 OMAH, NY 48 th 5 bl 0 hr V V V
46 054473 DYAH 18 th 0 bl 0 hr V V V
47 054657 SITI NUR HASANAH, NY 23 th 4 bl 0 hr V V V
48 054658 NANA SURYANA , TN 31 th 10 bl 0 hr V V V
49 014373 ZASMARA ARIMBI S,AN 7 th 5 bl 0 hr V V V
50 031371 MULYANA S, TN 36 th 4 bl 0 hr V V V
51 054654 ROHAYA , NY 75 th 9 bl 0 hr V V V
52 054619 CITRA AULIA, AN 15 th 5 bl 0 hr V V V
53 054294 SRI SUNARTI, NY 60 th 9 bl 0 hr V V V
54 054417 KETUT BUDIARTA, TN 39 th 10 bl 0 hr V V V
55 031407 M AKHMAL S , AN 5 th 11 bl 0 hr V V V
56 042664 NANANG SULISTYO ,TN 20 th 10 bl 0 hr V V V
57 054628 NURHIKMAH, NY 35 th 9 bl 0 hr V V V
58 054629 SITI NURAINI, NY 3 th 0 bl 0 hr V V V
59 050674 DETI BEKTI , NY 26 th 0 bl 0 hr V V V
60 054630 M. FEBRIANSYAH, AN 0 th 7 bl 0 hr V V V
61 053652 AI NURYATI ,NY 23 th 10 bl 0 hr V V V
62 002026 JEHAN SHAFA RAMADHAN 11 th 0 bl 0 hr V V V
63 054631 FAHRI, AN 2 th 10 bl 0 hr V V V
64 030474 SANTIKA ZUMIANNAULI, 20 th 10 bl 0 hr V V V
65 054632 ALFIAN MANDAGI, TN 24 th 10 bl 0 hr V V V
66 052703 SITI MARYAM EVANISAH,23 th 6 bl 0 hr V V V
67 040701 M RAFA A, AN 1 th 3 bl 0 hr V V V
68 033871 M EGI, AN 16 th 2 bl 0 hr V V V
69 011189 TRI HANDOKO,TN 33 th 4 bl 0 hr V V V
70 009579 DWI PURWANTO,TN 48 th 6 bl 0 hr V V V
71 020171 UMI SUIDAH,NY 39 th 7 bl 0 hr V V V
72 012188 CHUSNIATUR RAVINGAH 12 th 3 bl 0 hr V V V
73 054577 SALAM , TN 33 th 5 bl 0 hr V V V
74 033617 GLORY NATASHA SITORUS2 th 1 bl 0 hr V V V
75 050991 YEHEZKIEL HIZKIA SITOR 0 th 4 bl 0 hr V V V
76 043435 MARDIANA, NY 32 th 7 bl 0 hr V V V
77 054634 ANDRI KURNIAWAN,AN 14 th 8 bl 0 hr V V V
78 049859 LILI SURYANI, NY 24 th 5 bl 0 hr V V V
79 016585 ARKANANTA RASYID U,A 3 th 8 bl 0 hr V V V
80 025601 DINDIN F, TN 29 th 11 bl 0 hr V V V
81 053361 RINA SEPTIANA SUMADI,31 th 0 bl 0 hr V V V
82 054635 MEITHA LEWIH RAHAYU 25 th 4 bl 0 hr V V V
83 019098 NIBIH HARYANTO,TN 34 th 4 bl 0 hr V V V
84 035315 SITI KOMALASARI, NN 21 th 1 bl 0 hr V V V
85 054637 TANTI ,NY 43 th 3 bl 0 hr V V V
86 002416 REDINA GULTOM,NY 39 th 1 bl 0 hr V V V
87 053047 ENDI SUTARDI, TN 44 th 5 bl 0 hr V V V
88 048331 SINAN, TN 71 th 10 bl 0 hr V V V
89 024145 DEWI , NY 33 th 3 bl 0 hr V V V
90 044650 DZAKI ALDIRA SAPUTRA, 9 th 11 bl 0 hr V V V
91 016035 THOUFIK GUNAWAN,AN 14 th 8 bl 0 hr V V V
92 054642 MERI, NY 50 th 9 bl 0 hr V V V
93 054565 AYI KARTINI, NY 48 th 8 bl 0 hr V V V
94 054644 MADI WAHYUDIN, TN 42 th 5 bl 0 hr V V V
95 054646 ADE LINA BR SIBURIAN , 0 th 0 bl 0 hr V V V
96 002775 AKHMAD AMIRUDIN, TN41 th 1 bl 0 hr V V V
97 054650 SITI LATIFAH, NN 25 th 1 bl 0 hr V V V
98 054651 SUPRI YANTO, TN 24 th 3 bl 0 hr V V V
 99 054652 AJAT SUDRAJAT, TN 19 th 7 bl 0 hr V V V
100 054571 WANTA, TN 24 th 11 bl 0 hr V V V
101 030991 MAMAD, TN 35 th 0 bl 0 hr V V V
102 054641 ARIPAH BT KUDIRA, NY 40 th 7 bl 0 hr V V V
103 033931 NI WAYAN ,NY 35 th 6 bl 0 hr V V V
104 018097 M DHAIFULLAH DZAHWA15 th 2 bl 0 hr V V V
105 054659 ZURYATI , NY 35 th 7 bl 0 hr V V V
106 054660 JEPRI SANTOSO, TN 25 th 0 bl 0 hr V V V
107 027168 DWI RIYANTO, TN 37 th 8 bl 0 hr V V V
108 054662 ISAM GUNAWAN , TN 21 th 6 bl 0 hr V V V
109 021995 HULWAH KANIA FRILINAI15 th 8 bl 0 hr V V V
110 054665 INDAH ANGGUN MULIA, 15 th 8 bl 0 hr V V V
111 021376 ANDRI KURNIAWAN, TN 29 th 6 bl 0 hr V V V
112 017446 SUKIRNO,TN 35 th 1 bl 0 hr V V V
113 041078 SAPTO DWI PUTRANTO, 32 th 4 bl 0 hr V V V
114 054635 MEITHA LEWIH RAHAYU 25 th 4 bl 0 hr V V V
115 049408 HENDI HERMAWAN , TN 29 th 8 bl 0 hr V V V
116 010111 PUTRI FITRIA WULANDA 22 th 0 bl 0 hr V V V
117 046309 ZAURA ZIEANDRA PUTRI,5 th 11 bl 0 hr V V V
118 053320 ARY FITRIYANI, NY 20 th 9 bl 0 hr V V V
119 054668 TINI, NY 32 th 6 bl 0 hr V V V
120 050445 MUHAMAD SALIM,TN 25 th 2 bl 0 hr V V V
121 053273 RISKA PRASETIA, NY 22 th 11 bl 0 hr V V V
 LAPORAN SENSUS HARIAN PASIEN RAWAT JALAN
POLIKLINIK : SEMUA POLIKLINIK
HARI : SENIN
TANGGAL : 01/10/2018
UGD
DIAGNOSA
KASUS
(13) (14)
Anak Z09.8 -- POST RAWAT FEBRIS
Anak Z27.1 -- IMUNISASI PENTABIO DAN POLIO
Anak J18.0 -- Bronkhopneumonia
Anak R50.9 -- Fever
Anak J06.9 -- ISPA
Anak J06.9 -- ISPA
Bedah K37 -- Unspecified appendicitis
Bedah K37 -- Unspecified appendicitis
Bedah M79.19 -- Rheumatism, unspecified, shoulder region

Bedah Z48.8 -- Unspecified haemorrhoids without complication

D21.6 -- Benign neoplasm, connective and other soft tissue
Bedah of trunk, unspecified
Non Bedah K04.0 -- Pulpitis
Non Bedah K05.1 -- Chronic gingivitis
Non Bedah K04.0 -- Pulpitis
Non Bedah K05.3 -- Chronic periodontitis
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z33 -- Pregnant
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z48.8 -- Single spontaneous delivery, unspecified
Z09.0 -- Follow-up examination after surgery for other
Kebidanan conditions
Kebidanan Z33 -- Pregnant
Kebidanan Z33 -- Pregnant
Kebidanan Z33 -- Pregnant
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z33 -- Pregnant state, incidental
Kebidanan Z33 -- Pregnant state, incidental

Non Bedah Z09.8 -- Dengue haemorrhagic fever

Non Bedah L04.9 -- Acute lymphadenitis of upper limb
Non Bedah Z09.8 -- Gastritis, unspecified
Non Bedah Z09.8 -- Urinary tract infection, site not specified
Non Bedah Z09.8 -- Typhoid fever
Non Bedah T14.0 -- Superficial injury of unspecified body region
Non Bedah B17.9 -- Inflammatory liver disease, unspecified
Non Bedah E14.9 -- Unspecified diabetes mellitus without complications
Non Bedah K30 -- Dyspepsia
Non Bedah M10.0 -- Idiopathic gout
L02.9 -- Cutaneous abscess, furuncle and carbuncle,
Non Bedah unspecified
Non Bedah H61.2 -- Infantile cerebral palsy, unspecified
Non Bedah H60.0 -- Abscess of external ear
Non Bedah G80.9 -- Infantile cerebral palsy, unspecified
Z09.8 -- Follow-up exam after other treatment for other
Non Bedah conditions
H81.0 -- Meniere's disease
Non Bedah E07.9 -- Disorder of thyroid, unspecified
Z48.8 -- Other specified surgical follow-up care
Non Bedah G80.9 -- Infantile cerebral palsy, unspecified

Non Bedah O21.1 -- Hyperemesis gravidarum with metabolic

disturbance

B35.3 -- Tinea pedis

A09.0 -- Other and unspecified gastroenteritis and colitis of
Anak infectious origin
Non Bedah R51 -- Headache
Non Bedah R50.9 -- Fever, unspecified

Anak R50.9 -- Fever

Anak R50.9 -- Fever
J02.0 -- Pharyngitis
Non Bedah J02.9 -- ISPA
Non Bedah D64.9 -- Anaemia
Non Bedah J00 -- Common cold
Non Bedah T14.1 -- Open wound of unspecified body region
Anak J00 -- Acute upper respiratory infection, unspecified
Anak J21.9 -- Bronchopneumonia, unspecified
Non Bedah K37 -- Unspecified appendicitis
L02.8 -- Cutaneous abscess, furuncle and carbuncle of other
Non Bedah sites
Non Bedah B35.6 -- Tinea cruris
Anak R50.9 -- Fever, unspecified
Non Bedah R50.9 -- Fever
Non Bedah O60.0 -- Preterm labour without delivery
Non Bedah J45.9 -- Asthma
Non Bedah J20.9 -- Acute bronchitis, unspecified
Non Bedah A09.9 -- GEA
Non Bedah J20.9 -- Acute bronchitis, unspecified
Non Bedah A88.1 -- Vertigo
Non Bedah L50.9 -- Urticaria, unspecified
Non Bedah J18.9 -- Pneumonia, unspecified
Non Bedah R50.9 -- Fever, unspecified
Anak R50.9 -- Fever, unspecified
Anak J06.9 -- Acute upper respiratory infection, unspecified
Non Bedah K30 -- Dyspepsia
Non Bedah M19.9 -- Arthrosis, unspecified
J06.8 -- Other acute upper respiratory infections of multiple
Non Bedah sites
Non Bedah G43.9 -- Cepalgia
Non Bedah J00 -- Common cold
Non Bedah Z00.0 -- General medical examination
Non Bedah Z00.0 -- General medical examination
Non Bedah Z00.0 -- General medical examination
Z00.6 -- Exam normal comparison and control in clin research
Non Bedah program
Non Bedah M79.1 -- Myalgia
Kebidanan O60.0 -- Preterm labour without delivery
Bedah K12.2 -- Cellulitis and abscess of mouth
Anak J06.9 -- ISPA
Non Bedah A88.1 -- Dizziness and giddiness
Non Bedah R51 -- Headache
Non Bedah J06.9 -- Acute upper respiratory infection, unspecified
Non Bedah A91 -- Dengue haemorrhagic fever
Anak J06.9 -- ISPA
Anak R50.9 -- Fever, unspecified
Anak R51 -- Cepalgia
Non Bedah R51 -- Cepalgia
Non Bedah M54.5 -- Low back pain
Non Bedah J45.9 -- Asthma
Non Bedah K30 -- Dyspepsia
Non Bedah A09.9 -- GEA
Anak K59.0 -- Constipation
Non Bedah O21.0 -- Mild hyperemesis gravidarum
Kebidanan O60.0 -- Preterm labour without delivery
L04.0 -- Acute lymphadenitis of face, head and neck
Kebidanan O60.0 -- Preterm labour without delivery

Mengetahui,
Kepala Ruangan

____________________________
N RAWAT JALAN

DIRAWAT
DI RUJUK
KEADAAN PASIEN

PULANG
TINDAKAN NAMA DOKTER
(15) (16) (17)(18) (19)
Dr. Zahedi Affandi, SpA V
POLIO,PENTABIO,INJECT (SUNTIK) 1 - 3 , Dr. Zahedi Affandi, SpA V
INHALASI (NEBULIZER), Dr. Linda Elianora Sinaga, SpA V
Dr. Linda Elianora Sinaga, SpA V
Dr. Linda Elianora Sinaga, SpA V
Dr. Linda Elianora Sinaga, SpA V
ANGKAT JAHITAN 1 - 5,GANTI BALUTAN/ GV, Dr. Imelda Susandri Leleury, Sp.B V
WT / GV (GANTI PERBAND) BESAR, Dr. Imelda Susandri Leleury, Sp.B V
Dr. Imelda Susandri Leleury, Sp.B V
Dr. Imelda Susandri Leleury, Sp.B V
Dr. Imelda Susandri Leleury, Sp.B V
Dr. Imelda Susandri Leleury, Sp.B V
TAMBAL LIGHT CURE BESAR, Drg. C. Dara Dewati A.K V
PSA / ENDO ANAK AKAR GANDA,TAMBAL FUJI IX / II KECIL, Drg. Novelia Ayu Puspitasani V
PSA / ENDO ANAK AKAR GANDA,TAMBAL FUJI IX / II KECIL, Drg. Novelia Ayu Puspitasani V
Drg. Berthin Hartiningsih V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG INTIP, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
WT / GV (GANTI PERBAND) SEDANG, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
USG PRINT, Dr. Arif Siregar, SPOg V
MICRO ATHENA, Dr. Marlina, Dipl. CIBTAC V
MICRO ATHENA + INTRACEUTICALS, Dr. Marlina, Dipl. CIBTAC V
APS LABORATORIUM V
APS LABORATORIUM V
APS LABORATORIUM V
APS LABORATORIUM V
APS LABORATORIUM V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
 Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
Dr. Nurfaita Mislihar, SpPD V
EKSTRAKSI SERUMEN TELINGA, Dr. Satria Nugraha W, Sp.THT V
EAR TOILET, Dr. Satria Nugraha W, Sp.THT V
EKSTRAKSI SERUMEN TELINGA, Dr. Satria Nugraha W, Sp.THT V
Dr. Satria Nugraha W, Sp.THT V
Dr. Satria Nugraha W, Sp.THT V
Dr. Satria Nugraha W, Sp.THT V
Dr. Satria Nugraha W, Sp.THT V
EKSTRAKSI SERUMEN TELINGA, Dr. Satria Nugraha W, Sp.THT V
dr. Irwan Abdurachman V
PASANG INFUS,INJECT (SUNTIK) 1 - 3 ,INHALASI (NEBULIZER), dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
WT / GV (GANTI PERBAND) SEDANG, dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
INHALASI (NEBULIZER), dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
INHALASI (NEBULIZER), dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
INJECT (SUNTIK) 1 - 3 , dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
 dr. Irwan Abdurachman V
WT / GV (GANTI PERBAND) KECIL, dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
INHALASI (NEBULIZER), dr. Irwan Abdurachman V
INJECT (SUNTIK) 1 - 3 , dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V
dr. Irwan Abdurachman V

yang membuat,

AGUS
 MNGL DI UGD

KARYAWAN
ASURANSI
KEADAAN PASIEN CARA PEMBAYARAN

BPJS/KS
UMUM
DOA

PT

(20) (21) (22) (23) (24) (25) (26)

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